Once nursing school is complete and the graduate has passed the NCLEX-RN exam he or she will receive a nursing license issued by the State. This makes the graduate eligible for employment in that state. So, now the fun really begins by building an amazing resume and a focused and purposeful job search.

The graduate can work on dazzling the interviewer in-person, during the RN interview, but first, he or she needs to get noticed by submitting an exceptional resume and perhaps recommendation letters.

Basics of a Resume

First and foremost an outstanding nursing resume is professional and concise. These are required and absolutely mandatory to apply for any nursing position, even though filling out an online application is also required. The key to a successful resume is to keep it simple yet persuasive while always remembering to create the best possible image of oneself on paper.

Many graduates choose to browse images of resumes online before committing to a resume style. The style will affect which sections and words are bolded, centered, underlined, and other formatting variations. Choosing a format that makes a strong impression is a good place to start.

Here are a few guidelines to follow, whichever format is chosen:

• Make your name stand out
  • The top of the resume states name and contact information, this should be either bold, have a big font size, be underlined, or all three and if your middle name is unique it may be wise to add it as this may catch the attention of the HR Representative
• Be sure to list an email address as well as phone number, address, and name
  • Avoid listing any social media links for a nursing position
• It must be free of grammatical and spelling errors
• Have a friend proofread the resume and read it out loud more than once to yourself
• Hire a professional to proofread, usually for a nominal fee
• Keep it simple and concise
  • Unless there are a lot of extras to list a new graduate nurse should not need more than one page
• Stick to basic fonts
  • The preferred font is Times New Roman because it is easy to read and fits well on a page

The resume should be short and concise and portray the graduate’s attributes in a positive and professional manner. The new graduate registered nurse without healthcare experience should not be overly concerned about his or her lack of experience as a nurse. Employers are expecting this and look forward to teaching the new graduate nurse the policies and procedures of the organization. Many employers embrace new graduates and appreciate the opportunity to mentor.

The image portrayed should be that of an eager and humble new nurse who wants to learn from experienced nurses who are smarter and better at nursing he or she is. The arrogant new graduate does not get very far in nursing either during the resume and interview process nor on the job.

The nursing resume usually consists of these sections

• Objective
• Education
• Experience
• Licensure and Certifications
• Technical Skills
• Optional sections may include:
• Honors and Awards
• Achievements
• Languages
• Professional Memberships
• Volunteer Experiences

FUN FACT: Occasionally, employers may ask nursing candidates to provide their NCLEX-RN scores during an interview or on a job application. While this is rare, candidates can contact their local state board of nursing to access results. However, with the introduction of the Computer Adaptive Testing (CAT) in 1994, most states went to a “Pass” or “Fail” result and no longer provide actual scores.

Objective

This is a general statement about the directive of the graduate. These have evolved over the years from a brief-phrase stating the graduate’s intent to something similar to an abbreviated cover letter.

Some objective statements may be as long as a short paragraph. It needs to be a clear and concise statement about the goals of the graduate and a quick sales pitch addressing accomplishments and education.

Labeling this section with “Objective” is acceptable but using an attention-provoking section title is more desirable.

For example,

Eager New Graduate Registered Nurse (section label)

• Dedicated BSN graduate with honors from Brown University, GPA 3.5.
• Licensed registered nurse holding ACLS and BLS certifications and over 600 hours of clinical experience.
• Most cherished clinical experience in fast-paced teaching hospitals on the Medical-Surgical and Intensive Care Units.
• Excels in multitasking and communication and technically proficient in electronic medical records including Epic and Cerner.
• Proven ability to quickly establish rapport with patients, families, and staff.
• Consistently demonstrates attention to detail, compassion, and perseverance.

Education

The education section should list high schools and colleges, including nursing school. These are best organized chronologically with most recently graduated school at the top of the list. Please include the name of the school, degree earned, and year of graduation. Adding geographic location and areas of study is also acceptable.

For any other nursing programs, such as Certified Nursing Assistant (CNA) or Licensed Practical Nurse (LPN), please add to this section as well, and be sure to highlight these accomplishments as they may prove to make the graduate stand out above others. Bolding, italics, or underlining may be a good method of doing so.

For example,

Education

• Brown University, Bachelor’s of Science in Nursing (BSN), 2016
• Pruitt Nursing Aide School, Nurses Aide Diploma (CNA), 2015
• Charleston Community College, Associate’s Degree in Nursing (ADN), 2014
• Phoenix High School, High School Diploma, 2012

Experience

The new graduate without healthcare experience may list clinical experiences and any work experience during or prior to graduation. Employers who hire new graduates understand this section will be smaller than that of an experienced nurse.

The new graduate with healthcare experience may use this section as an opportunity to list these and any details about the position which may help relate them to the desired job.

Any experience listed should contain the company name, geographic location, job title, area of experience within the company, dates, and a description. The description should be short and concise, however, if the graduate needs to fill space on the page, creating multiple lines of experience descriptors may be wise.

For example,

Experience

University Hospital Seattle, WA March to August 2015

• Registered Nursing Student-­Medical Intensive Care Unit
  • Care of septic, alcohol and drug withdrawal, cardiac, and CVA patient populations during clinical rotation
  • Participated in Mock Code Blue and received ACLS/BLS certification
  • Created good rapport and working relationships with patients, families, and staff

Cook Medical Center Seattle, WA January to March 2015

• Registered Nursing Student-Neuro Intensive Care Unit
  • Care of CVA, aneurysm, traumatic brain injury, and alcohol and drug withdrawal patient populations during clinical rotation
  • Developed appropriate and effective rhythms for the workday
  • Able to critically think through and prepare for worst-case scenarios

Licensure and Certifications

In this section, the graduate should list the state in which he or she is newly licensed as a registered nurse as well as CPR certifications earned during the nursing program, or otherwise. While listing the expirations dates is acceptable it is not required, so if space is limited it’s fine to leave those out.

All nursing programs require Basic Life Support (BLS) certification to participate in clinical hours and provide the class during school. Some programs may offer or require Advanced Cardiac Life Support (ACLS) certification towards the end of the nursing program when clinicals may be in critical care areas, such as the intensive care unit, labor and delivery, or operating rooms.

If hired into a critical care position, the ACLS certification is a job requirement and many employers will provide the class during the internship. However, to appear as a more desirable candidate, the graduate may become certified in ACLS prior to being hired. Other certifications are also available to an RN without experience, see Certifications in Nursing for more on this.

For example,

Licensure and Certifications

• Washington State Nursing Licensure expires October 2017
• Advanced Cardiac Life Support (ACLS) Certification, expires October 2017
• Basic Life Support (BLS) Certification, expires October 2017

Technical Skills

This section is intended for electronic medical records (EMR) programs used during clinical hours, other computer software experience, and any medical equipment with which the graduate has had exposure.

For example,

Technical Skills
Epic and Cerner experience, proficient in Microsoft Word and Outlook, and Alaris IV pumps

Optional Sections

Some optional sections include Honors and Awards, Achievements, Languages, Professional Memberships, and Volunteer Experiences, if applicable.

RNs have the unique ability to basically choose the type of workplace which best suites his or her ideal environment, usually this happens through trial and error and years of experience.

The RN can work in an environment with pretty curtains and a nice waiting room to a rough-and- tumble county hospital whose primary patient populations are inmates and homeless people. He or she may prefer clean and fresh patients who come from home and have a minor elective procedure or a not-so-fresh patient who was found unconscious in the street and is now barely hanging on for dear life.

Hospitals

• Emergency Roomarguably the most fast-paced and dynamic department a RN could choose to work, a day in the ER is never the same twice. Patient populations can be very different depending on the location and size of the hospital
• Intensive Care Unitthis department requires perfection, attention to detail, and a strong sense of self to tolerate some of the emotional highs and lows the RN will experience. Large hospitals will have more than one type of ICU:
  • Neurological ICU for patients with a traumatic brain injury of some variation
  • Cardiac ICU for patients who have had cardiac surgery or cardiac catheterization procedure, or post-myocardial infarction, etc
  • Medical ICU for patients with sepsis, withdrawal from a substance, stroke, MI, active gastrointestinal bleeding, etc
  • Trauma ICU for patients who have sustained injuries due to a motor vehicle crash, fall, attempted homicide, attempted suicide, drowning, etc
  • Burn ICU for patients with a large surface area of burn injury, the RN manages wounds, treats sepsis, and maintains the patient’s airway, among other responsibilities
  • Pediatric ICU for children or adolescents with life-threatening injuries or diseases, the RN sees miraculous recoveries as well as heartbreaking loss of children
  • Neonatal ICU for infants with life-threatening injuries or diseases, like the Pediatric ICU, the RN will experience dramatic highs and lows and requires a strong emotional core to prevent burnout
• Floor patients are admitted to the floor for monitoring and treatment of a stable diagnosis which could deterioration to unstable and require transfer to a higher level of care, such as the intensive care unit. RNs on the floor must be amazing at assessment and rapidly respond to an emergent situation. Floor patient care can be difficult due to high ratios, short staffing including having enough certified nursing assistants, and the fact that, many floor patients are not on telemetry monitoring
• Medical-Surgicalis for patients who have had surgery and are stable or have a stable medical diagnosis which may get worse, this unit has a good mix of patients and is often preferred by new RN graduates for it’s broad array of experiences
• Orthopaedicsis for patients who have sustained a bone fracture and/or need surgery to repair or replace a bone or joint. Common diagnoses for this population is Total Knee or Hip Arthroplasty. The RN helps to rehabilitate and teach this patient about new mobility standards, etc, which must happen for the patient to transfer to home
• Oncologyis for patients who have some form of cancer, many are receiving chemotherapy and/or radiation or preparing for a bone marrow transplant, which can require a very long hospital admission. RNs on this unit will experience many emotional highs and lows, so it requires a RN with a strong emotional core.
• Telemetryis for patients with a new or previous diagnosis of a cardiac dysrhythmia, cardiac complication, or have undergone a cardiac surgery. Some telemetry patients are being treated for a different condition but require monitoring of their heart because of a preexisting condition. A telemetry technician is assigned to monitor the EKG’s and notify the RN of an abnormality. RNs on this unit must be quick-thinking and understand appropriate cardiac interventions.
• Mother/Baby requires the RN to take care of newborns and post-delivery mothers. This unit is fast-paced and requires quick-thinking and strong assessment skills to monitor for hemorrhage and deterioration of either mom or baby. This nursing role requires the RN to care for 2 patients as a set.
• PsychiatricUnit patients are admitted for mental illness and disease, either temporary or permanent. RNs will be able to explore a wide range of skills relating to mental behavioral health.
• Operating RoomRNs will care for patients who require surgery, there are 3 areas of the operating room available to RNs
  • Pre-OP, or before surgery, involves the RN obtaining a medical and social history, documenting personal belongings, and preparing the patient for surgery
  • Peri-OP, or during surgery, involves the RN assisting or circulating the operating room while the patient is under anesthesia
  • Post-Op, or after surgery/recovery room, involves the RN recovering the patient from anesthesia and ensuring the patient’s airway and hemodynamics are monitored appropriately while intervening as necessary
• Labor and DeliveryRNs assist in delivering babies and everything that comes before and goes after this process. RNs in this area will be working in a fast-paced environment with very high stakes as the birthing process can rapidly escalate to an emergency or surgery. Especially good assessment skills and recognition to a developing crisis is required.
• Cardiac Catheterization LaboratoryRNs assist the cardiac surgeon with cardiac catheterization procedures, including cardiac stent placement, intra-aortic balloon pump (IABP) placement, etc. Patients during the procedure are under anesthesia and require intensive monitoring. This patient population has often just experienced a myocardial infarction and was transferred emergently to repair the blocked vessel.
• RadiologyRNs perform CT and MRI scans, and X-rays. RN’s often inject angiography dye or administer barium for specialized exams.
• Interventional Radiology (IR) the RN in this department assists the physician with procedures such as central line placement, nasojejeunal tube placement, PEG tube placement into the stomach, colostomy insertion, etc. The RN is required to set-up the IR room similar to how an operating room is prepared.
• Wound CareDepartment the Wound Care RN is specially trained in caring for wounds of various types, colors, and causes. Bedside nurses consult this RN for complex wound care and recommendations as well as Wound Vac initiation and management. RNs in this department should enjoy wound care and are rewarded by the improvement of wounds it’s contribution to overall patient health.
• Rapid Response Team is comprised of specialized RNs who are experienced and competent in rapid patient assessment and intervention for the deteriorating patient. A Rapid Response, or RRT, is called on the overhead loudspeaker at hospitals by non-critical care nurses who have determined a patient is deteriorating and needs immediate assistance. This is done when the patient is still breathing and has a heartbeat, so it is not a Code Blue. RRTs will sometimes become a Code Blue if the patient continues to deteriorate and the RRT team needs additional assistance.

The Registered Nurse, or RN, is required to follow the Scope of Practice as mandated by each state. The nursing Scope of Practice is defined by the American Nurses Association (ANA) as, “the ‘who,’ ‘what,’ ‘where,’ ‘when,’ and ‘how’ of nursing.” It provides a legal definition of what nurses can and cannot do, legally.

Once the RN passes the NCLEX-RN and accepts licensure in a state he or she agrees to follow the Scope of Practice for that state. This is a legal and ethical requirement and the RN is held, by the State, to this standard. This is important because of the many areas of nursing and the many types of employers a RN may have.

The RN is covered, legally, by the state’s Scope of Practice and not necessarily by the job description or employer policies and procedures. These may hold up to some extent in a court of law but it is generally understood that the Scope of Practice is the standard for nurses. No policy or procedure should ask nurse to step outside of the state’s Scope of Practice.

Once the RN specializes in a certain area, such as, aesthetic nursing, the ANA in conjunction with each specialty organization offers resources to promote understanding of the individual Scope of Practice. Certification in a specialty area is a way to further the RNs legal responsibilities as each certification has it’s own Scope of Practice. It ensures competency in a new skill set to which the RN is now legally held.

For example, an inexperienced new graduate RN is not allowed, by state Scope of Practice, to perform laser hair removal. This makes sense because the new graduate RN has had no training in school to perform this task. But if the RN is hired by laser hair removal clinic, trained, and certified to perform this task, he or she is now covered by the Scope of Practice to perform this skill. Additionally, the general skill set of nonmaleficence is promoted because it ensures that an inexperienced RN without any training will not be performing laser hair removal on a patient, hence, doing ‘no harm.’

Another example, the new graduate would not be qualified to monitor a patient with an Intraventricular Device, which are placed for patients with traumatic brain injuries, because the RN has had no training with such devices and is not competent in this skill directly out of school. But once the RN is hired and trained to monitor a patient with this device he or she is now covered under the Scope of Practice. Later, the employer may require certification to promote learning and hold the RN to the high-standard of that certifying body, the American Association of Critical Care Nurses.

Each state’s Nurse Practice Act (NPA) is determined through the Boards of Nursing. As states are responsible to protect the public, nurse boards are charged with ensuring nurses practice within defined laws of practice.

Ignorance of the law is not an excuse to not follow the Nurse Practice Act. Nurses are responsible to know the details of the NPA in the states where they practice. Nurses can be held accountable when they, even mistakenly, violate NPA standards. For example, certain states require a nurse to report a driving while under the influence (DUI) violation. If not reported to the Board of Nursing, a nurse may face disciplinary action through the board.

Each state’s NPA is governed and enacted by that state’s legislature. Because the NPA is not detailed or sufficient enough to stand alone, the boards of nursing were created to further define and interpret laws around the NPA. Each Board of Nursing (BON) may enact more stringent laws related to the NPA, but may not go beyond the boundaries of the act. Each BON reports to the National Council of State Boards of Nursing (NCSBN) who oversees the laws and standards.

According to the NCSBN, each state’s Nurse Practice Act language must include:

• Authority, power, and composition of a state nursing board
• Education program standards
• Standards and scope of nursing practice
• Types and titles of licenses
• Requirements for licensure
• Grounds for disciplinary action, other violations, and remediation

The NCSB collaborates with many nursing authorities to set, revise, and define nursing practice. The American Association of Colleges of Nursing (AACN), the American Nurse Association (ANA), the American Organization of Nurse Executives (AONE), and the National League for Nursing (NLN) are some of the major players used to interpret regulations and determine standards of care.

A Standard of Care is different than a Scope of Practice. Standard of Care refers to care that is performed in consistence with other nurses of similar education, competency, and experience. Nursing practice and standards of care are often referenced together. For example, professional organizations such as the American Nursing Association publish authoritative statement documents, by interpreting the NPA and Standards of Practice, to define the overall practice of nursing.

As the practice of nursing requires knowledge, skill, and autonomous decision making, the Nurse Practice Act is the law that governs those decisions to protect the community from harm. Nurses are expected to know the NPA for the state in which they practice. The NCSB’s Scope of Practice Decision-Making Framework tool is a useful tool nurses can utilize to determine nursing practice responsibilities.

Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences to maintain and develop medical data and systems to support the practice of nursing, and to improve patient care outcomes. Technologies that have evolved due to health care/nursing informatics include:

• Computerized provider order entry (CPOE)
• Electronic medical records (EMRs)
  • Test results
  • Progress notes
  • Nursing notes
  • Medication records

Top of Form

There are three “building blocks” of nursing communications — data, information, and knowledge. Data includes direct observations that do not need interpretation, such as:

• Patient’s name
• Age
• Vital signs
• Disease history

Information is data that has been interpreted. Examples include:

• Prevalence of hospital-acquired infections, by care unit
• Percentage of patient care delays in outpatient clinics, by specialty

Knowledge is the amalgam of information to identify relationships that provide further observation to an issue. For example:

• The effect of nurse-patient ratios and patient outcomes
• Developing care protocols (i.e. anaphylactic reaction protocols, pressure ulcer protocols, etc.)

While nurses incorporate all three communication “building blocks” in their daily routines, the three concepts are also stored in computer programs and software to assist health care providers across the continuum to provide high-quality, safe patient care.

Nurse informaticists work to develop communication and information technologies in health care. They also serve as educators, researchers, software engineers, and chief nursing officers. Using the “building blocks” listed above, they help develop evidence-based policies and procedures for organizations.

Why Is Nursing Informatics So Important?

Nurses need information to care for patients safely. They need to be able to access medical histories, medication lists, lab and imaging results, and physician/interdisciplinary team notes to get a complete picture of a patient’s clinical status. They use this information to make decisions efficiently to improve patient care outcomes.

Nurse informaticists, as well as other health care informaticists (pharmacists, physicians, etc.), play a critical role in the continuous development and improvement of health care technology. Communication is inarguably one of the most important aspects of patient safety. The contribution of nurse informaticists in developing and improving technology such as electronic medical records and computerized provider ordering has been crucial in reducing medical errors, patient care delays, and health care costs.

For example, before CPOE, nurses would need to transcribe provider orders by hand. Hard-to-read handwriting and human error caused transcription inaccuracies, which in turn led to medication errors, delays, and omissions.

Today, software exists where providers simply click a button and the right medication, dose, and frequency is selected. Additionally, some programs cross-check orders against the patient’s allergies and/or duplicate orders to further protect patient safety.

Nurses who have strong analytical and critical thinking skills, enjoy working with technology, and enjoy problem-solving and project management make excellent nurse informaticists.

Those considering the specialty of nurse informatics should, at a minimum, obtain a bachelor’s degree in nursing (BSN). While an advanced-practice degree is not always required, it is highly recommended. Advanced-practice nurses are those who have completed a master’s program in nursing (MSN) or doctoral degree program (DNP).

To advance to a master’s degree or doctoral in nursing, a student must complete an accredited nursing program and obtain a BSN. Successful completion of the NCLEX-RN is needed for licensure. The length of time it takes to earn an MSN depends on the nurse’s starting point:

• Nursing students enrolled in a BSN program complete in about four years
• RN to BSNtakes about two years
• BSN to MSNtakes about two years
• BSN to DNPtakes three to four years
• MSN to DNPtakes one to two years

There are both online informatics programs and classroom programs available to accommodate students. Both types have pros and cons depending on students’ needs, therefore researching individual schools is encouraged.

Nursing Informatics Education Requirements and Training

Some graduate programs require nurses to gain a few years’ clinical experience before enrollment. Some schools allow nurses to work concurrently during the program. Working as a unit-based technology support user (also known as a “super-user”) or with the information technology (IT) team allows nurses to gain necessary technical skills needed to work as an advanced-practice nurse informaticist.

Educational Prerequisites

Master’s degree programs require completion of general advanced-practice courses, as well as courses specific to nursing informatics. While courses and practicum may vary slightly, curriculum for the nursing informatics track may include:

• Statistics for evidence-based practice
• Database management
• Research
• Project management
• Clinical information systems
• Information security and privacy
• Informatics theory
• Leadership

Examination, Licensure, and Certification

Certification in informatics can be completed concurrently within the MSN/DNP program or obtained via independent study from the American Nurses Credentialing Center (ANCC) or other learning institutes. Eligibility for certifications obtained outside of an MSN/DNP program can differ, and students are encouraged to research requirements when choosing an educational institution.

The ANCC offers board certification for nursing informatics. Eligibility for certification include:

• Hold a bachelor’s degree or higher
• Have practiced as a registered nurse full time for two years (or part time equivalent)
• Have completed 30 hours of continuing education in nursing informatics within three years before certification
• Have met one of the following practice hour requirements:
  • Have practiced a minimum of 2,000 hours in informatics nursing within the prior three years
  • Have practiced a minimum of 1,000 hours in informatics nursing in the last three years and have completed a minimum of 12 semester hours of credit in informatics courses that are part of a graduate-level nursing informatics program
  • Have completed a graduate program in nursing informatics that includes a minimum of 200 hours of supervised practicum

Certification is by exam, and the credential is valid for five years.

Licensure and certification are different—certification means nurses are competent to perform in the field of nursing informatics; licensure means they are legally permitted to practice in their state of residence. State nursing boards list the requirements for testing and can vary from state to state. BSN, MSN, and DNP nurses, after meeting specified requirements, may apply to their state board for licensure. Read more for further clarify on nursing informatics certifications.