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Nursing: A career for the ages

A historical look at one of the most enduring, satisfying, and compassionate careers on earth.

Salute to Nurses turns 20 this year, marking two decades of honoring caregivers who have touched patients’ lives in special ways. While 20 years is impressive, it’s a drop in the bucket when it comes to the history of nursing in Massachusetts. That stretches back 151 years to the New England Hospital of Women and Children in Boston, the first true training school for nurses in the United States. It opened in 1872 and graduated the country’s first trained nurse, Linda Richards, in 1873. Richards was white; the first African American nurse, Mary Eliza Mahoney, graduated from the school six years later. The early graduation of an African American nurse in 1879 put in motion a tradition of diversity that endures and is expanding even to this day.

Massachusetts has continued to advance the nursing profession, keeping pace with the practice of medicine. Nursing has expanded to include nurse midwives, psychiatric nurse specialists, and nurse anesthetists, among others. “There are so many opportunities within nursing now that you can really find your niche,” observes Deb Baker, vice president of patient services and chief nurse executive at Mount Auburn Hospital in Cambridge, part of Beth Israel Lahey Health. “This sub-specialization speaks to the further professionalism of nursing.”

The New England Hospital for Women and Children was founded by Marie Zakrzewska on July 1, 1862. Image Source

This is also evident at Dana-Farber Cancer Institute, where Senior Vice President, Patient Care Services, and Chief Nursing Officer Anne Gross notes that the role of nursing within oncology has evolved along with cancer science. “We now have nurse navigators, who help patients and families coordinate care throughout the trajectory of treatment; nurse practitioners, who follow patients week to week while they’re on treatment; and nurse scientists, who advance research to help patients maintain the highest quality of life through treatment,” Gross says.

In addition to the expansion of roles, technology has also transformed entire nursing specialties. “If you’re a nurse in the cardiac catheterization lab, interventional radiology, or the operating room, you’re working with some of the most sophisticated equipment there is,” adds Nancy Gaden, senior vice president/chief nursing officer at Boston Medical Center.

To Gross, all of this change is one of nursing’s chief attractions. “It’s a profession with so many niches to explore. You can reinvent yourself throughout your career,” she says.

Nursing is a reliable, stable, even lifelong profession that is consistently and constantly hiring, and Massachusetts can be a great place to be a nurse. “Massachusetts has always ranked among the top states for nurses’ salaries, behind California and New York,” says David Schildmeier, director of public communications for the Massachusetts Nurses Association. The salary range, from approximately $30 to $98 per hour, includes school nurses, public health nurses, visiting nurses, acute care hospital nurses, nurse practitioners, and midwives. The training pipeline is also strong, with 32 schools of nursing offering a range of degrees, from a certificate in practical nursing to a bachelor of science in nursing all the way through to a doctorate. 

And a strong pipeline is good because demand for nurses in the region is high. Even on the other side of the COVID-19 pandemic, “hospitals remain busy with an aging population that requires more healthcare services,” says Gaden, who also serves as president of the Organization of Nurse Leaders for New England. To meet staffing needs, hospitals are “going to have to innovate.” As an example, Gaden points to the flexibility of travel nursing, where nurses work for 13 weeks and then are able to take time off before a new assignment. “That’s something we need to figure [out] how to do. We have to reinvent acute hospital nursing to offer nurses exactly what they’re looking for now.”

The New England Hospital for Women and Children now exists as The Dimock Center, a partner of Beth Israel Lahey Health. Image Source

In 2023, innovation includes creative thinking around diversifying the profession — the conclusion of The Future of Nursing 2020-2030, a report from the National Academy of Medicine. “In order to be prepared to care for the changing demographics of the US population, we need to create more opportunity for people from diverse backgrounds to come into the health professions,” Gross says, referencing the report. “We need to develop programs that make it possible for people from diverse communities to pursue careers in nursing and then create work environments that support that kind of diversity.” Dana-Farber is exploring a number of initiatives along these lines, including scholarships and tuition reimbursement.

Mount Auburn is running its own training programs to prepare nurses for in-demand specialty areas such as perioperative, emergency medicine, and critical care. “We are focusing our efforts by investing in our own nurses,” explains Baker, who notes that organizations are also leveraging technology to complement the work of bedside nurses. “Let’s say a patient is going to be discharged today,” she continues. “I may ask the telehealth nurse, available on a mobile computer monitor, to go over a patient’s instructions with them.” This has a triple advantage: “It offers a nurse the opportunity to work remotely, which we know they want. It gives patients focused attention with someone who isn’t pulled in multiple directions. And it takes some of the pressure off bedside nurses so they can continue to function at the top of their licenses.”

All of the nurse leaders interviewed are enthusiastic about the future of nursing, both in Massachusetts and nationally. “There’s tremendous opportunity for young men and women to come into this profession,” Gross says. “Despite the fact that we’ve all been through a tough time because of the pandemic, the essence of nursing hasn’t changed. It’s still a phenomenal profession that offers so many ways to make a difference in acute care, the community, public health, and policy making.”

Gaden agrees. “There’s so much to be excited about in nursing. Nurses remain one of the most trusted professions in the US, and it will continue to be moving forward. We’re recreating ourselves and innovating so that all nurses can find joy in their practice again.”

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