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Nursing Careers Beyond the Hospital

Nursing Careers Beyond the Hospital

Mid-career nurses who want to reinvent themselves without starting over can apply their clinical skills and experience outside of the hospital. Take a look at these career possibilities. Perhaps one of them is the key to helping you rediscover your passion for nursing.


Want to strike out on your own? Many nurses carve out lucrative niches as consultants, offering data analysis, strategic planning, project management or architectural services.

Gwen Uman, PhD, RN, is one of them. As the cofounder of Vital Research, a Los Angeles data-analysis firm, Uman began by analyzing dissertation data for fellow graduate students. Her business grew as her clients moved up the career ladder. Today, her company designs research studies, develops custom surveys, and provides qualitative and quantitative data analysis and results interpretation. Clients include clinicians, healthcare providers, trade associations, professional organizations, government entities, consumer groups, and such non-healthcare groups as school districts, universities and credit unions.

"Beyond health and methodology expertise, consultants must have the ability to communicate in a language the client understands -- basic English, not research jargon," Uman explains. "You need a feel for the client's content area and must be able to market and sell your services. That includes closing a deal, estimating jobs accurately and figuring out market-rate pricing."

Medical Office Manager

Nurses are well-suited to running a physician's office, a hectic job requiring a wide range of skills and constant multitasking. "With HIPAA, OSHA and compliance laws at every turn, this position is much more complex today," says J. Roger Landers, executive director of the Professional Association of Health Care Office Management (PAHCOM). Landers suggests that nurses break in as a billing supervisor or coding supervisor at a group practice and then work their way up to office manager.

PAHCOM, the Practice Management Institute and the Association of Registered Health Care Professionals all offer certification programs. While most older office managers learned on the job, some schools now offer associate's degrees in healthcare office management.

But be forewarned: According to PAHCOM's 2004 salary survey, medical office managers earned just under $61,000 in salary and benefits. This may not be competitive with the compensation nurses can earn in hospitals, Landers says.

Research Nurse

Research nurses are the eyes, ears and hands that conduct much of today's clinical research. Working with the principal investigator and research coordinators, staff research nurses participate in clinical trials that evaluate new drugs and medical devices. They evaluate potential studies, screen and schedule patients, conduct patient visits according to protocols, review patient progress and help report study results.

These nurses typically work in academic medical centers, educational institutions, pharmaceutical companies and private research foundations, but private-practice physicians are now also hiring research nurses.

Research nurses generally enjoy positive, long-term relationships with patients and garner the appreciation of physicians, says Kristine Brindak, BSN, RN, patient service manager for the clinical research unit at the Institute for Human Performance at The State University of New York Upstate Medical University in Syracuse, New York.

Plus, the work is exciting. "We know we are contributing to the future of medicine," Brindak says. "We're on the cutting edge."

See a sample resume for a hospital RN seeking to transition into a career as a research nurse.

More Paths to Explore

Other nurses successfully launch second careers as:

  • Case Managers: Distinct from hospital case managers who coordinate patient care, these professionals work for managed-care companies, home-care agencies, nursing agencies and management-services organizations to minimize duplication of care and services and maximize clinical and financial outcomes. These employers value nurses who understand Medicare/Medicaid regulations, managed-care guidelines and the care guidelines issued by the Joint Commission on Accreditation of Healthcare Organizations. Case managers also must be proficient in criteria issued by InterQual and Millman & Robertson, two leading developers of level-of-care guidelines.
  • Pharmaceutical, Medical Equipment and Supply Educators: These nurses educate the hospital staff members who will be using the endless stream of new medical equipment, supplies and pharmaceuticals.
  • Telemedicine Nurses: Interacting with patients via phone or Internet, these nurses advise managed-care subscribers based on physician-developed protocols. Academic medical centers often employ nurses as research assistants to perform telephone consultations with patients participating in clinical trials.
  • Nurse Educators: Nurses are in great demand to join the ranks of nursing-school faculty and to teach in community-college diploma programs.
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