But nursing can also take you nowhere if you don’t make active choices.
As the director of a nurse practitioner program, I saw a ton of nurses who were in my class. Not because they were passionate about becoming an NP, but because they didn’t know what they wanted or what else to do.
You may fall into something you like by taking a chance, but I want you to be a little more intentional about such a big decision.
If you are at a mental crossroads in your career and can’t decide what to do next, think about these three main pathways.
Ultimately, no matter what you do, even falling into something, no path is wrong, except doing nothing when you want to do something. Different paths will take you to different places, which will open different opportunities, and it’s all good. It’s more about what you love doing that you will flourish in. And keep learning . . .
Follow the pathways to see where you might want to end up!
The Three Main Pathways for Nursing
1. Go to Nursing Graduate School
2. Build a Career in Hospital Administration or in Corporate America
3. Become a NursePreneur
Option #1: Go to Nursing Graduate School
Option #1 is what most nurses think of when they are in a career rut and want to advance their careers. For many nurses, this is an awesome choice, and it’s what they want to do. So what comes under this umbrella?
Advanced Practice roles—Nurse Practitioner, Clinical Nurse Specialist, Nurse Anesthesia, Midwives.
Let’s start with Midwives—this is usually an easy and straightforward career path.
You don’t typically become a midwife by accident or because you don’t know what else to do. Midwives are more often than not very zealous and passionate about what they are doing. This career path is intentional.
This area is one I see a lot of nurses going into because of the lure of money and a perception of a “cool factor”. I personally hate the operating room, even though I first-assist for my neurosurgeon still. But I have never been able to understand the attraction to this role. Mostly because to me the OR is cold and I can’t nurture my coffee all morning in there. Two major negatives and dealbreakers for me!
Though, I have nurse anesthetist friends who absolutely love their jobs. And this is a great career option for many.
But before you choose this path remember a couple things – the pay differential between nurse anesthetists and nurse practitioners is not that significant anymore, there is a major power struggle ongoing between anesthesiologists and nurse anesthesia and you will likely remain in a clinical environment (great if that is what you want).
Finally, the governing body for the CRNAs recently mandated the degree be terminal, meaning you will not be able to practice as a nurse anesthetist unless you have a DNP. This will extend the length and cost of all CRNA programs.
If you want to remain at the bedside (even if it is the OR) then this is an option to consider. Make sure you follow a CRNA around to be sure you would enjoy the role.
Clinical Nurse Specialists
Ok I’m going to be super controversial here and I may very well receive a lot of hate mail over it, but here it goes. First, I will say, the role of the CNS is very specialized and extremely important. HOWEVER, from a hospital administration and even an academic perspective, the role is interchangeable with a nurse practitioner.
As the director of the acute care NP program at my university, I discouraged all my students from doing a CNS track for several reasons. First, the CNS track at my university was exactly the same as the acute care NP track. There was absolutely NO difference. NPs and CNS students took all the same courses throughout the entire program. However, when it came time for clinicals, the CNS students precepted with CNS practitioners, while NPs precepted with other NPs or MDs.
Now the CNS students sat for the CNS boards and NP students sat for the NP boards.
So what’s the problem? Here it is. The pool of job opportunities for CNS is much smaller than other nursing roles. And very frequently, hospitals like to hire NPs into the role of the CNS, because they think they are getting a two-fer. NPs can work as providers or as a CNS without any additional training. However, the CNS practitioner cannot work as an NP. I’m not saying its fair or right, it just IS.
If a CNS wants to expand their career options and work as an NP, they have to do a post-masters in acute care. A CNS at my university who wants to work as an NP will have to take the same exact clinical courses they took as a CNS student but this time precept with an NP or MD. In fact I always had a handful of students who were certified CNS practitioners in my class as post-masters students, usually because their hospitals forced them to get a provider license to comply with a plethora of rules and regulations – both real and imagined.
If you choose the CNS role, my suggestion to you is to find a program that actually specializes in the role of the CNS and tailors classes directly to the role (and doesn’t just simply throw you into the acute care NP program).
The role of the CNS is much more aligned with the nursing model and perspective. The downside of the CNS role is that the CNS is frequently in meetings all day or recruited to act as the nurse educator for their assigned unit.
alter your career course easily.
The role of the NP is more aligned with the medical model and perspective. While the role of the NP continues to explode and evolve, one of the downsides to the NP role is that many physicians like to use NPs as a dumping ground for all the things they don’t want to do themselves—such as paperwork, documentation, order entry and talking to patients. In addition, NPs are used as medical scribes—i.e., walk around with the doctor to do his/her notes, orders, and instructions without any autonomy or independent thought. This idea is 100% physician/practice dependent.
Other Nursing Degrees
Then there are other nursing degrees you could consider, such as community systems, informatics, and nursing leadership. If you are interested in software/computer systems, informatics is a hot area to get into.
Terminal degrees DNP and PhD
These degrees will not get you more money at the bedside, but they will open doors to the world of academics and hospital administration if those areas are of interest to you. Be sure to go for the right degree for the right reason.
The DNP is, in many senses, a more practical degree, meaning, the point is for nurses to take research that exists and to implement it into systems to improve the overall healthcare system. Whereas the point of the PhD is to create the research for the DNP to implement.
I think of the PhD as the creator of primary research and the DNP as the innovative project manager who implements the systems. Both are important roles, but make sure you know who you are when choosing to do one over the other.
Option #2: Build a Career in Hospital Administration or in Corporate America
If you want to move away from the bedside and get more into the politics of how the corporate world functions, then a career in hospital administration or a corporate job is a good path, the best way to get a position in hospital administration is to be part of committees and volunteer to take leadership roles. You will get noticed very quickly, and when a position opens up, you might even be nominated to apply for it.
The best thing would be to take the steps now to be prepared for that moment. Consider getting a non-nursing graduate degree. I am personally biased toward degrees you don’t have to explain to anyone and have universal appeals, such as an MPH or MBA. With these degrees, you get a broader, bigger perspective that you can bring back ideas to nursing as opposed to only ever having a nursing perspective—though I’m sure a lot of people would argue that point.
If you only ever know to nurse, you limit your viewpoint. By exposing yourself to broader ideas and different industries, you will be amazed how much could apply to the hospital setting.
If you are serious about a career in administration or the corporate world, again I would strongly suggest you apply to an MPH or MBA program and start joining committees. Generally, it doesn’t matter which committee. If you show up at the committee meeting, you will be valued and praised instantly. If you volunteer to do some work and follow through with it, you will become a hospital hero!
Your best bet to get a job in corporate America is to network through Linked In and set up an account on Glassdoor to get notified of new positions that are being posted.
Option #3: Become a NursePreneur
I’m quite sure this is probably not an option you have seriously considered in the past. But I think it’s an exciting and underrated option. And it’s something that you can do no matter where you are in your career—just starting, just ending, in the middle of a degree program—ASN, BSN, MSN, Doctorate, it doesn’t matter. There is no “entry” level. Becoming a NursePreneur is a mindset.
Though make no mistake about it, there is a learning curve, and I’m willing to bet you will put more time and energy into being a NursePreneur than any of the other options described above (at a fraction of the cost). But the rewards of becoming a NursePreneur are so compelling.
NursePreneurs see and understand problems. Then they devise solutions and sell them in the form of a product, service, or both. For instance, let’s say you love to cook and create recipes. You work in a cardiac unit with heart failure patients. You know that patients after they leave the hospital resort to poor eating habits. What if you designed a virtual cooking membership program for family members who cook for heart failure patients. Imagine you charge $69/month per person, and they get a monthly menu, a weekly grocery list, and some how-to videos. You build up a community of 100 heart failure patients, and you have an income of $6900/month.
You get to do something you love doing—cooking and creating recipes, you help patients who need this information, but there is nothing out there for them, you impact their outcomes by reducing their salt intake with your delicious recipes, and you don’t need to do any overtime. In fact, at $6900/month, you might not even need to go back into the nursing unit at all! The whole process is both that simple and not straightforward at all
There are a million variations and possibilities of this scenario that can be applied to any patient population, any healthcare problem, and any setting (Check out my e-book 25 Niches for Nurses below). As a NursePreneur, you need to actively search out issues around you that your audience needs, wants, or desires you to find a way to solve them.
Not sure this can be done? All you need to do is Google health coaches to find a million different people in the space of selling digital products and services. But they lack what we as nurses have–a real understanding of what our patients want and what the healthcare system can’t deliver on its own. Plus nurses are the most trusted profession in our society. Given the choice of a health program delivered by a nurse versus some guy who decided this was a good market to be in, the nurse will win out again and again.
It’s all about the structure and laying the foundation. I would approach becoming a NursePreneur as an investment in yourself, much in the same way you would get an advanced degree in nursing or a non-nursing specialty. There is a lot to learn, and there is a lot to do. But the best part of being a NursePreneur is that there is no ceiling on how much you can make and no barrier to how much impact you can have. And, the better your system works, the less you need to work. Once you have a system down for your service or product and you are making the type of money you want, then you can be location independent and should only be working 1–2 hours a day at the most.
The other options can’t even come close to touching those benefits!
However, be warned that becoming a NursePreneur is probably only 20% of nurses out there. Most nurses will not want to take the risk of being a successful entrepreneur or devote the time and effort that will be necessary to build a thriving business that runs itself. And that is ok and also good to know about yourself!
No matter what you choose to do, the career options in Nursing are amazing and will take you to new heights. We need every type of nurse out there; whether it’s a midwife, NP, CNS, CRNA, DNP, PhD, or corporate nurses, leaders or NursePreneurs, they are all valuable to our profession. And there is no reason why you have to be one type of nurse!
Ideas for nursing businesses come from a variety of places, but your workplace is an absolute goldmine. Remember the first $1000 is the hardest because you have to prove your idea is needed.