Career paths: the short, sweet, and roundabout

1 September 2013

We look to nurses as learners, educators, and leaders in this edition. Read on about teaching fledgling nurses in the classroom and on the ward, fostering leadership skills, nurses sharing their career tales, and milestones past and future in the recognition of competence and professional development.

Career paths can be straight, windy, or full of detours. Nursing Review asked five nurses from across the country in senior roles to tell us what path they followed to where they are today. They all share a common passion for nursing but none share the same path.

One took a side trip to caregiving, another started their journey as an enrolled nurse, one literally grew up on hospital grounds, and others had career paths that took unexpected u-turns. They each have a good tale to tell and tips to share on career planning, the skills and qualifications helpful in their roles, the value of ongoing education, and how important a good mentor can be.

From caregiver to aged care nursing director

 

NAME:

Kate Gibb

JOB TITLE:

Nursing Director, Older People – Population Health, Canterbury District Health Board

NURSING QUALIFICATIONS:

  • Caregiver*
  • BN 2004
  • Christchurch Polytechnic Institute of Technology
  • PGDip in Health Sciences (Gerontology Nursing) 2008
  • University of Otago, Christchurch
  • PGDip in Health Management (in progress) University of Otago, Christchurch

*I first started my nursing degree in 1997 but soon realised I needed some time out to ‘grow up’ a little bit more. I had been working part-time as a caregiver while studying, so I decided to go full-time as a caregiver, which I loved. I later re-started my studies and focused on gaining clinical experiences that would support me in a nursing career for older people.

Briefly describe your initial five years as an RN?

Immediately after qualifying, I worked as an RN in the residential care facility I’d already been working in as a caregiver. I then gained a place on the new graduate programme with the Canterbury District Health Board, at Older Persons Health’s Assessment, Treatment, and Rehabilitation service at The Princess Margaret Hospital. After some time as a staff nurse, I returned to the aged care sector in various senior clinical roles, eventually becoming manager of a rest home, hospital, and retirement village.

Did you have a career plan (vague or definite) on becoming an RN? How did those first five years influence your subsequent career?

I had the fortune of working with an amazing mentor who encouraged me early on to consider a leadership role within aged care, and who spent time and energy supporting my development through my few years as a RN. I continued to love working with older people, so I knew that this was the area of nursing I wanted to pursue. The nursing experience and skills gained from working with older people are significant – the level of autonomy, assessment skills needed in caring for people with such complex needs, and leadership skills gained in working in residential care are often undervalued.

What qualifications, skills, or stepping stone jobs do you think were particularly helpful and/or necessary in reaching your current role?

I initially completed a postgraduate diploma in gerontology nursing and have begun another postgraduate diploma in health management, which I should finish in a few months. I’ve also been fortunate to be a member of the New Zealand Palliative Care Council since 2008, and this has been a fantastic opportunity to better understand our health system and strategic planning to improve outcomes for our older people.

What personal characteristics do you believe are particularly important for nurses working in your role?

A passion for nursing first and foremost! While I don’t work directly with older people currently, the ability to listen and form relationships is as important in my role now as it was when I was in previous more ‘hands on’ roles.

What career advice would you give to nurses seeking a similar role to yours?

I think ongoing education is so important for exposing nurses to a breadth of knowledge outside their workplace. I’m a firm believer too in the impact mentorship can make. I would highly recommend nurses finding someone whose career pathway you admire and asking for their support.

Describe your current role and responsibilities?

My role is to provide professional leadership, knowledge, and strategic advice to nurses and organisations working with older people throughout Canterbury and the West Coast, and to work with primary and community providers to promote and support collaborative nursing initiatives and developments. This means I get the opportunity every day to meet and work with passionate people working within our health system to make a difference to older people in the communities where they live – I’m very fortunate.

Guided by making a difference for Māori & Pacific

 

NAME:

Amio Ikihele

JOB TITLE:

Senior Lecturer at Manukau Institute of Technology’s Faculty of Nursing and Health Studies

NURSING QUALIFICATIONS:

  • BN 2004 Manukau Institute of Technology
  • PGCert in Health Science 2009
  • University of Auckland
  • Cert in Tertiary Teaching 2010
  • Auckland University of Technology (AUT)
  • PGDip in Health Sciences 2012
  • University of Auckland
  • MHSc (First Class Honours) 2012
  • University of Auckland

Why nursing?

My interest in nursing was brought about by my grandparents’ health; both suffered from long-term conditions (LTC), with my grandmother having serious complications from type 2 diabetes. My mother was caring for them, and I wanted to understand more so I had the knowledge to help my family and others.

Briefly describe your initial five years as an RN?

I worked for four years as a primary health care nurse in South Auckland with Mangere Health Centre and one other clinic. I then became a GP liaison for Breast Screening with Counties Manukau District Health Board for one year before returning to Manukau Institute of Technology (MIT) in 2009 to work as a lecturer at the nursing faculty.

How did those first years of nursing influence your subsequent career?

As a student, I realised working in PHC was the area where the biggest impact could be made on improving the health of people with LTC. I worked with a lot of Māori and Pacific people in my first jobs and felt this was where I was needed most.

Māori and Pacific health has always been a passion for me because of the health disparities faced by these two groups and I want to help to improve this situation

Being Niuean and Māori, I was able to relate to both Māori and Pacific people and their families and understand their needs.

In my breast screening role, I worked to raise awareness of the need for breast screening amongst Māori and Pacific women, where there are a lot of disparities in screening rates and a higher incidence of breast cancer. Because the age for breast screening is 45 to 69, there were definite barriers with me being young. The role was all about building relationships and trust to enable them to feel safe when using the service.

What led you into your current field or specialty?

Lecturing was always a job that I wanted to do. A position came up and I thought I would go for it.

When I was training to be a nurse, there were only ten Māori and Pacific nursing students in a class of around 80. I also have a big interest in workforce development, so I wanted to see more Pacific and Māori people training to become nurses, and I love teaching so I felt this was a way I could encourage others into the field.

By teaching the student nurses about the health disparities faced by Māori and Pacific, I hope to enable them to be both clinically and culturally competent when working with Māori and Pacific individuals and their families.

What qualifications, skills, or stepping stone jobs do you think were particularly helpful and/or necessary in reaching your current role?

When I first started at MIT, I was completing my postgraduate diploma. To be a lecturer, I needed to show my career plan and that I was working towards my Master’s degree. I started my Master’s in 2010 and wrote a thesis about the sexual health behaviours and sources of information amongst New Zealand-born Niuean adolescent girls. During the writing of my thesis, I had my two children and completed my Master’s in 2012. I loved writing my thesis and am contemplating doing my PhD in 2014.

What personal characteristics do you believe are particularly important for nurses working in your role?

A passion for nursing and a love of teaching, plus good time management, a sense of humour, and an ability to relate well with others from diverse cultural backgrounds.

What career advice would you give to nurses seeking a similar role to yours?

Go for it! If you feel that teaching is something you want to do, then apply because there’s always a lot of support that will be provided in order to help you transition from being a clinical practitioner to a lecturer to help you succeed in this role.

Describe your current role and responsibilities?

I work as a senior lecturer and teach on MIT’s new Bachelor of Nursing Pacific programme that started in 2011, which will see its first graduates at the end of 2013. I love teaching on this programme because it incorporates the importance of being both clinically and culturally competent when working with Pacific and non-Pacific people. Our students learn to work within two worlds, a skill which is strengthened by the experiences they bring with them from home and through their personal development within the course.

Career u-turn leads to rural specialist role

 

NAME:

Cathy Sampson

JOB TITLE:

Rural Nurse Specialist,

West Coast District Health Board

NURSING QUALIFICATIONS

  • RN 1987 Nelson Polytechnic
  • BN 1994 Otago Polytechnic
  • PGDip in Occupational Health 1996
  • University of Otago
  • PGCert (Child and Family Health Nursing) 2003 Otago Polytechnic
  • Prof. Cert. in Allergy Nursing 2007
  • University of South Australia
  • MN 2007 Otago Polytechnic
  • PGCert (Advanced Clinical Nursing) 2010 University of Otago

Briefly describe your initial five years as an RN?

I held several staff nursing roles in Dunedin Public Hospital (gynaecology, mental health, and casualty) for two years after graduating. I then joined colleagues in the United Kingdom as an agency RN working in private hospital medical wards, home-based care for the disabled, and a community unit for people with AIDS. I returned to Dunedin’s ED on night shift while studying for my postgraduate diploma in occupational health.

Did you have a career plan on becoming an RN?

No, I didn’t have a clear plan. However, my time overseas did help to shape my path into primary care.My years as a hospital-based nurse were valuable in consolidating basic skills but I became aware that acute care and the constraints of secondary care were not a natural fit for me. My experience in the AIDS unit in London highlighted the value of prevention in primary care. Hence, my move to occupational health, then public health, and onto my clinical Master’s dissertation in paediatric allergy nursing.

What led you into your current field or specialty?

The move to rural nursing was completely by chance. I had been working hard at developing an allergy nurse specialist role in Dunedin. However, a series of family and chance events caused me to take a bit of a u-turn. As it turned out though, rural nursing is a very good fit for me. It utilises all the skills and experience gained over the previous 20 odd years and still enables me to put energy into prevention and primary care. As a mother, wife, and daughter, it has also allowed me to work part-time, enjoy a rural lifestyle, and be near extended family in my hometown.

What qualifications, skills, or stepping stone jobs do you think were particularly helpful and/or necessary in reaching your current role?

My rural nurse specialist (RNS) role encompasses seven separate nursing contracts including well child, mental health, and PRIME (Primary Response in Medical Emergency). Contracts and hours do vary but RNS usually work alone and are on call afterhours. You need to have experience, and ideally qualifications, in a variety of nursing specialties, as well as the ability to work independently and flexibly. Fortunately, most of my varied primary care roles were autonomous; however, it would be fair to say my learning curve in the first year was near vertical as I gained role specific skills and qualifications. My Master’s degree was not specific to rural nursing, but it did provide the discipline to up-skill quickly. Gaining a PGCert in advanced clinical assessment and applied pharmacology was especially useful.

Regular clinical supervision has been equally vital to maintain safety when working and living in a small isolated community where your neighbours and friends are also your patients. There are no specific rural nurse organisations but monthly meetings with the region’s other rural nurses is important to keep up-to-date, debrief, and prevent professional isolation or burnout.

What personal characteristics do you believe are particularly important for nurses working in your role?

An ability to maintain professional and personal boundaries, while at the same time remaining approachable and credible within the community is important. Being the main health provider in a small remote community can be likened to living in a fish bowl, your every move is watched. A thick skin, broad shoulders, and a sense of humour are vital!

What career advice would you give to nurses seeking a similar role to yours?

Gain as much experience in a variety of nursing roles and then start applying and give it a go. Rural nursing is immensely rewarding. It is one of the few nursing roles where you get to provide wrap-around care to the whole age spectrum and be flexible to meet their needs in a meaningful way. You just need to be careful not to try to be everything, to everyone, all of the time.

Describe your current role and responsibilities?

I work in a remote rural community of approximately 650 people on the West Coast. The rural nurse role is shared between two RNs working seven days on and seven off, including after-hours on-call cover. We operate a nurse-led service filling those seven contracts. Clinical support is provided by a weekly GP clinic and regular video or teleconference contact with our GP for routine issues, and ED doctors and specialists for acute concerns.

Childhood dream to wear the red cape

 

NAME:

Annemarie Pickering

JOB TITLE:

Nurse Manager, Adult Emergency Department (ED) & Admission and Planning Unit (APU), Auckland District Health Board

NURSING QUALIFICATIONS

  • RN 1989 Auckland Technical Institute (now AUT)
  • BN 1995 AUT
  • PGCert in Nursing Management 2004 University of Auckland
  • Critical Incident Management training 2010 Auckland Region CD Emergency Management Group
  • Lean Six Sigma Greenbelt training 2011 Auckland DHB

Why nursing?

Ever since I can remember, I have always wanted to be a nurse. I particularly wanted to wear the nursing uniform, which back then was a red cape and hat. This was my dream and my impetus to become a nurse.

Also, my father was an ambulance officer and we lived in a station house within the grounds of North Shore Hospital, so I spent my childhood years in the ambulance station where I loved hearing all the stories of life in the ambulance services. Living in the grounds of hospital meant I was always around patients. My friends and I would often walk with the patients down to the lake.

Briefly describe your initial five years as an RN?

I started my career at Auckland Hospital in 1990 in a general medical/infectious diseases ward, which gave me a strong foundation in basic nursing care and helped me to consolidate my practice as a new staff nurse.

Two years later, I transferred to the emergency department (ED) as a staff nurse.

In 1995 I was appointed as a clinical charge nurse in ED working on rostered shifts. I had to maintain overall responsibility for the emergency department when I was on shift. I managed a group of 15 staff nurses and was responsible for their appraisals and regular ‘one-to-ones’.

What led you into your current field or specialty?

I enjoyed my clinical placement in ED as a student and always thought I would like to specialise in that area. But felt I needed to work in a general ward initially to build my skill base.

What qualifications, skills, or stepping stone jobs do you think were particularly helpful in reaching your current role?

Following completion of my BN, I was promoted to clinical charge nurse in ED. After five years in that role, I was asked to take on various senior nursing roles within the change management programme and the rollout of the electronic rostering programme, during which I gained valuable experience in health management and project work.

The time away from clinical practice gave me a broader perspective of how the hospital functioned as an entity. It also reinforced for me that emergency medicine was my real passion. I was appointed as the nurse manager of ED and the assessment ward at the end of 2001.

Part of my role then was to plan the new adult emergency department and the admission and planning unit (APU), in Auckland City Hospital. APU was unique at the time, not only to New Zealand but also across Australasia, and I am very proud of my involvement in developing the APU model.

What personal characteristics do you believe are particularly important for nurses working in your role?

Managing more than 200 nursing staff can be tricky at the best of times. Therefore, a sense of humor and a good memory for names is essential. I maintain an open door policy enabling staff to approach me at any time.

I believe that developing a strong and collaborative senior nursing management team is the key element of the role. Also working closely with the clinical director, other hospital senior nurses, and managers enables us to achieve our goals. I have found that having a supportive family and network of friends is essential to survive in this type of role.

What career advice would you give to nurses seeking a similar role to yours?

I believe it is essential to have postgraduate education within the area you are interested in. You also need a passion for the area you choose and to pay attention to the detail of nursing practice to ensure that all of your patients receive excellent care.

Describe your current role and responsibilities?

I currently manage the equivalent of 220 people across the two acute areas of ED and APU.

The roles range from managing hospital volunteers (friends of ED), health care assistants, and senior nurses, including nurse practitioners. I am responsible for the day-to-day management of both departments and for the future planning of these two areas.

I work in partnership with the Adult ED/APU management team, as well as the wider hospital staff in streamlining processes, standards, and policies. Managing the flow of patients throughout the hospital in order to meet the MOH six-hour targets is a key challenge. I ensure that the nurses in the departments are trained and prepared for their roles; and that encouragement is given to grow professionally and achieve a sustainable work-life balance.

Planned pathway and chance direct career

 

NAME:

Virginia Dyall-Kalidas

JOB TITLE:

Facility Manager, Enliven Presbyterian Support Central

NURSING QUALIFICATIONS

  • EN 1986
  • BN 1998 UCOL
  • MN 2004 Massey University

Briefly describe your initial five years as an RN?

I spent one year working in oncology and one year in surgical services at MidCentral District Health Board. I then moved into Māori health and worked as a tamariki ora nurse before moving to another Māori health provider as their clinical team manager. Since then I have held various roles: OR clinical coordinator at MercyAscot Private Hospital; health centre manager at Auckland Women’s Prison; and community health operations manager for ProCare PHO (primary health organisation).

Did you have a career plan on becoming an RN?

Once I became registered, I gave a lot of thought to where I wanted to be and planned out a pathway. I stuck to that plan and achieved what I wanted within the five-year time frame. During that time, I realised I did not want to work within a secondary care environment as I found it too constricting.

I was also very lucky during this period to work with some very experienced nurses and to belong to a peer review group. The performance appraisals in those early years identified my personal strengths and the areas of self-development I needed to work on. I was lucky that I worked in a supportive environment.

What led you into your current field or specialty?

It was by chance that I ended up in my current field. I was living in Auckland and shifted towns because of my husband. After considerable thought, I decided that I would apply for a position in aged care. This seemed a very logical move for me as aged care is a fast growing field. I also felt I had something to offer and my skills were transferable to this health area. After applying to Presbyterian Support Central, I was appointed as facility manager of one of their Enliven Homes in Palmerston North.

The experience of moving into this health field has been a positive one, and I have a feeling of being valued for the skills and strengths that I bring, as well as having opportunities for further professional development. I have been encouraged and supported to build and share my knowledge, to take up professional development opportunities, and to be an ambassador for the aged.

What qualifications, skills, or stepping stone jobs do you think were particularly helpful in reaching your current role?

I think that every step of my career has helped prepare me for this position. When working in Māori health, I was lucky enough to attend Institute of Management courses as well as other management training.

Completing my Master’s degree also assisted me in the way I critically analysed information in my work environment prior to implementing new practice. It gave me an understanding of the value of research in planning and facilitating change.

I have had vast experience in community groups, both volunteer and professional, as well as health-related appointments. This has ranged from being chair of a national organisation for 12 years as well as holding numerous national board positions.

Being open and ready to grasp all opportunities – whether paid or voluntary – and being open to change, along with perseverance, allowed me to develop a range of qualifications and skills.

What personal characteristics do you believe are particularly important for nurses working in your role?

  • Resilience
  • Good sense of humour
  • Communication skills
  • Maintaining work/life balance
  • Effective listening
  • Visionary
  • Belief in yourself
  • Forward thinking
  • Positivity
  • Intuitive processes
  • Seen as a role model
  • To facilitate others growth.

What career advice would you give to nurses seeking a similar role to yours?

  • Make a plan
  • Gain a broad experience in a range of nursing fields
  • Develop strong and supportive networks
  • Forge community links – i.e. community groups
  • Grasp opportunities as they arise
  • Believe in yourself
  • Identify and utilise a mentor
  • Attend clinical supervision
  • Speak to people in the role
  • Complete Master of Nursing or business qualification.

Describe your current role and responsibilities?

Currently, I am a facility manager of two residential aged care facilities. One is a 63-bed facility with 33 hospital beds, 24 dementia beds, and 6 rest home beds and the other is a 44-bed rest home.

Responsibilities include:

  • • Implementing/embedding the Eden philosophy
  • • Business and occupancy management
  • • Risk minimisation and quality improvement
  • • Financial management
  • • Staff management
  • • Accountability/professional responsibility
  • • Management of nursing care
  • • Accountability and interpersonal skills
  • • Interprofessional health care and quality improvement
  • • Health and safety management.