RN Career Paths in New Mexico: Becoming an RN
Professional nursing in New Mexico: It’s a world of challenge and opportunity. Among the challenges: The state has fewer registered nurses per 1,000 residents than the U.S. norm, and many fear it does not have enough nurses for the decades to come. Among the opportunities: There are some very farsighted organizations in the state. They are actively working to meet staffing needs and also allow RNs to contribute in innovative ways to the health of the New Mexico population.
Settings are as diverse as the landscape. The vast majority of the state’s RNs are employed by hospitals. The state has some large facilities – the University of New Mexico Health Sciences Hospital and Presbyterian – which hire registered nurses for specialized units. It also has some very tiny hospitals. Some facilities are under the banner of Indian Health Services.
Other workplaces include skilled nursing facilities, ambulatory care centers, and various community and public health settings.
Becoming a New Mexico RN
Licensure is granted by the Board of Nursing following completion of an approved program and an examination. RNs occupy a wide berth on the nursing license ladder. RNs can enter the field with associate’s or bachelor’s degrees. Both types of program prepare graduates to pass the NCLEX-RN and practice safely under the registered nursing scope of practice (RN programs in New Mexico).
There is often some difference in career paths for nurses with different professional nursing degrees. Some years back, the New Mexico Center for Nursing Excellence, New Mexico’s nursing workforce site, published a document outlining the expectations at the associate’s and bachelor’s levels (and at other levels, both lower and higher). At the bachelor’s level, the word “complex” creeps in more frequently. An associate’s degree nurse forms appropriate nursing diagnoses. A bachelor’s level nurse forms nursing diagnoses in complex situations; this could extend even beyond individuals and families to the population level. The associate’s level nurse is expected to be able to assess data, looking at it from within a cultural context; the bachelor’s level nurse is expected to be able to assess complex needs from pre-admission to post-discharge, again, from within a cultural standpoint.
There are some differences even for expectations in professional membership. Ideally, the associate’s degree nurse participates in professional organizations. Ideally, the bachelor’s nurse has active involvement in professional organizations and takes on leadership roles. (At this level the participation might be in specialty organizations.)
Spotlight on the University of New Mexico Health Sciences Hospital
Hospitals often tout the opportunities they provide for nurses to take on leadership roles and influence health on a wide level; this may be reflected in the organization’s career ladder. The University of New Mexico touts evidence-based practice programs, shared governance models, and other opportunities for input. The evidence-based practice program provides a way to test changes that could improve care. The Nursing Research Council invites meeting attendance by nurses in who are in bedside roles as well as those in education and leadership roles.
UNM Health has a Clinical Advancement Program (CAP) that recognizes and rewards different types of excellence: professional accountability, professional practice, educational growth, and research; research includes use of other’s research as well as generation of research
Nurses in Health Promotion
In 2014, the New Mexico Center for Nursing Excellence Action Coalition published a strategic review of the role of nursing in promoting the state’s health and combatting its most serious challenges. The following were among the many ways nurses could impact health:
- Carry out regular home visits to improve diabetes self-management
- Use effective motivational interviewing strategies to improve health outcomes for elderly patients
- Assess fall risk through home visits
- Provide obesity case management
- Develop hypertension education plans
- Promote early prenatal care through social media campaigns
Leadership was stressed. In this case, leading doesn’t necessarily mean being a supervisor. It can instead mean taking the initiative to work with professionals across disciplines and organizations. The ideas – and discussion of what needs to happen to make them reality — and are themselves a reflection of leadership. Nurses from different practice areas and different parts of the state were selected for participation.
Foundational work included a literature review focused on the following documents among others: the Bernalillo County Health Assessment, the Con Alma Foundation Strategic Plan, and the Institute of Medicine’s Leading Health Indicators for Healthy People 2020, March 2011 report.
RN Job Postings
The following is a sampling of job postings from early 2018:
- Progressive care unit (telemetry)
- Private duty home health
- Inpatient rehab
- Emergency department
- RN-pediatric unit
- Psychiatric nurse
- Psychiatric inpatient RN supervisor
- Flight nurse
- Disease manager RN (with Spanish fluency)
- Hospice registered nurse case manager
A number of positions are generalist.
Areas of High Need
According to the 2017 New Mexico Health Care Workforce Committee Report, New Mexico faces an overall shortage (relative to national benchmarks). The following are among the counties noted as significantly below benchmark: Dona Ana, Lea, McKinley, Sandoval, Valencia.
A 2013 University of New Mexico Center for Education Policy Research Report notes the likelihood of severe shortage in the future.
New Mexico registered nurses averaged $33.02 an hour in 2016.
Wallet Hub has placed New Mexico #2 on the list of best states to be a nurse. For opportunity and competition, it scored #1. Work environment was a much lower #31.
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