March 28, 2021
Given the change of course that has happened in the world, we wanted to provide expert opinions on what aspiring graduates can do to start off their careers in an uncertain economic climate. We wanted to know what skills will be more important, where the economy is doing relatively well, and if there will be any lasting effects on the job market.
Companies are looking for candidates that can handle the new responsibilities of the job market. Recent graduates actually have an advantage because they are comfortable using newer technologies and have been communicating virtually their whole lives. They can take what they've learned and apply it immediately.
We spoke to professors and experts from several universities and companies to get their opinions on where the job market for recent graduates is heading, as well as how young graduates entering the industry can be adequately prepared. Here are their thoughts.
Utah Valley University
Oakland University William Beaumont School of Medicine
Arizona State University
Southwestern Adventist University
Dixie State University
Spokane Community College
Lakeview College of Nursing
Francine Jensen: When the COVID-19 pandemic hit, nursing educators wondered if the challenges of being on the frontlines as nurses would drive people away from the profession. Luckily, this did not play out. Our admissions pools are as large as ever, and we are attracting people who are now more anxious to be nurses. The pandemic has raised awareness of the roles of nurses and the need for nurses in our country, and this has been good for the profession.
COVID has made us all, including nurses, re-think our priorities. We will see shifts of nurses applying for positions they always wanted; more staff who have been cross-trained to other areas who decide to stay; and other nurses who took this chance to retire. These will drive movement in the profession, which will free up opportunities for other nurses coming in.
We'll also see trends with nurses who are leaving bedside nursing and becoming nurse practitioners, a specialty which continues to grow.
Francine Jensen: At baseline, you'll need your RN licensure to enter the profession. One useful certification some universities are offering is a certificate in gerontology, which gives you focused training on that population-useful as the baby boomer generation continues to age. Over time, you can progress to receive your DNP or nurse anesthetist licensure where you'll take on advanced roles in nursing practice.
Francine Jensen: Salaries are often tied to the region where you work, so think carefully about where you decide to practice. Working night shifts and weekends will net you a dollar or two more an hour. One useful strategy to grow your wage is to regularly change your employment situation and negotiate your starting salary. Additionally, once you are in advanced roles in nursing, your salary will increase, so consider when the best time is to go back to school.
Oakland University William Beaumont School of Medicine
Department of Foundational Medical Studies
Abram Brummett Ph.D.: You may have heard of the "Fauci Effect," which has driven the interest in medical professions up. Applications to OUWB are up since the pandemic, and I suspect that interest in medical fields will go up across the board to include fields such as nursing, physician assistants, occupational therapists, social workers, and my discipline, clinical bioethics. The pandemic has exposed medical professionals as the heroes they always have been and that exposure has been inspiring to others.
Abram Brummett Ph.D.: Teaching soft skills is a really important part of what we do in the medical humanities and clinical bioethics. While we wrestle with difficult ethical dilemmas in contexts such as the end of life, birth, child-rearing, sexuality, and suffering, we also work hard to resist a reductionistic view of patients as a complex set of tubes, pumps, and chemicals that can result from years of medical education. We do this by encouraging a "holistic" approach to patient care that sees a patient situated within a whole matrix of social, psychological, religious, and economic factors that influence the doctor-patient relationship. Soft skills are a vital part of this approach, being able to talk with, earn the trust of, and motivate patients to follow a treatment regimen is just as important as an accurate diagnosis. Medicine remains, and will always be, a science and an art, and we are here to emphasize the art.
Abram Brummett Ph.D.: My field as a bioethicist is quite different from working as a physician and is all I can really speak on with regards to salary. I'm working on a study now with some colleagues tracking the current employment models and compensation rates of clinical ethicists around the U.S. A full time clinical ethicist can make anywhere from 70-120,000 depending on education and experience. We expect this salary will only go up as the field continues to standardize.
Erica Lee: I hope that the biggest trend for new nurses entering the profession will be extended orientation periods. Unfortunately, many student nurses have missed out on inpatient clinical exposure during the pandemic in an effort to limit numbers of individuals entering into facilities. This may affect how confident the new graduate RN's feel in the environment and extra attention to orientation could help.
Erica Lee: All graduates should keep civility front of mind. This doesn't only mean acting with kindness and assuming best intent, it also means calling out incivility when they encounter it which is a far more difficult skill to master. I recommend role modeling after individuals they trust and admire and eventually it will become second nature.
Erica Lee: Salaries have not increased dramatically in the past 10 years, but the way they are calculated is more innovative. In the greater Phoenix area, employers are offering an initial new graduate RN salary, then adjusting it to market rate after a year of service. Separate from that, there is also opportunity for a merit-based increase which not only incentivizes retention but promotes excellent performance.
School of Nursing
Julie Kruse Ph.D.: There are several areas in nursing that will most likely see an increase due to the COVID-19 pandemic.
1) Telehealth Nursing: Telehealth has been defined as the sharing of heath information by patients and providers either synchronously or asynchronously using a telephone, videophone, or biometric monitoring unit (Bowles et al, 2012; Radhakrishnan et al, 2016). The COVID-19 pandemic has stimulated growth in the area of telehealth and some researchers have estimated that over 30% of outpatient visits were conducted by telehealth in 2020.
The American Hospital Association reported that the number of hospitals either partially or fully implementing telehealth grew from 35% in 2010 to 76% in 2017. The compounded annual growth of telehealth is projected to grow over 28% from 2019 - 2025 according to an Arizton Market Report.
Even though the COVID-19 pandemic stimulated a spike in the growth of telehealth, this area of health care has been rapidly expanding over the past decade. Telehealth has been used with success in managing patients with heart disease, diabetes, COPD, and chronic wounds. Additionally, there will be a need for telehealth services to treat mental health conditions such as anxiety and depression as well as providing public health outreach to women, infants, and children.
2) Nursing in Outpatient and Community Settings: There will continue to be a shift from nursing care in hospital settings to community and outpatient settings.
3) Mental Health and Wellness: There will be a continued and increased need for mental health and wellness services. In a recent national study by Ettman et al. (2020), it was reported that the COVID-19 pandemic has resulted in a 3-fold increase in the number of people who reported depressive symptoms. This increase in depressive and anxiety symptoms from the pandemic is further supported by the Kaiser Family Foundation who report that 11% of adults reported anxiety and depressive symptoms from January-June of 2019 versus 41.1% in January of 2021. The demand for nurses in this field will continue to expand as the number of people who experience mental health and substance misuse conditions continues to outpace the number of nurses and clinicians who can provide care.
Julie Kruse Ph.D.: In terms of certifications, this really depends on the type of nursing that you are interested in specializing in. For telehealth nursing there is not a specific certification; however, many nurses who work in telehealth have certifications in Ambulatory Care Nursing (AAACN, 2021) which has the broad scope of knowledge necessary for this field. In terms of mental health nursing, obtaining licensure as a Psychiatric Nurse Practitioner will allow you to provide mental health care services to children, adults, families, groups, and communities. The American Psychiatric Nurses Association (2021) has a website that offers additional information about careers in this field of nursing.
Julie Kruse Ph.D.: In the last century, nursing has been a stable career choice in terms of job stability and with the continued and projected nursing shortage, it will be a viable option in the future. Nursing is also a career choice that offers a comfortable living wage.
The U.S. Bureau of Labor Statistics (2019) reports that the median salary for a nurse is $73,300 (range $52,080- $111,220) with a median hourly rate of $35.24 (range $25.04- $53.47). According to Nurse.com nursing salaries have had increased growth by 2.6% every year since 2014. The nursing shortage combined with a comfortable living wage makes nursing an excellent career choice.
American Academy of Ambulatory Nursing (2021). https://www.aaacn.org/certification/telehealth-certification
Dr. Terri Gibson: From what I read from nursing organizations and journal literature, big trends include the following:
-Wages seem to be increasing, even slightly for nurses providing direct care at the bedside. There continues to be a need for well-prepared nurses to work in acute care hospitals. With elevated rates of burnout among nurses, students need to be prepared to work under stressful conditions. For me as an educator, it means I have spent time encouraging and supporting the care they give themselves. We've worked on assessments and teaching-learning activities so they are aware that when they are healthy-physically, mentally, emotionally, and spiritually, they can provide safer, better quality patient care. We spend some time learning ways to optimize their well-being through attention to stress management, good nutrition, regular exercise, healthy relationships, and spiritual renewal.
-Another trend is to bring students into the working environment as techs to take care of patients in the hospital or under the auspices of an RN license to assist with Covid vaccine administration. From my experience, students want to participate in care delivery now, so they have some preparation for what their future holds once they have their license and start into their first position as a nurse.
Dr. Terri Gibson: We have learned that prospective employers really appreciate when students have worked at the bedside. This includes as a nurse technician. In particular, they appreciate students who have spent full shifts working along an RN in a care delivery setting. We call this the Nursing Capstone Clinical, which is usually offered a student's final semester of nursing school. Not only do employers know that students have been able to show up on time and meet the demands of a 12-hour shift and all the care that is implemented during those hours, students also highly value the experience. They feel that now they have a better sense of what to expect. They've also benefited from the wisdom of their preceptor, particularly when unusual incidents come up that would not have been addressed in nursing school. The RN preceptors we have worked with have been awesome role models in this regard.
Other skills would be personal presence and patient support/communication. I do mock interviews for my senior nursing students and I receive great feedback from both students and the leader volunteers from local healthcare organizations that conduct the interviews for me through this Leadership Class activity. The students appreciate that they have a better sense of what to expect in an interview. The interviewers seem to appreciate those students who can step up and engage fully in the interview, identifying their strengths, ability to communicate and show that they care and have a passion for patient care.
It seems many employers need something that catches their attention from the myriad number of applicants and limited jobs they have to offer a new grad. Volunteerism, leadership opportunities and participation in special nursing-related projects seems to provide an extra boost to those students who show their enthusiasm and competence for nursing in this way.
Dr. Terri Gibson: Definitely. I've been licensed over 30 years and have seen increases-thankfully. I remember working as a nurse for $9 an hour. It was great to get a position in a clinic for $17 an hour. Moving into the hospital setting meant I earned even more per hour. Now there are many positions available to nurses and sometimes unfortunately, great variations in wages. We talk about needing more nursing students and the shortage of nursing educators, and how we need to support educators to have wages more closely aligned with others who practice in an acute care setting. I hope something changes to help correct these significant needs. According to recent reports I've read, earnings are still a big impetus for where people choose to work.
Dixie State University
Judy Scott: The enduring impact will be the experience gained by attending nursing school during a pandemic. The students, as well as the faculty, have learned to be adaptable to the changing circumstances they have encountered. Another positive would be the increase in empathy they might feel for their patients, fellow nurses and staff members as they have seen the difficulties encountered during this pandemic.
Judy Scott: Being able to pass the NCLEX-RN exam with their first attempt will have a large impact on the student's ability secure that first position after graduation. Many students have taken advantage of the opportunity to work as an apprentice nurse during their last semester of school, thereby obtaining valuable work experience. Those that have not, will experience a nurse precepted experience working along side a nursing professional.
Judy Scott: All graduates need to be able to communicate well with Patients, their families, fellow nurses and staff as well as Primary Care Providers. They need to have an enquiring mind, a thirst for learning and expanding their knowledge base. Developing clinical judgment-insightful thinking will help the graduate care for their patients and to be a valuable member of the healthcare team. Professional behavior needed to collaborate with the interdisciplinary health care team to ensure the best care possible is provided for all patients and families is another important soft skill needed.
Spokane Community College
Department of Nursing
Elizabeth Curtin: I believe so, especially with health care. We are in a nursing shortage right now and, unfortunately, nation-wide, we are seeing higher attrition rates in nursing, especially with the new nurses. Health care facilities are going to have to come up with new programs to help mentor the new nurses and to also support the seasoned nurses or the nursing will become even worse.
Elizabeth Curtin: There are many healthcare-related jobs, as nursing isn't the only one where we are seeing a shortage. There is a need for pharmacy techs, respiratory therapists, lab techs, phlebotomists, the list goes on. Also construction always needs skilled workers. My son has worked continually with a company that does fireproofing and construction and hasn't missed a paycheck since the pandemic started.
Elizabeth Curtin: More hands-on skills, resilience, adaptability to the ever-changing environment.
Lakeview College of Nursing
Keri Stolz-Russell: I would say that one of the biggest trends we'll see are nurses who experience "burnout" much more quickly. Taking care of COVID patients is exhausting both mentally and physically. I know that I always have to prepare myself mentally to enter a COVID room and go through my mental checklist of dos and don'ts, make sure all the supplies that I'll need if they're not already in the room, make sure I have a "gofer" nearby so I can poke my head out if I need something, and prepare myself to be uncomfortable under all of the PPE. The mental fatigue doesn't end there once I have left the patient's room. The facility I work for does not allow COVID positive patient s to have visitors which means there are a lot more families calling for updates along with long explanations as to what certain medications are, whether or not their family member is getting the treatment described on T.V., and whether or not I think their loved one will make it. The mental fatigue is then brought home with me. I'm concerned about bringing it into the car where my children sit to go run errands and attend school activities. I am concerned about taking off my scrubs as soon as I get home, putting them in the washer, taking a shower, and praying that I didn't bring it into my home.
Keri Stolz-Russell: I truly think that all depends on where you're trying to go. Regardless of where you want to go, I think doing an internship is always a great idea and will help narrow down your interests while providing some experience at the same time. Once you land on a specific area I would suggest working toward a certification in that area. Having that will show your development commitment to that specific area and could possibly allow for some advancement.
Keri Stolz-Russell: I tend to lean toward a Med/surg job. Med/Surg is fast paced and provides new nurses with a variety of diseases processes, complications, medical equipment, and ways to develop their clinical and critical thinking skills. I know that many new grads have the desire and goal to be an ER or CCU nurse, which is great of course, but I personally think that some experience on a med/surg floor first should be a stepping stone to getting there. It's interesting because when getting report from an ER nurse I can always tell who has had experience on a med/surg floor compared to those who have always been an ER nurse. These nurses tend to "have all of their ducks in a row" regardless of how long they've had their patient and they know more specific details regarding the patients living situation, meds that were given, and what actually brought them to the ER. On the other hand, ER nurses who only know the ER setting aren't as detailed, but rather give a brief overview as to why the patient came in and what has already been done. I've been told by coworkers who went from a med/surg floor to the ER or CCU that they were thankful that they started on med/surg first because it allowed them to develop the skills and clinical/critical reasoning at a slower pace as opposed to being forced to play "catch up" immediately down in ER or CCU while caring for critically ill patients.