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Nursing careers for the 21st century.

As a labor and delivery nurse, Sameerah Shareef nursed women in childbirth and their newborns. No experience, however, influenced her working career as much as the birth of her first child, which was, she says, "pretty terrible."

"I viewed birth as a normal kind of process, but it turned into [something] a lot more terrifying than it had to be," Shareef says. They treated every [birth] like it was going to be a problem. It was disappointing, and I had to figure out why."

With that agenda, and after eight years' nursing experience in maternal/child services, Shareef decided to become a nurse-midwife she completed the Kentucky-based Frontier School of Midwifery and Family Nursing off-site with the help of preceptors and examination proctors, and passed the American College of Nurse-Midwifery board examinations.

Now as a certified nurse/midwife, Shareef and her practice partner work with Blue Care Network Health Central, a Blue Cross-Blue Shield health maintenance organization in Lansing, Michigan. She provides obstetric services for normal pregnancies and gynecology services for well women. She works with the support of consulting physicians, to whom she refers women with abnormal pregnancies and disease. Certification in this practice area has boosted her earning power considerably - the average salary for a nurse-midwife is nearly $44,000.

"I realized that what I wanted to do was be on the wellness side, doing preventive things. Midwifery is really about babies and families. It's more than what I did as a staff nurse," Shareef says.

Shareef caught the high tide of change in health care services. While nursing has always promised steady employment - today 90,000 African-Americans are registered nurses - the future rewards of the development of the profession await those who continue to develop their skills. Statistics show that nursing will add 44 percent more positions in the 21st century - an explosion, says the president of the National Black Nurses Association, Dr. Linda Burnes Bolton.

"There is a wonderful opportunity for people who are really committed to helping other individuals realize their human potential," says Bolton.

Nurse/midwifery is one area ripe for entrepreneurial-minded nurses, says Margaret Carlton Warren, associate professor for nursing at North Carolina A&T State University. Nurse/mid-wives and nurse practitioners are eligible for payment from insurance companies. Other critical employment areas include community care-home health (acute care), community mental health, out-patient surgical centers and birthing centers. The director of three nursing divisions at Cedars-Sinai Medical Center in Los Angeles, Bolton says that exciting new opportunities await committed nurses. One is the new nursing surgical specialty - RN First Assistant - which promises a minimum $125,000 salary.

Preparation For Nursing

Education paves the way to a successful nursing career. Shareef will receive a Master of Science in Nursing (MSN) this year when she completes nine credit hours in the Case Western Reserve University nursing program. The university and the Frontier School are affiliated programs. Like Shareef's, 43 percent of all MSNs are granted in a clinical practice area.

Historically, hospitals operated nursing schools and taught nursing as a set of manual skills used in the care of sick people. These programs culminated in a diploma. Until recently, most nurses trained in diploma programs. But efforts to upgrade the nursing profession moved nursing training to the college campus.

The associate degree in nursing is now considered the most basic nursing degree. Community colleges now house most of these intense, two-year nursing programs which have, clinical skills as their centerpiece. They also introduce the student to professional approaches.

The profession is aiming to have every nurse qualified at the baccalaureate level, through four-year university programs. BSNs receive thorough professional groundwork. In addition to the clinical skills, they study the history and philosophy of nursing, the role of nursing in the healing process, working on a health care team, creating and maintaining records, planning, training methods, research, statistical methods, critical thinking, and decision-making. BSNs work more independently than other nurses and often have more potential for a management career.

Programs set in the community and using long-distance learning technologies are now being used to help diploma and associate's degree nurses earn the BSN. One such program is the Kellogg Foundation Community Partnerships Initiative grant programs.

After basic nursing education - whether diploma, associate or baccalaureate degrees - all nurses must take a licensure exam administered by their state.

Once a nursing career has begun, advancement requires continuing education or certification, writes Teresa Cervantez Thompson in the Health-care Career Directory (Visible Ink Press, 1993).

The Master of Science in Nursing (MSN) degree is generally a two-year academic program requiring classroom and clinical work and an essay or thesis; 90 percent of all MSN degrees are granted in one of three areas: clinical practice area, such as nurse/midwifery; education; or management/supervision. Most nursing PhD degrees are granted in the area of education, for those seeking careers in nursing education administration. The PhD degree usually involves two years of classroom and clinical work, written and oral examinations, and a thesis.

Certification recognizes and validates competencies in skilled nuts: ing. There are as many as 100 different nursing specialties. Nursing specialty societies offer certification in their areas. One such occupation is nurse anesthetist, which is one of the highest paid nursing specialties at an average $76,000.

Certification is promoted as a way to expand nurse responsibilities, increase salary, and survive cutbacks. Indeed, insurance companies are pushing for certification of nurse specialists, says Carol Shaner, who administers certification programs in the continuity of care and gastroenterology. Though nurses receive higher salaries in specialty areas, those salaries are lower than those of physician specialists.

Advice For New Nurses

So many new opportunities for nurses. So many programs to jumpstart lucrative careers. Is it wise for new nurses to continue immediately after receiving their bachelor's degrees to graduate studies as lawyers and doctors do?

Experts say no. In fact, most MSN and certification programs require at least one year of full-time experience. "Since so much of graduate school is a shared experience, new BSNs are not desired students. They can get a lot from the program, but can't give a lot to it," says Susan Wheeler, director of student affairs at Michigan State University College of Nursing.

Also, Wheeler adds, graduate school involves independent working in a clinical situation, and new nursing graduates have no experience with that.

The best path for new nurses is the traditional one, nursing experts say. Newly-minted nurses should seek a hospital nursing staff position upon graduation. Expect to undergo a three: to six-month orientation with a preceptor. And expect to have lots of company. The 1992 U.S. Health and Human Services National Sample Survey of Registered Nurses, a survey conducted every four years, shows that 1.2 million of 1.8 million nurses are working in positions with a staff nurse-type title. These titles include charge nurse, general duty nurse, public health nurse, school nurse, staff nurse, and team leader.

If you find staff nursing to your liking, know that advancement is possible, usually to manager of a hospital unit, Thompson says in the Healthcare Career Directory. This promotion usually takes three to five years, and can also require working on a night shift.

Most of today's nursing leaders - such as National Black Nurses Association president Dr. Bolton, and nurse-midwife Sameerah Shareef - started as staff nurses and worked many years in these frontline positions.

"Experience helps overcome the fear of being a nurse," says Shareef, an eight-year veteran of staff nursing. "You have to see yourself doing things. It helps you to gain professional confidence."
NURSING SALARIES FOR SELECTED TITLES


TITLE AVERAGE SALARY


Staff nurse $35,212


Nurse practitioner/
midwife $43,636


Clinical specialist $41,226


Nurse clinician $38,307


Certified nurse
anesthetist $76,053


Researcher $39,218


Occupational nurse $36,685


Private duty nurse $37,770


Source: The Registered Nurse Population: Findings from the National
Sample Survey of Registered Nurses, March 1992. Evelyn Moses, Chief,
Nursing Data and Analysis Staff, Division of Nursing.


Dedria A. Humphries Barker is a writer in Michigan and the Editor of Take Care multi-cultural consumer health magazines.
COPYRIGHT 1995 IMDiversity, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1995 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Opportunities in Nursing
Author:Barker, Dedria A. Humphries
Publication:The Black Collegian
Date:Feb 1, 1995
Words:1348
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