Managing Your Career

Successful people actively manage their careers rather than wait for “lucky breaks.” Although trusted others may guide or influence career development, every individual must manage his or her own career. Tools to document accomplishments and ways to extend career development beyond the work setting are considered in this chapter. Continuous lifelong learning and the ability to demonstrate and document competency are critical elements in effective career management.

Objectives

• Differentiate among career styles and how they influence career options.

• Analyze person-position fit.

• Develop a cover letter and résumé targeted for a specific position.

• Analyze critical elements of an interview.

• Describe a variety of professional development activities, including academic and continuing education programs.

• Identify contributions you could make and benefits you could derive from active involvement in professional organizations.

professional association (organization)

résumé

The Challenge

Daniel Weberg RN, BSN, MHI, CEN Director, Academy of Continuing Education, Arizona State University College of Nursing and Health Innovation, Phoenix, Arizona

When I graduated from nursing school 5 years ago, I knew that I wanted to work in the emergency department right away. I was surprised at the opposition from most faculty and friends who told me, “You have to get at least a year of experience in med-surg first.” Another challenge for me early on was the drive I felt to expand my skills in different directions, not only in direct bedside care. During my undergraduate nursing courses, I had taught myself how to run the human patient simulators used in the learning laboratory, and I thought there might be a market for those skills. My struggle during this time was finding the direction to get to an objective that I could not clearly express and find a unique type of job that had not been created yet.

What do you think you would do if you were this nurse?

Introduction

The number of career options and paths within nursing is staggering. Some of these options are the “traditional” and highly valued roles nurses have performed for centuries—providing direct care to patients, leading teams or organizations, teaching, providing public health or school health services, or working in an occupational field. Other options have emerged over the past decade, and new options continue to emerge. Serving all patients and healthcare consumers as a legislative aide, for example, is not a common role, but it is one that helps shape the state’s or nation’s view of health care. Screening patients for insurance benefits and working in the clinic at a local grocery or chain store are other examples of the less traditional roles nurses fill. However, these numerous options provide a challenge: how to build a career, which education best serves the role, which experiences best prepare nurses for a specific field or role, and what new activities and roles need to be developed? Because a career extends over a lifetime and because nursing is defined by law, not by employing organizations, making choices can redirect a nurse’s future. Some options build primarily on experience and others on education and experience; all, however, require that a nurse engage in professional development and continue to advanced expertise to meet the evolving challenges in health care. How nurses reach their career goals depends on the goals they set and how they manage their career development.

A Framework

A career can be defined as progress throughout an individual’s professional life. It can be developed in numerous ways, but it begins with selecting positions that contribute to career goals. Because so many roles can be performed in the name of nursing, the driving force for a career option should be the same as the force that drives a decision about a particular position. That force is the fit between a person and the position or career path. There is a relationship between an individual and a position, and that same relational fit is exhibited in a career path (Figure 29-1). A good fit is built on strong, similar goals and tolerable (or growth-producing) differences. The whole of any work situation is composed of the two elements—person and position—interacting in an environment in which other elements influence both. The whole is symbolized by blending a person’s talents with a position’s expectations to create the productive whole. Analyzing positions and the required skills in light of individual talents can help applicants determine positions that fit with their strengths and define gaps to be addressed. When gaps occur, skills development might be needed to form a fit or the position may not be a good fit.

The person/position fit and how that fit evolves throughout a career are critical considerations in appreciating positions held throughout a career. Thus, when considering a career path, such as practitioner or administrator or educator, the person needs to recall prior positions held and the aspects of those positions that were most rewarding. As an example, if a nurse held multiple positions and then he determined that the teaching and learning opportunities were the most rewarding aspects, the career plan of educator might emerge. Whatever career is pursued, one key strategy is planning to obtain the right education and experience.

Generations may view work, positions, and careers differently, yet many similarities exist across generations. For example, Deal (2007) reported that all generations prefer face-to-face coaching. Younger generations, however, sought more frequent feedback than did older generations. In addition, Deal reported that almost everyone surveyed wanted to learn and thought learning was important. The learning related to the work he or she needed to do, not to the generational group in which he or she was categorized. An important finding was related to the stereotype of younger generations wanting to learn everything via a computer; that was a wrong assumption. The key to applying these points about coaching and learning is that leaders and managers must listen to others to learn what others want and need. This strategy can apply to career development as well. Listening to what individuals tell others about their own interests and strengths can help them identify appropriate resources for personal and professional development and for creating effective networks. Speaking up and listening carefully are important skills that every nurse can use in being successful in a position and in pursuing a career path.

Another way to think about career development is to consider the work of Citrin and Smith (2003), who studied “extraordinary” careers. They identified three broad categories of promise, momentum, and harvest. These terms suggest movement from early to late career. Thus, early in one’s career, the focus is on developing skills, establishing credentials, and socializing into the role. Mid-career, the focus often shifts to honing specific areas of expertise (the things by which we will be known) and being more aware of the fit of positions within the broad array of opportunities that will enhance some goal. Finally, in a later career stage, many individuals focus on the profession (the broad view of the work) and how to leave it better off as a result of being a member of the profession. This movement through nursing life is predicated on having a vision of a career as opposed to a series of jobs.

Finally, the classic work of Friss (1989) provides another way to look at careers through considering styles (Table 29-1). Her view of four possible career styles describes one being no better than another; rather, each is different. Steady state (positional plateau) careers describe those individuals who select a role and stay in that role throughout the career. This type of career style is common in rural settings and for those individuals who commit their working life to a positional category such as staff nurse, clinic nurse, or nurse practitioner. The focus of this career style is to become increasingly competent in the role and clinical area. Linear careers are those that represent vertical movement in the organizational hierarchy. This movement often creates more organizational knowledge and a more diversified view of what comprises nursing. This movement is characterized by changes in title; for example, moving from staff nurse to nurse manager to director represents this kind of career style. Entrepreneurial and transient style is appealing to nurses who wish to “see the world” or have a creative bent. The final style, spiral, focuses on the movement in and out and up and down. For example, nurses who move from within an organization as a staff nurse to nurse manager at another organization, then move in that organization to a nursing director role, and later leave for another opportunity exemplify this style.

TABLE 29-1

CAREER STYLES

	EXAMPLE	DESCRIPTION	MOTIVATION AND CHARACTERISTICS	MANAGERIAL CONSIDERATIONS
Steady State	Staff nurses	Constancy in position with increasing professional skill	Increasing expertise High professional identity Obligation to serve Maintenance of standards Autonomy in performance of care Preference for action Personal accountability The work itself Stability	Hold work in high esteem Decentralize Use and recognize abilities Provide feedback about patient outcomes Reward competence and tenure Provide continuing education Provide permanent assignment
Linear	Nursing service administrator	Hierarchical orientation with steady climb	Requisite authority and power Had a challenging first job Guided by internalized norms Money Recognition Opportunities for self-development	Provide management development Reward and value both education and competence Modify management selection and development systems Provide decreasing supervision
Entrepreneurial and Transient	Nurses in private practice; temporary assignments	Desire to create new service; meeting own priorities	Limited organizational commitment Opportunists Novelty/creativity Other people Achievement	Use flexibility to organization’s benefit Avoid burdening them with organizational and practice decisions Provide immediate feedback
Spiral	Nurse who returns after raising a family	Rational, independent responsibility for shaping career	Novelty Prestige Intense period of employment followed by non-employment or a different employment Care for others Opportunities for self-development Typically well paid, service-oriented Recognition	Configure specific job that needs doing Be flexible about terms and length of commitment Find challenging initial assignment Negotiate Encourage creativity

Data from Friss, L. (1989). Strategic management of nurses: A policy oriented approach. Owings Mills, MD: AUPHA Press.

It would be easy to label nurses’ careers if they could each be described by a single style; however, the fluidity of the profession allows nurses to switch foci along a career path to gain a specific experience or meet a personal need. This dynamic suggests that it is difficult at best to label a nurse’s style, career category, or generational attributes. The same dynamic makes leading and managing a group of nurses a challenge and provides for great diversity to meet organizational needs and nurses’ career goals. The best opportunity for nurses to manage their careers and for a manager to help nurses gain important experiences is for the individuals to know themselves.

Knowing Yourself

Being a professional holds both privileges and obligations. The legal privileges and expectations are codified in the state nursing practice acts, rules, and regulations. Because licensure is designed to provide the baseline (i.e., the minimum expectation), it does not identify or obligate any practitioner to function in a professional manner as defined by the profession itself. For example, no practice act identifies membership in a professional association or providing community/professional service as an expectation. Yet the profession, through various professional organizations, embraces the expectation that nurses will belong to professional associations and provide leadership in improving communities. For example, the Forces of Magnetism (www.nursecredentialing.org/Magnet/ProgramOverview/ForcesofMagnetism.aspx) identifies the expectation that nurses are involved in their community. The challenge, of course, is how to incorporate these activities into a busy, committed life! It often is those “additional” activities and interests that enrich a career and provide for invaluable insight into clinical and professional issues. Knowing what is important, what is valued, and the commitment needed forms the basis for understanding one’s self.

Whether positions are plentiful or scare, knowing one’s self can focus the available work or selection process toward capitalizing on one’s strengths. Even assessing one’s strengths through a formal avenue (e.g., Strengths Finder 2.0 at www.strengthsfinder.com/113647/Homepage.aspx or Buckingham’s [2008] The Truth about You: Your Secret to Success) can provide insight. Therefore the beginning of creating a person/position fit is understanding the person involved. Throughout school and initial experiences in nursing, insight begins to evolve that helps each of us determine our preferences for our life work. It is not that some positions are valueless; rather, it is that some positions add more to what we want to be able to achieve in the long term than other positions. As an example, any position that offers educational compensation or flexible scheduling might work well for the short term if the goal is to return to school and complete advanced education for a specialized role.

Exercise 29-1

Using an established description of a registered nurse—for example, the one created by the Texas Board of Nursing to describe beginning competencies of new graduates describes personal interests, skills, and abilities in the following areas. Consider your talents and values from the multidimensional view of nursing: communication, physical and psychological care, management, learning, teaching, scholarship, and involvement in the profession.

Being able to describe yourself from various perspectives is useful. First, knowing your strengths tells you what you bring to a position and what you can rely on. When you know your strengths, you can say what they are in a succinct manner and use them as a filter in reading position descriptions to find your fit and to learn the organizational language. An analysis of your competencies allows you to see what work needs to be done to meet required or desired standards and competencies. Finally, entering into such analyses can help you see the bigger picture of your career and how what you can learn from a particular position might contribute to your overall goals. The career styles described in Table 29-1 include the motivation and characteristics of each style. Seeing how your self-analysis fits with the descriptors in the third column may suggest how you see yourself approaching your career. The goal of all this work is to know yourself well so that your pursuit of a position or career path fits you and your strengths.

Knowing the Position

Few people, including nurses, assume a position and remain in that position forever. Exceptions occur in rural areas and in highly specialized positions. Thus most nurses hold more than one position throughout their work life. Those positions can be selected by chance or by plan. Chance positions should not be ignored, but they should be evaluated in light of career goals and an assessment of the position and the organization. Managing a career actively allows for these chance opportunities to enrich the career rather than detract from it. Rapid changes in health care require an evaluation of each employment opportunity. Can a position contribute to increased skills and competencies? Does a position have the potential to recast one’s professional profile so that others see the potential for greater contributions? Are the benefits of the position so enticing that they offset limitations of the position itself? These are the kinds of questions to ask yourself when considering a particular position.

Position assessment begins with understanding the basics of the organization and its vision and mission. Assessment also requires finding out specifics of the position, which may be available only through an interview. Bolles (2009) points out that most managers look first within the organization to promote someone rather than looking broadly at the talent available. This is in contrast to how many people seek jobs; they look broadly first. So, one key strategy to use is selecting an organization where you want to work, even if the position is not exactly the right one. The potential for inside connections and networking, in addition to knowledge about management styles in the organization and future position openings, can lead you to the position that is the right fit for you.

Career Development

A career extends beyond employment positions. A career includes the various ways in which an individual engages in activities that provide care to patients, support that care, educate for that care, support the providers of that care, study the ways in which to deliver the care, and engage in the broader perspective of professional and community service. Thinking broadly about a career in a rapidly changing field such as health care is critical to remaining competent and relevant. Licensure carries certain expectations about maintaining competence and reflecting professional standards. Legislators enact legislation based on the needs of the citizens and in response to political pressures. When a profession is protected by legislation, others, such as consumers, insurers, regulatory agencies, and employers, expect that professional standards have been and will continue to be met. Continuing competence is a focal issue for every professional.

In today’s rapidly changing society, a position that was once “a fit” may no longer work. The position may have evolved as much as the person did. If the movement was in harmony, the fit remains, but if the position changes one way and the person another, the fit devolves.

Bolles (2009) also suggests that there are life-changing positions. These can best be described as changing positions and fields simultaneously (such as may occur with a spiral career style). For example, when a charge nurse in a critical care unit assumes the role of a chief nursing officer in a rural community hospital, a major shift has occurred. Nurses who follow a spiral career path, especially if they are second-degree students (meaning they have a degree in another field and then enter nursing), may also experience this phenomenon. These individuals may have worked in another field and now are pursuing their hearts. They may have become bored with a career that had few interactions with people, or they may have studied in fields such as science and realized that the best application of knowledge could occur in patient care. Because of prior career successes, these individuals may craft career patterns that appear very different from the majority of the profession: they are using talents from two fields and are trying to capitalize on both.

Core career development strategies are important to success. Selecting professional peers and mentors to share in your development is crucial to gaining good, ongoing advice. Having a few well-chosen peers, mentors, and role models who respond openly from various perspectives can enrich career planning and development.

Exercise 29-2

Think about an experienced nurse who serves as a role model to you. Would you want that person as a mentor? If so, consider how you would enlist that person’s assistance in molding your career.

Table 29-2 defines six key aspects of creating and managing a career. Although each aspect is important, one aspect that can be most useful to consider is the “who”—the mentor you choose. That person can inspire new thinking and new opportunities and steer you to various roles and clinical areas. That person can also create connections for you and help guide decisions related to timing and context. Mentors might even be able to create opportunities for you to test new approaches to clinical care or to new aspects of a position you thought of as boring.

TABLE 29-2

KEY ASPECTS OF CREATING AND MANAGING A CAREER

Who	Mentor
What	Role and clinical options
When	“Timing is everything”; always open to opportunities; don’t leave in the middle of a critical project
Where	Local or not; inpatient or outpatient
How	Proactive; your search is your job
Why	Seeking challenge/testing out ideas

Career Marketing Strategies

Even the steady-state or experienced nurse who is not seeking a new position needs to have a curriculum vitae (CV) or résumé that can document continued development of expertise. Interviewing, which is a two-way process, also contributes to successful position choices and career development.

Although professional data can be recorded in numerous ways, most people do not do so in a systematic manner. Therefore, when information about one’s career is needed quickly, it is difficult to recall and then to hone the most pertinent information for a position. A goal of this chapter is to develop a systematic strategy for creating marketing documents that you can use throughout your professional career. Some organizations use an electronic form of professional records so that an individual can readily access and convert the information into various documents. The National Student Nurses Association; the American Nurses Credentialing Center; and the Honor Society of Nursing, Sigma Theta Tau International, provide access to such an electronic approach. Portability of information is an important consideration so that information moves with an individual throughout a career.

Many position searches, even those internal to an organization, begin with a résumé. The key is to make information distinctive in telling your professional story and in establishing the appearance of a competent professional.

Data Collection

Depending on your unique background, the extent of data collection varies considerably. The first step is to collect all your professional career information. If you are fairly new in the profession, analyze anything special you did in school, such as electives, offices held, and special assignments, honors, and recognitions. If you are a second-career nurse, consider your previous work and how it relates to your profession now. If you have an employment history, start with your nursing positions. Include relevant information from volunteer roles, which can illustrate skills such as in leadership, ability to balance budgets, communication, and political astuteness, as well as indicate professional commitment.

To begin data collection, especially if you have not kept records before, begin with where you are and think back. If you have short experience or no difficulty recalling details, you are in great shape to start a systematic plan. If, however, you have a long history as a nurse or a prior relevant career, your task is more challenging because you have to actively think about what you did in the past and, for a prior career, determine how to translate those experiences into relevance for nursing. The important aspect of this phase is to begin the process and to save it electronically so that you can shape information for specific reasons using a cut-and-paste technique rather than creating an original document each time you need to provide information about yourself.

Compile as many facts as possible for each of the ten categories identified in Table 29-3. Even if you have no entry for a specific category, retain the heading as a reminder and think about what you would like to be able to list there in the future. If you do not have regular access to a computer, at least keep the information on a CD or flash drive so that you do not need to recreate it the next time. This is your private data bank for information to list on a curriculum vitae or to select for a résumé.

TABLE 29-3

DATA COLLECTION

TOPICS	FACTS NEEDED
1. Education	Name of school, address, phone numbers, website address, years of attendance, date of graduation, name of degree(s) received, minor earned, honors received (e.g., Dean’s List)
2. Continuing education	Dates attended, places, topics and any special outcomes, type and amount of credit earned
3. Experience	Dates of employment, title of position, name of employing agency, location and phone numbers, website address, name of chief executive officer, chief nursing officer, immediate supervisor, salary range, typical duties (role description)
4. Community/institutional service	Dates of service, name of committee/task force and the parent organization (e.g., name of hospital or professional organization), your role on the committee (e.g., chairperson, secretary, member), general description of committee’s functions, any unique accomplishments
5. Publications	Articles: author(s) name(s), year of publication, title, journal, volume, issue, pages; books: author(s), year of publication, title, location and name of publisher
6. Honors	Date, description of award, special factors related to award (e.g., competitive, communitywide, national)
7. Research	Date, title of research, role in research (e.g., principal investigator, co-investigator, team member), funded/unfunded
8. Speeches/presentations given	Date, title of speech presented, place, name of sponsoring organization, nature of the presentation (e.g., keynote, concurrent session), your honorarium
9. Workshops/conferences presented	Date, title of workshop/conference presented, place, name of sponsoring group and nature of the presentation, brief description of the activity, your honorarium
10. Certification	Initial date of certification, expiration date, certifying body, area/type of certification

Exercise 29-3

Go to the Evolve website (http://evolve.elsevier.com/Yoder-Wise/) and draft entries for your data bank. Using that information, draft a curriculum vitae and a résumé for a position you are seeking. As a checkpoint for yourself, make a list of four or five key strengths or facts that you want others to know. Be sure they are listed in your CV and described in your résumé. Save the list for preparing for interviews.