Innovations in technology, an aging population, a retiring nurse workforce, and healthcare reform are among the myriad forces driving the demand for new nurses while increasing the demands on practicing nurses.
Still, the rewards of nursing-a chance to make a difference in a person's life- remain unchanged, nurses say.
Julie Sugrue Sullivan, RN, a nurse at Newton-Wellesley Hospital recalls one of her most rewarding experiences as a nurse. She provided comfort to a patient who was critically ill and nearing the end of life. Although she did what she would do for any patient in that situation, a member of the patient's family went out of his way to thank her. "We shared a hug and a few tears together," Sullivan recalls. The experience reminded her of the profound impact nurses have on the lives of patients and their families.
"Nurses see people at their most emotional and vulnerable," observes Angela Cabral, RN, a nurse in the inpatient medical unit at Beth Israel Deaconess Medical Center, who cares for patients with a variety of complex chronic and acute health issues. Cabral is also a resource nurse, and among her duties is to approve patient admissions to the hospital. "For my patients, coming to the hospital is unexpected. Oftentimes, emotions run high as people try to navigate their way through a new and scary landscape," she says. "As a nurse, I need to be the calm in the storm."
In practical terms, that means arming patients and their families with knowledge about how the hospital runs, what their plan of care is, and encouraging their participation in their care so they feel less helpless.
This emotional core of nursing is embroidered by a swirl of changes requiring nurses to continually adapt and sharpen their skills while staying on top of the latest technology and standards of care.
Thus, in addition to displaying profound empathy, nurses must demonstrate exceptional critical thinking skills, decision-making abilities, teamwork and team building skills, creativity, communication, educational preparation, and mastery of technical skills and procedures. "There is no way to become stagnant in this job," remarks Cabral. "Every day I come to work I learn something new," whether it's the results of a new research study or a practical tip from a patient living with a chronic illness.
People who possess these skills and want to apply them to nursing will find an abundance of job opportunities in the coming decade. Employment of registered nurses is expected to grow by 22 percent from 2008 to 2018, much faster than average for all occupations, according to the U.S. Bureau of Labor Statistics. More than 580,000 new jobs will result, among the largest number of new jobs for any occupation. Many of these new jobs will be in physicians' offices, home health care services, and nursing care facilities.
In Massachusetts, estimates project a need for an additional 25,000 nurses by 2020, according to the Center to Champion Nursing in America. In part, this demand is being fueled by healthcare reform, which has allowed some 440,000 more people to receive the healthcare they need.
Another trend contributing to an anticipated nursing shortage is the exodus of retiring nurses coupled with the growing healthcare needs of an aging population. Meanwhile, technological advances in patient care have permitted a greater number of health conditions to be treated.
Nilsa Olson, RN, BSN, a staff nurse in Emerson Hospital's Endoscopy Unit, has seen these technological advances firsthand, she says. Thanks to changes in insurance guidelines and "vast improvements in screening equipment," she says, far more people with colorectal cancer and esophageal/gastric cancers are surviving with earlier detection and treatment.
Peggy Burke, RN, a permanent charge nurse at Newton-Wellesley Hospital, has also witnessed numerous changes in her 28 years as a nurse. One important development is the evolution of healthcare to be more of a team effort. She often collaborates with other nurses, physicians, lab technicians, physician assistants, and ancillary staff such as pharmacists, registered dieticians, social workers, occupational and physical therapists, registered dieticians, and respiratory therapists, in a patient's care.
This trend toward multidisciplinary care is an aspect of nursing Burke says she finds particularly rewarding, in part because of the relationships it fosters.
Nursing offers an unbeatable variety of opportunities, says Burke. Jobs can be found not just in hospitals and home healthcare but also in school nursing, occupational health, teaching, administration, legal consulting, and forensic nursing.
Adds Cabral: "The best part about this, personally, is that as I grow older and my life interests change, there will always be new opportunities for me to work as a nurse. I see a lot of people change from other careers to become nurses for this very reason."