Moving up in the Nursing World

I think it's wonderful that you are thinking in terms of your career goals. The following is based on knowledge of colleagues' and my own experiences....

First of all, you will need to move into an environment that actually has the potential for mobility, and this is probably not in a clinic setting - as you have already observed, clinics have a really flat heirarchy and job growth is very limited. Hospitals offer the best environment for career growth because there are so many levels of responsiblity and many diverse areas in which to practice. Just getting additional education without experience will not work - especially not in today's environment. All those 'great jobs' require practical skills and knowledge that can only be acquired through experience.

Once you are in the right environment, you have to get positive notice by people who have the power to advance your career. There is only one way for this to happen - doing more than you have to. Seriously, volunteer to participate in extra activities - particularly those that are essntial to the organization's most important strategic goals. Talk with your supervisor and make sure he/she knows that you are interested -- you'll probably be knee-deep in a task force before you can blink! If you're interested in education, volunteer to do some inservices or become a BLS/ACLS instructor.

Basically, you have to begin to think like a manager - rather than a task-oriented blue collar worker with a 'that's not my job' attitude. Yeah, a lot of your coworkers will call it sucking up & you may have to deal with that but if you have to choose sides -- you should opt for the one that contributes to your goal.

I am looking into MSN programs now, you can do NP, Leadership (management), or education. If you already have your BSN, you can work as a manager or director (usually MSN is preferred but not required). So there are ways to move up the ladder, but you have to have an idea of where you wanna be first.