Oh, the places you'll go

"Even in the most difficult financial times, nursing allows you to find meaningful work," says Patricia Reid Ponte, senior vice president for patient care services and chief of nursing at the Dana-Farber Cancer Institute in Boston. She adds that although newly minted nurses will find fewer jobs at Boston area hospitals, opportunities abound in other settings, such as community hospitals, schools, doctors' offices, government agencies, home care, extended care facilities, and hospice.

"Everyone will find a job," agrees Dorothy Upson McCabe, who directs the Divisions of Nursing and Health and Safety for the Massachusetts Nurses Association. "It might not be the job you envisioned when you graduated, but you will find a job." And once a nurse has a foot in the door, opportunities for advancement abound.

Kathie Jose, chief nursing officer (CNO) for the Lahey Clinic, reassures today's graduates that the future is bright for nurses. "Now people are hesitating to retire," she says. "But this will pass. Eventually, experienced nurses will leave and will need to be replaced." According to the U.S. Bureau of Labor Statistics (BLS), this exodus will create hundreds of thousands of job openings for RNs and is one reason employment of RNs is expected to grow much faster than the average for all occupations through 2016.

Jose adds that the nurses who fill the vacated positions increasingly have to blend "high touch with high tech." With the complexity of patient care and spread of new technologies-electronic medical records and bar coding, for example-"nursing is an art and a science. It's about caring and being very competent."

Looking ahead, demand will be strong for nurse practitioners in the primary care setting, says Kathy Davidson, vice president and chief nursing officer at Caritas Norwood Hospital. This is due to the shortage of primary care doctors. She adds that there is also a need for nurses to work at the bedside as well as for those who work in certain specialty areas. Generally, RNs with at least a bachelor's degree will have better job prospects than those without one. Job openings will be most plentiful in doctors' offices, hospice, intensive care units, assisted living and long-term care facilities, and home health care agencies. Changing demographics will also lead to a need for specialists in critical care, diabetes, oncology, and wound care. And all four advanced practice specialties-clinical nurse specialist, nurse practitioner, nurse-midwife, and nurse anesthetist-will remain in demand through 2016.

There is also an enormous need for faculty in nursing programs, says McCabe. Wendy Slabodnick, who directs the Wound Care Center at Emerson Hospital, says she loves working in wound care because of the gratitude her patients express. "Every day we are saving limbs and healing wounds in people who were told they would never recover. So when they do, there is a tremendous amount of satisfaction."

In her 20-plus years on the job, Slabodnick has worked as a floor nurse, started up an inpatient and two outpatient wound centers at hospitals, worked in home health care (in middle management and as executive director), and helped start a wound care division at a biotech company. "There is so much we can do with a nursing degree," she says. "It is really limitless."

Some nurses don't deal directly with patients at all. These include nurse coaches, legal nurses, forensic nurses, case managers, and infection control nurses. Nurses also work as researchers, administrators, nurse educators, and nurse informaticists.

Wherever nurses work and in whatever capacity, the variety is topped only by the rewards. When CNOs such as Jose and Davidson make their rounds, they say, they are reminded daily of how exceptional nurses are; whether it's seeing a nurse midwife deliver a baby or reading a letter from a woman thanking her clinical nurse for caring for her husband and mother and offering reassurance and a shoulder on which to cry.

"Just the other day I watched a nurse sit down beside an 87-year-old gentleman, take his hand, and spend time with him," says Jose. "And the man was not even her patient!" Afterward, the nurse offered her insights to another nurse who was responsible for the man. "To see that level of caring and concern was very special."