ASN vs. BSN: What’s Best for You?

April 15, 2014 in Licensure, Nursing School

With the completion of either degree, you have the opportunity to take the NCLEX and become a Registered Nurse.  The Bachelor’s (BSN) degree is typically 4 years of classes that include nursing skills and assessment, as well as extended curriculum in nursing research and community health. Prerequisites are fulfilled within this timeframe, as well. There are an estimated 800 BSN programs in existence. The Associate’s (ASN/ADN) degree is half as long (2 years, without prerequisites) and encompasses the practical patient-care realm of nursing curriculum. ADN programs focus only on basic nursing care (such as assessment and clinical skills). There are about 1,100 of these programs in the US.

As a new or upcoming graduate, finding a job is probably on your mind (after passing the NCLEX!). (Learn How to Pass the NCLEX) It is fairly common for large hospitals to state preference for “BSN prepared” RNs. Others require it. A main reason for this change in hiring practice stems from hospitals’ attempts to achieve Magnet Recognition, a national credentialing program governed by the American Nurses Credentialing Center, which deems a hospital’s overall competence.

Most institutions offer a small pay differential to employees who have a BSN. In most parts of the country, floor nurses typically see increased pay in correlation to higher experience and tenure at the specific institution.

So, aside from getting that job, why should you continue on from an Associate to a Bachelor? If you already have the job of your dreams and only went to school for an Associate’s degree, you may still need to go back to school. Many medical centers are considering requiring all of their nurses to be Baccalaureate prepared. With more BSN nurses employed, a hospital has an easier time attaining funding and prestigious laurels such as Magnet Recognition and the Beacon Award. The Institute of Medicine campaigned in 2010 for an 80% baccalaureate-prepared nursing workforce by 2020. Although it hasn’t been passed as a law anywhere yet, it is being lobbied for in a few states’ legislation.

Another reason to further in your education would be to advance your career. Do you plan on staying at the bedside forever? If not, you’ll need your BSN. Most hospitals now require their managers, directors, and nursing educators to have at least a BSN. If you are interested in becoming a FNP, CRNA, or nursing instructor you’ll need a masters; you need to earn your BSN first, though.

If you’re not enrolled in a nursing program already and you have a bachelor’s degree in some other field, you can apply to an accelerated BSN program. These are only 18-21 months long.

If finances play a major role in your decision of which program to attend, an Associate’s degree is probably a better choice. Tuition generally costs much less, and you’ll be able to start working as a nurse faster.

There is also one other less common way to become a nurse: the route of a nursing diploma. Diploma nursing was offered during WWII through the 1970s in order to fulfill the amount of nurses needed. The education was provided by various hospitals and medical centers, instead of traditional colleges. While they are trained extensively by hands-on learning, diploma nurses hold no college degree. There are few institutions that offer this method of attaining your RN, today.

If you have already graduated from an ADN program and are interested in continuing your education, there are “bridge” programs available. RN-BSN and RN-MSN programs (about 700 and 150, respectively) allow you to earn an advanced degree through online classes while practicing as an RN. Many hospitals offer some tuition reimbursement as long as you agree to stay employed with them for a certain period of time; for example, my hospital offers an 80% tuition reimbursement with a 1.5 year contract.

With these facts in mind, it is smart to consider all possibilities to plan for the future. Your career goals can depend on these specific degrees, so hopefully this will help to clarify some of the finite differences between an ASN- and a BSN-prepared nurse.

What’s It Like to Be a New Graduate Nurse?

March 25, 2014 in On the Job

I survived my first week off orientation!!!  I write to give you all a taste of one new grad nurse’s experience throughout the first couple months in the real world of nursing.  I offer my experiences as something to which some of you may relate and something for which others may expect after finishing nursing school.

I am part of a new graduate nurse residency program in a pediatric hospital.  In just starting out, there have definitely been challenges, but overall, I am loving it!  I was extremely fortunate to have a wonderful and patient preceptor, to work on a unit with exceedingly kind and helpful nurses, and to meet several others who constantly offer themselves as resources to me.  I also had bi-weekly meetings with my manager, nurse educator, and preceptor both to check in with me and to see how I was progressing.  Starting my career in such a welcoming and supportive environment allowed my nerves to subside quickly, and I could concentrate on learning well.

However, since I am new to this role and I work in an often confusing and stressful environment of a hospital, there have certainly been challenges.  These have included time management, coordination of care with other disciplines, and literally orientation both to the unit and the system.  In talking with the nurses on my floor and other new grad nurses, time management seems to be one of the most common difficulties at first.  Different aspects of both the environment and this profession can occasionally feel overwhelming; I have found that I just need to stick with it, keep practicing, and continually improve with experience.

Here are a couple things I’ve found to help me not only survive but thrive through these first few months:

  1. Be patient with yourself.  I’ll admit, this is not my strong suit.  I want to be great at everything right away and be able to meet everyone’s needs and exceed expectations.  I often need to remind myself that I won’t be a SuperNurse right away.  There is a learning curve in any new profession, and this is especially true in nursing.
  2. Remain vigilant and keep a questioning attitude.  With several simultaneous demands and pressure to be quick from multiple sources, it is relatively easy to get mixed up and turned around.  Always double, triple, quadruple check everything.  Always ask questions, especially if you are unsure or if something doesn’t seem right.  Being cautious keeps your patients safe.
  3. Know your resources!  It took me a while to figure out who to call for what and when (and I’m still working on it!).  I asked my preceptors for a list of important phone numbers that I keep on my ID at all times, and I use it constantly!  It is a huge time-saver and I highly recommend it.
  4. If you ever feel like you’re drowning or really struggling, ask for help.  It is never worth risking patient safety, your brand new license, or your own mental health to suffer silently.  No one knows to help you if they are not aware of any issues you may be having.
  5. Find enjoyment!  We have a tough job.  When I start to get discouraged, frustrated, or flat-out exhausted, I try to remind myself why I wanted to become a nurse and remember everything that I love about my job.  Also, finally getting paid for the work that you had to pay to do in nursing school is also pretty nice, too.

Best of luck to all my fellow new nurses and future new nurses!  Please leave comments or feel free to send me an email!  I’m happy to help as much as I can and offer any insight I can provide.

Nursing love <3

Katie O’C

How to Get the Most Out of Your Break

February 24, 2014 in Miscellaneous, Nursing School

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For those of you in nursing school, winter or summer intercession can be a great opportunity to get ahead, buff up your resume, or simply brush up on rusty material.  We’re all familiar with the rigorous lifestyle required of nursing school, so break is an ideal time to focus on nursing that is outside of your textbook.  Here are a few suggestions for summer 2014:
  • Study abroad – Whether it’s through your school or an independent organization, there’s lots out there involving international travel with a focus on health care.  For example, my school hosted a trip to Guatemala every winter break with an emphasis on the area’s women and children
  • Apply for a hospital internship – Several hospitals offer summer internships to nursing students who have reached a certain year in their curriculum and meet other requirements
  • Work as a CNA/nurse tech – Look into facilities that are seeking temporary help or are nearby your home or school if you plan on working part time when school picks up again
  • Enroll in summer school – Taking a class over break can lighten your work load during the semester or may even allow the possibility of graduating early
  • Take a CPR class – Get certified with BLS, ACLS, PALS/PEARS if you’re interested in pediatrics, and NRP/STABLE if you’d like to work with neonates
  • Volunteer – While you have a little extra time, put in some community service hours at your local hospital, senior home, blood center, soup kitchen, etc. (e.g. Meals on Wheels, Habitat for Humanity)
  • Begin compiling your professional portfolio – Unless your school has a class specifically for career building, it can be hard to find time for this tedious task.  Start working on your resume, asking for letters of recommendations, and looking into RN residency programs
  • Self-study – Most nursing material is built on concepts from fundamental classes, for example advanced pharmacology is based on what you learned in intro to pharmacology, and so on.  It can be easy to fall behind if you aren’t on top of it, so it’s a good idea to stay sharp over break
Some of these options may be more appealing if you’re in your second or third year of nursing school, as they have your career in mind as you get closer to graduation.  No matter what you do with your break, start thinking about it now, because you may need to meet early application deadlines or reserve your place a few months in advance.  Don’t forget to have some fun too!

How to Get a Great Letter of Recommendation

February 10, 2014 in Job Hunt, Nursing School

Letter-of-Recommendation

Are you graduating soon? Or just looking for a job? Asking for references doesn’t have to be a daunting task and I hope these next tips will help you in asking.

The first thing to do is to think about which professors know you well enough to write a reference. Would you want a virtual stranger to write something a potential employer would see? Probably not. Have you asked a certain professor for help on a topic or discussed patients you’ve had in clinicals? Has a certain clinical professor spent time showing you various procedures? Notice I didn’t emphasize all professors had to be nursing – I used professors from both my music and nursing degrees.

In today’s world there are many ways to ask for a letter of recommendation: email, phone, letter, in person. My personal opinion is you should ask in person if they would be interested and then give them a handwritten formal request for a letter of recommendation. If it isn’t possible to give the professor a handwritten request an email request of the same nature would be okay.

The following is the letter I used both in email and handwritten format.

Hi Professor _________,

I am writing to ask if you would be willing to write a letter of recommendation for me. I am currently putting together my nursing portfolio and think a letter of recommendation from you would enhance my portfolio.

I learned a lot during your clinicals and appreciate the time you took to challenge me to think critically. It is a skill I will continue to use. Though the amount of time at clinical was short I hope it is sufficient enough for you to be able to write a letter of recommendation. If you could gear the recommendation towards the __________ and a nursing career there I would greatly appreciate it.

Please let me know if you are willing to write a letter of recommendation for me. If so could you please have it to me by ___________. Thank you for your time and consideration in advance.

Kind Regards,

Notice I explained why I would like the letter of recommendation, and things I liked specifically about their clinical. I also gave them direction to what their letter of recommendation should be about and a deadline for the letter. At the end I signed my name and included my phone number and email.

Your letter doesn’t have to be long, but it should include those key things mentioned in the previous paragraph. Feel free to use the template I included.

Good luck with your coming semester and don’t be afraid to ask for recommendations!

Innovation in Nursing – Not what you would expect!

February 7, 2014 in Miscellaneous, On the Job

When one imagines the personality of a typical nurse, terms that usually come up are “caring”, “passionate”, “smart”, or “critical thinker.” It’s a rare occasion that the word “innovative” is used.

However, this is a bit of an oversight. As Nurse Keith mentions in his post, nurses are innovative in paving the way for new nursing paths, whether in informatics, leadership positions, or as independent practitioners with higher degrees. But innovation can even be seen in the day-to-day workings of a floor nurse. From this very essential level of nursing, which every nurse is trained to perform early in their career, nurses must be creative in order to provide care that is above expectations.

Nurses must find a way to combine the wishes of the patient, family, medical team, dietician, pharmacist, physical therapist, respiratory therapist, and other professionals into the care of their patients. As a bedside nurse, the nurse takes on the role of advocate for their patient, ensuring that the patient remains safe and on the road to recovery. It takes quite a bit of creativity in order to respect the wishes of the patient and family and still perform satisfactory care. At this level of nursing, innovation is key for all aspects of care. On the technical side, necessary equipment that may be uncomfortable to the patient can pose a challenge that the nurse must balance. They must coordinate care with procedures that need to be done that day, and may need to find creative solutions that can incorporate all necessary care. Sometimes the care a patient requires in one day would take more than 24 hours in a normal situation! In this case, nurses must be able to find ways to coordinate care in an effective and safe manner.

Those of you who are nurses on a unit in a hospital will understand how much inventiveness you need to use on a daily, if not hourly, basis. One may attribute innovativeness to nurses expanding beyond the level of bedside nursing, but that ability to think outside the box is truly developed as a bedside nurse. This level of nursing, which all of us at one point or another have experienced, helps build the foundation of innovativeness that is vital to the profession of nursing, no matter which avenue of nursing you pursue.

This post was written as part of the Nurse Blog Carnival. If you are interested in participating find out more details and sign up here.

The Top Three New Year’s Resolutions for Student Nurses

January 24, 2014 in Miscellaneous, Nursing School

NewYearsResolutions_main_0Usually I’m not a huge fan of New Year’s resolutions, simply because I like to think working on bettering ourselves is a year round thing, and to be honest, I can’t quite remember what mine were last year.  This year, however, was a bit different.  After taking the time to reflect on 2013, I am proud to say that it’s probably been my most accomplished year yet.  As a BSN graduate, a newly licensed RN, and a working nurse, I can’t complain.  Of course there is tons, and I mean tons, of room for growth and learning, but it’s been a big year.  Although it’s just the beginning, it has been so exciting (and a little scary) launching my career and seeing nursing friends around me doing the same.  This New Year’s was a nice reminder of how important self evaluation is, not only for our nursing, but simply for our health and happiness, and I don’t do it often enough.  So in the spirit of this brand new year, I decided to make a few resolutions for myself as a nurse.
  1. Pay it forward.  There are so many individuals who have been part of my struggle and my success – family, nursing classmates, mentors, etc.  I feel extremely grateful for every single act of kindness, both big and small, and I know when I have the opportunity I’ll gladly reverberate that energy back into the nursing community.
  1. Remember to breathe.  The first year of practice in nursing is undeniably tough, and I aspire to put my heart in my work, be eager to learn, and stay driven through the rough spots.  At the end of a hard day, I hope to push through with a little nursing humor and a lot of chocolate.  Just keep swimming, just keep swimming…
  1. Practice what you preach.  As nurses we spend so much of our time getting others healthy that it can be easy to forget to do the same for ourselves.  A little self care can go a long way.  Exercising and eating healthier is a favorite resolution by many, but now as a nurse, I’m finding it’s more important to me than ever before that I advocate for healthier decisions for myself and those around me.  We’re nurses around the clock, right?
I can’t wait to see what 2014 has in store for me, and I’m wishing you all a wonderful New Year readers!  Best of luck!  Feel free to comment and share some of your own resolutions, as well.

7 Things You Need to Do Before You Graduate

January 21, 2014 in Job Hunt, Nursing School

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Heading into your last semester of nursing school you may be excited, nervous and a number of other emotions. What you don’t want to be is unprepared. Here is a list of some things you should begin to do the last semester of nursing school:

  • If you don’t already know, start thinking about what type of nursing you’d like to do.
  • Think about where you might like to work and live after graduation. Start researching hospitals/facilities/home health agencies in these areas to find ones that fit you. Some applications come out in February or March and are only open for a certain amount of time, so its important to start this part as early as you can!
  • Ask for letters of recommendation from professors – more advice on this coming soon!
  • Think about creating a portfolio with resume, writing sample, reference list, letters of recommendation, copies of all certifications, and other nursing related items. Not all schools require this, but it helps when going to interviews.
  • Buy yourself a NCLEX prep book if you don’t already have one and start to do questions daily. Even if you have no idea what the question is about it’s important to get used to the style of questions.
  • This is usually the semester where capstones/practicums happen so thinking about what area you’d like that to be in is also important.
  • Work on your resume and have it looked over here at RNDeer (http://www.rndeer.com/services/) or through your career center at school.

Finally, be proud of yourself! You’ve come a long way and have undoubtedly grown as a person and as a nurse. You will make it through this semester. 

The 4 Things You Must Know for a Successful Job Hunt

January 7, 2014 in Job Hunt, Resume Help

nurseonjobhuntLooking for work can be a strenuous task for new graduate nurses, so it is important to be proactive and organized to keep on top of it! Here are some tips for the avid job hunter:

  • Keep track of your progress with an employment matrix, using a spreadsheet software such as Excel or Numbers. See the example below! You may edit your table to your own liking. Include important dates, such as submission of an electronic application and its deadline, and the contact information for both the nurse recruiter and the nurse manager if available. Sign up on job listings to be emailed if a position arises that matches your qualifications, and mark your calendar for new graduate residency program application windows. Some even like to put themselves on a strict schedule of X amount of applications per week, day, etc.jobhuntblog
  • Take the extra initiative to go above and beyond!  Within two weeks of submitting an electronic application, follow up on your status by calling the nurse recruiter of the facility.  Send a personable thank you letter to the nurse manager within 48 hours of an interview.  Make an effort to make an appointment and introduce yourself at Human Resources with your resume and cover letter.  Sometimes applicants can be turned away because HR is extremely busy or facilities are not able to accept hard copy documents, but don’t be discouraged.  These steps are a personal choice, but I have found that I am usually able to sit with at least one nurse recruiter who appreciates my visit and lets me know that I am being heard.  Be persistent, and always be polite!
  • Network, network, network!  Request a unit tour from the nurse manager of the facility that you are interested in.  Connect with your contacts on LinkedIn, and if you’re still in nursing school, attend the annual National Student Nurses Association convention.  Befriend other volunteers in your community service projects, and spark conversation with other health professionals in your CPR classes, for example.
  • Lastly, take advantage of the resources around you.  For example, my school allows alumni students to utilize tools such as resume reviews and mock interviews for an entire year post graduation.  RNDeer has just opened its brand new online career center, offering an array of nursing specific pre-professional packages.

Be the applicant that you would want hired as your own nurse!  Put your best foot forward, be genuine, and show your hospital why it not only is the best fit for you, but what you have to offer them as an asset, as well.  Good luck, and go get ‘em!

How to make it through Your First, Second and Every Holiday Shift as a New Nurse Graduate

December 19, 2013 in On the Job

Guest Post by Elizabeth Scala

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Being a new nurse is tough.

I remember my first holiday. You want me to do what?!? I’m from NY but my first job was in MD. I was miles from home and this would be the first year that I’d miss Thanksgiving.

Not only was I sad, missing my family and all of our traditions, but I was lost.

I’d never cooked a whole turkey by myself before. How was I going to feed everyone in time when I got off of work at 4? (Oh yeah, if I wasn’t having Thanksgiving at home you bet I invited everyone from my fiancés family over for the holiday meal! I wouldn’t advise this if it’s your first time cooking and you have to work the day prior and day of… but oh well, lessons learned).

So now that you’ve found yourself in a brand new job and you’re totally excited and proud of what you do, that novelty may quickly wear off when it’s time to work night shift over holiday time. “I want to be with my family and friends!” you might be thinking, “Not here with the skeleton crew, barely getting by each shift…”

How can you make it through your first, second, and even future holidays? (Because, let’s be honest. They never get easier with time). Here are two tips to help you beat those holiday blues:

  • Holiday is within you. I know it sounds totally cheesy and very cliché but the holiday season lives within your spirit. You can make or break this and every future holiday you have as a nurse. I honestly wish someone told me this right up front, but they didn’t. And because of that I suffered through many-a-holiday season with a frown on my face. Instead- what can you smile about? What is it about your job that brings you joy? Where in your life can you experience gratitude? The holiday cheer comes from within and if you can remember that you can rock any holiday shift coming your way!
  • Get creative. As newer graduate nurses I’m sure you’re all savvy when it comes to technology. When I worked shift work they didn’t have all of these fancy mobile devices and applications. Here’s a suggestion: when you’re not at work (but not at home with family because you do have to go into your shift later on) you don’t have to miss the holiday fun. Open your laptop or tablet and pull up Skype or some other form of messenger. Enjoy the holiday in a virtual way!

What happens if you don’t like your first nursing job?

December 18, 2013 in Job Hunt, On the Job

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As a new graduate nurse, finding your first job is an arduous experience. The pressure is on to find the “perfect” job, your dream job. But sometimes due to circumstances out of your control, you may find yourself working in a not-so-perfect atmosphere, which was exactly what happened to me in my first job. The geographic location in which I could work was somewhat limited due to my husband being in the Marine Corps so the hospital choices for me were few and far between. I had to make the best out of what I was given, and ultimately I have found myself in an amazing job. My second job.

Don’t get me wrong- I did not land my first job in an awful hospital. In fact, I am now extremely thankful for the opportunity I had at that first hospital because I feel I grew in maturity as well as confidence as a nurse. As a new grad I was excited, eager, proud, and motivated to begin my career as a nurse, yet those sentiments were not reflected in the attitudes of the other nurses in the unit I was working. For that reason I quickly felt discouraged and deflated (again, another reason why working in a healthy work environment is so important- see my previous post!). After about 3 months, I knew I was not going to be happy long-term in my first job- mainly due to the work environment. I realized that instead of sacrificing my happiness, I needed to take a scary step forward and stand up for what I deserved as a nurse, which is a mindset that I still have today.

The next question I asked myself was, “how long before I look for my second job?” knowing that this would be an important topic of discussion with future employers. I decided to start looking for a new job at 7 months experience with my first job. My reasoning was that I was able to give enough time at my first job to truly make a rational educated decision, and I also wanted to respect the investment of the hospital in training me. However, I also had to think about my own personal happiness, which is why I started looking at my 7-month mark, rather than after 1 year. Luckily, I found a NICU nurse residency program at another larger, local hospital. I carefully crafted my resume and cover letter to reflect why I was leaving my current job, while at the same time respecting the hospital that I was fortunate enough to start my nursing career. I applied and had an advantage in the application process since I had “prior experience,” although just 7 months. A week later I had an interview and subsequently was offered the job. Because of my 7 months experience at my first job, I started my second job in a Level III NICU with more confidence than I would have as a new graduate, and for that I am thankful.

My advice to you if you find yourself in a similar situation is to not get discouraged. If it turns out that your first hospital isn’t a great fit, that’s okay- do your research and look at your other options. There are always options available to you, no matter how daunting it may seem. Try to make the best of it while you are working your not-so-dreamy job, while in the meantime still job hunting. Don’t get caught up in the negativity, and most importantly don’t forget to remain respectful and gracious as you are making your exit to bigger and better things.

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