Nursing positions are not traditionally associated with high levels of career growth. While nurses do receive raises, similar to any other profession, they are typically scheduled and based on seniority rather than performance.
A nurse entering the workforce today can often have a reasonably accurate expectation of how much money they will make on the day they retire. While this system has worked well enough historically, and nurses do make a reasonably comfortable, if not extravagant, salary, it is not consistent with factors that contribute to high levels of workplace satisfaction and long-term retention.
In this article, we take a look at how career mobility can positively influence the world of healthcare.
Overview
There are several factors that heavily influence the likelihood that a person will stick around in a profession. Interestingly enough, compensation is not one of the highest-ranking factors. It is something people think about, but other considerations are often prioritized above it.
These include autonomy, workplace relationships, finding meaning in the work you’re doing, and having opportunities to grow into new roles.
Nurses benefit from working in an industry that is inherently meaningful. They often form strong relationships with their coworkers, and they earn a salary that, at least ideally, meets their personal needs.
These are all positives, but there is an issue. Limited career mobility, coupled with high levels of oversight, can result in nurses feeling disengaged and burned out. Creating targeted opportunities designed to address these factors can go a long way toward reducing turnover.
New Opportunities
To create opportunities for career advancement, the good news is that hospitals do not necessarily need to invent new roles. There are already several positions that are well suited to expanding nursing career potential while providing higher levels of responsibility.
At the most basic level, there are charge nurse positions. These roles combine managerial responsibilities with traditional bedside care. They are attainable without pursuing additional certifications or degrees and can be a good, though somewhat limiting, option for nurses interested in expanding their career potential.
There are also specialized roles, which enhance responsibility without adding extensive educational requirements. Specialized certification jobs are not exactly promotions, but adjacent careers that still involve patient-side nursing in highly focused capacities.
For example, a nurse with a specialized certification might work with aging patients, diabetics, education, school nursing, or psychiatric nursing. If you are passionate about a particular area of medicine and want to focus most of your time there, pursuing a specialized certification is often the best way to do it.
Potential Pivots
There are several ways a nurse can pivot into new and more impactful roles that go beyond changing their certification. For example, there are nursing consultancy roles, which are not precisely promotions but adjacent jobs that may come with additional responsibilities and higher levels of compensation.
These positions are well suited for people who want to work on the strategic side of healthcare. Consultants often interact with administrators, lawmakers, or families, providing insights that have the potential to touch many more lives than would be reachable through traditional bedside care alone.
Administrative careers are another way to stay in healthcare while pivoting away from the bedside aspect of the profession. Administrators do not work directly with patients, but they make decisions that have a high impact on patient outcomes.
Administrators routinely make choices that affect thousands of people every year. To become an administrator, you will most likely need a graduate degree, but the potential for advancement is higher. There are many potential promotions within administrative tracks, and earning potential is higher as well.
If you are determined to stay on the nursing side of the profession, you may decide to pursue an advanced practice role.
Advanced Practice Nursing
Like many of the roles described in this article, advanced practice positions are not precisely promotions, but they do provide new and exciting opportunities for nurses. Becoming a nurse practitioner means stepping into a new role that builds directly on responsibilities you already carry as an RN.
While there are several types of advanced practice positions, the most commonly known and sought after is the nurse practitioner role. Nurse practitioners have many of the same responsibilities as general practitioners.
They can write prescriptions, make diagnoses, develop long-term care plans with patients, and generally have a high level of impact on the people they serve. Many people already receive their primary care from nurse practitioners and may hardly notice the difference.
Nurse practitioners, like many advanced practice nurses, often earn more than $100,000 in their first year on the job. If you are interested in gaining more responsibility and increasing your earning potential as efficiently as possible, pursuing an advanced practice position is often the most direct path.
Because these roles require a graduate degree, they typically take a minimum of two to three years to complete, and longer if pursued on a very part-time basis. That said, most advanced practice curricula are designed to accommodate the schedules of busy, working nurses.
This does not eliminate all of the challenges, but it does make these opportunities more accessible.
Conclusion
One of the best ways to improve retention through promotional incentives is simply to make sure nurses have a means to pursue all possible opportunities. Lay out a clear promotion track for jobs that do not require additional credentials, and offer as much financial support as you can for jobs that do. Tuition assistance is expensive, but ultimately less costly than high turnover. If you are struggling to start, one of the best first moves may simply be to talk to your staff. What are their biggest priorities? What do they hope to see offered to them? You can’t do everything at once, but identifying one or two major priorities and pursuing them actively will go a long way toward building trust with your employees and giving them the resources they need to stick around for a long time.

