RN Career Paths in Wyoming: Becomin an RN

Wyoming is dependent on its thousands of professional nurses, or RNs. Diverse health systems have grown concerned about meeting their workforce needs and meeting the needs of the population as a whole.

Preparing for an RN Career

RNs have significant amounts of theoretical and practical training. Basic competence is demonstrated by passing the NCLEX examination at the RN level. Approved RN programs result in degrees at different levels (RN programs in Wyoming). At this point, there are still more associate’s level RNs than bachelor’s level RNs in Wyoming.

Registered nursing licenses allow RNs to practice in any of many arenas. Positions do need varying amounts of specialized skill; expertise is developed over time. Sometimes a bachelor’s degree is asked at the hiring level.

Wyoming RN Work Settings

RNs by and large work for hospitals and medical centers, though a substantial minority have other employers. The following are the most common settings identified by Wyoming RNs:

  • Hospital
  • Ambulatory care
  • Nursing home
  • Insurance
  • Home health
  • School health

Wyoming has 16 critical access hospitals — indeed, more than half of the state’s hospitals are CAHs. Critical access hospitals are what the name implies. They’re facilities that have been determined to give critical access to people in remote areas. None have more than 25 acute care beds. Service agreement with larger hospitals provide for patients with needs beyond what can be provided locally.

These sites employ more than one might expect based on the number of beds. The organization may provide many outpatient services, for example, infusion treatments for people with illnesses like cancer, Crohn’s Disease, multiple sclerosis, and emphysema. This means they have some need to hire nurses into specialized roles. CAHs tend to need ‘expert generalists’, though.

Skilled nursing facilities — nursing homes — may be located on the same site. Indeed there may be more nursing home beds on the campus than acute care beds. While nursing homes are often thought of as the domain of the LPN and CNA, they do hire RNs. The director of nursing services must be an RN (In small facilities, the person in this role may also have hospital duties.) Director of nursing represents an area of potential advancement for those interested in caring for the elderly and other populations with chronic sub-acute needs. According to state code, these positions are to go to RNs with experience in areas like health services management or geriatric, psychiatric, or rehabilitation nursing.

Three of Wyoming’s CAHs made the 2017 top 100 list: Community Hospital, Star Valley Medical Center, and Washakie Medical Center.

Larger hospitals like Wyoming Medical of course have far more in the way of specialized units and specialized positions. The following are among the positions Wyoming Medical Center was working to fill in early 2018:

  • Wound Ostomy Continence
  • IV Therapy
  • Neurology
  • Progressive Care Unit

The changing healthcare terrain brings new opportunities and new roles. The University of Wyoming recently announced that an assistant professor in their school of nursing had been awarded a grant to develop an integrated primary care mental health initiative. The moneys would fund (among many other things) an RN case manager/ coordinator who would help with integration of these two fundamental areas of healthcare.

Care management and case management are areas of high demand in many parts of the nation.

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Roles that Require Specialized Education

The Board has issued advisory opinions about roles that require specialized education beyond what is included in a generic nursing program. Wyoming, like a number of states, has specifically addressed the role of the Registered Nurse First Assistant, an expanded peri-surgical role carried out under surgeon direction. A prospective RNFA can expect to complete six semester hours beyond the basic; education is to meet standards set by the Association of periOperative Registered Nurses (AORN). CNOR certification is another expectation. Beginning in 2020, the expectation is that new RNFAs will have education at at least the bachelor’s level.

The pre-hospital nursing role also requires clinical experience beyond the generic .Verification of competency is to be kept on file. The Board has made a strong recommendation that pre-hospital nurses maintain one of the following two certifications: Certified Transport Registered Nurse (CTRN) or Certified Flight Registered Nurse (CFRN) certification. The Board notes that nurses in this role will have had experience in areas such as high-risk obstetrics, unstable newborns, and people with serious illness or injury — these are populations who will require a high level of care en route.

Some nurses notably go far beyond the educational level required for the above noted positions. There is high demand for advanced practice nurses. These role requires graduate education.

Salary and Career Outlook

The Bureau of Labor Statistics reports that Wyoming registered nurses averaged $30.28 an hour, or $62,980 a year in 2016. The $62,980 figure assumes 52 40-hour weeks.

Wyoming has been projected to see 20% occupational growth for RNs over the course of the 2014 to 2024 decade.

Filling positions has become a challenge for a number of Wyoming organizations. There are concerns about meeting needs in the future as the population ages.

Healthcare systems are working proactively to bring new nurses up from the novice level. They may, for example, offer residencies that include structured learning experiences as well as preceptorship. Still, there are many positions that require experience. Developing one’s career can mean many opportunities across a lifetime, even at times when the hiring market isn’t tight. Distinguishing oneself as a student can mean better chances of landing a desirable residency straight out of school — if this is indeed the path the nurse wants to take.

Currently the Southeast part of the state employs the most registered nurses; the Central region comes in at #2.

Wyoming recently joined a compact that allows nurses in participating states to practice across state lines.

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