Evolution of career goals, opinions on practicality, please

[hotflashion, BSN, RN]

My nursing history in a nutshell:

May 2009: Graduated. A real go-getter in college, graduated magna cum laude, was a BWOC, super involved in the college, the department, and my class. Hindsight tells me I should have been devoting myself to getting a job post-graduation, but what's done is done!

Aug 2010: Got a job but only worked 1 month because it was very bad, unsafe; I quit, reluctantly.

Jan 2011: Took a so-so refresher course at the local community college. Also, Spanish for Medical Professionals.

July 2011: Worked two weeks at a residential summer camp. Loved it.

Sep-Nov 2011: Flu clinic nurse. Job location had me feeling a little humiliated but it was a job and money.

- - - - -

I also volunteered at a free medical clinic but it closed in Dec 2011. I volunteer as a vigil sitter for a palliative care department at a local continuing care community. I do other volunteer work, too. I go to psych grand rounds at a local teaching hospital. I'm currently attending an American Sign Language class at a local school for the deaf in hopes I will be able to make contacts and get hired there as a school nurse.

- - - - -

I recently answered an ad for a hyperbaric technician job. This is an allied health occupation, not a nursing job. The work setting is a wound care center associated with the local commmunity hospital. I would enjoy this job, as I would get some patient contact and it would have some very technical aspects. I'd recently begun to think of wound care and foot care as areas to explore, and I think hyperbaric technician at a wound care center would dovetail nicely with both of these. The hyperbaric technician job requires attendance at a course to learn about hyperbaric medicine. In the absence of actual working experience I'm all for education!

- To become wound care certified you can do this through study and then by working with a preceptor for 120 hours. There is one preceptor in my state.

- To become foot care certified, there is a similar path by completing a course and getting some practical instruction.

So, my thoughts right now are to take the hyperbaric medicine class. It's coming up in my area in a couple of weeks so I am in decision making mode right now. Then start working on the wound care certification. If I top that off with foot care certification I could perhaps work in a podiatrist's office, or my talents might be useful in a SNF or assisted living facility.

- - - - -

I desperately need a focus. As I come up on 3 years post graduation, I can feel my nursing education and what I learned slipping away. It's impossible to maintain my knowledge in all areas of nursing. I can take a more heavy duty nursing refresher (3 month program) at one of the nearby Big City colleges, but I doubt at my age (old) and with my history post-graduation, even with the heavy duty refresher, that I would be considered for a hospital nursing job. So, my idea is to pick a specialty area and go for it, become an expert on paper and then hope someone will give me the chance to actually work.

Any thoughts or opinions welcome.

[hotflashion, BSN, RN]

I guess my first note was too long?

[llg, PhD, RN]

I think you answered your own question -- and nobody knows what else to say. Other people may know what to say .. but don't want to hurt your feelings.

You need to decide on a focus. Make a plan and stick with it. Stop hopping around from thing to thing and decide what type of work you want to do for the next 5 years. Then assess what it will take to get a job doing that type of work. Then start doing those things -- and stick with them even if they are not pleasant.

Be honest with yourself in your assessment of yourself and the local job market. With that track record, you are not a very attractive job applicant. Look at yourself through the eyes of an employer -- and employer with 10 (or more) applicants for every job opening. It appears you have never stuck with anything for very long. You may have to take a job you don't want and work at it for a year to turn that around.

I'm sorry if this response is not what you were looking for, but I think it may be what you need. I really do wish you the best of luck in your efforts to establish a career.

[hotflashion, BSN, RN]

There are very few jobs I would not take. Just about my only restriction is that a job not be hazardous to my health or safety, or to the health or safety of the patients in my care; the first job I had was "all of the above." The other two were seasonal, I did not quit they ended. I am honest with myself. That's why I'm here, asking if it makes sense to get specialized at this stage of the game. I honestly don't know what else to do.

Ha ha, I guess I was hoping a nurse hiring manager would see what I've done and have been doing and say they admire me for my determination!

Your "hopping around from thing to thing," which certainly sounds negative, is my attempt to be open for opportunities, to stay connected with patient care, to learn about areas that have intrinisic interest for me, all of which show that I am proactive in bettering myself. I didn't take Spanish just for kicks, it was because I was working in a clinic that saw lots of Spanish speakers.

Although it seemed at first that your response was not what I was looking for perhaps it is: you said get focused. I certainly do feel like I need to focus. But you certainly sound cold.

[cjcsoon2bnp, MSN, RN, NP]

To the OP, I'm sorry that you felt llg's post was cold as I am certain that her intention wasn't to hurt your feelings. With that being said, I think that her response was both candid and cut straight to the point. While your nursing history has a lot of interesting (and marketable) experiences, it seems to be missing a common thread or focus. I would suggest that you sit down and inventory where you see your career going in the next year, five years and ten years. From what I am reading in your post it seems unclear if you wish to continue your career as a nurse or if you wish to explore other healthcare related careers. After you have decided on what you are going to do then you need to make a plan on how you are going to accomplish your goals. If your goal is to work in a hospital then I would suggest that you sign up for that refresher course you mention at the nearby Big City College ASAP and begin searching for positions in Med/Surg unit in order to get the foundation you need to pursue other specialties (Hyperbaric Nursing, Wound Care Nursing etc.) Based upon the nursing history that you provided, I might suggest you look into a position in Public Health/Community Nursing seeing as there appears to be a common thread of community health related positions in your work/volunteer history. Unfortunately, due to the large amount of time from your graduation from college (May 2009) and the present (June 2012) it will mean that you will have to explain your lack of nursing experience and your gaps in employment to future employers. You will need to tie together your employment and volunteer experiences and show them a common theme that related to a strong commitment to continue your education and the service of different patient populations in the community setting. As I mentioned before, if you are interested in pursuing either Wound Care or Podiatry Nursing I would strongly suggest you obtain some hospital or long-term care experience as a foundation before investing a significant amount of time and money trying to become certified in these areas. You may find that the job market may be tough even with these certifications if you lack the general nursing experience that many positions require as a prerequisite. Best of luck and please let us know what you decide to do.

!Chris

[hotflashion, BSN, RN]

Well, I do appreciate the time you took to respond but I still think you are missing the point. I was a new grad. For various reasons -- some in my control, most others out -- I couldn't get a job and found myself almost 3 years from graduation, with a spotty record, trying to figure out the best way to get a job. The old advice to "get 1-2 years of med-surg under your belt" is just not viable for every new grad being minted, jobs of any kind are scarce for those without experience, and so what are the rest of us to do?

I'm too old to futz around and I wanted to earn some money before I spent more on education for a career that I had no guarantee was going to get off the ground. My life circumstances are very lucky in that my inability to "get flying" has not been a disaster. But, I have finally taken off: I have a job in assisted living and I'm pretty sure I can be happy in this little corner of the healthcare world. The pay is low and the working conditions are pretty bad, and I would have liked to have started off in a better place, but I'm sticking with it and I hope I can make a difference. I figure I have 10 working years (if I'm lucky) and I'm determined to make them the best I can. I now have a focus and a direction to go in, and I am in motion.

This being my last career after many years doing other things, I am definitely an outsider to this world; I've experienced culture shock. I find a lot to be critical of, and the nursing world doesn't like criticism. To me this world seems very dysfunctional, as if there is a profession-wide agreement that bad behavior (problems, shortcomings, failures) within our ranks should not be spoken of (especially to outsiders!), and an attitude of "we've had it tough and you should too, so stop yer crying." Maybe in 10 years, after having had a career as a nurse I will have a different perspective. I'll let you know.

[llg, PhD, RN]

I'm happy to read you found a job and a focus are. I wish you the best of luck with it.

I am sorry you were offended by my earlier post. I was just trying to give you the true picture of how your early attempts to launch your nursing career appeard from my perspective. Perhaps I should have just left your post unanswered.

Good luck with your current job.