RN Careers in Vermont: Becoming an RN
A Vermont RN license can lead to many diverse career options, both now and in the future. The population is changing. The profession is changing. The jobs one sees advertised today aren’t represented in quite the same proportions today as they were a handful of years back. But professional nursing is the largest single segment of the healthcare workforce and those who prepare themselves well can choose from multiple sectors and many, many roles.
Launching a Professional Nursing Career
A person attains first-time licensure through education and examination. There are multiple pathways for those who are, or have been, licensed. The Board website includes a prominent link to nursing re-entry programs (https://www.sec.state.vt.us/professional-regulation/list-of-professions/nursing/registered-nurses.aspx).
Vermont has set minimum hours for foundational sciences as well as nursing theory and clinical practice. Minimum educational standards may be met through programs at different levels (RN programs in Vermont). AHEC reports that all five of Vermont’s programs now offer the Bachelor of Science in Nursing. The Associate of Science option does still exist, though organizations in the state have come out in support of the BSN becoming the standard (https://www.sec.state.vt.us/media/684285/The-Baccalaureate-Degree-as-Entry-to-Professional-Practice-6-8-15.pdf).
Overview of Vermont RN Work Settings and Roles
Hospitals represent the largest employer of Vermont RNs. They employ nurses in multiple settings. The following figures are from a 2017 workforce report:
- Inpatient 24.1%
- Inpatient and outpatient 13.1%
- Outpatient alone 4.6%
- Emergency room 3.8%
Currently home health accounts for 6.5% and nursing homes, extended care, and assisted living, 7%, but this is expected to increase. Vermont’s population of individuals 65 and older has been projected to see 50% growth over a period of about 15 years – and with it, the need for healthcare professionals to meet their needs. Long-term and residential care expected to see the greatest increase, percentage-wise, followed by home health.
Vermont’s survey, published by the University of Vermont AHEC Nursing Workforce, Research, and Development, included sufficiently nuanced categories that it was possible to pinpoint the primary work setting of most of the state’s RNs; the ‘other’ category (quite large in some states) was only 3.8%. Among the settings reported by less than 1% each are adult day programs, employee or occupational health, seasonal camps, and dialysis.
Mental health centers, community health, and public health have somewhat higher representation with at least 1% reporting each. School health services was reported by 3.8%.
AHEC Nursing Workforce, Research, and Development called one particular finding their biggest surprise: telehealth and telephonic health now in second place, coming in at 17.2%. They speculated at the cause, noting that previous surveys had focused only on the population who reported working in Vermont and thus may (with emphasis on the word ‘may’) have failed to capture an emerging trend.
There are different types of work that may be telephonic or performed remotely: triage, health coaching, utilization review. Remote data collections and monitoring are not limited to the spoken or written word. Even heart rhythm may now be monitored remotely.
The face of care is changing around the nation with some shift away from acute care settings. Case management and care coordination roles are a crucial element. AHEC noted that 7.9% of the state’s RNs now reported their specialty as case manager.
Vermont’s Campaign for Action seeks to improve healthcare by placing more nurses into leadership roles (https://campaignforaction.org/issue/promoting-nursing-leadership/#the-goal).
Public Health Nursing in Vermont
Public health provides an option far removed from the emergency department or hospital inpatient unit. Registered nurses are vital to many programs, among them, those in maternal and child health. The Vermont Division of Maternal and Child Health reports that the Nurse Family Partnership, an evidenced-based program that brings nurses into the homes of low income first-time mothers, has seen successes in getting pregnant women to quit smoking or at least reduce their usage.
Career Outlook and Areas of Need
AHEC Nursing Workforce, Research, and Development notes that system transformation should actually result in more need for providers. One reason: more people surviving and thus in need of continued care!
Vermont has more nurses per-capita than the average state, but it appears that it does not have too many. Indeed, organizations often need to be competitive – and innovative – to meet their workforce needs.
A hospital survey conducted in June and July of 2017 found Vermont hospitals facing an average 9.5% vacancy rate for registered nurses.
Attracting adequate mental health nurses has been an area of concern for the state. The Vermont Psychiatric Care Hospital was forced to close beds in 2015 due to a lack of nurses. The state took steps to correct the situation. Part of it came down to money: reclassifying nursing salaries to make them more competitive, prioritizing psychiatric nurses for state loan repayment. Training was also addressed.
Employers, too, take steps to make positions more attractive. Often this means respecting nurses’ expertise and allowing them a voice. The AANC recognizes the connection between nurse engagement and care quality with its prestigious magnet hospital designation.
Vermont has two magnet hospitals as of early 2018: Rutland Regional Medical Center and Southwestern Vermont Medical Center in Bennington.
Vermont’s registered nurses earned an average of $32.59 an hour in 2016; the Bureau of Labor Statistics figures this at $67,780 a year.
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