Monday, December 11, 2017

In Your Career, Effort is Rewarded by Outcome

In a 21st-century nursing job market where competition is tough, effort is rewarded by outcome. For those nurses and healthcare professionals who sit on their laurels and don't do the work, career growth can be stunted. But for those willing to put in the sweat equity, the potential return on investment is high.

effort = outcome

Doing the Work

Career development isn't rocket science, but it's also not a walk in the park. Your career can just happen to you if you're not paying attention, but if you dig deep and do your due diligence, you can create the nursing career you really want.

The work of nursing career-building and career management is multifaceted. Here are some areas I see as crucial in the big picture of your nursing career:
  • Education
  • Networking
  • Clinical skill-building
  • Personal wellness and inspiration
  • Building other miscellaneous skills

Education can and should be an ongoing project of your nursing career. Education can be formal, of course, and many nurses make the choice to return to school and continue to advance their academic standing.

If you have an Associates Degree in Nursing, I recommend pursuing your BSN. I say this because many hospitals are now choosing to only hire nurses with a bachelors, and this general practice is growing. ADNs can still find work, but I believe that the job market for ADNs will continue to narrow and compartmentalize in the years to come. With so many in the healthcare sphere now recognizing the BSN as the preferred entry-level degree for the profession, it's now a no-brainer for most nurses to get their BSN.

With nurse practitioners now the fastest growing profession in the United States, countless people are hopping on the NP and APRN bandwagon and going back to school. According to the Bureau of Labor Statistics, nurse practitioners will see 31% job growth nationwide through 2024, with registered nurses hovering around 16-17%. Meanwhile, all professions as a whole will only see about 7% job growth in the same period. Do the math -- if you're interested in either working as an NP in a facility or hanging your own shingle as an entrepreneurial nurse practitioner, the opportunities will continue to expand, especially if an increasing number of states continue to grant full practice autonomy to NPs.

I have quite a few nurse colleagues who have pursued an MSN in education, a master's in informatics or healthcare administration, as well as a PhD or DNP. Further education isn't the key for everyone's career, but for many of us, it's what we need to move forward and upward.

Aside from formal education, let's not forget continuing education and certifications. We can learn in the context of seminars, webinars, and online and in-person CEU courses. We can also gain a great deal of education from podcasts, blogs, books, articles, and journals. Education doesn't need to be formal to be effective at moving the needle of your career. And certifications can really boost your marketability in your chosen area of nursing focus.


Those of you who have read my first book (or tuned in to this blog or my podcasts) know that I'm a big believer and evangelist for professional networking.

Building a strong network of like-minded professionals could not be more important at any stage of your nursing career. Whether you need a recommendation, a referral, advice, or a reference letter, your network is where you can turn for all of this and more.

Social media is one place to lean in for networking (LinkedIn, etc), but face-to-face networking skills are also important. Learn how to network and put effort into growing your list of connections throughout your career.

Clinical Skill-Building

Aside from amassing book knowledge, clinical skills are important for a large swath of nurses working in the field. Granted, we don't all have clinically oriented jobs, but those who do need to keep up their skills and continue to advance their expertise.

Hands-on clinical skill-building can happen on the job, of course. Many nurses gain skills just by watching skilled colleagues or engaging with a clinical nurse educator in their workplace.

Some nurses choose to pursue certifications or trainings in order to become more effective nurse clinicians. A nurse midwife might seek training in performing colposcopies. A nurse in the cardiac field might study ECG interpretation until he's an absolute expert.

Building clinical skills increases expertise and knowledge, and also increases marketability. And for career growth, marketability is important for the long haul in a shifting healthcare landscape.

Personal Wellness and Inspiration

It might seem odd to include personal wellness and inspiration as a means of achieving nursing career success, but it's one of the most important aspects. A highly skilled nurse clinician with advanced degrees and oodles of certifications can still be an essentially unhappy and unhealthy person.

I've known plenty of nurses with plenty of experience and knowledge under their belt but they were still miserable, both personally and professionally. This is sad but true, and one reason I've discovered for this negative outcome is that certain nurses choose to not work on themselves on a personal level.

Emotional, psychological, and spiritual growth are as important for nurses as anyone else, sometimes even moreso. When we lack self-awareness, personal insight, and the power to perceive our lives through different lenses, we lose out on our ability to be truly happy. A clinically astute nurse with unresolved issues of addiction, depression, loneliness, or low self-esteem can still end up having a wretched career or a less than palatable end to their career (Nurse Jackie being a fictional example of such).

If you're a nurse who's dedicated to helping others when they're at their most vulnerable, you not only need clinical skills, but you also need to be able to process your own feelings that surface in the course of your work. Developing emotional and relational intelligence are skills that bring a vast array of personal and professional benefits over time.

Physical wellness and the effort you spend on your own body's well-being will also be rewarded by outcome. Feeling fit, getting strong, maintaining heart health, and having improved balance will serve your career in terms of your stamina and strength, as well as the number of healthy working years you'll have for earning a living and supporting your family and realizing your dreams.

Nurses need to feel inspired, motivated, and fulfilled by their work, otherwise nursing becomes just a job and not an inspired calling. And if nurses are emotionally, spiritually, and physically healthy, all the better.

Building Other Miscellaneous Skills

Plenty of other skills can benefit a nurse and a nursing career. Since nurses are so involved in patient education and coaching, communication skills are crucial for positive nurse-patient connection. Communication can also improve professional relationships, leadership abilities, and relationships with paraprofessionals, direct reports, and non-healthcare colleagues.

Writing and speaking skills can serve nurses in myriad ways. Writing can be leveraged as a potential source of extra income. Writing skills can also help a nurse get published in academic and professional journals, gain notoriety, and increase career possibilities.

Public speaking skills can also be utilized as a source of income as a keynote speaker or presenter. Beyond that, when we become more skillful at presenting a logical argument or imparting useful information to colleagues or patients, everyone benefits. Whether you want to do a TED Talk or simply present a poster at a conference or grand rounds, attending ToastMasters or otherwise learning public speaking skills will stand you in good stead throughout your career.

Skills in the savvy use of social media can benefit your career in more than we can count. From networking with like-minded colleagues and meeting new people to learning about the latest innovations in nursing and healthcare, social media is a portal to learning, connection, and a little fun along the way.

Effort and Outcome

Whether you put effort into weightlifting, running, writing, public speaking, formal education, or emotional wellness, your efforts will be rewarded by positive outcomes.

Strong back and leg muscles mean less risk of work-related injury. Improved public speaking skills translate to a more successful poster presentation at a nursing conference. And an advanced degree or certification can result in a promotion, a new job, or an entirely new career avenue to explore.

Whatever you do, effort is rewarded by outcome. So apply elbow grease, put in the work, shed some tears if you need to, and reap the rewards that result from doing what you need to do to move forward in an inspired way.


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. Keith has written for,, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog,, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality and social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and intelligent cat, George.

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