Monday, December 19, 2022

The Conscious Creation of Your Nursing Career

As the year comes to an end, it's always a good time to pause, reflect, and take stock of the current state of your nursing career. As I've often said in my writing, podcasts, and keynote addresses, you can always choose to allow your career to happen to you, or you can instead take inspired action and make it happen. Which sounds better to you? 

Conscious Career Creation

Consciously making your nursing career happen involves several key factors: 

  • The will/desire to create a career that's unique to you
  • The discipline to consistently focus on your career's evolution
  • The inspiration to think creatively 
  • The independence of thought to do what's best for you, not what others say you should

When you decide to create a career on your own terms, anything is possible. Many will tell you what you should do, but if you can hold true to what holds meaning for you, your career will be much more satisfying than if you simply do what others say is prudent. 

As author, professor, and activist Derrick Bell states in his wonderful book, Ethical Ambition: Living a Life of Meaning and Worth, "Trying to simultaneously balance my dreams and needs is tough, and requires an ongoing assessment of who I am, what I believe, value, and desire."

Plenty of nurses follow a tried and true career strategy of working one or two years in med-surg and then specializing in an area suitable to their temperament and clinical interests. This works for many nurses, and if your career takes you down such a path, there's much to gain. The ICU, ED, trauma, and other specialties provide opportunity for serious focus on pathophysiology and a plethora of nursing skills, and we need nurses in these areas of practice who are thrilled to be there. 

And then there are those for whom the road less traveled has a stronger calling. I myself completely eschewed the med-surg/acute care route, despite the warnings of my peers and professors that it was career suicide to not do at least a year of med-surg. Nonetheless, I dove directly into heartfelt work in a federally qualified health center (FQHC) serving marginalized communities, and I never looked back. 

Mr. Bell also wrote, "I truly believe that in making honorable choices about our lives, we can acknowledge sacrifices we make and the risks we take and recognize that what others view as losses and foolhardiness are the nourishment upon which our spirits thrive." 

No matter what your disposition as a nursing professional, conscious career creation is paramount. So, let's break it down. 

The Will/Desire to Create a Unique Career

Whether you're interested in trauma, nursing research, the pharmaceutical industry, NICU, hospice, or entrepreneurship, having the will or desire to create and curate your own career is central to the process. Without will, without desire, you have nothing but simply going where the tides take you. But when you get in touch with what you want deep down inside, that's where the magic happens. 

Some questions to explore include: 

  • What is it that makes me truly happy? 
  • What kind of people do I like to work with? 
  • Is doing hands-on care something that matters to me?
  • What aspects of work feed my emotional and spiritual lives? 
  • Are there certain types of activities, tasks, or challenges that appeal most to my intellect? 
  • What voices and messages in my head (e.g.: from my past, my family, etc) are strongest when it comes to choosing a life path and a career? 
  • What scares me about my work and career? 
  • What excites me? 
  • When I'm on my deathbed, what kinds of accomplishments would I want to look back on? 

The Discipline to Consistently Focus on Your Career

Discipline plays a big role in crafting a career that matters. The undisciplined nurse goes along with the crowd and does what they're told they should do. With lack of discipline on display, the nurse does as little as possible other than show up at work and do their job. 

There are also those who must remain in a job that's less than ideal due to their obligations to family and their dependents. Derrick Bell states: 

It is not, of course, a betrayal of ethical ambitions when circumstances require that you remain in a job or a relationship that is not evil, but not very rewarding. Duty to family, to children, to elderly parents, even to an employer may mandate remaining in a job with little future and even less satisfaction. In order to maintain their health coverage or for any number of reasons, likely millions of Americans — at every income level — find themselves trapped in unfulfilling jobs Even in this situation, you will be faced with choices that can have a profound effect on your spirit. If you perform your job as well as you can, treat your co-workers with the respect they deserve, and if the opportunity arises, stand up in some small way to a practice, policy, or environment that you see as demeaning or simply less than ideal, your job  — even though it may not be the one you always dreamed of — can give you a measure of satisfaction. 

If you take a disciplined approach to your career, you can choose to methodically examine various aspects of your career and then take inspired action in those arenas. The disciplined approach might include: 

  • Consistent building and nurturing of a professional network so that you have a growing "brain trust" of individuals to whom you can turn for advice, support, or mentoring as needed — and who can also turn to you
  • Ongoing career assessment with any eye towards initiating change when change is called for
  • Always having an updated resume on hand in order to be ready for any opportunity that might arise
  • Having a solid online presence in the professional world (e.g.: LinkedIn)
  • Keeping abreast of changes and developments in one's areas of interest
  • Being involved in professional organizations, committees, or other groups as a way of networking and developing various aspects of one's intellect and professional knowledge

The Inspiration to Think Creatively

Creative thinking is more crucial for career development than you might initially think. You might ask, "So where does creativity come in? Isn't that the realm of artists, musicians, dancers, and people in those types or careers?"

Actually, creative thinking is important no matter where you might find yourself, and a nursing career has plenty of space for creativity of thought. Creative thinking might look like: 

  • Talking to a career coach to explore possible next career steps
  • Exploring a hobby that engages a different aspect of your intelligence
  • Keeping your mind open to changes in the world around you
  • Reading the latest research in nursing, healthcare, medicine, psychology, sociology, and other disciplines for inspiration and fresh ideas 
  • Never saying "never"

Independence of Thought 

Ah, now we're at the good part: independence of thought. As noted above, we can very easily follow the crowd and do what everyone else is doing. Yes, it's safe, but is it interesting? 

The career suicide I was warned about? It never happened. And when there was only one other nursing podcast on the internet, did we let that stop us? No, we launched RNFM Radio, a groundbreaking nursing podcast, and were simply ahead of the curve. And when I became a Board Certified Nurse Coach, it was a very new thing for the nursing profession, and no one knew where it would go — now nurse coaching has been legitimized and normalized within the nursing world. And this blog? Well, it was one of the first nursing blogs in existence, and it's been going for over 17 years. 

Being a nurse who thinks for yourself is a potent statement of personal power. When you're willing to go against the flow, make unpopular decisions, reject the terribly detrimental "but-that's-the-way-we've- always-done-it" mentality (which, by the way, are the most dangerous words in healthcare), you're claiming your individual sovereignty and sense of personal agency. 

If you pause right now to take stock of your nursing career, assess if you're in touch with these four ket factors: 

  • The will/desire to create a career that's unique to you
  • The discipline to consistently focus on your career's evolution
  • The inspiration to think creatively 
  • The independence of thought to do what's best for you, not what others say you should

If any of these areas of your personal and/or professional career development are lacking or need shoring up, there's no time like the present to initiate inspired action on your own behalf. Your career is your own, your life is your own, and how you conduct yourself and evolve over time can be an exciting, invigorating, and inspiring.

Whether it's the end of the year, the beginning of the next, or any other time that suits you, doing this deep dive of self-inquiry just might take you to places that your nurse's soul is destined to go. 


Keith Carlson, RN, BSN, NC-BC, is a Board Certified Nurse Coach offering holistic career development for nurses and healthcare professionals. All things Nurse Keith can be found at

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. written for,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University,, 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. 

Living in beautiful Santa Fe, New Mexico, Keith shares a magical life with his partner, Shada McKenzie, a gifted, empathic, and highly skilled traditional astrologer and reader of the tarot.

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