By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
An academic colleague recently told me that she had spoken to a class of senior students about career options in nursing. She was very surprised that all but 3 students out of a class of 100 planned to move into an advanced practice role such as NP or CRNA. She asked me how this could be and where were these young students getting their career advice. She wondered if any of these bright, high energy new nurses had even considered other career opportunities. It is a good question because I too have seen this trend. I am also aware that the NP role is not the right one for everyone. As leaders, I think we can be influential in providing some additional career decision making guidance.
In their book, Decisive: How to Make Better Choices in Life and Work, leadership authors Chip and Dan Heath suggest that our decision making is often flawed because we fail to consider a range of options. The Heaths argue that humans are hampered by four “enemies” of decision-making rooted in our unconscious behavior: narrow focus, confirmation bias, short-term emotion and overconfidence in the outcome. The solution to better decision making is to expand your thinking using the WRAP Model.
The 4 Step WRAP Model
Widen Your Options
In our decision making, we often turn our choices into either/or without expanding our options. The Heaths suggest that you ask yourself the question – If I could not choose either one of these options, what else would I do? – to avoid narrowing your options. For many of our new graduates, the two options might be a staff nurse role or a nurse practitioner role. We should ask – what other career possibilities within nursing have you investigated? You might be surprised at how little thought went into the decision to become a nurse practitioner.
Reality Test Your Assumptions
Many of us regularly consult rating sites such as amazon, trip advisor or yelp before we buy a product, use a hotel or visit a restaurant. Unfortunately, we don’t always test our assumptions in the same way when we do career planning. We need to seek and listen closely to dis-confirming opinions. Many NPs today work extremely long hours and are expected to be very productive in high patient turnover offices. Does every new graduate want that? What are the pros and cons of the decision. Why do we have many nurses who become NPs but don’t leave their staff positions because they would miss the pay, benefits and teamwork. Some NP students have told me that the level of accountability scares them because care is much more individually delivered with far less team input. One medical center has recently implemented a day in the life program so students can reality test their assumptions about roles before making any firm decisions.
Attain Distance before Deciding
The Heaths advise that we should put some time and even space between you and a decision which better enables you to take the short-term emotion out of it. As a new graduate, I initially believed that I wanted to work maternal child but my ideas changed. I fell in love with taking care of veterans in the VA and never looked back. We can be too easily influenced by what feels familiar to us from our exposure to our nursing faculty, and what other members of our graduating class are doing. The trend today is to go right back to graduate school within a year, but that is not the right decision for everyone. When it is a very important decision, ask yourself how you will feel about a potential choice in 10 minutes, in 10 month and in 10 years. Always honor your core priorities.
Prepare to be Wrong
Even when taking the three above steps, not every decision that you make will be the right one. Every semester, I have at least 1-2 nurse practitioner student transfer into the nursing administration track because they realize that the NP role was not the right decision for them. We need to prepare to be wrong about some of the decisions that we make today and be willing to act when we realize it.
Having a process to help in career planning decisions is important. We need to advise our new graduates to pay close attention to dis-confirming information and look for alternate ways to frame their decisions. They also do need to be prepared to act if things go unexpectedly well or poorly when they start an NP program. The process described by the Heaths in their book doesn’t guarantee a good outcome. But it sets guardrails to keep us from falling into the common decision-making traps that can lead us in the wrong career direction for us.
Read to Lead
Heath, C. & Heath, D. (2013). Decisive: How to make better decisions in Life and Work. New York: Crown Books.
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