Which route to take in nursing/health care?

shahlom4605 · Jul 17, 2010

I had a recent conversation with the Executive Nurse for the Harris County Hospital District in Houston and she told me they are not hiring anything but BSNs. I think you will have more job opportuntiy, more money, and more opportuntiy for advancement if you get a BSN. Physician Assitants have the same job function and SALARY as an Nurse Practicioner but I think the NP route is better for the patient. I have heard from physicians that NP's get more respect than PAs. 90% of the students in PA programs in Texas are women. NP's start at $70,000 in Houston, the average salary is $85,000. I took am making a career change and entering an acclerated BSN program because I see nursing as the only field that offers financial security, flexible time, and future career options.

I too have a master's and have struggled to find a job. I have an undergrad degree in biology and love helping people, nursing makes sense for me. I admire nurses and the hard job they have. At this point, I would do anything for a job that will help me take care of my family even after reading so many negative stories on this site.

I am scared about being able to do iv's and co-workers who give attitude and don't do their work, but again a job is a job.

Think the long term, the face of health care is changing. 40 million entering the system in 2015.

alabamacrimson · Jul 18, 2010

Don't you have to get some experience actually working before you can enroll in any NP training program? I think there is alot of bad info out there. I was told that while having an ASN and a bachelors is NOT the same as having a BSN, it is better than having just an ASN, and that my present bachelors would get me BSN pay, the ability advance the same as someone with a BSN. True, not true?

I'm being told that in the next 10-20 years, that to become an RN anyway, the minimum required will likely be a BSN, that the writing is on the wall.

Then there is the med school thing. That takes a long time, but it would not take much longer to get to my residency then going and getting an ASN/BSN then training to be an NP. I admire nurses and the nursing field. But I am a pragmatist. These stories of new grad after new grad not being able to get a job are very discouraging, and I feel for all those people. They put in a lot of hard work and have been really disappointed. I don't want to be in that boat.

llg, PhD, RN · Jul 18, 2010

Yes. There is a lot of bad information out there. You are certainly right about that.

One of the reasons for some of that bad information is that employment conditions vary in different locations, different types of facilities, and different types of nursing specialties. In some regions of the country and in some facilities and in some specialties, it is nearly impossible to get a job without a BSN. In other places/circumstances, ADN's are given the same consideration. That's why there is no substitute for investigating your LOCAL job market by speaking with people who really know the hiring practices of the places that might interest you as an employer. (Not every local nurse knows the hiring practices of the local hospitals.) You're going to have to do some networking, make a few phone calls ... perhaps attend a few meetings of local nursing organizations ... to meet people "in the know" about your local facilities. But I believe that is the only way to get the information you seek.

Another reason for the bad information out there is that people often base their perceptions of employment conditions based on specific cases involving individuals (maybe current, maybe a few years old) that might not reflect the overall situation well. "I knew somebody who ...." is not sufficient evidence to adequately assess a job market. That's why it is so important to connect with people who know the current and likely future local job market.

Finally ... while I am NOT one of those people who believe you need a "calling from God" to be a nurse ... I do believe you should be VERY cautious about basing your career path choices on the recommendations of others. For every person you meet who meet who thinks "XYZ is a good job," I can find 2 other people who tried XYZ and hated it. To be successful and satisfied in ANY job, you need at least 2 things:

(1) You need to have some attraction to the actual work that the job involves. You spend your time on the job doing the things required by that job. If you don't enjoy doing those types of things, you are going to be miserable regardless of how stable or financially rewarding that job is. So, think about the various roles in nursing from that perspective. What type of work will you enjoy? Can you see yourself being happy taking care of acutely ill patients in a hospital? ... in an ICU? ... Do you want to establish longer-term relationships with patients in a long-term care facility? ... Do you want to see multiple patients per hour in an outpatient clinic or urgent care center? ... Think about the different career options in terms of the actual work that the nurse does in those roles in those types of settings and imagine yourself actually doing that work for 40 hours every week. Will you be happy doing that particular type of work?

2. The 2nd thing you need to be satisfied and successful in any job is the ability to do the job well. You need to have some underlying talent plus the appropriate education to do the job well. You may already have some clues about what your natural talents are -- and you'll have more opportunity to figure that out as you go through the various clinical rotations in nursing school and work in that first job or two after graduation. The appropriate education is something you can't be sure of until you figure out the career direction you want to take. However, eventually, you will need a BSN or higher to have a lot of options and career mobility. That is true just about everywhere. So if you decide that the ADN is right for you now, be aware that you might have to go back to school later to advance your career.

Good luck to you!

alabamacrimson · Jul 19, 2010

Yes. There is a lot of bad information out there. You are certainly right about that.
One of the reasons for some of that bad information is that employment conditions vary in different locations, different types of facilities, and different types of nursing specialties. In some regions of the country and in some facilities and in some specialties, it is nearly impossible to get a job without a BSN. In other places/circumstances, ADN's are given the same consideration. That's why there is no substitute for investigating your LOCAL job market by speaking with people who really know the hiring practices of the places that might interest you as an employer. (Not every local nurse knows the hiring practices of the local hospitals.) You're going to have to do some networking, make a few phone calls ... perhaps attend a few meetings of local nursing organizations ... to meet people "in the know" about your local facilities. But I believe that is the only way to get the information you seek.
Another reason for the bad information out there is that people often base their perceptions of employment conditions based on specific cases involving individuals (maybe current, maybe a few years old) that might not reflect the overall situation well. "I knew somebody who ...." is not sufficient evidence to adequately assess a job market. That's why it is so important to connect with people who know the current and likely future local job market.
Finally ... while I am NOT one of those people who believe you need a "calling from God" to be a nurse ... I do believe you should be VERY cautious about basing your career path choices on the recommendations of others. For every person you meet who meet who thinks "XYZ is a good job," I can find 2 other people who tried XYZ and hated it. To be successful and satisfied in ANY job, you need at least 2 things:
(1) You need to have some attraction to the actual work that the job involves. You spend your time on the job doing the things required by that job. If you don't enjoy doing those types of things, you are going to be miserable regardless of how stable or financially rewarding that job is. So, think about the various roles in nursing from that perspective. What type of work will you enjoy? Can you see yourself being happy taking care of acutely ill patients in a hospital? ... in an ICU? ... Do you want to establish longer-term relationships with patients in a long-term care facility? ... Do you want to see multiple patients per hour in an outpatient clinic or urgent care center? ... Think about the different career options in terms of the actual work that the nurse does in those roles in those types of settings and imagine yourself actually doing that work for 40 hours every week. Will you be happy doing that particular type of work?
2. The 2nd thing you need to be satisfied and successful in any job is the ability to do the job well. You need to have some underlying talent plus the appropriate education to do the job well. You may already have some clues about what your natural talents are -- and you'll have more opportunity to figure that out as you go through the various clinical rotations in nursing school and work in that first job or two after graduation. The appropriate education is something you can't be sure of until you figure out the career direction you want to take. However, eventually, you will need a BSN or higher to have a lot of options and career mobility. That is true just about everywhere. So if you decide that the ADN is right for you now, be aware that you might have to go back to school later to advance your career.
Good luck to you!

Good advice. I get all the time "well have you made up your mind about nursing vs medical school" well the issue is, as you point out, that maybe I don't have the info yet. I will check into local nursing organizations. I get all the time "call so and so, he/she's a nurse, they can fill you in" but they have been working for 2 to 5 years or more. The hiring has changed alot in that amount of time. I want to contact people for the purpose of networking as well. I worked as a Chaplain for some time in a hospital setting and spent time talking to nurses and doctors and taking care of patients from the spiritual side of things. I establised relationships with patients, doctors and nurses where I worked. I also had a dad pass away from cancer, and a mother who is physically disabled. All these things caused the health care bug to bite me.

I have been told that there is only one hospital group in the area that will even hire a new grad, unless you are willing to work the ER. The ER, I am told, has such a high turn over rate that a new grad can slip in. When I check the local hospitals website, I see lots of positions for RNs, some specifically say experience required, others do not. I am told here at allnurses that hospitals will do this to fish for applicants, not because they are real positions open. Who really knows?

The BSN seems like a good idea, but a gamble as far as getting into the program. The local university takes 1 in 4 applicants to go straight into BSN-its ridiculously competative. Thats why I think if I go that route, bridging to a BSN would be better. I guess regardless of what I decide, its going to take some time.

On the med school side, I am going to talk to the head doctor at the family practice that my family has gone to since the 70's. With all the bad information I received regarding nursing, it almost makes me want to jump over to the med school side of things. It seems like a more stable choice.

HouTx, BSN, MSN, EdD · Jul 20, 2010

Great thread & lots of good information shared.

I just wanted to add - the Healthcare landscape is changing rapidly. Stability is not guaranteed in any job - including physicians. Their 'world' is changing even faster than nursing. Increasing regulation and pressure from insurers are impacting clinical practices, rapidly expanding technology expectations & shrinking reimbursement / incomes.... it ain't pretty. For example, incorporating electronic records into a private practice can cost upwards of $150k, and that doesn't include the ongoing 'cost of ownership' - but it's required in order to maintain reimbursement levels in the very near future.

The real job expansion is in healthcare technology these days, not in clinical services.

It's going to be a wild ride.

alabamacrimson · Jul 20, 2010

Great thread & lots of good information shared.
I just wanted to add - the Healthcare landscape is changing rapidly. Stability is not guaranteed in any job - including physicians. Their 'world' is changing even faster than nursing. Increasing regulation and pressure from insurers are impacting clinical practices, rapidly expanding technology expectations & shrinking reimbursement / incomes.... it ain't pretty. For example, incorporating electronic records into a private practice can cost upwards of $150k, and that doesn't include the ongoing 'cost of ownership' - but it's required in order to maintain reimbursement levels in the very near future.
The real job expansion is in healthcare technology these days, not in clinical services.
It's going to be a wild ride.

You know TX, that is a good point. I will bring this up when talking with the physician and see what he has to say about it. He did tell me too that the passing of ObamaCare will have a big impact. One day in the office he told me that its good and bad. Good in that it creates 40 million new patients (and that can be a negative too, if the resources are not there), and bad that it brings more government regulation and involvement.