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Nurse Beth MSN

Med Surg, Tele, ICU, Ortho

Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.

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Nurse Beth has 30 years experience as a MSN and specializes in Med Surg, Tele, ICU, Ortho.

I love helping new nurses, and I blog about how to get hired and all things nursing at my awrd-winning blog,  http://nursecode.com. I authored then popular "Your Last Nursing Class: How to Land Your First Nursing Job" on Amazon! It's the ultimate guide with insider tips to land your nursing job!

Here is a great & detailed review of my book from Kyle Schmidt at BluePipes.com. http://blog.bluepipes.com/nursing-job-search-book/ I've worked Med Surg, Tele, GI, and ICU. I spent several years in Nursing Management, and currently work as a Staff Development Specialist. Plus a lot of fun side jobs 🙂

Nurse Beth's Latest Activity

  1. Dear Nurse Beth, Hello! I am currently a nursing student going into my last semester of nursing school. I received an email from a job recruiter about an RN position. While it's not my "dream" job, I'm not opposed to working in this specific area and I do believe it would be a good fit for me starting off. I am just wondering the best way to reply to a recruiter and if it's too early to start applying to RN positions even though I won't be graduating/certified until May? Thanks for any help Dear Graduates in May, Congrats on starting your fourth semester! It is not too soon to apply for RN new grad positions. Nurse residency cohorts are offered only 2-4 X a year in any given facility, and spots are often awarded far ahead of time. You could easily be hired for a residency position starting in August, for example, with the contingency that you've passed the NCLEX by then. So, don't hesitate as there is often competition in landing a residency position. Best of luck to you. Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  2. Dear Nurse Beth, 

    I am a new graduate nurse and accepted a nurse residency position in L&D. I am very grateful, but I am working at a small hospital with an underdeveloped nurse residency program. There is very little training, I do not have a consistent preceptor, and I am working between days and nights due to the lack of nurses available to train. The nurses that I do train with aren't designated preceptors, I'm just put wherever they can put me at.

    The nursing unit as a whole is very unorganized. The hospital has very few policies to guide our nursing practice in L&D. Because of this, all of the nurses do things differently and it is hard to keep up when training with several different people. There is a lack of accountability and continuity. Nurses are leaving in huge numbers and we are very short staffed. We also have a short residency of 14 weeks compared to 20 weeks of other bigger hospitals in my area. We have received two training classes on fetal monitoring and there are no other classes for new residents that are pertinent to L&D. Other experienced nurses on my unit are helpful and very supportive but are frustrated themselves. They have warned me that starting as a new nurse in this unit will not be good due to the disorganization and lack of policies and stated that it's not helpful to start out as a nurse being taught to cut corners. They described the unit as one that you come to after having experienced. I have see a lot of unsafe practices and patients put as risk and I am nervous. I also feel that I am not getting a lot of experience during actual deliveries as many of my shifts I have precepted in triage because they didn't have anywhere to put me or we get an admission that does not deliver during our shift. 

    I understand that it is very unfavorable to leave during a residency. I am half way through and I did not sign a contract. I am not sure what to do as I do not feel prepared to provide safe care given the training I am getting. My nurse manager is aware of the issues but she is new and I don't think she is able to address them right now. I have an opportunity to apply for another nurse residency at a better hospital with a better program but they only hire twice a year, and I will have to wait longer to apply if I don't act soon. Should I stick it out with my current hospital or try to go elsewhere?

  3. Dear Nurse Beth, Hi! I am a new grad RN with 3 months of experience so far in an acute care setting. For many reasons such as unsafe nursing practices at this hospital as well as my desire to relocate ASAP, I am still trying to apply to other hospitals. My question is, when I am applying for new grad positions (6 months or less of experience), how do I address this in my cover letter? How should I go about the desire to change hospitals without speaking bad about the hospital I am currently at? Any help is appreciated! I am extremely lost at what to do. Dear Wants to Change, Some residency programs will accept you with less than 6 months experience, and some specify no hospital experience. You may not find it easy to land a residency position, but that depends a lot on your area. You don't need to address your short tenure in your cover letter. If you do land an interview, it's best to say that it wasn't a good fit. You are right to avoid saying anything negative about a previous employer. Without knowing the details of your situation, try to stick it out. The first few months of nursing are difficult, and 3 months is too soon to be sure it won't work out. If you can make it to one year, you will be far more marketable. Best wishes in your decision, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  4. Nurse Beth

    The Stigma of Men in Nursing

    Here is a prelude which is actually a prologue. I am writing this edit after the article below was published, based on the well -written feedback. While I pinged off a recent article and point of view written by a nursing student at Penn State, my sources, as pointed out, are old, and don't reflect the current state. As a writer, I intend to bring forward more well-researched info, and this article missed the mark. There is far less stereotyping, especially at the clinical level, where male nurses are often embraced, than at the social level. One reader did say, however, that more often that not, he is asked if he's the MD or if he's going to become an MD. I don't believe that men in nursing is a non-issue. Perhaps at the individual experience level at the bedside...but the bigger picture to me is how the slow but steady influx of males will influence the profession. I think more men will benefit the profession in many ways, and I also think gains will be made that a feminized profession was unable to accomplish. As one reader said, male privilege does exist. The comments so far have been well-thought out and respectful. I appreciate the feedback. “Caring, nurturing, comforting...healing touch. Women's work.” These are words and feminine imagery used to describe nursing, a profession so strongly identified as female that it’s odd to realize, in ancient times, nurses were men. However, since the time of Florence Nightingale, males have been a minuscule minority in nursing. What holds men back from becoming nurses, even in this modern day? One reason is the fear of almost certain stigma. Taking on a feminine role affords men an ambiguous social status. Family and friends may disapprove. As a result of stigma, role strain, and isolation, very few men join the profession. Of those that do, more than 85% as compared to 35% of women drop out or fail (Poliafico,1998). Men in nursing are at once advantaged and disadvantaged. While nurses are considered subordinate to doctors, male physicians treat male nurses better than females or at least with more respect. Ironically, male nurses command higher salaries than their female counterparts and hold proportionately more prestigious positions (Evans, J., & Frank, B. 2003). This may partially be due to the fact that males gravitate to the highest-paid specialties, such as nurse anesthetist. Stereotypes and Barriers In healthcare, men are expected to be doctors. Not only is nursing female-identified, but it is also considered by many to be gender-inappropriate for males. Hiring male nurses in labor and delivery and nursery is close to taboo in many places. Male nurses are expected to work ED and highly technical or high-acuity areas such as ICU. Men who choose nursing face questionable social status as many people do not consider nursing a respectable role for males. Some believe male nurses are misfits who aren't successful or capable in any other career. Media portrayal perpetuates the image of nurses as exclusively female. Male nurses are non-existent or ridiculed, as in the movie Meet the Parents with Ben Stiller. Male nurses may be subjected to curiosity and even suspicion as to why they are a nurse from their patients. They may feel they have to defend their masculinity and may distance from their female colleagues in order to do so. Homosexual Even though men choose nursing for career opportunity, salary, and job security, they can be categorized as homosexual based on their career choice. The excerpt below is taken from a study of men in nursing. Robin: “There’s sometimes I’ll go in and see a large male that’s used to looking after himself and he has a cardiac problem. I’m not going to go in and wash his back...it comes back to this whole homophobic thing” Evans, J., & Frank, B. (2003).p. 282 Touch Touching is an accepted form of caring, but men are stereotyped as sexual aggressors and fear being accused of sexual misconduct. Unlike female nurses, who are free to touch and show emotion, male nurses have to be careful with touch. Nursing school does not equip males to negotiate such gender conflict, and trains them from a completely female perspective. Acceptance by Female Nurses Male presence in a female-identified profession creates tension between the sexes on the job. This is partly handled by the women expecting traditional behaviors from the men- help with physical tasks such as lifting, and acknowledging them as leaders. But whether or not female nurses are ready to accept large numbers of men into the profession is unclear (O’Lynn, C. E. 2004). Would men take over the only feminine stronghold in the paternalistic field of healthcare, climbing the career ladder at a fast pace, on the backs of females? Would the nursing profession benefit from more males and do female nurses expect men to improve the status of nursing? Will it bring respect and gains that have been lacking because nursing is a female profession? And if so, is that not a sad commentary? Future of Men in Nursing The United States Census Bureau in 2016 reported 11% of the nation’s 3 million nurses to be male. While a small percent, it’s a significant increase from the 1970 statistics where only 2.7% of nurses were male. The American Assembly for Men in Nursing, together with the IOM, has set a goal of 20% male enrollment in U.S. nursing programs by the year 2020. To help encourage men into nursing, it’s important to speak up about negative media portrayals and make nursing education truly male-friendly, addressing their needs. Men need role models and mentors. High school guidance counselors have a part to play in introducing nursing to all young people. In the end, men bring a different and enriching perspective. Perceptions take a long time to change but will change by sheer numbers of males in the field as it did with female doctors. The presence of male nurses is no doubt increasing, and patients benefit from the increased balance.
  5. Nurse Beth

    Afraid I can't pass FNP school

    Dear Nurse Beth, I am in a situation that I don't know how to proceed... I have been an RN in the OR for 11 years and have 3 years experience to primary care, I have started FNP school last year as it was always my calling and got so disappointed with it that I have no will to finish it. My classes are once a week and I have lots of reading materials and assignments to complete, up to here all as expected, but my professor does not seem to get it that being educated in a foreign country it is harder and it takes more effort on my part. She gets to class and talks about her day instead of actually teaching something and she is the class coordinator so when complaints were made to the nursing chair, he got really defensive and nothing changes. My 2 colleagues from class made the same complaints but all we get back is you should be dedicating yourself more. I have a student loan and I am half way through it but I don't think I am learning enough. Also all the help we were told we would get for clinicals does not even happen... so discouraging... I love being an RN and really want to be an FNP but I don't see myself passing tests or boards the way all this is right now... Any suggestions? Thanks... Dear Disappointed, Not all schools are created equal, and unfortunately, students don't always get what they paid for. There is a forum here on allnurses titled "Students" and from there, "Student Nurse Practitioner". Schools are listed by name and hopefully you can find your school and communicate with others who attended the same school, for support. Without knowing the school and the reputation of the school, it's hard to advise. If it has a dismal reputation, and a low pass rate, you might be better off to cut your losses. If it's a respected school and you just have a poor teacher, it might be worth it to try and hang in there because you've made a significant investment. If you decide to stay, take your focus off of the teacher and do everything you can to learn. Consider a tutor. Learning is a 2 way contract. While teachers should be accessible and supportive, not all are, as you discovered. Put this in the mental folder titled "things I cannot change". Many schools do not provide clinical coordinators, and it's important to start reaching out to find a doctor who will agree to supervise you. Best wishes in your decision, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  6. Nurse Beth

    Why Nurses Should Join the Gig Economy Right Now

    In general, hospitals offer residency positions to nurses who have never worked. But it's really up to the individual facility, and exceptions can be made to rules. At my hospital, 3 months ago, we put a newly licensed nurse who had worked SNF only into our residency program. It was the difference between her getting 4 weeks of orientation or 12 weeks of orientation plus year-long support. Clearly the residency was where she belongs, and we educators were very happy with the decision It will depend on how competitive the spots are, and the philosophy of the organization. Good luck to you!
  7. Nurse Beth

    Advice for ED Interview

    Dear Nurse Beth, I am an RN-BSN with three years experience on medical-surgical. I have an interview for Emergency with another hospital. I meet with Human Resources December 4th. I have switched hospitals 3 times already with good reason (mostly due to relocation). Any advice for interview preparation specifically related to Emergency, or in general? Dear ED Interview, You have solid experience with 3 years in, and you landed the ED interview. These are both in your favor. So far, so good. The most obvious challenge is responding to the 3 hospitals in 3 years question. Re-location is a good reason, as is "it wasn't a good fit". Avoid saying anything negative about a previous employer. If you have family or close ties nearby, it would be good to let them know as you'll be seen as more likely to stay in the area. Be prepared to ask questions of them, when they invite you to. You could ask what opportunities exist for advancement, for example. Research their mission and values. Find out if they have any disease-specific certifications, such as a Chest Pain Center, or Stroke Center. Find out what computer system they are using, such as Epic or Cerner, and if you are experienced, let them know. Is there a prominent second language spoken in your area, and are you fluent? Have you had any customer service training, such as AIDET? Are you aware of which conditions are targeted to reduce re-admissions, such as heart failure? If you are given a clinical scenario, know that they are not looking for a clinical expert in emergency nursing, but for a safe practitioner. Your response should always include staying with the patient, calling for help, providing support and performing an assessment. If you are able to anticipate interventions, such as obtaining ABGs and CXR for respiratory distress, even better. Be prepared for "tell us about yourself" (short and pertinent to staying in the hospital, such as "my goal has always been to work ED"). Include a short story if able as stories are memorable. Likewise, be prepared for "what's your greatest weakness" (segue into an actual value, such as "I tend to work overtime, but am actively working on work-life balance as I feel I have more to offer my patients and the team when I make my health a priority. I just joined a yoga class." Avoid appearing timid or retiring in your interview as nurse managers look for a good fit for their units, and ED attracts strong personalities. Good luck! Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next! Read Are You Cut Out to be an ED Nurse?
  8. Dear Nurse Beth, I'm currently working on a Telemetry floor at a [community] hospital about 50 miles east of Raleigh, NC. I'm torn between the idea of moving back home to California by the end of the year, and staying for three to six more months. I'm a foreign graduate from the Philippines, just started my endorsement/reciprocity process. One of the reasons I want to move back to California is for a better working condition. I was only trained for 8 weeks even though I asked to be trained the full 12 weeks. In my one month of being off orientation, I had to take care of six patients -- the last time I had to do that was 2 months ago. Any thoughts? If not California, what compact state would be the best to look into? Dear Wants to Move, Stay until you have completed at least 1 year of employment, and until your endorsement to California is complete. In your next job, you will not be considered a newly licensed nurse, but an experienced nurse. Newly licensed nurses are given longer orientations than experienced nurses. For example, a newly licensed nurse may be given 12 weeks of orientation and an experienced nurse, 4-8 weeks. Every facility is different in terms of what they provide. There is no doubt that the workload is better in California, and the nurse-patient ratios are protected by law. On Tele you will have only 4 patients. No other state has comprehensive mandated staffing ratios. I can't speak to working conditions in other states, including compact states, because they vary greatly from facility to facility. I'm unclear on how you are working as a nurse while just starting your endorsement/reciprocity process. Once you are eligible, apply for endorsement to California. The process can take some time, and some foreign graduates have to make up some curriculum. Just follow the steps and stick with the process. Filipino nurses have a strong presence in California and we've benefited by the diversification. Their core values include group harmony and a high regard for the elderly and authority. I personally love the sense of humor and playfulness not to mention the pancit and lumpia at every occasion. Who knows? Maybe we will work together and I can help you pass your Arrhythmia competency Best wishes, Nurse Beth (Miss Beth) Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  9. Dear Nurse Beth, I have over 15 years experience in all specialties of nursing with the first 8 years in ICU/step-down/oncology surgery. For the past two years it has been difficult to get a job. Recently during an interview, the recruiter told me that I have great experience, but from 2013 till now, there is no job consistency. The recruiter went on to say if someone with 3 years experience were to apply to the same position, they would get hired instead. I've had jobs that lasted for a year to a few months. I am looking for a stable full time position where I can remain for a long time. What can I do to not be judged this way? Can I be judged this way? Dear Judged, Your recruiter is not judging you, he/she is being frank about your current hireability. You want a stable, full-time position where you can remain for a long time, but your resume says otherwise. Yes, you have solid experience, but potential employers see you as a flight risk. In addition, your experience was close to 7 years ago, and the light is dimming. You could consider a nurse refresher course, although your problem is more tenure than experience. To change the perception, you need to establish 1-2 years of uninterrupted employment. You may need to do this in a setting or a specialty that is not your first choice. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  10. Dear Nurse Beth, I'm currently enrolled in school. Would like to do my RN. I'm a LPN 30 plus years. Am I being unrealistic about becoming an RN and being able to find a job at 60 or older? Dear Unrealistic, A lot of people will tell you to go for it and there are successful examples of people who do get their RN at a later age. But those same people may not tell you that you will have far more challenges than your classmates. Ageism in nursing is real. Two things are highly important as you make your decision. Realism First, it's important is to be realistic. By simply posing the question "Am I unrealistic about finding a job at age 60?" and because you're an LPN, you do seem to be realistic. As an LPN, you already know that bedside nursing is physically demanding and you likely have few delusions about the nature of the work, although there is a big role difference between LPN and RN. Job-wise, you will be competing for new grad positions with candidates who are decades younger than you. All things being equal, an employer will hire the younger employee who is not as likely to use as many costly insurance benefits, for example, or who is more willing to work overtime. Some employers prefer younger candidates because they are more malleable. They are not as likely to question leadership decisions and are less critical. Keep in mind that as a new grad, you will not necessarily be seen as more qualified because you have LPN experience. Some employers do not view LPN experience as an advantage. Those that do not view it as an advantage may actually view 30 yrs of LPN experience as a disadvantage. They will question if you will be able to successfully transition to the new role of RN. You will need to let go of your LPN mindset and adopt an RN role and mindset. At age 60+, you will have to try harder than others to land your first position. You may need to consider settings more undesirable and locations in outlying areas. Are you able/willing to work night shift, and are you open to skilled nursing? Would you re-locate if there are no jobs in your area? How is your stamina? Take stock of your health and estimate how long you plan to stay in the workforce. For many people, working until 70 is entirely doable. You could work a few years on the floor, then transfer to a less demanding job, such as infection prevention, or wound care consult. You say you are already in school, and that's good. You have a student mindset, and are oriented to school in general. The RN program is intense, and not easy. Once you commit, stay the course and keep your eye on the goal. Many clinical aspects will be much more comfortable for you than for your classmates, as you will not have the jitters inserting a nasogastric tube or foley catheter. Personal Importance The second consideration is to weigh how important this is to you. Choosing to get your RN means choosing not to do other things. You will spend less time with family and friends and temporarily suspend most hobbies. But ultimately, if it's your life desire to be an RN, and you will regret having not done so, do it. If you deeply want this , you will find a way to not only earn your license, but to land a job. Your personal desire outweighs your age, your finances, and most all obstacles. Along the way, you will inspire others. Key Tips During nursing school, network energetically and purposefully. Don't wait until you graduate to make connections to land a job. Make yourself seen on the floor and introduce yourself to the nurse manager. Leave a personal note thanking her/him for the clinical rotation experience on their unit, with your contact information. Let them know you will be applying for a job. Read my book below before your second year for many more such strategies . It will give you the insider tips you need to make your application stand out among others, which is needed just to land an interview. You can be amazing in person, but to impress them you have to capture their attention with a compelling resume and cover letter. It's estimated you have 3 seconds to gain the reader's attention with your resume. Once you have an interview, you must go in prepared and at the top of your game. This means knowing what questions will be asked, and what they are looking for in your responses. An example is how to answer "What's your greatest weakness?" and what not to say. Landing the right job for you will be a process, not an event. I hope you will keep us apprised of your decision, and I'm rooting for you! Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next! (on Amazon)
  11. Dear Nurse Beth, I worked on a Medical Rehab unit for 16 yrs then became disabled due to an injury at work. I had my certification in Rehab nursing but let it expire due to medical issues. How can I regain this back. I miss not having the certification on my files. Thanks I am in the process of getting more education in the medical field. Dear Misses Certification, The Certified Rehabilitation Registered Nurse (CRRN) exam is given by the Association of Rehabilitation Nurses (ARN). Rehabilitation nurses care for patients with chronic illnesses and disabilities. RNs who earn their nursing rehab certification may use the initials CRRN after their name. Since your certification expired, you must meet the eligibility requirements and re-take the exam. Eligibility includes two years of practice as a registered professional nurse in rehabilitation nursing within the last five years. Contact the ARN https://rehabnurse.org/crrn-certification/earn-your-crrn to find out more and be sure and study from their sample exam booklet. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  12. Nurse Beth

    Leaving before 1 year? Don't know what to do..

    I was shocked to read that you have 10-12 patients on Tele. I don't know how they justify this or how those in charge can sleep at night. In California, safe staffing laws limit the nurse-patient ratio to 1:4 on Tele. It's a reasonable number given the acuity of patients, the fact that often more than 50% of staff have less than 2 yrs experience, and the shortened length of stay. Four beds can mean 6 patients due to discharges and admits. All this to say that it's not you, it's the situation. I agree with other posters saying to hang in there 6 months if you are able. At 1 year, you are marketable and should never have to work under these conditions again. Best wishes.
  13. Nurse Beth

    Nurses and Bullying: 4 Things You Can Do

    Great article, thank you. I was a new nurse manager when a doctor who was a well-known bully began to berate me at the nurses station bc a lab was not resulted. It was so humiliating. He was tall, imposing, and absolutely withering in his manner. I asked him if we could speak in private and amazingly, he agreed. He followed me to my office. I said "Dr. Baker, we both want the same thing. The best for your patients. I will do everything I can to provide the best patient care on this floor, but you cannot undermine me in front of my staff. If you ever have a problem, let me know. In private". To this day I have no idea where those words came from! But it worked and he gave me nothing but respect from then on. I learned a lesson that day that I had to use later on with a nurse colleague who bullied me. Another story :).
  14. My answer would be the same, as in more details are needed. Culpable in what way for what mistake?
  15. Dear Nurse Beth, What responsibility does the clinical nurse educator have to their student? If the student does something wrong, is the educator culpable for it if they observed it and did nothing? Dear Wondering, I'm an educator in the hospital setting, and if I or my colleagues observe a nurse doing something wrong, we have a responsibility to do something. Let's say the nurse inserted a nasogastric tube and was about to administer medications through it, but had not checked placement. Or the nurse was leaving the room with the bed in high position. Both of these scenarios involve patient safety. The educator would immediately stop the nurse from administering medications, and lower the bed. The primary responsibility is patient safety. I would do these things as naturally as possible, with the goal being neither to shame the nurse nor alarm the patient. Then I would take the nurse aside privately and coach him/her. Let's say it's not an immediate patient safety issue. If a nurse hung a secondary addit, such as an antibiotic, and left the roller ball clamped (common rookie mistake), I would just watch and say nothing. Within a short amount of time, I would encourage him/her to go in the room and check on their antibiotic. At this point they will see their mistake and correct it. The rationale is self-discovery, and active vs passive learning. Very effective. If you as a bystander were observing the antibiotic scenario, you might think I was doing nothing. Likewise, if I decided to speak to a nurse in private, you may think I had done nothing, when in fact, I had. Without knowing the details, I can't really answer your question about culpability. At a high level, though, yes. Students do not have a license, so the educator would have ultimate responsibility. However, newly licensed nurses do practice under their own license. Culpable as in a lawsuit? Perhaps. Culpable to the BON? Depends. To the organization? Most likely. Best wishes, my friend Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  16. Dear Nurse Beth, I'm a CNA at a nursing home, and some of my coworkers have shared resident obituaries on Facebook after they passed. I've thought about doing this a few times, especially with those residents I formed a closer bond with, but have always hesitated and decided against it in fear it would be a violation of privacy. My question is - is sharing a resident/patient's obituary on social media a violation of HIPAA? Dear CNA, It's not technically a HIPAA violation, especially if the obituary was published in the newspaper. Obituaries typically don't include protected health information (PHI). Still, it's not a wise decision. Your employer most likely would not sanction this, which could place your job in jeopardy. It could also violate the wishes of the family. While your co-workers make have been very close to the deceased person, and feel grief when they pass, it's still a business relationship, not a personal friendship. This is more of a boundary issue that a legal issue, and you are right to pay attention to your inner voice of caution. Best wishes my friend, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!