The 5 no-nos of alphabet soup

When I was in nursing school, one of my professors made it very clear that, no matter what areas of nursing we decided to go into, we would all be nurses. She also made it clear that, regardless of how many nursing positions we accepted away from the bedside, we would still be nurses. For this reason, she said we should always list RN behind our names before any other credentials—to show that we are nurses before anything else and to reduce workplace incivility among colleagues—ADNs vs. BSNs vs. MSNs, etc.

Because of that professor’s instruction, I wrote my name and credentials that way for years, until that fateful day when a well-respected colleague told me I was doing it wrong. I let him know why I listed my credentials in the order I did, but he didn’t let up. Because I completely respected him and his viewpoint, I decided to do a little research and found he was right.

Even before I realized I was incorrectly listing the pomp-and-circumstance letters behind my name, I had a real issue with the massive dissension those letters create among nurses. Rather than become too irritated by the squabble, I decided to joke about it and refer to the collection of initialisms that follow nurses’ names as “alphabet soup.”

The more letters the better, right? Not necessarily.

Look at websites that list names and credentials of more than a handful of nurses, and you will often find the letters behind names listed in various orders. The nursing profession does not mandate the “proper” way to list credentials. As with many of other areas of nursing, there is no consensus. Observing the inconsistencies this has caused in the alphabet soup that follows some nurses’ names has given me many a hardy laugh. I have literally seen it all. Below are my nominations for the five biggest no-nos when listing nursing credentials.

No-no #1: Listing your RN license first

While the rationale for why RN should be listed first made complete sense to me, most “how to” guides will tell you that the alphabet soup has a certain order—and for good reason. List your highest degree first, followed by your license and, lastly, a credential identifying a specialty you have, if any, in nursing. The rationale is simple: List your honors in the order they are most secure. In other words, you list your degree first, because it is the least likely credential to be revoked or taken away.

The credential that identifies certification in a specialized area is listed last, because it has to be renewed regularly, and you may either lose the certification, decide to let it go, or become certified in another area. The certification credential is more fluid than the others; one year you may have it, the next year you may not. With regard to your license to practice nursing—your RN credential—that’s listed second, because it’s more stable than a certification, but not as stable as an academic degree.

No-no #2: Listing every degree you ever earned

It's completely unnecessary to list within a string of credentials every degree hanging on your wall. I have seen some nurses list an associate degree followed by a nonnursing bachelor degree, followed by a bachelor of science in nursing degree. Here’s the thing: Your highest degree is the only one that truly matters. While it’s nice to write your life story in alphabet soup, that’s what résumés and curricula vitae are for. Some people rationalize that if they had a nonnursing degree prior to obtaining a nursing degree, it should be noted. Well, my thought on that is simple: If you are working as a nurse, unless that other degree is higher than your nursing degree, it is not essential to list it behind your name. If people want to see your nonnursing degrees, they can look at your résumé.

No-no #3: Listing more than one nursing license

This is probably the no-no that bugs me most. If you are an advanced practice nurse (APRN), we know you are a registered nurse, so there is no need to list both your RN license and your APRN specialty. It is also not a good idea to list APRN as your license, because there is no APRN license in nursing; the license is based on your specialty. When looking at your credentials, people don’t want to know that you are an APRN; they want to know what type of APRN you are. APRN is an overarching category that encompasses various types of nursing licenses—certified nurse midwives (CNMs), certified nurse anesthetists (CRNAs), nurse practitioners (NPs), and clinical nurse specialists (CNSs). Also, listing both APRN and your specific APRN license—as in “Your Name, APRN, CNM”—is not only redundant, it’s unnecessary for the aforementioned reasons.

No-no #4: Listing more than one specialty certification

You may want to list all your certifications in the form of alphabet soup, but why not leave something for people to learn about later? Really, you only need to list one certification. Which certification you choose to list is completely up to you. I tend to think that nurses should list their most honored certification, the one that requires the most work to maintain, or the one that is most prestigious to other nurses.

For instance, if I were a fellow of the American Academy of Nursing (FAAN), I would list that and not my inpatient obstetrics certification (RNC-OB) from The National Certification Corporation (NCC). Also, it is important to remember that some certifications can be combined with your license, while others cannot. For example, women’s health nurse practitioners who have been certified can list WHNP-BC, in place of WHNP, and still include another certification in their alphabet soup. However, nurses who are certified as advanced forensic nurses need to list both their licenses and AFN-BC.

Nurses should be careful to list only those certifications that are nationally or internationally accepted. For example, although most labor and delivery nurses are required to maintain fetal-monitoring certificates issued by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), this certification should not be included in our credentials. To help distinguish between certifications that are credentials and those that are not, answer the following questions. If you answer yes to each one, you have a certification that can be listed as a credential.

• Did you have to pay extra money to obtain the certification (not to take a class, but to submit an application and take the test)?
• Did you have to take a test similar to the NCLEX-RN to obtain this distinction?
• Do you have to earn more CEUs than other RNs to maintain the certification?
• Do you have to show proof of CEUs or retake the certification examination to maintain the certification?
• Does the certification come from a national or international credentialing organization?

If you are still unsure, look for the proper way to list the certification on the certifying organization’s website. If no instruction is provided for listing the certification with your other credentials, it’s probably not the type of certification that should be included in your alphabet soup.

No-no #5: Listing non-specialty certifications

Unfortunately, I have seen nurses who list advanced cardiac life support or other required patient-care certifications among their credentials. What’s worse, I have even seen BLS—yes, as in basic life support—listed as a credential. Clearly, nurses who do this do not understand that a credential is a degree or certification that’s above and beyond anything required to work with their patients.

If you aren’t sure whether or not you’re certified, you probably aren’t. Certifications require an application process that is completely separate from each state’s nursing-license application process, and there is a test that must be passed. Such certification tests are similar to the NCLEX-RN, but they are each given for very specialized areas. A number of certifications can be found on the American Nurses Credentialing Center, while other certifications developed specifically for women’s health nurses, pediatric nurses, and nurse educators are found at The National Certification Corporation and the National League for Nursing, respectively.

As nurses, we have fought long and hard to receive certain distinctions based on our education. I agree with nurses who believe it is important to let others know of our commitment to our profession and our commitment to meet and maintain the highest level of distinction in our areas of expertise. However, to do so, we don’t need a list of letters behind our names that is long as the alphabet itself. I’ll use myself as an example. here:I list my credentials as “MSN, RNC-OB, C-EFM.” This lets others know that I have a Master of Science in Nursing degree. I am a registered nurse, certified in inpatient obstetrics by the NCC and with additional certification in electronic fetal monitoring, also from the NCC (this in addition to my AWHONN advanced fetal monitoring certificate, which is not listed among my credentials).

I encourage RNs to give a great deal of thought to their alphabet soups and list only: 1) their highest earned academic degree (in other words, it shouldn’t be an honorary degree), 2) one nursing license (with certification, if appropriate), and 3) one nationally or internationally recognized specialty certification. Not only is this the proper way to cite your nursing credentials, it also keeps members of our profession from looking like egotistical credential fanatics who only maintain certifications so we can list them behind our names.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The ministry of nursing

I recently heard this quote: “Your job is what you’re paid for; your purpose is what you’re made for.” I absolutely love this! I recognize that not every job involves work about which one is extremely passionate. After all, there are times when we have to do what we have to do in order to pay bills and keep our heads above water. But those are just jobs. Without a doubt, nursing is a profession and a unique health care discipline, but for some it may be simply a job.

When I first became a nurse, I couldn’t understand how any nurse could not love working in the profession. I thought it was a slap in the face of nursing to work in a position that calls for a caring, nurturing disposition, yet hate what you do. I began to realize, however, that some of my colleagues had either been working so long as a nurse that, even though they didn't love what they were doing, they didn’t want to change careers, or they had become accustomed to a lifestyle they didn’t want to give up. For them, nursing had become nothing more than a job! I looked at these colleagues and thought, “I could never be like that.” Then it happened to me!

After working nights, full time, for almost 5 1/2 years, I had gotten to the point where I hated my job—the nurse bullying and management manipulation, the favoritism shown by the charge nurse for certain nurse buddies, the feeling that I was just an employee about whom upper management did not care. It was more than I wanted to deal with. I had to get out. Nursing was no longer my passion; it was simply that which provided my paycheck. This was a problem for me. I don’t believe in doing anything I am not passionate about. Quite honestly, I spend far too much time working to have a job I hate. I knew something had to change!

I took a day-shift position, away from the bedside. It was the best move I ever made in my nursing career, not because of the change in duties, but because of what my chief nursing officer said during employee orientation. She observed that she was not a nurse in the nursing profession, but rather a nurse in the ministry of nursing. That one statement completely changed my outlook on my place in the nursing profession.

I was reminded that my desire to become a nurse was what had driven me to college in the first place. Had it not been for that desire, I don’t know that I would have gone to college. Seeing nursing as a ministry with a purpose refueled my passion for the profession; not ministry in the sense of providing spiritual guidance but as a vehicle for helping others achieve their absolute best. In addition to caring for patients, I began to see nursing as a way for me to encourage others to use the opportunities provided by the profession to get out of poverty, obtain a good education, and step into leadership roles. 

If you have come to a point in your career where you no longer feel the same passion for nursing you once did, I encourage you to change your view of the profession. Instead of viewing nursing as simply a job, view it as a wonderful opportunity for intellectual growth. Find avenues within the profession that allow you to use the gifts or talents you have. Look into new job opportunities and career advancements. Consider returning to school. Share with others how nursing has provided freedom to travel, meet new people or care for interesting patients. See the profession as a way to leave a legacy in this world. As a nurse, the work you do is not about you. It’s about the people you care for, inspire and encourage. In short, it’s about the ministry of nursing.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Nurses are not second-rate physicians!

I am a nurse who absolutely adores my profession. I have no idea what I would be doing if I weren’t a nurse. There was no question in my mind which major I would declare when I began filling out my college application. I only applied to one school, and I chose one major—nursing. Each time I returned to school, it was to obtain another nursing degree. At one point, I entertained the thought of pursuing an EdD, but it was because I wanted to be the best possible nurse educator. No matter where I work once I obtain my PhD, I am a nurse first. I will always be a nurse. My passion for the nursing profession fuels my disdain for the idea that nurses are second-rate physicians.

People sometimes make the most asinine assumptions about why nurses go into nursing. I have heard it all. We weren’t intelligent enough to go to medical school. We didn’t want the liability that comes with being a practicing physician. We didn’t like science enough to become a premed major. Medical school is too expensive, and we didn’t want to spend a lifetime paying back the loans. I can’t speak for all nurses, but I take offense to these assumptions. I, for one, did not choose to become a nurse because life’s circumstances prohibited me from becoming a physician.

Nursing is not a steppingstone to a medical degree. In fact, the two disciplines are quite different from one another. Nursing is one discipline, medicine another. Physicians do not supervise nurses, nor is it required that physicians vet nurses. Nursing is a profession, not a trade. We have our own theories, schools within universities, professional organizations, and state boards. Physicians do not teach nurses, and they do not regulate our practice. A physician has never hired me and, unless I choose to work in a private practice, never will. Unbeknownst to the general public (or maybe just unbeknownst to me until I went to nursing school), nurses write their own assessments, diagnoses, and care plans. Nurses work with physicians, and, in most circumstances, not for them.

I know of a few nurses who decided to become physicians. There is nothing wrong with this, but it is not the norm. And I know very few nurses who went into the profession desiring to become a physician, but not doing so because of lack of intelligence or money. I have had a few physicians encourage me to go to medical school, but why on earth would I want to do that? I didn’t become a nurse to test the waters of the health care industry; I became a nurse because I wanted to be a nurse.

As a huge fan of the television show “The Waltons”—yes, my favorite TV show is one that went off the air before I was born—it upset me to no end that the writers decided to make Mary Ellen Walton a physician when she was already a nurse. Why was nursing not good enough to stick with? Did the character have to become a physician to gain status? What subliminal messages were the writers trying to send the show’s viewers?

I didn’t learn that Mary Ellen had decided to become a physician until I was already an RN. As a child, I saw Mary Ellen attend and graduate from nursing school, and I saw nothing wrong with that. To confirm her love of health care and her ability to act as an autonomous, intelligent, and caring health care provider, was it really necessary to change the character’s profession? Of course not! Nurses are all these things and more.

No matter how many times nurses are compared to physicians, I am not swayed to leave the profession I so dearly love. If I want to work as a primary care provider, I can do this as a nurse practitioner. If I want to work as part of an anesthesia team, I can do this as a nurse anesthetist. If I want to deliver babies, I can do this as a nurse midwife. Nurses can even become certified to work as first assists in operating rooms.

The profession of nursing offers so many possibilities. The ability of a nurse to move seamlessly from one specialty to another is unmatched. Nursing is a rewarding profession. Nursing is a well-trusted profession. Nursing is a profession in high demand. There are many things nursing is. A second-class profession behind the medical profession it is not.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Those who can’t ... teach?

While an undergraduate nursing student, I was introduced to the saying, “Those who can, do; those who can’t, teach.” One of my nursing professors said it’s a statement often used to negatively compare nurse educators to nurses involved in direct patient care. At that point in my education, I didn’t really think much about it. After all, I had no plans to become a nurse educator.

A year later, however, after completing my second year as a nursing student, my plans changed. I did decide to become a nurse educator, and went on to obtain a master’s degree in nursing education. However, despite having an education degree, I never actually worked as a paid educator … until now.

As a doctoral student, I am required to work as a teacher’s assistant, and I have quickly learned that studying teaching and learning theories, teaching methodologies and philosophies, and even learning the science behind creating an effective examination, is much different than actually putting this knowledge into practice in the classroom.

I began working with my assigned teaching mentor the summer before my first year in the program. She allowed me to have some input into the creation of the syllabus. I helped create the grading rubric for the students’ papers, and I was allowed to suggest references they could use when writing those papers. As a part of my teaching-apprentice class assignment, I was also required to teach the students one lesson. Although we were only required to teach for about 30 minutes or so, I taught the entire two-hour lesson that day. Preparation for that one lesson took weeks. I had never been responsible for an entire lecture and, although I enjoy speaking in front of audiences, there are so many things to consider when presenting information to impressionable freshmen and first-year transfer students.

If working on the syllabus and my one lesson plan wasn’t time-consuming enough, I had to help grade papers and quizzes, a much more in-depth process than I anticipated. Educators must take into consideration the reasons students miss certain quiz questions or interpret an essay question in a way the instructor had not intended. Grading papers was something I had never done before, and I struggled with it somewhat. Fortunately, the instructor I worked with was really good about sitting down with me to help me understand what is most important when assigning grade points to various aspects of student papers. She helped me frame my comments in ways that promoted critical thinking and didn’t make the students feel that I was chastising them for their writing. My experience with this instructor was so valuable that I decided to work with her again, this time as a paid teaching assistant.

My responsibilities as a paid TA are much greater than they were as a teaching apprentice. To be honest, I thought I was taking somewhat of the easy way out. I thought, “Hey, the syllabus and quizzes have already been created. What more is there to do?” I quickly learned that the answer to that question is, “A lot!” Good nurse educators update their syllabi and lectures annually. This year, in fact, we assigned an additional textbook, rearranged the order of the topics covered in class, and created a different format requirement for papers. We even changed up the rubrics a little, and we’re in discussion about increasing the amount and type of technology used during lectures. I’ve learned that teaching a particular class one time doesn’t mean you don’t have to prepare when the time comes to teach it again.

To those people who believe the old saw that “Those who can’t … teach,” I encourage you to forgo commenting on something you know nothing about. As someone who has worked on “the floor” for many years, I can honestly say that, for me, working in practice is much easier than working in education. No offense to anyone who works in a practice setting, but when you go home, you don’t usually take your work with you. You don’t mull over lesson plans for weeks (or possibly months) before giving a lecture. You don’t wonder how the information was received during those lectures. You aren’t concerned about the reason a certain student hasn’t shown up in class for two weeks. You don’t keep up on the latest literature so you can incorporate some of it into next year’s syllabus. You don’t clear your night or weekend schedule so you can sit at home and grade tons of papers multiple times each term. You don’t counsel students who are having issues adjusting to college life. You don’t go home at night wondering if you said the right thing during office hours. You don’t; you just don’t!

Now, this isn’t to compare the relative importance of practice and education, because they should not be compared. Both areas need dedicated nurses who are committed to the work involved. Now that I have worked in both settings, I can honestly say that teaching is the most difficult, yet rewarding, job I have ever taken on.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

5 tips for choosing a doctoral program

I seem to have adopted a pattern of making life-changing decisions based on emotion. Fact checking and research did not factor into my choice of an undergraduate program (see my post “Do you know the way to San Jose?”), nor did they affect my selection of an MSN program. (The latter decision was made purely for the sake of convenience. I was working full time nights, and I didn’t want a traditional program that would require me to attend class. An added bonus was the program’s inexpensive cost. I knew I wouldn’t have to take out a loan to pay for my degree.) The way I went about selecting my PhD program (see previous post) was slightly unconventional and, although I’m delighted with my decision, I don’t recommend my decision-making process as a method for everyone to follow.

In hindsight, however, I unconsciously considered some key factors in making my decision to apply to UCLA. And now that I am in my second year of the program, my knowledge about choosing a graduate program is based on both wisdom and experience. Here are five tips for those thinking about applying to graduate school.

Tip #1: Follow the dollar signs.

Funding for graduate students is available in abundance. Whether it’s scholarships, traineeships, or fellowships, the money is there, and it’s money you don’t have to pay back! If you don’t have the money to pay for your education outright, and you don’t want to take out loans, look at the programs that offer the greatest funding.

Sometimes funding comes in the form of tuition reimbursement for students who work as teachers’ assistants or as research assistants. Working as a TA or RA is a great way to pay for your education, and it’s a win-win situation. You gain valuable experience as an instructor or novice researcher, and the school gets an instructor or researcher at lower cost. Be careful to read and understand all of the small print associated with receiving financial aid. Sometimes, the institution requires recipients of such aid to work in a certain area or commit to a certain number of years of teaching or research following graduation. If you are considering applying for funding, see my two-part post “Scholarship alert!!! 10 tips for success in applying for scholarships.”

Tip #2: Make sure your research interest fits the school.

Once you become a graduate student, your research will become your life. Before applying to a specific school, be sure someone on the faculty is an expert in your research area. Most nursing school websites have pages that list faculty members’ current and past research areas. In fact, some schools have a faculty research page that lists all of the faculty’s research, and a significant number of schools also list recent faculty-member publications and conference presentations. Identifying the research interest, publications, and presentations of various faculty members will help you determine whether or not the school fits your research needs.

It’s also important to look at the type of research being done in the school. If you are interested in qualitative research, but the school is full of mostly quantitative researchers, it may not be a good fit for you. Likewise, if you are interested in community-based participatory research, and no one on the school’s faculty is engaged in this type of research, you may be better off looking elsewhere.

In addition to reviewing school of nursing websites, note the authors of journal articles in your area of interest. I’ve found that nursing is a small world, which becomes even smaller when you begin to seek out experts in specific research areas. When reading journal articles, you will begin to see the same names over and over again. Look up the school where those researchers work. If the researcher is a “big name” expert, he or she has probably been at that school for quite some time.

Tip #3: Assess resources available at the school.

Don’t underestimate this criterion for choosing a school. One thing I love about UCLA is its Louise M. Darling Biomedical Library. (Not only are all of the journals, books and other reference materials of importance to nursing students located there, but we still have access to eight other libraries on campus. (Yes, UCLA has nine libraries on campus.) It also has a graduate reading room (secured so only those with a graduate ID from one of the biomedical schools are allowed entrance), graduate student gym—no undergrads allowed, I love it!— and a graduate-student writing center that includes, as one of its benefits, 250 free pages per quarter. There are plenty of other campus resources I love, but this is not about me.

Questions you may want to ask yourself when selecting a graduate school include: What types of databases does the school subscribe to? Can I access other libraries at nearby schools? Does the library participate in interlibrary loans? Is there a library or librarian dedicated to servicing your school or major? Do undergraduates and graduates use the same library? Are resources available to assist graduates with writing? What types of counseling services are available? Is graduate housing provided? Is graduate housing separate from undergraduate housing? I’m sure there are other resources of specific importance to you. Determine what your nonnegotiables are, and then compare them to resources available at the graduate school or schools you are considering.

Tip #4: Check the rankings.

I wasn’t one to care much about national rankings at the undergraduate or master’s level, but a school’s rank is definitely important at the doctoral level. My take on this is simple: The only school that really matters when it comes to rankings is the one from which you receive your highest degree. Being able to say that I am a student at UCLA holds a lot of clout. The same should be true for your school of choice. After all, why pay a bunch of money or spend a significant amount of time working as a TA or RA in exchange for tuition reimbursement only to graduate from a program that is not well recognized or, worse, a program that is not highly respected?

U.S. News and World Report ranks graduate programs in nursing. (They rank UCLA at No. 21 but, of course, it’s No. 1 in my eyes.) If you are looking to be trained as a researcher, you should also pay attention to where the school ranks when it comes to research funding. The National Institutes of Health is a major funder of schools of nursing, and up-to-date funding information can be retrieved from their Awards by Location and Organization database. (Click on the various criteria provided to look at information from various perspectives—organization, location, etc.) Other important decision factors to consider, including accreditation, are available from the National League for Nursing and the American Association of Colleges of Nursing.

Tip #5: Talk to current students in the program.

This is probably the most important factor to consider. You don’t want to enroll in a program only to later find yourself saying in frustration, “If I knew then what I know now!” Currently enrolled students are your best resources when it comes to getting the unadulterated truth about a program. They understand and have been indoctrinated into the “<insert program name here> way.” They know the politics associated with getting into and, more importantly, getting out of the program. They can give you inside information on teaching philosophies of professors and their methods of grading. They can tell you if your research interest is a good fit for the program you are considering or if you would be better off applying to another school. They can give you the scoop on being a TA or RA, who do you want to work for as a TA or RA, and what the expected workload is if you become a TA or RA. They will also tell you whether you should work or not during any given term and if it’s a good idea to take courses outside of the school of nursing during another term. Students currently enrolled in the program are your allies. Use them wisely.

When choosing a graduate program, you have to do what’s best for you. I have provided five major tips for making that decision, but they are based on what I thought was best for me. If I were married or had children or had to go to school out of state, my preferences would change accordingly. Your decision to go to graduate school is a personal matter and, ultimately, the school you select should be based on no one’s opinion but your own. No matter the reasons you use to choose your graduate school, congratulations on making the choice to further your education!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

How I ended up at UCLA

I’m often asked how I chose UCLA (University of California, Los Angeles) as the school I would attend to obtain my PhD. To be honest, I don’t feel as though I chose it, but that it chose me.

Before I was halfway through my MSN program, I began looking at nursing PhD programs. I also considered EdD programs, because my MSN is in nursing education, and I have a passion for teaching. Enrolled at the time in an online program, I was not keen on pursuing another online program, but I knew this meant I would have to move. I looked around the UCLA School of Nursing website, but did not see how the PhD program would be a good fit for me, because my research interest was nursing education and the PhD program at UCLA does not focus heavily on research related to that interest. In fact, until a chance meeting with the nursing school’s director of recruitment, outreach and admissions, my mind was made up that UCLA was not the place for me.

During a break at the 2010 Leadership Summit in Honolulu, Hawaii, USA, sponsored by the Honor Society of Nursing, Sigma Theta Tau International, I approached UCLA School of Nursing’s exhibit table. To be honest, I was alone and, because the woman behind the table was also alone, thought I’d stir up a little conversation. I told Rhonda Flenoy-Younger—director of recruitment—that I had looked at UCLA, but didn’t think the program was for me.

She encouraged me to look at the information on a flash drive she handed me, and she took down my email address. She also introduced me to the dean of the School of Nursing. In speaking with him about my research interest, he encouraged me to apply to UCLA but not with the same research interest. When I returned home, I began receiving emails from Flenoy-Younger, inviting me to meetings of the Pan-African Nursing Students and Alumni Association (PANSAA) at UCLA. I ignored the first two meeting invitations, but responded to the third.

At the PANSAA meeting, I immediately felt a level of comfort among the students that I hadn’t felt at my undergraduate school or in the online MSN program from which I had recently graduated. Very interesting to me was that there were alumni in attendance, some who had graduated in the 1970s and ‘80s. Even the dean was there. I left that meeting feeling that, maybe, UCLA had something to offer after all. 

The next day, after attending a PhD information session presented by the UCLA School of Nursing (UCLA SON), I was sold! The support I felt from the faculty, their obvious love of research and UCLA, the personal stories of those on the student panel, and the commitment of the School of Nursing to provide tuition for all graduate teachers’ assistants was all I needed to make my decision. I left the session with my mind made up—I would apply to UCLA and would continue to apply until I was accepted.

A few days later, while attending the 2010 Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) convention in Las Vegas, Nevada, I met a nurse educator-researcher who encouraged me to contact a faculty member at UCLA SON who was her personal friend. After contacting the professor, I set up a meeting with her.

First, though, I met with another faculty member, who encouraged me to choose a research interest about which I was truly passionate, not one that simply coincided with my MSN degree. At that point, my interest changed from nursing education to teen-pregnancy prevention. A week or two later, I met the friend of the nurse I had met at the AWHONN conference. Unbeknownst to me, the area of nursing about which I was now most passionate was the research area of this faculty member. I was sitting face-to-face with a world-renowned expert in teen pregnancy, and I had no idea! The encouragement I received from these two faculty members only strengthened my resolve to obtain my PhD from the UCLA School of Nursing.

Watch for my next post on choosing a doctoral program.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

PhD or DNP? How to choose

 Before looking into doctoral programs, prospective nursing students should decide which route is right for them. Currently, two major nursing degrees are awarded at the doctoral level—the Doctor of Philosophy in nursing and the Doctor of Nursing Practice. In my discussions with BSN- and MSN-prepared nurses, there seems to be a little confusion about the two doctoral degrees. My advice is, do your research and know which degree you want before deciding what school to apply to. Put another way, looking at various schools of nursing and using this information to decide which degree you wish to pursue is not the proper way to make the decision. This is because the two degrees are vastly different and, depending on what you want to do with it, pursuing the wrong degree will be a complete waste of your time.

The PhD is a research-oriented degree. The DNP, on the other hand, is a practice degree, which can be likened to degrees obtained by physicians, dentists, pharmacists and optometrists or ophthalmologists. There are a few major differences between the PhD and the DNP. While everyone may not agree with my explanation, consider the following categorical differences.

Prestige

Because of their vast differences, the degrees should not be directly compared but, in general, the PhD is regarded as the more prestigious of the two. Of course, the PhD has been around longer and is more widely recognized. It is also the terminal degree in nursing, meaning that no higher degree is attainable. If you looked at nursing degrees from a step-chart perspective, they would look something like this:

The chart may be slightly misleading because, in pursuing nursing degrees, a person doesn’t have to go from one step to the next. For instance, the point of entry for a person seeking a nursing license can be a diploma, an associate degree, a bachelor’s degree or an entry-level master’s degree. Also, a nurse doesn’t have to obtain a master’s degree before pursuing a doctoral degree. Still, the chart is a good indicator of how each nursing degree is viewed with regard to prestige.

Two types of knowledge

While both degrees are designed to produce nurses who will contribute to the knowledge base of the profession, one thing is clear—the PhD-educated nurse is expected to create new knowledge. A PhD dissertation cannot be successfully defended without the generation of new knowledge. As nurses who are more focused on practice than research, those in DNP programs may or may not have generated new knowledge upon completing their capstone projects.

An easy way to differentiate between the two degrees is to see the PhD nurse as a knowledge-creator and the DNP nurse as a knowledge-applier. Where a PhD program focuses on understanding the philosophical and theoretical foundations of nursing and using these foundations to generate new knowledge, a DNP program focuses on taking knowledge available to the profession and transferring it to practical application.

Focus on hands-on-nursing

Obtaining a PhD requires no clinical hours at the bedside or direct patient care. Obtaining a DNP, however, typically does require some type of practice hours to prove a student’s competence in his or her specialty area. If you are studying to become a nurse educator, for instance, you may have to work in an academic or clinical education setting. Or, if you are obtaining your DNP to become a nurse practitioner or clinical nurse specialist, you will spend many hours under the preceptorship of an already licensed advanced practice nurse.

PhD students take courses such as philosophy and theory to stimulate abstract thinking about the nursing profession whereas DNP students take courses such as pathophysiology and nursing assessment, knowledge and skills more geared to nursing practice. I have seen PhD nurses work per diem or volunteer in order to maintain their nursing skills, provide community service or supplement their income, but never have I come across a PhD-prepared nurse who works full time providing direct patient care. DNP-prepared nurses, on the other hand, often work in patient-care settings as nurse practitioners, clinical nurse specialists, nurse administrators, nurse educators and nurse researchers. Both PhD and DNP nurses teach in academic settings.

Choose wisely

Whichever degree you choose to pursue, make your choice wisely. If you are in a PhD program but want to be a full-time nurse practitioner, you may find yourself miserable. If you are in a DNP program, but want to be a world-renowned neuroscience researcher, you may also be miserable. Although it is OK—and highly encouraged—to compare and contrast the two doctoral degrees in nursing, it is imperative to understand that neither degree is “better” than the other. They are complementary. Both are needed to keep patients safe and to continue advancing the practice of nursing.

I like to joke that the PhD is the attractive, older sister and the DNP the sassy, younger sister, but their momma and daddy love them both the same. I need my DNP “siblings” just as much as they need me. We are one big happy family.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

What do you do with a PhD in nursing?

Almost weekly, I am asked about my choice to pursue a Doctor of Philosophy in nursing. The frequency of this makes me wonder if the general public only sees nurses as bedside handmaidens who take orders from physicians. The more frustrating thing is when these probing questions come from other PhD students.

I was shocked the first time I was asked by a non-nursing PhD student, “What do you do with a PhD in nursing?” I’ve now grown used to hearing this question from my doctoral colleagues outside the school of nursing. Still, it’s quite bothersome, because the question usually isn’t framed as an inquiry about what area of research I’m interested in or what type of employment I plan to seek upon graduation. It’s more, “Why in the world would a nurse want a PhD?”

Before I became accustomed to the question, I wasn’t sure how to answer it. Oftentimes, it was difficult to decipher whether or not the person asking was trying to be sarcastic (especially if the question came from another PhD student). At one point, I became irritated by the question and started giving a pretty snappy reply: “The same thing you do with a PhD in anything else!”

After completing a year of doctoral studies, however, I now realize that the general public is unaware of all the wonderful avenues available to nurses. So, now I view the question as an opportunity to educate.

What do you do with a PhD in nursing? Whatever you want! There are PhD-prepared nurses who teach, conduct research, evaluate programs, write books, lead health care organizations and work for the government. With a doctoral degree, the sky is the limit. One thing I doubt most nurse PhDs want to do is work full time in direct patient care. At the doctoral level, nursing is less about hands-on patient care and more about the abstract thinking that helps move the profession forward. More than anything else, a nurse with a PhD has the training needed to conduct research and add to the body of available nursing research knowledge. While not all PhD-prepared nurses choose to work as researchers, all have been exposed to great amounts of research and have had to demonstrate their ability to conduct high-quality research on their own.

Three jobs I’ve noticed that most PhD-prepared nurses consider are listed below. The job descriptions provided are based on my observations of nurses employed in these positions, and they may vary from facility to facility:

Nursing faculty member—A nurse educator who works in an AS, BSN, MSN or PhD program as a classroom instructor. Nurse faculty members are also responsible for creating, implementing and evaluating program curricula and mentoring nursing students. Oftentimes, in addition to their teaching responsibilities, they are expected to conduct research. They typically disseminate this research in scholarly journals and at research conferences.

Director of nursing research—a nurse researcher who serves as administrator of the nursing research department of a health care facility or coordinator of the facility’s nursing research program. The director may supervise other nursing research employees, or he or she may be responsible for overseeing all nursing research projects conducted within the facility. The director of nursing research is typically the go-to person within the facility for questions regarding the design and implementation of a desired research study. He or she may or may not be responsible for dissemination of research findings.

Director of clinical services—a clinical administrator who oversees daily operations of patient care departments in a health care facility. He or she is the liaison between upper management and department managers. Although the director is not involved in direct patient care, he or she is aware of the work flows in each department that promote optimal patient care. The director may generate or receive reports addressing the efficiency of departmental work flows, and this information is then given to each department manager in an effort to increase efficiency and patient satisfaction.

Other jobs available to PhD-prepared nurses include research or high-ranking administrative positions in pharmaceutical companies, research institutes, health advocacy organizations, health care information technology corporations and nursing or other health-related publishing companies. A nurse who has attained a PhD can practically work anywhere that research, education, or program evaluation takes place. The important thing to remember is that graduation from a reputable PhD program ensures that a nurse has received proper research training.

If you have any additions to the types of jobs held by nurses with PhDs, please post below. I’d like to learn of new opportunities for nurses with the terminal degree.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Star-struck!

As I sit in the airport preparing to leave Indianapolis and the 2012 Leadership Forum, hosted by the Honor Society of Nursing, Sigma Theta Tau International, I am still in awe that I got a chance to meet her! She may not be a Hollywood star, a world-famous singer or another type of pop celebrity, but Loretta Sweet Jemmott, PhD, RN, FAAN, is a celebrity in my eyes.

You see, as a doctoral student, I have become very familiar with certain nurse researchers and their literary works. When you see the same names over and over again, the authors begin to become your nursing idols. They are the nurses you look up to, the researchers whose work you want to mimic, the change agents who have created the paths you want to follow.

In the same way that music fans admire Beyonce or Carrie Underwood or Michael Jackson, PhD students admire nurse researchers and, once inspired by their work, we want to know as much as we can about who they are. We Google their names, read their faculty Web pages and may even be bold enough to e-mail them with a question or comment concerning one of their publications. Once I discovered that Professor Jemmott had worked on research and published with my faculty adviser, I was over the moon! While I may not have known her personally, knowing that she worked with my adviser made me feel that much closer to the possibility of meeting her.

Imagine my surprise when I opened my Leadership Summit program booklet only to find that Jemmott was the keynote speaker at one of the Leadership Forum luncheons. Ahhhhh!!! I could have screamed, but I just smiled widely, instead. I've never been extremely impressed by celebrities, but I thought "This is how people must feel about Beyonce!" Throughout my first two days at the conference, I eagerly awaited the opportunity to meet Professor Jemmott.

Then it happened, President Prevost introduced Jemmott to the forum audience and my thumbs went into overdrive tweeting bits and pieces of her address:

• @tmontgomeryrn: "If it's gonna be ..., it's up to me!" ~ Loretta Sweet Jemmott #STTI
• @tmontgomeryrn: "When you feel like a failure, you don't quit. ... You go back to school." ~ Loretta Sweet Jemmott #STTI
• @tmontgomeryrn: "Do not take for granted that things will happen because you're here. ... Things happen because you make them happen." ~ Loretta Sweet Jemmott

Once Jemmott finished speaking, we were given the opportunity to meet her. Of course, I made a beeline straight to her table. I couldn't believe how nervous I was about meeting her. I stumbled over my words a little. "Good afternoon, Dr. Jemmott. My name is Tiffany Montgomery, and I'm a second-year student at UCLA. My advisor is Dr. Deborah Koniak-Griffin. I am really interested in your work. I e-mailed you once, but." She stopped me while I was speaking and told me to call her. I could have died and gone to heaven. ME call YOU? Really? I was so nervous in recording her number that my hand was shaking. My writing looked like complete chicken-scratch.

Yours Truly and Dr. Jemmott

I felt as if I'd just met the president of the United States. The woman who, in my mind, is equal in status to President Obama had just given me permission to call her to discuss her research. Were it possible, spontaneous combustion would have ignited my body and I would have burst into a million little pieces.

As I sit in this airport, shivering from the cold air conditioning, the world of nursing has become a little smaller. The likelihood of meeting world-renowned nurse researchers has become a little more real. I have no desire to meet bigwig movie stars or entertainment celebrities, but the thought of meeting more nursing research celebrities is very exciting. These nurse celebrities will someday be my colleagues. Wow!

To some, it may seem a little strange that I have become starstruck over a nurse. Honestly, I think it's a little strange, as well. Children are not taught to idolize their favorite authors or scientists or scholars, but I have a childlike fascination with the nurse researchers whose work I discuss in the papers I write. These are the people I want to be like. They are the role models whose careers I am trying to mirror. They are the names who take my breath away when I see they will be speaking at a conference I am attending. Maybe it's a little nerdy; maybe I'm a geek. Or maybe I'm just a young woman who is well on her way to being a great nurse scholar in her own right. My money is on the latter.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

Life happens!

When I first began writing this blog, I thought I could easily write an entry each week. This overzealous thinking was that of a young woman with too much time on her hands. Yes, I was working a full-time job. Yes, I was involved in leadership positions in various nursing organizations. Yes, I traveled whenever and wherever possible. But I still had lots of time to do other things, and I didn’t see how writing 500-1,000 words per week would weigh me down.

Enter my first year as a PhD student. If you haven’t noticed yet, this is my first blog entry since April. When I began writing this blog, I had no intentions of ever taking that much time off from writing, but life happened.

One of the biggest mistakes I have made on my leadership journey is packing my schedule too tightly. I used to think that if I was sitting around doing nothing, I was wasting my time. I felt as though I needed to be doing something “productive” every minute of every day. I never took into consideration the fact that unforeseen circumstances present themselves at the most inopportune times. I never thought about the possibility of having to cancel prescheduled activities because of a situation that had to be dealt with immediately, or worse, doing those prescheduled things halfheartedly because my mind needed and wanted to be elsewhere.

In the months between my last blog entry and this one, I have learned to lighten the schedule a bit and leave room for those surprise emergencies that inevitably pop up. Sick parents or children, relationship issues, personal illnesses, loss of loved ones, financial crunches—all these things happen, and there is no way to plan for them. It is now clear to me that a good leader will allow his or her schedule to be flexible enough to handle these things, in addition to commitments already made. While we can never predict life’s unfortunate circumstances, we can be better prepared to handle them without fear of dropping the ball in every other area of our lives.

“Don’t put off for tomorrow what you can do today.” Good advice! Whether our schedules are jampacked or wide open, it is always best to complete the tasks at hand as soon as possible. When the storms of life come raging at us, we may not have the time, energy or resources to complete the most simple of tasks. We may need to direct all of our attention to the storm and brace ourselves until it passes. Leaving time for unanticipated life events can make those trying times a little less stressful.

If my time away from this blog has taught me nothing else, it has taught me to leave room for the unexpected so that, when it arrives, I will not be in complete disarray. Maybe what I have learned from my misstep will prevent you from making the same mistake when planning your schedule.

For Reflections on Nursing Leadership (RNL), published for the Honor Society of Nursing, Sigma Theta Tau International.