RN Careers in Hawaii: Becoming an RN
Healthcare is big in Hawaii – as elsewhere – and nursing represents the single largest share. It’s no wonder that state organizations in the state are heavily invested in ensuring a well-prepared workforce. Their workforce research is an introduction to the diverse career pathways one can take as a professional nurse.
Professional Nursing Standards at the Entry-Level and Beyond
Nursing licenses are granted by Hawaii Professional & Vocational Licensing. The prospective RN will need to complete a professional nursing education program (RN Programs in Hawaii) and pass a licensing examination. Hawaii now requires RNs to meet continuing competency requirements for license renewal; this can take multiple forms.
There is often a difference between the educational level nurses need to practice at the RN level and the degrees they actually hold — more and more frequently, nurses are exceeding the minimum. Hawaii schools prepare professional nursing students at the associate and baccalaureate levels. Graduates of both programs take the NCLEX examination at the same level and are licensed at the same level. (Only those nurses who move into advanced practice roles eventually earn a higher license, based on education at the graduate level.)
The level in between is widely recognized, however, even though not it is not reflected in licensing laws; there are many positions that ask more than an associate’s but less than a master’s. Hilo Medical Center and Queen’s Medical Center are among those that post positions with the notation that the Bachelor of Science in Nursing (BSN) is the preferred qualification. National organizations have pushed for an increase in BSN level nurses, and Hawaii is ahead of the game: 72% of Hawaii’s RNs compared to 53% at the national level. In the Honolulu area, not surprisingly, the rate of BSN-prepared nurses is highest in the state (http://www.hawaiicenterfornursing.org).
Some nurses pursue higher degrees while working in the field. The Center for Nursing calls Academic Progression in Nursing (APIN) a critical part of workforce development. A majority of Hawaii nurses who are pursuing education at the BSN level are doing so through online programs offered by out-of-state institutions.
Third party certification can also demonstrate competency beyond the entry-level. Unlike the NCLEX, certification examinations are specialty-specific. Hilo Medical Center notes that its nurses are encouraged to seek certification. Hilo nurses hold certifications in the following areas, among others:
- Diabetes Educator
- Medical-Surgical Nursing
- Critical Care
- Wound Ostomy and Continence
Work Settings and Roles
The most common RN work setting is the hospital; the most common specialty, acute care. However, it is difficult to characterize any one role as typical.
The Hawaii Center for Nursing 2017 Workforce Supply Report provided the following information: 58% of Hawaii’s registered nurses work in hospital settings, 8% in nursing homes, and 5% in ambulatory care. Many settings are represented, with 2% to 4% of the state’s RNs reporting each of the following: home health, physician’s offices, insurance, public health, community health, dialysis clinic, and hospice. Assisted living facilities, correctional institutions, school health, and academia each account for about 1%.
41% of the state’s RNs report an acute care specialty while 8% report gerontology and 6%, perioperative. 2% – 4% each report pediatrics, mental health, non-clinical specialties, home health, adult health, oncology, nephrology, cardiology, community health, rehabilitation, or hospice/ palliative.
The most common role is that of staff nurse. Often it’s the nurses with specialized skills who are in high demand. The following are a sampling of units where Hawaii RNs were sought for hire in late 2017:
- Emergency Room
- Operating Room
- Pre- and Post-Op
- Intensive Care
- Family Birthing Center
- Psychiatric Unit
Positions are not limited to staff nurse and charge nurse or supervisor. The following are among the possibilities: care transition specialist, telephonic care coordinator, infection control RN, and clinical educator.
Premier Hawaii Healthcare Organizations
The American Nurses Credentialing Center awards magnet status to hospitals with high caliber nursing and high quality overall. These facilities are known for nurse retention. Like magnets, they can make nurses — very good ones – stick. Hawaii has one magnet facility, the Queen’s Medical Center in Honolulu; this is as of 2017. Queen’s Health Systems, the parent organization, offers tuition assistance in addition to the more traditional insurance and retirement benefits.
Nurses Creating Healthcare Knowledge
The nursing profession offers opportunities to challenge oneself in one’s own practice and also in the wider healthcare world. The Center for Nursing offers workshops for nurse teams in writing articles for publication. The following are noted among the topics: reducing re-admissions for diabetes and substance abuse patients, code status predictors for heart failure patients, and improving nursing care for trauma-affected adolescents. These topics represent the kind of problem nurses are already tackling – professional development allows them to bring their work to a larger audience.
Average RN Salary in Hawaii
Hawaii is the third highest paying state for RNs; the state’s registered nurses earned an average of $42.75 an hour in 2017. The Bureau of Labor Statistics has figured this at $88,910 for a year (based on 40-hour work weeks). The average work week for a Hawaii nurse is closer to 38 hours, according to the Hawaii Center for Nursing.
Actual salaries are highly variable, dependent on setting, role, and experience level, as well as location. RNs at the 10th percentile in Hawaii made $28.64; those at the 90th percentile made $57.94.
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