Monday, January 07, 2019

So You Want to be a Nurse?

Deciding to become a nurse and enter the worlds of nursing, medicine, and healthcare is a courageous act. If you want to be a nurse, doing your due diligence and truly understanding what healthcare and nursing are all about is definitely a smart preliminary strategy. Once you learn more, this momentous career decision may set you on the road to becoming a highly valued nursing professional.

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The Allure of Nursing

Nursing holds a certain allure in our society -- after all, nurses are ranked as the most trusted professionals in the United States year after year in the Gallup poll. This well-deserved esteem that the general public has of nurses is confirmation of the profession's importance in the scheme of things.

Why does (or did) nursing draw you in? What is it about the notion of being a nurse capture your imagination?

When I speak with nurses or those who want to become nurses, I often hear some aspect of the following:

"I want to help people."
"I saw a nurse care for my family member and I was totally inspired to do that too."
"I want to contribute to society."
"My mother/sister/aunt was a nurse, and I want to follow in their footsteps."
"I need a career and it seems like there's always a need for nurses."

If I hear someone say that they want to help people, I try to guide them to dig a little deeper into their motivations -- you can help people doing so many different types of work, and I want to make sure that the individual is being realistic about the rigors and challenges of nursing.

Yes, the allure of nursing is there, but we need to ascertain our true reasons for pursuing the profession and whether or not it's actually a good fit and if there's potential for personal fulfillment and career satisfaction. Of course, you can never know for sure until you're in the thick of it, but I strongly advice thinking deeply about why you want to be a nurse and what the reality of nursing truly is.

the burned out nurse

The (Harsh) Reality of Nursing

Most nurses would probably agree that the reality of nursing is sometimes different from the perceptions of non-nurses. Yes, we help people for sure, but the path to helping our patients can be a challenge.

Staffing: Some of the realities of 21st-century nursing have to do with understaffing, high nurse-patient ratios, mandatory overtime, and not being able to provide the care we really want to provide. This is a common refrain from nurses, especially in hospital settings.

Bullying and aberrant behavior: Bullying (also known as lateral violence) and aberrant behavior are scourges on the nursing profession. There are plenty of theories about why bullying is so rampant in the profession: it could  be internalized patriarchal oppression, chronic nurse low self-esteem, or any number of other factors. No matter, it's a reality and some nurses will need to deal with this head on. Luckily, there are resources like Dr. Renee Thompson, the foremost expert on nurse bullying. It's sad, but if you want to become a nurse, you're likely to experience or witness bullying in the course of your career, and you'll have to decide what to do about it.

Burnout and compassion fatigue: Due to the above-mentioned staffing issues, high ratios, bullying, and other vicissitudes, burnout and compassion fatigue are all too common in nurses. This can lead to poor self-care and compromised mental, physical, or spiritual health.

Maintaining boundaries: When we get close to patients and their families, maintaining our professional demeanor and boundaries can be hard. I've made some errors in judgment a few times in this regard in terms of leaning in and offering too much, but I have no regrets.

Despite these challenges, many nurses are happy in their work and careers -- you just have to want it badly enough to wade your way through any problems and challenges that stand in your way. I know a great number of nurses who'd readily say it's totally worth it.

The Choice of Nursing

This is a chicken-and-the-egg question. Nursing can certainly tap you on the shoulder and choose you when you're totally unaware. You can also consciously choose and pursue nursing with a clear idea of what you want out of your future career before you even begin the process.

Fulfilling a family legacy of nursing could be construed as nursing choosing you, but making the choice to become a nurse is yours and yours alone. I had three aunts on my dad's side who were nurses (one of which worked with General George S. Patton during World War II), so their nursing blood was metaphorically coursing through my veins -- and still is.

For those who simply choose nursing due to projected job growth and the eternal need for new nurses, some disappointment may loom on the horizon. From my perspective as a career coach, I perceive that, in some job markets (especially high-profile, high-growth cities like San Fransisco, Seattle, Austin, and New York) the competition is stiff indeed. Cost of living can and should likely impact your career-related choices, especially if you're under the impression that you'll be able to waltz into any job you want after graduating and earning your RN license.

Some say that nursing is a calling or avocation, and it is, but it's also an occupation and a job. However, if it's "just a job" for you, contentment and satisfaction may be somewhat elusive.

The Joys of Nursing

Many nurses would agree that the challenges of the profession are far outweighed by the joys of nursing. Hands-on care can be very satisfying, especially if you're a person who loves to work directly with people. Then again, there are plenty forms of nursing that don't involve patient care, including consulting, teaching, and research.

As the years go by, an increasing number of nurses like myself are choosing entrepreneurship, either early in their careers or later on as their careers mature. I know nurses who are writers/bloggers, artists, filmmakers, podcasters, consultants, inventors, and business owners of various kinds -- we even have Members of Congress who are nurses.

I have no regrets when it comes to my career. I've worked with some amazing people (and some less than stellar individuals), and a great many of my patients have been inspiring and lovely, some of whom end up feeling like family. I mentioned maintaining boundaries above, and my last word on the subject is that truly transformational nursing care is based in love and compassion, and when you open your heart to your patients and their families, deep connections can be made and navigating those feelings is one of the nurse's many things to think about.

One of the major joys of nursing for me is the fact that the profession offers so much variety. If you're a person who gets bored easily, changing specialties and trying novel things can be inspiring, fun, and intellectually stimulating. Nurses can work in critical care, med-surg, telemetry, labor and delivery, and other clinical specialties, but they can also work behind the scenes in IT/informatics and a plethora of other non-clinical areas of focus.

In my opinion, nurses also need to be polymaths. Some nurses are generalists with fairly good knowledge of many things, and some are quite narrow in their knowledge through intensive specialization. I personally love the notion of the polymath nurse, a person who knows a fair amount about many things and who moves through the world with intellectual curiosity. This is a true joy of nursing for me.

Satisfaction is also a very positive by-product of being a nurse. Nursing is just great work to do in the world, and nurses can feel good about their contribution to society and the individuals and families they touch in the course of their work.

I can't sugarcoat it: nursing is not necessarily an easy career path, and some nurses find they're miserable and burned out. On the flip side, many nurses love their work and their career choice, and they're fully committed to nursing being central to their life's mission and vision.

For whatever reasons you choose nursing, know that any profession or career will have its challenges, of course. The operative question here is whether you feel that the importance and allure of becoming a nurse outweigh the negative aspects of this career path.

Do your due diligence, talk to those in the know, shadow a nurse at work, and gather as much information as you can before making this key life decision. Nursing certainly isn't for everyone, but it's definitely a hand-in-glove fit for some of us who try it on for size. Follow both your right-brain and heart we well as your left brain and intellect -- hopefully you'll find a satisfactory and inspiring solution.


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 the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

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,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AUSMed, American Sentinel University, Black Doctor, Diabetes Lifestyle, 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, 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 remarkably intelligent cat, George.

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