1. Seagraves, Karen B. ACNS-BC, ANP-BC, APRN-BC, MPH, MS


Deepen your roots and reach new heights in your career while staying with your current employer.


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DO YOU CRAVE A CHANGE, a challenge, or maybe just higher pay, but you're afraid to jump ship in the current economy? If you've worked for your current employer for a long time, the threat of losing your benefits and your seniority may be keeping you in your current position. Or facilities in your area may not be hiring.


You may be able to experience the change you desire by taking advantage of new opportunities while staying in your current organization. This article will explore these options.


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Bloom where you're planted

Because many hospitals have shifted their focus from employee recruitment to retention, you have more opportunities than ever to gain enriching work experiences. One new trend is for hospitals to offer professional development programs. Criteria for advancement levels or steps are set and provide opportunities for growth. Nurses can choose from different elements to meet requirements and showcase individual talents. They may receive financial incentives as additional percentages added to their base salary over time or as one lump sum on completion.1


Criteria may include activities such as mentoring, precepting students or new employees, working in a relief charge role, or obtaining customer service recognitions from patients or fellow employees. Successful completion of these programs can move you to the front of the line for promotion and into a position where your voice can be heard.


Cashing in on benefits

Tuition reimbursement can help you advance in your level of practice, increasing both your knowledge and income potential. Research studies repeatedly show that higher education levels advance critical thinking and decrease patient mortality.2 Many institutions will pay for professional conferences and seminars that enhance the care of specific patient populations. Check your employee benefits to see what your organization offers.


Obtaining specialty certification is recognized as a mark of excellence in nursing. Besides having the cost of review courses or exam fees reimbursed, you may receive increased compensation or recognition for this achievement. The American Nurses Credentialing Center (ANCC) offers many exams in areas such as medical-surgical, oncology, neuroscience, pediatrics, and OR nursing.3 And many nursing specialty organizations, such as the Academy of Medical-Surgical Nurses and the American Association of Critical-Care Nurses, also offer certification. For more organizations, see Credentialing resources on p. 34, which continues on


Exams are offered at local testing centers with flexible scheduling. Certification is essential for hospitals working toward Magnet status and may also be required for advancing to a clinical leadership role such as a staff-development specialist or nurse manager at some institutions.


Getting an education

Attending educational programs presented by a hospital system or locally sponsored offerings can increase your competence and self-confidence and expand your practical skill sets for little or no cost. Computer classes can lead to a position in informatics, and classes in leadership development and conflict management can lead to supervisory or management roles.


Professional journals and websites may offer free or low-cost continuing education units (CEUs) or contact hours. Contact hours are units of education accepted by certifying bodies such as the ANCC for maintaining certification. While some states don't require CEUs, they may accept contact hours earned through state board of nursing-approved programming.3


Become an expert

Selecting a specialty within an area of practice on which to focus can help you become an expert, maybe even an indispensable one. This can enhance coworker confidence and help you develop into an informal leader.


Consider cross-training to other specialty areas, whether from back office to procedure rooms, from the bedside to postanesthesia care unit or I.V. team, or even by floating to other similar units.


Hospital administrators usually welcome internal transfers. Check out another job by taking one day to shadow a nurse who works in another area that interests you. Externships for experienced nurses offer a comprehensive introduction and transition into specialty areas including labor and delivery, peri-operative care, or critical care. Some specialty areas offer benefits such as higher pay and more flexible scheduling.


Take on a leadership role

Participating in shared governance or other internal interdisciplinary groups that guide the care and services of an organization can enlighten you about the administrative and leadership structure and functions. You could be a nurse representative on councils and committees that focus on education, quality and patient safety, policy and procedure, or professional development. If the organization doesn't have shared governance, introduce the idea to leadership and ask how you can become involved.


Volunteer for committees or community outreach activities. Getting involved in the community by participating in health screenings and speakers' bureaus will help you develop skills in communication and offer rewarding experiences. The leadership and organizational skills learned by participating in governance and volunteering are qualities management seeks when reviewing resumes and interviewing potential employees.


Share your knowledge

Writing for publication can let you share your insight and experiences with others who may benefit from your knowledge. Perhaps you worked on a special project or found an innovative way to handle an aspect of patient care. If so, write about your experience.


Writing is a formal way to share with other nurses by providing a clear, concise explanation for a procedure or a step-by-step guide to a process change. Sharing a meaningful personal experience may inspire fellow nurses and reinforce why they choose to stay in the profession.


Publications provide guidelines and tips for writing and submitting your work. For Nursing2010's guidelines, go to


Incentives for staying

Growing your career doesn't have to be expensive. In exchange for a commitment to remain at an institution for 1 to 3 years, many hospitals are paying off student loans or sponsoring full tuition for nurses who are going back to school for their bachelor's or advanced practice degrees. Scholarships for productive nurses who demonstrate excellence in leadership or clinical skills are one of the ways hospitals are emphasizing retention.


Because of a shortage of clinical nurse specialists, my employers decided to grow their own. Several nurses were chosen from the pool of applicants and, after a series of interviews, a group was chosen to receive full scholarships for a master's degree program. Additional scholarships are available to undergraduate nursing students showing great promise in academics and extracurricular activities.


Choose a route, then prosper!

Choose one of many opportunities for personal, academic, and professional growth in nursing. Despite leaner times, higher expectations are being placed on nurses to provide competent, high-quality care.


Customer service and patient satisfaction scores are used to guide annual compensation and set pay scales. You can make sure you're in the top of the range by participating in education and leadership programs. Developing the qualities that make you special and sharing your expertise and commitment can go a long way toward growing your career in nursing.




1. Riley JK, Rolband DH, James D; Norton H, James D, Norton HJ. Clinical ladder: nurses' perceptions and satisfiers. J Nurs Ad. 2009;39(4):182-188. [Context Link]


2. Halfer D. Supporting professional development: A magnet hospital's story. J Nurses Staff Dev. 2009;25(3):135-140. [Context Link]


3. American Nurses Credentialing Center.[Context Link]