Career Options Available for a Modern Nurse

As the healthcare industry continues to grow and evolve, Registered Nurses (RNs) no longer have to stick to just one path but have the option to change the direction of their career. In addition to being a noble and virtuous profession, nursing provides opportunities to offer your services in different work environments and in diverse roles. The career path acknowledges individual temperaments, personalities, and the preferred pace of the work environment.Apart from working in hospitals, long-term care facilities, and clinics, RNs can also pursue opportunities in research labs,  physician’s offices, NGOs providing healthcare services,corporates, insurance and law firms and in many other specialty roles. These options have multiplied with specialties and niches for nurses from all education levels. Apart from the bedside care, here is a list of diverse career options for a modern nurse and where they can pursue them:-

Physician Offices

Working as a primary care nurse in a physician’s office can be less stressful and exhausting as you will rarely have to deal with emergencies, and you will have a predictable schedule with fixed “office hours.” However, nurses working in a physician’s office need to be skilled in a variety of daily nursing procedures as they are often the first medical professionals that most patients come in contact with. Primary care nurses typically have to provide care for minor illnesses such as colds and allergic reactions however, they can choose to specialise in certain branches of medicine as the patients that you encounter might vary depending on your expertise. As primary care nurses encounter their patients on a daily basis, many form close personal relationships with them. Primary care nurses are most often employed in physician offices however, hospitals and other healthcare facilities also hire these nurses.

student thinking about her nursing career
A degree in nursing opens up a plethora of fulfilling career options
Research Laboratories

If academics are your calling then you can opt for becoming a nurse researcher. A research nurse works hard to help create, evaluate, and perfect new and old medications and treatments for various medical problems. As a nurse researcher you are at the forefront of new medical discoveries, and help develop breakthrough cures and medical treatments. As this is a highly specific category of nursing, a specialised educational background is required to train you for the profession. Moreover, you must be able to effectively communicate with scientists, physicians, researchers, patients, and corporate executives as you will be working alongside them. Qualified research nurses have the option to work in a number of different settings including research organisations, universities, pharmaceutical companies, teaching hospitals, and government agencies.

Nursing Care Facilities

Transitioning from a bed-side role to a managerial position requires a combination of clinical expertise and leadership skills. The role is instrumental in creating a professional environment and fostering a culture that contributes to optimal patient care along with the opportunity to grow. Apart from supervising nursing staff in a hospital or clinical setting nurse managers oversee patient care, make management and budgetary decisions, set work schedules, coordinate meetings, and make decisions about personnel.

Nurse Ethicist

Ethics influence every facet of a nursing practice. However, despite being challenged with ethical problems on a daily basis, many student nurses never get the opportunity to explore and resolve its complexities. A nurse ethicist works in hospitals, clinics and research facilities to help the staff in combining science with principles and morality. Their duties are three-fold:-

  • Clinical ethics consultation, education, and management
  • Syllabus development and execution for medical student clerkships and residency programs and
  • Research and publication
Nursing Informatics

As effective communication is at the core of nursing, an informatics nurse boosts the management of information and communications in the profession. They take the clinical and the technical languages of the healthcare industry and make it user-friendly and patient-centric while driving improved outcomes for patients and enhanced clinical workflows for healthcare staff. Documentation is the major emphasis in the field of nursing informatics.    

Private and Public Education Institutions

As demand for the nursing profession increases, so does the demand to train qualified nurses. Becoming a nurse educator allows nurses to get the combined satisfaction of providing learners with the technical skills, refined skills, as well as the depth of knowledge that are instrumental for improving the quality of patient care. In order to train future nurses of the world, nurse educators must possess excellent communication skills, critical thinking abilities, and have a solid clinical background along with comprehensive and substantive knowledge in their particular area of instruction. The work setting is diverse ranging from long-term care facilities and hospitals, to universities, community colleges, vocational schools, etc. In addition to working in educational institutions, many nurse educators also work in clinical settings.

Doctor
A medical expert in a private or public educational institute is a rewarding career prospect for a nurse
NGOs 

Although nursing implies care of the vulnerable, the role is often misunderstood and restricted to a traditional hospital setting. However, nurses can also assist by filling the gap in communities without the access to physicians by working in NGOs. While this might be a highly rewarding experience, RNs working in these settings need to acknowledge the lack of resources available for undertaking the care of patients and require strong critical thinking and stress management skills to best serve their patients. Nurses who are interested in pursuing this objective can also work for ‘Doctors Without Borders’ or for the UN in countries such as Africa, Asia or other Middle Eastern countries having refugee crises such as Iraq, Yemen and Syria. They can  undertake leadership positions overlooking care of patients within the most critical zones. Expertise or experience in emergency, pediatrics, infectious diseases, tropical diseases, and/or public health is particularly applicable to the field. Organisations such as these also recruit nurse-midwives, nurse anesthetics, and neonatal nurses. Nurses expecting to work for Doctors Without Borders can expect participating in mass vaccination initiatives for measles or triaging an influx of displaced people fleeing conflict. Working in these challenging settings ensures that you are offering your services to those who are in desperate need of your care and attention thereby confirming a greater social impact. 

Volunteering at NGOs and facilitating mass vaccinations is an in-demand opportunity for a nurse.
Insurance and Law Firms

A career as a legal nurse is in demand with so many lawyers handling medical cases requiring well trained and experienced people with medical knowledge. Legal nurse consultants assist attorneys in the litigation process, and alternatively can also assist in evaluating healthcare and medical insurance claims, conduct medical research, and use their knowledge of both the legal and nursing fields to make recommendations and select medical expert witnesses. To become a legal nurse apart from a degree in nursing and some on-ground experience in the profession, some legal education is also requested by employers. 

Providing medical legal help is a well-paid career option for a nurse
Private Companies

Nurses can choose to offer their services for occupational roles in private companies. Nurses in private companies are expected to provide high-quality care to the employees of the organisation, however they can also choose to work in nursing homes, or provide care to patients in a hospital. Responsibilities include initial patient assessment, monitoring vital signs, and nurturing patients to recovery.  

Conclusion

To conclude, with the constantly evolving medical practices, an education in nursing can open up a diverse range of career options. With rising demand for qualified and trained nurses, the profession offers many worthwhile opportunities that can be pursued suitable to your personality type, especially if you are a little open-minded.  To identify the best option for yourself the only way is to be bold and explore them, be it in a hospital or non-hospital setting.

“Written by Siddhi Latey (Weloquent)”

Augmented and Virtual Reality in the field of Nursing Education

Introduction

One of the most exciting developments in virtual reality has been its rapid entry into medical education and healthcare. Researchers, doctors, and nurse educators are discovering innovative ways to leverage immersive technologies and transform both healthcare teaching and practice.

Financial as well as regulatory restrictions has burdened the nursing education, as a result of which, providing adequate training has become a challenging task for the nursing educators. Not only the patients, but the practitioners and the devices used are at a risk of harm and malfunction if the quality of training is not up to the mark.

Simulation-based training has been used and shown to be an effective tool in the fields other than medicine as the virtual reality provides a range of learning and training enhancing aspects.

The Problem

Various problems challenge the expected level of skill proficiency of nursing students who practice clinical skills with patient manikin simulators, and inside simulated learning environments labs. These challenges include, but are not limited to,

  • limited availability of nurse faculty to provide instruction and repetitive practice needed for nursing student’s opportunities to practice outside nursing laboratories regular hours of operations.
  • The capability of nurse faculty to address individual learning needs of nursing students during each practice session
  • Instructional and evaluation variability among nurse faculty.

VR Technology can address all the above mentioned challenges and enhance the ability of faculty to sometimes quantifiably evaluate, student-learning performance. Augmented Reality (AR) and simulation are technology interventions modalities that can be integrated into nursing curriculum to help nursing student achieve and improve clinical skill proficiency.

Advantages of AR /VR application for Nursing Education

There are many advantages to using virtual reality in nurse training. Nurses can build familiarity with technology in a controlled environment, and learn by “doing,” rather than “seeing.”

  • Simulation helps develop competences for professional practice. Students who have the opportunity to develop clinical practices in a simulated environment report an increase in confidence, as they were able to transfer significantly the knowledge learned in the classroom to the simulated environment. Studies have reported improvements in the areas of critical thinking, confidence and/or knowledge/skills after participating in the simulation.
  • Simulation provides a rich learning opportunity for students to integrate theory with practice while making real-time clinical decisions in an environment that poses no risk to patients. HFS is one such example that provides students with a safe environment to learn and make mistakes without compromising patient safety.
  • Simulation can standardize clinical experiences in an environment with often unequal clinical learning opportunities. The use of High-Fidelity Simulation (HFS) in health care education has emerged as a possible solution to address limited clinical experiences.. Research studies have shown HFS to be beneficial in acquiring new knowledge in many clinical areas, including Medical-surgical, advanced cardiac life support, and acute myocardial infarction treatment.
  • Human patient simulation-based clinical nursing education has the potential to promote transformative learning and lead to a metamorphosis of students’ preconceived meaning schemes. It allows students to engage in social interactions and enhance their psychomotor skills in a patient safe environment, which helps most students relax and increases their confidence in performing clinical skills during a simulated clinical experience.

Current Implementation of AR/VR in nursing and medical education

1. The 2019 International Nursing Association for Clinical Simulation and Learning (INACSL) Conference was held in Phoenix Arizona with the Hayden Vanguard Lectureship by Bradley Chesham.

The INACSL meeting is a leading forum for nursing simulation aficionados, researchers, and vendors providing the ideal environment to gain and disseminate current, state-of-the-art knowledge in the areas of skills/simulation operations and applications in an evidenced-based venue.

The Hayden Vanguard Lectureship recognizes innovation in Nursing Simulation. Bundle of Rays focuses on “clinical skills and health-based training” utilizing virtual reality to teach anatomy and physiology, combined with simulation technology to link imaging to patient assessment. Designed by nurses, these training programs focus on patient safety, quality assessment skills and escalation of clinical deterioration. All of this is done in small class sizes at dynamic venues, conceptualizing the future of healthcare education.

Showcasing Augmented Reality (AR) in real-time, Brad shared how he could pick up a digital beating heart on his desk, bringing digital animation into a real background. Combining these technologies allows educators to have multi-user sessions across mediums to teach countless learners at the same time, even if they are located at different locations around the world. Brad shared that through his startup Bundle of Rays, to provide education for multiple learners at the same time even though they are spread across a wide geographic region.

2. Another excellent example of implementation of VR in Nursing education is A VR game that allows nursing students to practice urinary catheter insertion — what Kardong-Edgren (Suzan Kardong-Edgren, a professor at the School of Nursing and Health Science at Robert Morris University in Pennsylvania) called “a perfect marriage of nursing skills and software development”. Nursing students wearing Oculus Rift headgear and interactive gloves, called haptics, practice cleaning their hands and inserting a catheter into a patient’s bladder. In a study published in the March 2018 issue of Clinical Simulation in Nursing, Ellertson, Kardong-Edgren and Ann Butt of College of Nursing at University of Utah, report that the VR-trained students had the same pass rate as students who practiced the traditional way, on manikins, and that the VR students said they enjoyed the learning experience more.

virtual reality game

        A nursing student practicing catheterization procedures with a VR game developed by Boise State University and Robert Morris University. (Photo: Boise State University)

Catheterization was a good candidate for VR training, because it is a procedure that is difficult to learn and dangerous to patients if done incorrectly

Normally, nursing students have to practice urinary catheterization 30 to 50 times before they can do it on human beings. Many universities, however, don’t have enough medical simulation facilities and students are often not interested in repeating the same procedure over and over, Ellertson said.

“The underlying goal of the training is going to remain the same, but the shift is that we want students to practice more,” said Ellertson, who led a team of eight software developers to design, test, and then improve the VR game.

Kardong-Edgren and her team of researchers tested 20 nursing school students, who had practiced urinary catheterization on manikins. Lab assistants taught the students how to synchronize and calibrate the VR gear to their own movements, and then asked the students to perform the procedure. After an initial 15-minute orientation, students were instructed to use as little or as much of the remaining hour allotted to practice catheter insertion.

In the virtual world, the student goes from one corner of the room to another to find a tray where the sterile package lies. Then they need to wash their hands, don clean gloves, pick up the catheter package, and bring it to the patient. After cleaning the patient’s bottom, they need to correctly open the package, and insert the sterile catheter. To emphasize the importance of proper sterile technique, a green cloud of small falling particles appears on the screen if students did not wear their gloves properly.

The possibilities for using virtual reality in nursing are endless.

virtual reality result

Medical professionals will be monitoring the student’s practice on computers, where they can see the student’s vision on the left and real-time video of them on the right. (Photo: Boise State University)

Two weeks later, the students who underwent VR training for that hour did the same procedure on manikins. Professors compared their performance with that of nursing students who had only worked with manikins. Results showed that the VR-trained students not only had the same pass rate as the manikin-only group, but they also rated the VR training experience as “fun, engaging,” and they noted that it made them “lose track of time.”

A Novel Multiplayer Screen-Based Simulation Experience for African Learners Improved Confidence in Management of Postpartum Hemorrhage.

Introduction:

Postpartum hemorrhage affects approximately thirteen million women every year and remains a leading cause of maternal mortality in Asia and Africa. Mannequin-based simulation is the most common way for practicing care of critical patients but has its challenges when it comes to global health in developing countries.
A novel multiplayer screen-based simulation is developed in virtual world to practice team coordination with PPH cases. It was hypothesized that such a screen-based simulation may enhance the learner’s confidence and ability to manage critical PPH cases. The same was implemented in Mulago, Uganda.

3D virtual reality game

Screen-shot of 3DiTeams—postpartum hemorrhage—multiplayer screen-based simulation. Each character is controlled by a unique individual using a computer, mouse, and voice-over-IP headset.

Methods:

  • Study Design : pre- and a post-intervention survey.
  • Sample size : 48 interprofessional subjects
  • One of 9, 1 Hour simulation sessions in PPH software
  • The subjects were tested on 15 self-assessment question, before and after the intervention. And was designed to probe the areas of learning as defined by Bloom and Krathwohl: affective, cognitive, and psychomotor.

Results:

The confidence scores in each category of Bloom’s Taxonomy : affective, cognitive and psychomotor as well as combined score of all three increased significantly following the simulation experience.

Conclusion:

The study provides a preliminary evidence that multiplayer screen-based simulation represents a scalable, distributable form of learning. The same can be used effectively in global health education and training.

Award Winning AR Training and Simulation

Virtual Reality Airway Learning Lab, a program that uses cutting edge virtual reality technology in clinical education.

It was honored to win the Best in Show award at the annual International Meeting for Simulation in Healthcare in 2018 in partnership with Adtalem Global Education (NYSE: ATGE), a leading global education provider. (Dr Eric B Bauman and Dr Nick Slamon)

Acadicus simplifies and democratizes the educational learning curve associated with VR training, allowing for cost effective scenario creation by faculty and instructional staff. Stakeholders are able to create authentic environments that may not otherwise be available to students… this helps solve the bricks-and-mortar, time-and-place challenges associated with traditional simulation laboratories.

The 3D recording feature within the Acadicus environment is a powerful way for faculty and staff to create and capture their own instructional content. The multi-user feature allows for remote learners to collaborate in real-time in authentic spaces that promote environmental fidelity in ways that encourage the suspension of disbelief and promote psychological fidelity.

Applied as part of a layered learning approach, Acadicus promotes learner engagement and creates sticky learning experiences that often rival or exceed real-life learning experiences, effectively driving learners toward curriculum objectives and outcomes.”

Introduction to various airway instruments and how they’re used. Overview of steps and technique in airway management

References:

1. Shinnick MA, Woo M, Horwich TB, Steadman R. Debriefing: The most important component in simulation? Clinical Simulation in Nursing. 2011;7(3):105-11.

2. Jeffries PR. Getting in S.T.E.P. with simulations: Simulations take educator preparation. Nurs Educ Perspect. 2008;29(2):70-3.

3. Alinier G, Hunt B, Gordon R, Harwood C. Effectiveness of intermediatefidelity simulation training technology in undergraduate nursing education. J Adv Nurs. 2006;54(3):359-69.

4. Birch L, Jones N, Doyle PM, Green P, McLaughlin A, Champney C, et al. Obstetric skills drills: evaluation of teaching methods. Nurse Educ Today. 2007;27(8), 915-22.

5. Elfrink VL, Kirkpatrick B, Nininger J, Schubert C. Using learning outcomes to inform teaching practices in human patient simulation. Nurs Educ Perspect. 2010;31(2):97-100.

6. Hoadley TA. Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation. Nurs Educ Perspect. 2009;30(2):91-5.

7. National league for nursing. Society for Simulation in Healthcare 2014. A Vision for Teaching with Simulation A Living Document from the National League for Nursing NLN Board of Governors. 2015.

8. Birkhoff SD, Donner C. Enhancing pediatric clinical competency with high- fidelity simulation. J Contin Educ Nurs. 2010;41(9):418-23.

9. National League for Nursing. Main obstacle to expanding capacity by program type. 2014.

10. Brannan JD, White A, Bezanson JL. Simulator effects on cognitive skills and confidence levels. J Nurs Educ. 2008;47(11):495-500.

11. Parker B, Myrick F. Transformative learning as a context for human patient simulation. J Nurs Educ. 2010;49(6):326-32.

12. https://arvrjourney.com/nursing-students-are-learning-medical-techniques-with-vr-fd4c5a8d642d

13. https://www.healthysimulation.com/inacsl/

14. https://acadicus.com/

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