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Developing a Patient-Centered Career Path

Every month I spend a few hours talking to students, both graduate and undergraduate, about what to do next in their careers. I have these conversations enough that I've started to think that the half-life of a bedside nurse in any clinical setting is about 15 years, though there is no research to support this (yet).  Colleagues at the RN Work Project just might figure it out as they study new graduate career patterns.

Anyway, the central theme of most of these discussion is the patients that care for or finding that patient population that makes them happy in their jobs. Sometimes its about creating the conditions that make for happy nurses caring for satisfied patients.

The central question is: How can you create a patient-centered career path?

Let's walk through a few questions to ask yourself. I'll use examples from my own career to illustrate.

Q: Who are the patients you love to work with and in which clinical setting?

A: I started off my career in med-surg and then settled into kidney transplant.  I love working transplant with its complex combination of medicine and surgery. Most of the time, I was assigned to care for Spanish speaking patients since I am fluent in the language. It was a culture I understood better than many of my co-workers thanks to years spent volunteering and studying in Mexico. I knew they'd pull me in to translate anyway, so it became easier just to be assigned to them even if it meant walking extra steps between rooms. I frequently took on limited English proficiency patients too. When you've learned to speak another language or had to struggle as a non-native speaker in another country, a certain amount of patience develops that translates well into direct patient care with those who do not speak your language.

Conclusion: My patients were transplant recipients and immigrants.

Q: Which masters degree worked best with my patients?

A: I actually started off in a nurse practitioner program. I had my first clinical and concluded it was not for me. That was not how I wanted to interact with my patients in a clinical setting. One thing I realized about what I liked best with working with patients was the teaching part. There's a lot of teaching that happens in transplant because patients who can't stick to their new medication regimen will end up back in the hospital really quickly with a rejection episode. For the limited English proficiency patients, I relished the challenge of trying to get them resources in their language to try to increase their health literacy. If it wasn't initially obvious, a nursing education masters was the right one for me to keep my career patient centered. It also prepared me well to be an effective clinical instructor.

Conclusion: Your masters degree should be about the thing that helps keep the patients in your work. Sometimes this will be through direct care, sometimes it might be more indirectly like in Nursing Informatics where you help build systems that enhance patient care and nurses' ability to deliver it.


Where your career goes after a masters degree will depend on many things, including your interests and life circumstances. Wondering about PhD vs. DNP?  Read here. Either one can keep patients the center of your career development and keep you motivated throughout your lifetime.

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