Becoming an RN: RN Careers in Maryland

Baltimore Magazine, noting that nurses are taking on many more roles than they used, states that it’s time for people to relinquish their old doctor/ nurse images and begin asking whether there’s a nurse in the house. Nurses also save – and alter – lives. It’s no wonder that there are plenty of Maryland organizations that want people with compassion and savvy to consider bringing a nurse into the house: their own. They want them to consider earning a nursing degree and join the nursing workforce as a registered nurse.

Through the Lens: A Look at the American Nurse features a number of nurses from the Boston area. The photographer noted that one of her hopes was to celebrate nurses; another was to draw people into the profession who have what it takes.

Becoming a Registered Nurse

RNs enter the field with different levels of education. The bachelor’s degree is becoming more common, but the associate’s is still a very viable route. Prospective RNs have to complete RN programs in Maryland that qualify them to take the NCLEX-RN. Once they pass the examination and demonstrate that they have the character and background, they’re ready to wear the title and get hired. The reality, though, is that some positions will take one or all of the following: experience, additional formal education, or specialty certification.

A person may find a surprising number of premier organizations that are hiring nurses straight out of nursing school. These will often include in the job title a notation that it is a position where new graduates are accepted; some titles indicate that the hire will be participating in a residency program. It can be an asset for a hospital to offer well-structured residencies that include yearlong mentoring and training.

One can even find positions for students still enrolled in nursing school. The University of Maryland Medical Center, one of Maryland’s magnet facilities, posted the following paid position ‘Student Nurse – – Operating Room’ in late 2017.

A Snapshot of Maryland’s Nursing Workforce

Maryland conducted a workforce study in 2015, publishing the results in 2016.

The hospital is the dominant setting for RNs nationwide, and Maryland proved no exception. 51.3% of Maryland RNs in the licensure survey identified it as their primary practice setting.

54.6% of the RNs identified themselves as staff nurses. The next largest category was case manager: 9.3%. Advanced practice accounted for 8.6%. 6.9% identified as nurse managers and 4.6% as clinical nurse leaders (an emerging discipline).

When asked to identify specialty, 10.9% selected acute care/ critical care. Medical surgical was selected by 9.3%; perioperative by 7.3%. Other common specialties included pediatrics (6%), maternal child health (5.6%), substance abuse and mental health (5.1%), geriatrics/ gerontology (4.9%), emergency/ trauma (4.8%), and home health (4%).

A nurse is by no means limited to these settings, roles, or specialties, though. Other viable options include community health, public health, occupational health, or — one most people remember!– school health. There are a tremendous number of specialties and subspecialties. The roles can be differentiated in different ways, according to organizational need.

Among those profiled in Through the Lens: A Look at the American Nurse were a Boston school nurse and a Boston public health nurse.

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Spotlight on John Hopkins Hospital

A visit to the website of John Hopkins Medicine can give one a sense of just how specialized hospital positions can be (https://www.hopkinsmedicine.org/nursing/index.html). The nursing recruitment section notes 16 specialties. A specialty area may encompass multiple units and populations. Pediatrics, for example, includes infant and toddler, child and adolescent psychology, and pediatric oncology inpatient, among others. Pediatric/ neonatal intensive care, considered a separate specialty, operates two units for different age groups. Multiple unit descriptions across these two specialties include the notation that a new graduate would participate in the ‘PEDS track’ of the new graduate orientation and then receive post-orientation mentoring.

John Hopkins provides information about the skill mix on some of the different units: for example, what percentage is RN and what percentage of RNs hold the Bachelor of Science in Nursing. Pediatric oncology, for example, is noted as being all RN, with 90% holding a BSN. All nurses on the unit have some form of certification; 1/4 have the Certified Pediatric Hematology Oncology Nurse (CPHON) credential.

Unique Skill Sets: Emergency Department Nursing

Some very experienced RN advisers helped Baltimore Magazine select 55 nurses to honor in 2016 (http://www.baltimoremagazine.com/2016/5/3/top-nurses-2016-unsung-heroes-of-health-care). Deliberate care was given to select nurses who worked across diverse specialties. Some are profiled online. Baltimore Magazine has taken an in-depth look at the work of one emergency department nurse. This particular nurse notes that she enjoys the fast pace of the ED (something that would be a source of stress to some others). She felt it was better for her personally that she didn’t work with the same patients for an extended period of time and get too attached to them. Still, she sometimes chooses to follow up. Like many nurses, she’s an advocate. She wants to see a bereavement room and a more team-based approach to letting family members know that a loved one has died.

While she found her niche in ED, others will find it somewhere else –possibly in a unit they hadn’t even been aware of. One of the nurses profiled advises beginning nurses to try out multiple clinical areas before committing themselves to a nursing specialty.

Expanded Roles

Maryland has identified two roles for which an RN must apply for expanded role: Worker’s Compensation Case Manager and Forensic Nurse Examiner.

The Worker’s Compensation Case Manager designation requires completion of an approved program. RN-WCCMs are eligible for inclusion on the Maryland Workers’ Compensation Directory of Qualified Rehabilitation Service Practitioners.

There are two types of Forensic Nurse examiner: Pediatric and Adult/ Adolescent. The Adult/Adolescent credential is dependent on completion of 40 hours of didactic coursework and 40 hours of clinical work; pediatric content comprises 62 hours of combined didactic and clinical coursework.

Expanded roles are not the same as advanced practice. The latter encompasses roles for which considerably more education is required.

Average Salary

Maryland registered nurses enjoyed average earnings of $35.92 an hour in 2016; the Bureau of Labor Statistics figured this as $74,710 for a full-time year.

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