The Nursing Career Minefield As Healthcare Organizations Merge

[Jim Keogh]

The healthcare industry is changing quickly. That's not news. However, these changes can have a dramatic effect on nursing as a career. The trend is for healthcare facilities to consolidate to gain leverage during negotiations with health insurers for the best reimbursement opportunity. Community hospitals join together to form large healthcare organizations that seem to monopolize healthcare for the area. Large healthcare organizations take over other healthcare organizations - and private practices - then open urgent care centers. The goal is to own the patient. But do they also own nurses? Own is a strong word. Nurses can leave employment of the healthcare organization at any time but are there viable alternatives if other nursing opportunities are controlled by the same healthcare organization?

When many desirable nursing opportunities are owned one way or another by the same healthcare organization, nurses have limited career opportunities. You either work for the major healthcare organization or you don't work as a nurse. Seems like this horror story may be exaggerated especially if your area hasn't been affected by the consolidation of a healthcare organization - and yes this may be going overboard a bit. However, jeopardizing nursing careers can become an undesired consequence of healthcare facilities trying to survive in a turbulence healthcare industry.

A former chief nursing officer said that a job is like a pair of shoes. It either fits or it doesn't fit and you don't know until you try it for a while. Let's take this one step further. Even a well-fitted shoe sometimes doesn't fit anymore. The shoe changes or your feet change. It is simply time for a new pair. Changing shoes - jobs that is - was rather a routine process for nurses. You send out feelers to friends inside and outside the healthcare facility. They give you inside information on open positions. You submit an application; show up for interviews; pass pre-employment huddles (i.e. health, background check); and you accept the position if all works well for you. You hedge the risk of jumping to a different healthcare facility by changing to per diem status in your current healthcare organization. If the new shoes don't fit, then you are still employed. The consolidation of the healthcare industry changes the playing field. Old reliable strategies for growing a nursing career may not work anymore since moving from one hospital to another might be transferring within the same healthcare organization.

And then a perfect storm is all you need - you are terminated. Terminated because your position is eliminated through consolidation or terminated because management doesn't feel you are working towards your potential; it really doesn't matter because either way, you are looking for work. Not the end of the world because there are usually other nursing opportunities in your area unless those healthcare opportunities are owned by the same healthcare organization. And the death knell to your nursing career is being placed on the healthcare organization's do-not-hire list. Your only option is to move in some cases.

Consolidation of healthcare facilities is happening. Healthcare organizations do adopt policies and procedures that ensure nurses and other clinicians (yes practitioners are experiencing the same pressures) are treated fairly; however, nurses still need to develop new career strategies that work within the era of consolidation.

Here are a few tips that will help you develop your career strategies:

Accept Change

The healthcare industry is changing - and change is swift and dramatic in some cases. Fighting change increases your frustration and eventually will leave your nursing career behind.

Be Proactive

Keep your career alive by increasing your credentials with board certification and go back to school to finish your degree. Healthcare organizations sell you to their customers (patients) and those extra credentials go a long way to maintaining your marketability.

Avoid Stagnation

No longer can you expect to be set in your career by finding a home unit and provide top-notch care to your patients for the rest of your career. Can you do another nursing job besides your current job? If not, then your career is stagnated and you might find yourself unable to keep abreast with changes are happening in the healthcare industry.

Prepare To Lose Your Job

Hopefully this will not happen but you now have time to plan what you would do if you should be called to human resources and be told that your services are no longer required. No job is for life especially now as changes in the healthcare market makes what seems to be a solid job one that is no longer needed.

Identify Growth Areas In Nursing

Healthcare organizations try to stay ahead of the healthcare market by closing underperforming services and opening services that show growth. You need to do the same by keeping abreast of healthcare news and get the training needed to work in the growth area of healthcare.

Develop An Inside Network

Become active within your healthcare organization. Volunteer for committees - and show up for meetings. Offer constructive opinions. Demonstrate that you are a nurse leader and not simply working a shift for a paycheck.

No one including leadership in healthcare organizations knows how healthcare will work in the future. One thing is for sure healthcare as you know it today will be dramatically different in ten years. Today's changes make the healthcare organization sustainable for the future - at least that's the hope of leadership of healthcare organizations. You too need to change to ensure that your nursing career is also sustainable for the future.