upSNUP

I am a new grad in Oregon and there aren't a lot of STABLE courses offered in the state. Actually most of the classes offered are actually recertification classes, not initial certification courses. The next class I can take is two months from now and I will have to drive two hours away from Portland to take it. It's kind of ridiculous that this is now a requirement before employment and yet it's so hard to find a class, but the nursing market is completely saturated in Portland (we have 25 amazing nursing schools here) and so employers have their pick and can make lofty demands; they like to ask that you have all those certifications prior to hire because then that's one less expense for them.

As a senior nursing student with a history as a doula, I can say that there were times when I had clients that totally behaved in an "us vs them" manner when they got to the hospital (and maybe they had that attitude before and thought a doula would somehow buffer their interactions with staff...not), but it was really embarrassing as their doula to encounter this. So in some circumstances, I think it might just be the preconceived notions and mentality of the patients, and not necessarily the doula poisoning them. On the other hand, I am sure there are bad doulas out there, just like there are some bad doctors and nurses. But I'm not about to look on all doctors and nurses with suspicion because I've seen a few bad eggs. That's all just anecdotal.

Honestly, a lot of people want to move to Portland right now and we have absolutely NO shortage of nurses. It's really hard to find a job. It's frustrating for people like me who are Oregonians, born and raised, and now we have to move away from our families because outsiders think Portland is quaint and want to move here and get jobs. If you live in an area where there is a shortage, my advice would be to stay there and make it easy on yourself and the Oregonians who are in the midst of an urban gentrification.

Geriatrics, hands down will be the greatest area of need in the upcoming years. This is because a) not a lot of people want to do geriatrics, and b) the babyboomers are getting older. The other area of greatest need is public health nursing. Again, not a lot of people seem to be drawn to it (perhaps because it's less technical than other nursing specialties), and due to the Obama healthcare reforms, and pull from nursing organizations, there is a pull to increase public healthcare nursing by 2020. This is to help reduce healthcare costs, as public health nurses perform a lot of preventative treatments. Lastly, any kind of home care nursing will be in high demand, again to reduce healthcare costs incurred by receiving care in a hospital. The Obama reforms want to increase home care nursing by 2020, as hospital facilities will likely not be able to accommodate the upcoming demands of increasing immigration and the aging boomer population. In addition, evidence has shown better patient health outcomes, and decreased hospital acquired illnesses with home care.

I don't think it's silly to worry about your license. It's important to have some amount of regard for the seriousness of your actions because people do lose their licenses. I'm in my last year of my BSN and whenever I perform an intervention or chart, I'm thinking about why I am doing it and how it would appear to an outside observer. I think this is especially important when you first start off and thinking clinically isn't yet second nature, but I think the worry probably dissipates more as you become more comfortable and have been doing it for a while. If this is really what you want to do, I wouldn't let your fears get in the way, but if you're not all for it, then I would be sure to really reevaluate before you jump in head first. Nursing school is a long road when you're in it.