Nurses are known for their high levels of empathy, but the pressure of being on the frontline during a global pandemic has left some nurses feeling like they’re running on empty.
In 2021, a year after COVID-19 was officially declared a pandemic, research by the Australian College of Nursing found a significant increase in the number of nurses leaving the profession, with heavy workloads, lack of resources, stress and burnout being cited as major factors. A survey by the Australian Primary Health Care Nurses Association (APNA) in late 2021 found that 28.7 per cent of nurses in primary health care in this country plan to leave their job in the next five years, with 78.8 per cent pointing to burnout related to the pandemic.
However, some nurses choose to diversify their careers rather than exit nursing entirely. For example, during the pandemic, many nurses took on roles administering COVID-19 tests and vaccines, while others moved into aged care. More broadly, options for nurses seeking to diversify their professional life include shifting into telehealth nursing or mental health, joining FIFO healthcare teams and taking up health management or leadership roles.
Further education plays a key role in helping nurses expand their professional journey.
Nursing in Australia: a snapshot
According to feedback given to the Australian College of Nursing (ACN) in January 2022, the combination of COVID-19 pressure and problems with the healthcare system are resulting in many nurses leaving the profession due to burnout.
“I think a lot of that is related to persistent shift work, persistent lack of flexibility, increasing workloads, not being listened to by your management and not being heard,” says Jessica Stokes-Parish, a nurse, researcher and educator. “All of these issues very much existed pre-pandemic, but it has exacerbated those issues.”
Shift work, Jessica stresses, is a major driving force for nurses to look for new opportunities away from the patient's bedside.
“Despite the fact that it’s a very female-dominated profession, where you would expect there’d be some flexibility around rostering and time, often that flexibility is not afforded to you, so it can make it really tricky, especially as a parent, to be able to juggle with kids,” she says.
“The other thing with shift work is both the mental health and the physical health toll. We have plenty of evidence that shows shift work is bad for your health, and a lot of nurses really feel that, so then they choose to move out of that bedside shift-work role. I think, too, people are looking for new opportunities, autonomy and growth, and that can often be a motivator too.”
Another source of stress for nurses is having large numbers of nurses leave the profession, increasing the pressure on those left behind. And, due to factors including an ageing workforce, Health Workforce Australia predicts there will be a shortfall of more than 100,000 nurses by 2025.
Opportunities for nurses
There’s a raft of opportunities in health care for nurses beyond bedside nursing, says Jessica. She was a full-time intensive care nurse before starting work as a teacher at a simulation centre, which opened her eyes to a love of education. Jessica went on to work as an associate lecturer in nursing at the University of Newcastle, a social media editor at The BMJ, and is currently Assistant Professor of Medicine at Bond University. She’s also a keynote speaker – and still works one day a week as an intensive care nurse.
“I’ve got so much autonomy within my role, and I bring my clinical expertise into that every day,” she says.
“This has given me more control over my schedule. I don’t have fatigue from constant shifts and rotating rosters. When I do go back to bedside nursing, I love being back there.”
Like Jessica, nurse Lucy Lehane has also been through a career transition. She started as ward nurse then moved into intensive care nursing followed by community-based care in homes, where she moved through the ranks and took on a leadership role. After suddenly becoming a single mum of three kids, Lucy had to re-examine her career path, which led her to enrol in a Master of Public Health. After she started working at Chris O’Brien Lifehouse (a not-for-profit cancer hospital in Sydney), initially on the oncology ward, she found an opportunity to delve deeper into an area she’d discovered a passion for while studying.
“In my master's, my elective subjects were around quality and safety and infection control,” she says. “We were looking at a more macro approach to health care and healthcare systems and processes – how to make them more efficient and more patient-centred. A job came up in the quality department so I moved into that role.”
While she loved being a quality and safety nurse specialist at Chris O’Brien Lifehouse, when a job as a clinical educator came up at the Australian Council of Healthcare Standards, a not-for-profit organisation dedicated to improving quality in healthcare, she jumped at it.
“I work in the education arm and we teach quality improvement methodology and clinical governance to health service providers and consumers of health all over Australia and beyond,” she says.
“I work with nurses, doctors and allied health people all over the country doing improvement projects on particular issues in their workplace.”
If Lucy and Jessica’s career paths have piqued your curiosity, here are some options for nurses in health care.
This area of nursing focuses on the care of people with mental illness, advocating for them and helping them manage their symptoms and understand their conditions. Mental health nurses might work in, for example, community health, aged care, forensic settings or acute and emergency care.
Among the skills you’ll need are empathy, good judgement and observation skills, problem-solving and interpersonal communication.
According to the Australian College of Mental Health Nurses (ACMHN), this is an area of growing opportunities due to factors including an increase in vulnerable people due to events such as bushfires, floods and COVID-19 as well as reduced stigma around mental health leading people to reach out for help more.
There are a wide variety of opportunities to study mental health nursing at a postgraduate level with courses designed to suit your schedule and specialty. Some people start with a graduate certificate (4 units and takes 8 months part-time) or a graduate diploma (8 units and takes 16 months part-time) . The good thing is that both of these options give you credit towards a master's degree if you choose to continue down that path.
Australia’s health system is under pressure, with issues including an ageing population, gaps in the workforce and rising costs driven by increasing incidence of chronic diseases, which means there will be a need for strong leaders moving into the future.
The key attributes that make for an effective health leader are being compassionate, adaptable, organised and people-oriented – qualities that nurses draw on every day in the field.
“If you look after a full complement of patients on a busy clinical ward in a hospital, you learn so many skills around time management and people skills – interacting with people and having difficult conversations; negotiating with other healthcare professionals, patients and their families,” Lucy says.
“The clinical knowledge that I’ve developed over the years has helped me in this role, but also softer skills, communication skills, listening, empathy, organisation and negotiation.”
Postgraduate health leadership courses are available at master's, graduate diploma and graduate certificate level. If you are interested in more of a business approach, you can study an MBA with a specialisation in health, for example the UTS Master of Business Administration Specialising in Health and Southern Cross University's Master of Business Administration (Health Services Management).
The field of medical research involves tasks such as undertaking nursing research projects, disseminating research information and promoting the utilisation of research findings into clinical nursing practice, patient management and organisation-wide functions such as safety, quality and risk management. The Australian Government says the future demand for roles in this area is very strong.
While at the Chris O’Brien Lifehouse, Lucy worked part-time as a research officer at the centre’s Cancer Nursing Research Unit, run in partnership with the University of Sydney.
“Nursing research is vital to current and future nursing practice,” Lucy says. “Research enables us to answer questions about our clinical practice and how to give the best care to patients. My clinical nursing background informed my contribution to the nursing research projects I worked on and the master's in public health gave me the foundational skills and knowledge in epidemiology and statistics I needed.”
Social work involves supporting people going through a range of issues, for example: crisis, trauma, family problems and social injustice. Counselling – a profession where you use a range of therapies to help people work through emotional challenges, such as depression, addiction and relationship problems – is another option that appeals to some nurses.
As a nurse, you’re already experienced in many of the skills needed for social work and counselling, including assessing patients, managing large patient caseloads and being able to intervene in crisis situations.
You may want to add to your existing skill set, in which case a graduate certificate or graduate diploma might be a good fit, or if you want to become a professional counsellor a master of counselling may be more appropriate. Courses are available both on campus and online. Master of Counselling are normally professionally accredited by the ACA (Australian Counselling Association). Some examples of accredited online counselling courses include:
Thinking outside health care
"For those considering leaving health care entirely, nursing has already prepared you for a variety of roles in the corporate world. You might be better qualified than you think", says Jessica.
“I think sometimes as nurses we underestimate our capabilities, and how transferable our skills are,” she says, for example: “Time management, organisational skills, being able to problem-solve and think on your feet to critically appraise what you’re seeing and doing.”
She adds, “With intensive care nursing, we’re troubleshooting and responding to changing situations constantly – that’s no different to many other industries.”
According to Creative Careers in Medicine, a community that supports Australian healthcare professionals pursuing non-traditional paths, some options to diversify your career include working in the pharmaceutical industry, insurance roles, medical writing, management consulting, entrepreneurship, career coaching, medico-legal, defence roles and medical education. And if you’re not ready for a big change, you could develop side hustles in one of these fields alongside your current role.
You might like to work with a careers coach or advisor to help you better understand your skillset and what sort of external roles you could work towards (including retraining).
The role of further education
Postgraduate education supports a successful career change for nurses by providing new, specialised skills required for professional transitions.
“Before I moved to my first education role, I did a master's degree around leadership and education,” Jessica says. “That was absolutely fundamental – I wouldn’t have got a look-in for an interview without it. I would encourage nurses looking to move into education to pursue different training that makes them stand apart.”
If you’re among that cohort of nurses looking for ways to apply your skills in a different field, or, if you’re exploring educational paths to move out of the profession, take a look at some of the courses available in the following areas:
