Finding the right practice environment that values your education is essential to your long term success and job satisfaction as a nurse. The American Association of Colleges of Nursing (AACN) has developed this brochure to assist nursing students, educated at the baccalaureate level and above, in making the best decision on where to practice following graduation.
Asking the Right Questions
AACN has identified 8 key characteristics or hallmarks you should examine when screening potential employers. Each hallmark identified in this brochure is followed by suggested questions that you may ask during an interview.
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Does your potential employer ...
Manifest a philosophy of clinical care emphasizing quality, safety, interdisciplinary collaboration, continuity of care, and professional accountability.
Does the organization’s written philosophy and mission statement reflect an emphasis on quality, safety, interdisciplinary collaboration, continuity of care, and professional nursing accountability?
Do nurses provide input into policy development and operational management of issues related to quality of care, safety, continuity of care, patient-staff ratios and clinical outcomes?
What is the nurse-to-patient ratio? What support staff are available on the unit to assist nurses?
Recognize the value of nurses’ expertise on clinical care quality and patient outcomes.
How are nurses held accountable for high quality practice?
Are there differentiated practice levels or roles and differentiated pay scales for nursing congruent with differences in educational preparation, certification, and other advanced nursing preparation?
Are professional and education credentials recognized by titles on nametags?
Does the organization utilize clinical nurse specialists, nurse practitioners, nurse scientists, and/or educators to support and enhance the work of staff nurses in clinical care?
Promote executive level nursing leadership.
What are the key responsibilities of the top nurse executive? Request job description.
Where is the top nursing voice in the organization? Are nurses represented in key committees and in governance? Request organizational chart
What resources and functions fall under the nurse executive? What professional development, educational, and research functions are included in nursing services? Request the organizational chart for patient care/nursing services.
Empower nurses’ participation in clinical decision-making and organization of clinical care systems.
Do nurses control decisions directly related to nursing practice and delivery of care, such as staffing, nursing quality improvement, and peer review?
Do nurses have input into the systems, equipment, and environment of care?
What is the specific patient population and nature of nursing care on this unit? What issues are evident in the performance improvement plans for this department? What role is defined for nursing staff in the unit plan? Request a copy of the unit/department plan of care.
How are nurses involved in establishing and monitoring the workload measurement system? How does this system influence daily staffing? Request a copy of the policy/procedure regarding the patient classification system.
Demonstrate professional development support for nurses.
What resources are committed to the ongoing professional development of nurses, i.e. tuition, continuing education, and certification?
Are there support systems such as internships and mentorships available for the development of staff?
What are the opportunities for professional growth? What can I learn here and how would employment here facilitate my career goals?
Maintain clinical advancement programs based on education, certification, and advanced preparation.
What rewards based on educational preparation are available?
Does the evaluation of clinical advancement, competencies, and professional contributions include consideration of:
Patient satisfaction
Self-initiated education
Dissemination of clinical information, e.g.nursing rounds, case presentations
Improvement of clinical outcomes andefficiency
Evidence-based practice
Ability to delegate to and guide non-bachelor’s prepared nursing staff
Serving as mentor, consultant, or precep- tor to students and recent graduates
Ability to work in an interdisciplinary context
Leadership role in institutional self- governance and practice committees
Create collaborative relationships among members of the health care team.
How is the quality of patient care and safety reviewed? Who is involved, and is it a peer review process?
Do nursing departments have interdisciplinary or shared leadership models?
Does the practice setting have interdisciplinary standing committees for quality improvement, peer review, patient safety, quality care, or disease state management?
Are clinical practice privileges extended to advanced practice nurses as part of the staff bylaws and credentialing system?
Use technological advances in clinical care and information systems.
Do nurses have electronic access to clinical nursing and health care knowledge and research results, including Web access? Is this access available on nursing units or departments of the practice setting?
Does the practice setting allocate budgeted resources for new equipment and patient care technology? Do clinical care providers have routine opportunities to provide input to the budget planning process?
What clinical information system, including patient care documentation, does the practice setting use? Is the system integrated throughout all or most clinical departments?
Do nurses from the practice setting feel that their practice is supported by up-to-date clinical care technology?
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Other statistics and information to request from a potential employer:
RN vacancy rate and RN turnover rate
Patient satisfaction scores (preferably percentile ranking)
Employee satisfaction scores
Average tenure of nursing staff
Education mix of nursing staff
Percentage of registry/travelers used
Key human resource policies, i.e. reduction in workforce (tenure vs. performance criteria)
Copy of the most recent JCAHO report and the number of contingencies cited
Are nurses unionized?
Copy of a contract
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