California State University, Stanislaus Chair of Nursing on Finding Your Niche in Nursing
By Jill Randolph
March 18, 2011
The following is an interview transcript with Dr. Peggy Hodge, Chair of the Department of Nursing of California State University, Stanislaus.
California State University, Stanislaus is a campus in the California State University system. It was established in 1957 and is located in Turlock, California. For each of the past seven years, CSU Stanislaus has been rated as one of the top 10 public master's universities on the West Coast by U.S. News & World Report. The main campus is spread across an area of more than 200 acres. The university offers an array of degrees and programs in diverse areas of study. Many students concentrate their studies in liberal arts, security and law enforcement.
Jill Randolph: What should high school students focus on to get into program like yours, and how soon should they start working on their plan?
Dr. Peggy Hodge: Students need to focus on science and math courses all through high school and earn good grades so that they are accepted to the college they want to attend. These classes are also important because science and math skills will be necessary throughout the nursing curriculum and after graduation.
Nursing is a difficult career and it takes dedication to be a good nurse, so high school students need to make sure it is what they really want to do. I recommend students take advantage of Regional Occupation Programs, career days, and talking to nurses to learn what they can about the career. They need to know what they are getting into and understand that it will not be like "Grey's Anatomy" or "House".
Jill Randolph: Do RN students have a mandatory number of clinical hours they have to complete to make sure they are on the right career path?
Dr. Peggy Hodge: Yes, all programs that lead to taking the National Council Licensure Examination (NCLEX) and becoming licensed have clinical hours. They are mandated by the state whether it is in a community college or a baccalaureate program.
Jill Randolph: Does your school provide RNs or is it strictly BSNs?
Dr. Peggy Hodge: Strictly BSN and master's. If students have an associate degree from a community college and want to come back to get a bachelor's degree, we have a RN to BSN program. We also offer the BSN for individuals without any nursing experience and want to go straight through and earn their bachelor's degree in nursing.
Jill Randolph: What type of personality and skills make a great nurse?
Dr. Peggy Hodge: Nurses have to be intelligent. Commitment to the profession is also important. It is not a job where they clock in, work an eight or twelve-hour shift, clock out, and not think about it again. It really is something they have to commit to because there are requirements for lifelong learning. They also need to be caring and compassionate.
Nursing is cognitively, physically, and emotionally demanding, but the field is huge and there are many options over the life of a nurse's career. A career in nursing is multifaceted and the possibilities are endless. They can be a nurse in the intensive care unit, a school nurse, a nurse educator, go into management, work in public health, work for insurance companies, or be a case manager or a researcher.
Jill Randolph: I understand many practices and hospitals require nurses to buy their own scrubs and pay for their lifelong learning experiences, but the doctors have a yearly allowance they can use toward books or education and doctor's lounges with free food. Why the discrepancy?
Dr. Peggy Hodge: Hospitals see nurses as overhead where physicians are considered revenue. Like the beds and lights, nurses are a cost to the hospital, but the physicians bring in money.
Nursing should be a revenue source, not a cost. There is evidence that patients are in the hospital for nursing care. They see the physician for 10 or 15 minutes a day at the most. They really are hospitalized for 24-hour nursing care. It would probably be different if the hospital could charge the insurance company for the nursing care that patients receive, like they can charge for X-rays and medication.
A lot of hospitals do provide uniforms for areas where it is required in the ICU or the OR. Many also provide either time off to take continuing education courses or pay for some of them. It is not a huge sum of money, but some hospitals do offer that as a benefit to nurses.
Jill Randolph: What about the growing emphasis on patient advocacy and prevention in which nursing is playing a bigger role. Do you think that will help raise the status of nurses?
Dr. Peggy Hodge: Changes are coming with healthcare reform that will make a difference in how nursing is viewed by the public. There is going to be more of a role for nurse practitioners and advance practice nurses, which will bring more recognition of the expertise and knowledge that nurses possess. Nursing is well thought of by the public, but unless they or family members have been in the hospital, the public at large does not always understand our role. Many people believe that we just follow doctors' orders, and they do not see the independent thinking and clinical reasoning it takes to be a nurse.
Jill Randolph: How has the job market for nursing changed over the past year? Have you seen signs of improvement, and if so, in any specific areas?
Dr. Peggy Hodge: The nursing shortage is very real. Temporarily, in many areas of the country, especially in California, the nursing shortage is on hold. Our students are having a more difficult time getting jobs now than they did two years ago because nurses who would have retired have decided to keep working due to the decrease in their 401(K). Nurses who were working part-time and their spouse or significant other was laid-off, are now working full-time.
Another issue is the result of high unemployment. Individuals who may have had elective surgery do not have health insurance right now and are not having those elective procedures, meaning the hospitals do not have as many patients. Those factors have temporarily decreased the need for nurses, but that is going to change as the economy improves and the crisis of the nursing shortage will return.
Jill Randolph: Which specialties within the field of nursing are most in demand right now?
Dr. Peggy Hodge: There is a great need for nurse practitioners and mental health nurses. Nursing faculty is also in demand because of a huge shortage in that area. We need master's and doctoral-prepared nurses to assume roles as faculty.
Jill Randolph: What are the most important things students can do to find a job in the nursing field? Given the job crunch across the board, how do they gain experience when there are fewer opportunities?
Dr. Peggy Hodge: Students should take advantage of their last semester in the nursing program, when they are placed with a preceptor, to complete roughly 150 to 200 hours. Students need to consider that time as the longest interview they will ever have. They must come in early, have a good work ethic, be a team player, get along well, and demonstrate they are smart and have good clinical reasoning. The nurses see all of this, and they can tell their manager, "hire that person". If the student is late, arrives with an attitude, and is busy texting, they are going to recommend that their boss doesn't hire that person.
Students also need to think outside the box. They may have an ideal position in mind, but they may have to work their way up to it. That might include working outside of the hospital, taking a part-time position, or moving. They should explore all of their options and not approach their job search with a narrow focus.
In California, we have approved a program by the Board of Registered Nursing called the nurse extern, which is similar to a work-study program and can help a student gain experience. I encourage students to try the program because it is a great opportunity to learn time management and offers exposure to the agencies that are doing the hiring.
Jill Randolph: Is there anything out of the ordinary that nursing students should do to stand out to employers?
Dr. Peggy Hodge: Students who have been actively engaged in community service activities make an impression. We had a student in Haiti building healthcare facilities when the earthquake hit. He was not providing nursing care, but he was in the healthcare arena and was certainly working above and beyond the call of duty. We also have students who are actively involved in working with homeless shelters. They are not getting paid for this and it is not part of school, but it shows who they are as a person and demonstrates something extra to a hiring agency.
Jill Randolph: What advice do you give students regarding networking?
Dr. Peggy Hodge: When students do their practical experiences, it is all about networking and making a good impression. It is important that the impression they make is the one they want to make.
We also encourage students to attend conferences. They should belong to the professional nursing organization for their area of interest, so that they can network with others and be aware of what is going on in their field. It makes them more professional and is something we encourage and expect from our students.
Jill Randolph: What is the most unusual interview question you have heard?
Dr. Peggy Hodge: I had an interview once where the nurse manager asked me to describe myself in one word. My word was "why" because I always ask the questions.
Similarly, I encourage our students to ask questions to help them understand their area of interest, network within that area, and move ahead of the competition.
