AMERICAN NURSE O FFICIAL J OURNAL MyAmericanNurse.com June 2020 2020-2021 Education and Career Guide How to fund your education Innovation as a career path Trending jobs Future of nursing education MyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 1 Editor-in-Chief Lillee Smith Gelinas, MSN, RN, FAAN Executive Editor, Professional Outreach Leah Curtin, RN, ScD(h), FAAN Editorial Director Cynthia Saver, MS, RN Managing Editor Julie Cullen Copy Editor Jane Benner Group Publisher Gregory P. Osborne Executive Vice President Steve Ennen Director of Professional Partnerships Tyra London Associate Publisher John J. Travaline Account Managers Mary Chris Schueren, Cara Sosnoski 215-489-7000 Production Director Christian Evans Gartley Art Director David Beverage Edited, designed, & printed in the USA AMERICAN NURSE O FFICIAL J OURNAL MyAmericanNurse.com June 2020 American Nurse Journal is the official journal of the American Nurses Association, 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492; 800-274-4ANA. The journal is owned and published by HealthCom Media. American Nurse Journal is peer reviewed. The views and opinions expressed in the editorial and advertising material in this issue are those of the authors and advertisers and do not necessarily reflect the opinions or recommendations of the ANA, the Editorial Advisory Board members, or the Publisher, Editors, and staff of American Nurse Journal. American Nurse Journal attempts to select authors who are knowledgeable in their fields. 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Osborne Executive Vice President Steve Ennen Finance Director/Operations MaryAnn Fosbenner Business Manager Jennifer Felzer Contents 4 Partnerships and innovation: The future of nursing education By Catherine Spader Collaboration, design thinking, and competencies are critical to prepare nurses to work at the top of their practice. 8 Trending jobs Learn about specialties in demand from nurses in the roles. 12 PhD vs DNP By Erik P. Southard Find fulfillment by making the right choice. 14 Money matters: How to fund your nursing education By Debra A. Wolff Don’t miss out on the many available resources. 19 The new normal: Nurses as innovators By Catherine Spader Nurses are leading the way to healthcare’s future. 22 Midcareer nursing advancement By Keith Carlson Reflect, be objective, and tap into your network 26 The places you can go with a BSN By Mary E. Fortier Answering why, what, and where can enhance your chances for success. 28 Choosing the right NP education By Kathleen Ballman, Dawn Carpenter, Christine Colella, Donna Lynch-Smith, Helen Miley, and Marcia Johansson Prepare to meet your education and career goals. 32 Forging your career from the start By Susan Rux Begin to map out your future on the first day of nursing school. 34 School survival skills By Debra A. Hrelic How to find success while working full-time and getting your BSN. 38 Should you say “yes” to the job? By Jessica Rhoades Three steps to finding your dream job. 37, 39 E DUCATION LISTINGS B ONUS ARTICLES Preparing for a job interview: Nurses as negotiators By Phyllis H. Horton Assess, research, and reflect as you prepare for your next job interview. myamericanurse.com/?p=66985 Using simulation to boost job interview confidence By Randy Hamm Can classroom simulation exercises increase student confidence in answering behavioral-based interview questions? myamericanurse.com/?p=67273 Nursing professionalism begins with you By Luci Bostain All nurses are responsible for maintaining the public’s trust. myamericanurse.com/?p=67426 Set goals to propel your nursing career By Luis Figueroa Education, certification, teaching, and active association membership are keys to professional growth. myamericanurse.com/?p=67321 © 2020 Healthcom Media. 2 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com 2020-2021 Education and Career Guide page 4 page 14 page 19 page 224 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com N ursing education is evolving rapidly to prepare nurses for mounting health- care challenges, including the COVID- 19 pandemic, healthcare inequality, integra- tion of electronic health records, and care across various settings. The World Health Organization (WHO), in its State of the World’s Nursing Report—2020, is calling for an ur- gent investment to accelerate nursing educa- tion. (Visit who.int/publications-detail/nursing- report-2020 to read the report.) WHO also advocates for strengthening leadership so nurses have an influential role in developing health policy and decision-making and can contribute to effective health and social care systems. 2020-2021 Education and Career Guide Partnerships and innovation: The future of nursing education Collaboration, design thinking, and competencies are critical to prepare nurses to work at the top of their practice. By Catherine Spader, RNMyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 5 Here’s a look at some of the innovative strategies associations and schools are us- ing to ensure future nurses are well pre- pared to meet evolving healthcare needs and work at the top of their licenses. Covering the essentials “Unprecedented changes in healthcare de- livery needs are accelerating innovative ef- forts in nursing education,” says Deborah Trautman, PhD, RN, FAAN, president and chief executive officer of the American As- sociation of Colleges of Nursing (AACN). In addition, the 2019 Activating Nurs- ing to Address Unmet Needs in the 21st Century report by the Robert Wood John- son Foundation states that one of the core functions of nursing practice is to build partnerships within and outside the health sector to find solutions to today’s health- care challenges. (Visit bit.ly/36wRQa6 to read the report.) AACN is taking a big step into the future by re- envisioning its Essential Series, the elements and framework on which to develop nursing curricula. “We are moving from bac- calaureate, master’s, and doctor of nursing practice curricula essentials toward competency-based education and assess- ment,” Trautman says. The goal of this ap- proach is to ensure equitable learning ex- periences and achieve a consistent level of competency in domains such as primary care, coordination of care, public health, and population health management. Many of the changes schools of nurs- ing have implemented because of the current public health crisis will likely continue and evolve, including online ed- ucation and virtual simulation. “Our ex- perience during COVID-19 has shown us high standards can be met with online education,” Trautman says. “Before this crisis, there was some concern about how well students would accept virtual simulation programs, but we have found it is not a problem, and some students even prefer them.” Creative collaborations solve problems Schools of nursing are responding to rap- idly changing healthcare demands by de- veloping creative new clinical collabora- tions and strengthening existing ones. “There is an ingenuity happening that is providing benefits to patients and a great learning experience for nursing students,” Trautman says. “These academic-based teams are helping students learn and ad- dressing care needs throughout the coun- try. I believe these partnerships will con- tinue to grow and strengthen in the future as a result of the pandemic.” Since 2013, the University of Connecti- cut (UConn) School of Nursing in Storrs has strategically focused on educating nursing students in the science of innova- tion. Initial efforts encouraged undergrad- uate nursing students to work with teams of engi- neering, business, and allied health students to take their ideas and solu- tions from concept to successful prototype. Projects include new products, services, and processes that students develop and then con- duct initial tests in clinical environments or in the simulation lab. “The more we can get students to work together and think about how to creatively problem solve, the stronger we will be in uncertain times,” says Tiffany Kelley , PhD, MBA, RN, DeLuca Founda- tion Visiting Professor for Innovation and New Knowledge at the UConn School of Nursing. UConn integrates innovation education throughout its curriculum across all degree programs (bachelor of science through doctorate). For undergraduates, innova- tion is introduced in their first semester. “We prepare undergraduates to be think- ing early about care delivery in different ways,” Kelley says. The school also offers the newly launched Healthcare Innovation Online Graduate Certificate. The 12-credit pro- gram integrates innovation theories from 2020-2021 Education and Career Guide Deborah Trautman Tiffany Kelley “The more we can get students to work together and think about how to creatively problem solve, the stronger we will be in uncertain times.” – Tiffany Kelly6 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE MyAmericanNurse.com business and social sciences and teaches medical and nonmedical professionals how to apply critical thinking skills to shift healthcare culture. The program, which stresses healthcare innovation the- ory and application and workplace cul- tures that foster innovation, encourages students to be divergent thinkers and teaches them how to assess potential benefits and risks associated with launch- ing their ideas to determine viability. The program’s capstone project is designed to advance students’ ideas as far as pos- sible with guided mentorship over 14 weeks. “One of the most dangerous state- ments we hear in healthcare is, ‘That’s the way we’ve always done it.’” Kelley says. “We evolve when we become per- sonally invested in addressing what is not working for the betterment of all.” Solving real-world problems in real time Students at Duke University School of Nursing in Durham, NC, are learning to solve real-world problems in real time in the Duke Health Innovation Lab. The lab is a physical space where practicing nurs- es, nursing students, fac- ulty, physicians, physical therapists, engineers, and other professionals collab- orate to develop, build, and test protypes of new healthcare products and delivery processes. Proj- ects include much-needed 3D-printed face shields, now in clinical use at the Duke University Health System, and telepresence robots in the in- tensive care unit to increase patient com- munication and reduce personal protective equipment use. (Visit youtube.com/watch ?v=KOLcTKhPEhE to see a telepresence robot in action.) “The lab and the team played a critical role in the journey of the robots and face shields from concept to use,” says Ryan J. Shaw , PhD, RN, associate professor and director of the Health Innovation Lab. Thinking by design Schools of nursing also are adapting the design thinking approach to foster innova- tion. Design thinking teaches students how to challenge their own assumptions to bet- ter understand patients and their needs to create quicker, more effective solutions. “The end goal of design thinking is to make the user experience the best it can be. It’s about creatively thinking forward, rapid prototyping, and testing ideas and products,” says Daniel Pesut, PhD, RN, FAAN, professor of nursing at the Univer- sity of Minnesota School of Nursing, and director of the Katharine J. Densford Inter- national Center for Nursing Leadership. The five phases of design thinking are discovery, interpretation, ideation, experi- mentation, and evolution. The University of Minnesota School of Nursing has adapted design thinking into its Health Care Design and Innovation Post-Bac- calaureate Certificate pro- gram. Courses teach the knowledge, skills, and abil- ities to bring design think- ing to nursing leadership and innovation. In one student project, a nurse observed and lis- tened to patrons at the lo- cal library and discovered they frequently discussed unmet health issues. She used design thinking to activate ideas about how li- braries can become portals to promote health and health literacy. Possible library services could include health counseling, a nurse practitioner clinic, and a health and human services professional to help pa- trons access health-related resources. “We are seeing many dysfunctional sys- tems in healthcare colliding and breaking down as a result of the pandemic,” Pesut says. “Teaching design thinking is an oppor- tunity to reboot and think differently about the future, as opposed to returning to old ways of thinking and old process models.” Uncovering the real problems to find the best outcomes The University of Pennsylvania’s School of 2020-2021 Education and Career Guide Ryan J. Shaw Daniel Pesut “Teaching design thinking is an opportunity to reboot and think differently about the future, as opposed to returning to old ways of thinking and old process models.” – Daniel PesutMyAmericanNurse.com June 2020 American Nurse Journal • 2020-2021 E DUCATION AND C AREER G UIDE 7 Nursing in Philadelphia also has incorporated design thinking into its Innovation in Health course, which is open to all university under- graduate and graduate students. “We need more rapid solutions to prob- lems, especially now with the COVID-19 pandemic,” says Marion Leary, MSN, MPH, RN, director of innovation at the University of Pennsylvania’s School of Nursing. “Design thinking allows nurses to rapidly create and test solutions to problems in months instead of years.” Leary also is a founding member of the Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders. Students begin by learning about the foun - dation of empathy, which refers to seeking out the true cause of a problem, rather than relying on preconceived ideas. For example, in one project, students performed interviews and observations in Philadelphia public schools with a goal of improving food insecu- rity. What they discovered after working through the design thinking activities was that the problem wasn’t what they thought it was. The real issue was asthma attacks in the classroom— and a shortage of school nurses trained to respond. Nursing students tackled the problem by creating a mock inhaler and a scan code. The code links online to each child’s individ- ualized asthma action plan, so teachers can quickly look up how to treat the child. “We can’t tell people what they think they need. Design thinking begins with allowing patients to tell and show us what they know they need,” Leary says. Primary care competency To address the healthcare needs of the fu- ture, WHO is recommending that nurses are educated and trained in the scientific, tech- nological, and sociological skills needed to drive progress in primary healthcare and that they work to their full potential. “Due to the shortage of physicians, physi- cian assistants, and nurse practitioners, pri- mary care is moving toward team care, and RNs are a vital part of the team,” says Mary A. Dolansky , PhD, RN, FAAN, Sarah C. Hirsh Professor at the Frances Payne Bolton School of Nursing, Case Western Reserve University in Cleveland, OH. Nurses’ role in primary care is partnering with patients to foster optimal patient self- management. This includes monitoring health, managing medications, teaching and coaching health improvement strategies, sup- porting success, and providing motivation for healthy activities, such as exercise and healthy eating. To achieve this, primary care RNs must be able to work to the top of their licenses—which they haven’t be able to in the past, according to Dolansky. Times are changing, and educational partnerships and better training are support- ing nurses to practice at the highest level possible. Frances Payne Bolton School of Nursing has teamed up with Louis Stokes Cleveland VA Medical Center in a feder- ally funded program to strengthen primary care training for nurses while en- hancing veteran healthcare. Program competencies in- clude care coordination, population health manage- ment, behavioral health integration, and chronic disease management. Other skills include rela- tionship building, team- work and collaboration, and leadership. “Nurses need to know how to step up and influence others and be the role model for the professional delivery of care,” Dolan- sky says. “This requires a transformation of curricula from a narrow focus on acute, in- patient care to a wider education and train- ing in primary care and health manage- ment.” The faculty is developing an observa- tional assessment of primary care compe- tence. The goal is to establish that baccalau- reate nurses are competent in primary care nursing as new grads. “It’s an exciting moment for nursing,” Dolansky says. “Primary care is a specialty in which we can shine and show the world the full extent of what a nurse does.” Catherine Spader is an author and healthcare writer based in Lit- tleton, Colorado. 2020-2021 Education and Career Guide Mary A. DolanskyMarion Leary “Nurses need to know how to step up and influence others and be the role model for the professional delivery of care.” – Mary DolanskyNext >