Nurses branch out beyond clinical settings

(Florida Today) The study “Nurses Working Outside of Nursing: Societal Trend or Workplace Crisis?” undertaken after a survey of registered nurses published in 2009 by Lisa Black, assistant professor at the Orvis School of Nursing at the University of Nevada, sounded troubling.

More than 4 percent of 35,635 RNs from all 50 states and the District of Columbia did not work in the profession and more than 12 percent did not work at all. Nearly 45 percent of nurses who did not work were retired and more than 38 percent did not work because they had family obligations. More than 27 percent of those questioned said they had left the profession because they were burned out or endured stressful work environments; more than 23 percent cited the sheer physical demands of nursing. More than 120,000 nurses now work outside the profession.

This comes in the midst of a nursing shortage that, according to the American Association of Colleges of Nursing, “is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care.”

Does nursing have a problem? Probably not so much as it has solutions, local nurses reply.

The nursing profession, they say, offers far more diversity than bedpans and blood pressure checks and they believe the expansion of the field into areas hitherto not considered now allows them to remain in it while making changes better suited to their lives. They have become product developers, consultants, auditors, trainers, teachers, risk managers, authors, forensics specialists, publishers and a host of other things.

Now nurses are entrepreneurs as well as health care professionals: independent contractors with interesting jobs, flexible schedules and often, greater financial reward.

Business side of nursing

Among those who has encouraged nurses to explore their horizons is emergency room nurse, author and publisher Patricia Bemis, who has been licensed since 1972 and, since 1999, has been president of the National Nurses in Business Association, which, in Bemis’s words, “teaches the business side” of nurse-entrepreneurship

“In the past, nurses were trained to work in hospital settings, but unfortunately, the marketing did not exist to show nursing as a creative career,” the Rockledge resident said. “They didn’t show (nurses as) people who could create care plans (as well as deliver them).”

Bemis, who is an online instructor and manager of allied health programs at the University of Florida, cites her own case: Having worked in emergency rooms since 1959, she “thought there was a better way to develop nurse training” in the E.R. setting and so she did it. Having taught thousands of nurses, she is the author and publisher of the “Emergency Nursing Bible,” now in its fifth publication, as well as other books.

“During my search for information on how to publish, print, distribute and sell the book, someone referred me to the National Nurses in Business Association, a professional association that provides continuing education and support for nurses in business. The president, Laura Vonfrolio, provided me with the information I needed to self-publish the book.”

Judy Young of Melbourne has an entirely different background and now, profession. A retired lieutenant colonel in the Air Force, she did not plan to work full time but did wish to remain in the field after retiring in 2004 as chief nurse at Patrick Air Force Base.

She became a legal nurse consultant, the definition of which is “a licensed, registered nurse who performs a critical analysis of clinical and administrative nursing practice, healthcare facts and issues and their outcomes for the legal profession, health care professions, consumers of health care and legal services and others as appropriate,” according to the American Association of Legal Nurse Consultants.

It also is a job that probably will allow her to remain in nursing longer than she might have in the strict clinical setting.

“Formerly, many nurses who were older simply retired because the physical demands are so great. It can be a physically and emotionally exhausting job, and after you spend so many years in it, you’re ready for a change. I had been a nurse since 1976 and I realized that nursing on a daily basis would be tough.”

Young, who returned to college at Nova Southeastern University Shepard Broad Law Center for a master’s of health law degree, said being a nurse-entrepreneur has allowed her to travel — she and her husband are avid boaters — and set her own schedule.

Pat Lewis, a registered nurse for 30 years, “decided to make the break from (full-time clinical nursing) in 2006,” is a licensed health care risk manager at Brevard Specialty Surgical Center and owner of Patricia A. Lewis, RN, Legal Nurse Consultant.

She also sees nursing-entrepreneurship as a way to keep going.

“After so many years, you do get burned out, and this way, we can keep our senior nurses, whose experience we need so badly, in the profession,” the Melbourne resident said. “It is better than seeing someone of a certain age having to completely reinvent herself or himself. This way, we do not lose all that experience.”

Experience critical to succeed

Experience does count, the nurse-entrepreneurs agree. All three continue their involvement in clinical nursing, Young and Lewis in part-time positions at local hospitals and Bemis as a certifier of E.R. nurses.

None denigrate or discount the importance of traditional, clinical nursing experience, which they say is critical to success as a nurse-entrepreneur.

“Younger nurses do need to do their training in the clinical setting,” Lewis said. “I wouldn’t recommend anyone going into these fields unless you do your clinical time. It gives you so much understanding as well as experience.”

Furthermore, nurses who look to entrepreneurship must realize that it comes with all the aspects of being an independent contractor/ business owner, like lots of bookkeeping and no benefits packages.

“Another of the drawbacks is that the work is not always consistent in some fields,” Lewis added. “It can be that way with legal consulting, for example, although risk management is a continuous thing.”

That nurses have expanded their profession and have chosen to stay in it, is of great satisfaction to the country’s top advocate for nurse-entrepreneurs.

“You know, there used to be a book called ‘101 Careers in Nursing.’ The latest edition of the book is ‘201 Careers in Nursing,’ ” she said. “That’s wonderful.”