RN Careers in Maine: A career that develops and changes across a lifetime

An infographic by Maine’s nursing workforce center shows the age of Maine’s RN workforce as a stair step with the lowest number in the under 35 age group and the highest in the 55 to 64 age group (https://usm.maine.edu/nursing/nursing-workforce-data-state-maine). Figuring in the aging of the general population, it’s a recipe for shortage — a larger shortfall even than the one the state currently faces.

But nursing isn’t a profession that one enters for a little while when needs are high. It takes substantial investment of time to develop proficiency; this extends even beyond the time it takes to complete an associate or baccalaureate degree in nursing. With the right attitude and some planning, though, one can have a career that develops and changes across a lifetime.

Becoming a Maine RN

First-time licensure is by examination. Professional nursing degree programs in Maine – those that qualify one to take the NCLEX-RN and achieve licensure – are offered at different levels. More than two-thirds of RNs and advanced practice nurses in the 35 and under age group earned their degree at the baccalaureate level. In some older age groups, though, the associate’s degree dominates.

Licensure can be attained soon after graduation. However, it takes time to learn to handle various situations independently, more yet to intuitively hone in on the most relevant aspects of complex ones. The Maine Partners in Nursing Education and Practice, along with other stakeholders, developed the Maine Core Competencies and also identified five stages of clinical practice. One will find a number of healthcare organizations in Maine that advertise combined internship and residency programs. They may reference the early stages of nursing practice: ‘novice’ and ‘advanced beginner’. Residency can carry a nurse through the first year of post-education practice. The ‘competent’ stage, though, typically comes after two or three years in the field.

Current and Future Needs

52.2% of Maine’s RNs work in hospital settings. Ambulatory care settings and long-term care settings each account for approximately 10%. Home care employs just over 7%; community health, 2.5%.

20.5% of RNs consider their specialty to be acute care. 11.1% consider it to be medical/ surgical. Geriatrics comprises 8%; home health, 6.2%.

As Maine’s population ages, the need for non-acute care (including skilled nursing) will increase disproportionately. While some positions can be staffed by either an RN or LPN, others require RN licensing. Duties can include management of clients caseloads, assessment and treatment planning, supervision of LPNs and CNAs, and provision of skilled nursing services in the home.

Supply and demand vary from region to region within the state. So does the need for nurses in different types of facility.

Four regions have been predicted to see large shortages: York/ Cumberland, Sagadahoc/ Lincoln/ Knox/ Waldo, Hancock/ Washington, and Oxford/ Franklin/ Androscoggin.

When measured by number of RNs, it is expected that most of Maine’s shortage regions will see the greatest need in the acute care arena. When expressed as a percentage, though, the numbers tell a different story. Home care and skilled nursing/ long-term care tend to predominate.

A different scenario has been predicted for the Oxford/ Franklin/ Androscoggin region, with a steep increase in the need for RNs in ambulatory care.

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Compensating for Short Staffing: Traveling Nurses and Voluntary Overtime

Overtime can be a source of extra income. It can also be a stresser and sometimes even a safety issue. Maine prohibits mandatory overtime for nurses except in certain extreme circumstances. Generally speaking, a nurse who has worked a mandatory 12-hour shift has the right to refuse extra hours. Moreover, he or she has the right to 10 hours of non-work time following a mandatory 12-hour shift.

Facilities in Maine and elsewhere do utilize overtime to make up for staffing shortfalls. They also utilize travel nurses. Travel nurses move from position to position, offering coverage to facilities that need their particular skill set, typically staying no more than a few months. Why do they do it? One big draw is the money – travelers make a good deal more per hour than their counterparts.

Public Health and Community Health Nursing

Community nursing and public health nursing represent a relatively small percentage of nursing positions but have the potential to play a large role in the state’s health.

Public health nurses may be hired directly by the state. Pathways vary depending on educational level. A Public Health I nurse has either graduated from a four-year nursing school or has a lower level of nursing education but has also accrued 15 units of coursework in related fields such as community health, rehabilitation, and psychology and has spent at least six months as a graduate nurse. A Public Health Nurse II has either accrued a couple of years of experience in public health or has four years of combined training and experience (to include 30 hours of coursework in related fields).

Duties at both levels can be broad: Maine’s public health nurses manage and coordinate care, carry out home and field visits, identify needs and problems at micro and macro levels, work with members of other disciplines to implement nursing services in various settings, and participate in response teams when urgent situations arise. Among the preferred qualifications: knowledge of public health programs and public health administration.

RNs are also utilized in community settings. For some, community health is a way to practice nursing in a different way — one that is more relationship-centered than acute care. The Bangor Daily News profiled two nursing students who opted for experience in community nursing as part of their college experience (https://bangordailynews.com/2017/05/18/the-point/whats-causing-maines-community-nursing-crisis/).

School nursing also entails a high level of professionalism. School nurses may have responsibility for large student populations that include significant numbers of students with severe allergies, chronic illnesses, and anxiety or depression (http://www.centralmaine.com/2017/12/10/school-nurses-on-front-lines-of-mental-health-societal-problems/). Not uncommonly, they are the first to recognize signs that there may be a serious problem: one that needs attention by a medical professional.

3.3% of Maine’s RNs consider their specialty to be school nursing.

RN Salary in Maine

The Bureau of Labor Statistics reported an average salary of $30.67 an hour or $63,800 a year for Maine registered nurses in 2016.

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