Long before politicians debated passage of the Affordable Care Act, major healthcare changes were occurring. And just as the shifting of the earth’s tectonic plates reshapes continents, these changes are completely reshaping healthcare delivery in the United States. That shift translates to an evolving and expanded role for nurses beyond anything we’ve ever experienced. But it also requires a new mindset for nurses.

Hospitals once were the foundation of our healthcare delivery system. But care has been moving out of the acute-care arena and into other settings, including the home, community, and alternate inpatient settings. This shift stems from a decades-long movement to challenge the status quo and find a better-quality, more cost-effective approach to meeting the changing demographics and healthcare needs of the U.S. population. Some acute-care hospitals will close, while others will convert a portion of their in­pa­tient space to primary and ambulatory care services.

If you continue to view nursing through the lens of the old hospital-based model, you might have cause to panic. But if you open your eyes and your mind to a new delivery model with expanded opportunities for nurses and better outcomes for patients, you’ll have cause to celebrate. What has worked for nurses in the past to maintain our career status won’t work going forward. Credentials and clinical skills alone won’t support us individually or as a profession. We need to look in new directions for employment, shift from a task-oriented mentality to a care-coordination perspective, and learn and use new skills to find, get, and keep our jobs.

What do you need to do to upgrade your nursing career? Here are 10 tips.

1. Broaden your career horizons

A few years ago, I had a conversation with a nurse about hospitals closing and care shifting. Incredulous, she asked where the care would be shifting to. I told her much of it would move to the ambulatory setting. Looking at me as if I had two heads, she said, “Ambulatory care??” as if I were suggesting she move to another country and take up basket weaving. The thought of working anywhere other than a hospital was foreign to her.

And yet many former hospital nurses already have made successful transitions to case management, population-care coordination, wellness coaching, and disease management, to name just a few areas. They report that not only is the work interesting, challenging, and rewarding but also allows them to use their nursing knowledge and skills in expanded ways.

2. Shift your focus

One of the biggest changes in the new healthcare paradigm is the shift from a sickness model to a wellness model. This gives nurses countless opportunities to make a positive impact, such as through wellness education and coaching, stress-management therapy, care management, and advocacy for patients, consumers, and healthcare providers.

3. Tune in

If you understand the underlying causes of the current healthcare movement, including the research and science behind it, you’ll transition more smoothly to the new model and be able to plan your future better. To help get a handle on what may be ahead, follow nursing and healthcare researchers, futurists, and thought leaders. You can’t fully integrate your nursing practice into a larger healthcare system if you don’t have all the facts. Read relevant articles and books, attend lectures and seminars, and engage in dialogue with colleagues and coworkers. From time to time, go through such journals as Nursing Economics, Modern Healthcare, and Becker’s Hospital Review and visit their websites.

4. Adopt an advanced-beginner mindset

Experienced nurses may want or need to shift to a different work setting or role at some point in the future. For example, a staff nurse may shift to case management or care coordination, either in her or his current place of employment or with a different type of employer. If such a shift is in your future, realize you won’t be starting over again; you’ll be building on the base you’ve already established in nursing and simply expanding your practice. You may have plenty to learn in that new role, but nurses are adaptable, flexible, and versatile. It takes about 3 to 6 months to master a new role. So set realistic goals for yourself and be patient with yourself and the process.

5. Boost your emotional intelligence

In his groundbreaking 1995 book, Emotional Intelligence: Why It Can Matter More Than IQ, Daniel Goleman defined a set of personal attributes he believes may be more important than intelligence in determining one’s ability to be successful and happy in life, work, and career. These characteristics include good self-awareness (knowing one’s strengths and weaknesses), being attuned to others’ feelings (not just patients in our case but also coworkers), being in touch with one’s own emotions, and feeling confident and optimistic.

More than ever, today’s employers are as interested in job candidates’ and employees’ emotional intelli­gence as they are in their credentials. Ways to improve your emotional intelligence may include pursuing higher education, taking on projects that showcase and develop your strengths, honing your communication and social skills, and building support systems. Coaching and mentoring also are invaluable tools.

6. Get connected

Historically, nurses have stayed isolated—and this has worked to our detriment. We can no longer operate in a vacuum. Our success, both individually and as a group, depends on creating solid connections and communities with fellow nurses, other healthcare professionals, and the population at large. This is particularly important during times of major change.

So join and get active in nursing and healthcare professional associations. This is one of the best ways to stay on the cutting edge of knowledge, information, and trends. It’s also a great way to share best practices, find role models and mentors, build support systems, and develop leadership, communication, and other skills (all of which can help boost your emotional intelligence). Your involvement in professional associations also shows you’re an informed and involved member of your profession or specialty.

An important networking tool is the business card, which enables you to exchange contact information. Have business cards printed so you can exchange professional contact information, make connections, and build relationships.

7. Beef up your credentials.

Don’t waste time and energy debating whether or not you need more education. Just go after it, if you haven’t already. The healthcare environment is more complex than ever, and the job market is more competitive. All nurses need to have a broader knowledge and skillset, beyond the clinical, to succeed and work at their highest potential.

Certification also is important in many clinical settings and beyond to raise the standard of practice. Nurses with advanced education and clinical certifications will be top contenders for any position. In a survey of nurse managers, 86% said they’d hire a certified nurse over a noncertified nurse if everything else were equal. Certified nurses report they feel more empowered, fulfilled, and confident—and make more money.

8. Explore your options

Don’t wait until you’re forced to make a career move to start gathering information. Start talking to nurses working in other specialties and roles, such as transplant coordinators, care managers, clinical nurse leaders, advanced practice nurses, and telephone triage nurses. Schedule an information-gathering “interview” with them, where you meet in person or over the phone to learn how they got started in their current role, what the trends are in their specialty, and what the rewards, challenges, and opportunities are. You can also do Internet research and attend seminars on nontraditional career options.

Be sure to consider business ownership as well as employment situations. Nurse entrepreneurs are growing in number every day, as the need for more personalized, patient-centric care and services increases. The National Nurses in Business Association, Inc. offers many helpful resources at www.nnba.net.

9. Update your image

Your professional image should match the professional person you are. Image includes your appearance, communication style, online presence (or lack of it), and résumé. If your image is outdated, others will assume your knowledge and skills are outdated as well. If you don’t have a LinkedIn profile, prospective employers searching for one might view you as out of touch with current technology. If your résumé doesn’t focus on accomplishments, your experience level may not be evident. If you sign emails only with your first name, you’re minimizing your value and impact; instead, provide your full name with title, credentials, and contact information. All of these aspects are part of your professional package and can contribute to—or detract from—your credibility and marketability.

10. One more thing

While hospitals traditionally have been the starting point for most new nurses, that model is shifting. Today, it’s more common for new nursing graduates to start in residency programs and new-graduate orientation programs in home care, public health, and various ambulatory settings (such as hemodialysis, infusion centers, and cancer care centers). So if you’re still telling students and new nurses they must get hospital experience before moving on to something else, you need to know that that advice is now outdated and impractical. There are too few hospital positions for new nurses across the country today. New nurses should be directed to areas with the largest growth potential for current and future employment.

Just as your computer needs periodic updates of software and hardware to operate at peak performance, you need to reboot and refresh your nursing career to the latest “version.”

Donna Cardillo is a keynote speaker, an author, and a columnist who helps nurses achieve career success. She has written Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional, The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career, and A Daybook for Beginning Nurses. She is also an expert blogger at
www.DoctorOz.com. Her website is donnacardillo.com.