Nursing Sabbatical

I started my BSN to DNP program August 2016 as a part-time student and full-time employee. As a part-time student, my schedule was designed for me to complete all the requirements for the Master of Science in Nursing (MSN) in May 2019 and start the courses for the Doctor of Nursing Practice program two weeks later. However, in January 2019 I received an email with the instructions to register for May graduation. I didn’t realize I was going to graduate separately for my master’s and doctorate. I wasn’t prepared to transition into a new provider role and simultaneously begin a doctoral program. I didn’t know how demanding the doctoral coursework was going to be. As my colleagues became nurse practitioners one by one, I observed how much time they dedicated to work: days, evenings, and weekends charting and meeting practice obligations. I already had school work to do on days, evenings and weekends. While it is possible and many of my colleagues went on to start working as nurse practitioners (NPs) and matriculate into the DNP program, I decided to wait.

Then, when it came time to graduate from the DNP program, I decided to wait again. I took a quasi-sabbatical in that I continued to work as a travel registered nurse (RN). I only worked 3 nights a week which gave me the one thing that remains the biggest barrier for clinicians, time. After 6 years of the BSN to DNP program, I needed time to reconnect with my loved ones and myself. I was six years older and life had changed personally, professionally, and globally. What did it all mean? Most importantly, what was my legacy going to be? Now that school was completed, what was I going to do with all my experience, education, and training?

In that time, I explored opportunities in and outside of healthcare including nutrition, Integrative Medicine, business franchises, and authorship. I also started to notice some trends amongst healthcare providers, namely limited thinking, something I was breaking away from.

The Gift & The Curse

Nursing affords us the honor and privilege to meet people at some of the most vulnerable times in their lives, in very intimate spaces, and for very serious circumstances. With time, you become both an expert in providing patient care for your clientele and in the environment itself. If and when you start working at a new location, you will have to make slight adjustments in your practice to fit the needs of the patients, co-workers, location, and time period for which you’re delivering care. Change environments and your practice changes slightly too.

One thing traveling nursing taught me is that while each clinical setting follows evidence-based practice guidelines, there is enough nuance in how those standards are delivered that working at a new location is almost like starting over. The idea of starting over can be crippling and trigger imposter syndrome. With time or amidst rapid employee turnover, you acquire a level of seniority, your preferred scheduled, a desirable income, a certain level of respect from your colleagues, and despite an ever-changing environment, certain things become very predictable. We become comfortable.

The Healthcare Wheel

After taking a step back for the last year to evaluate healthcare objectively, I liken healthcare practice to being on a wheel. After you graduate, you get a job which is the healthcare wheel. Once you’re on the wheel, you become very familiar with the wheel. It’s all you see. You know it inside and out. The more you’re on the wheel the more momentum you develop. You’re going so fast you don’t even have time for anything else except maintaining the momentum of the wheel. The lack of time then becomes the number one barrier to any quality improvement effort, professional development, or change in lifestyle. Our patients aren’t the only ones who find it difficult to implement change.

While you’re on the wheel, people present opportunities and bring fresh ideas, but you don’t even have the bandwidth to consider or entertain those ideas, because you have to maintain the momentum of the wheel, you can’t veer to the left or the right. As much as we want to engage in the opportunities outside the wheel, we end up picking up more hours and taking on more responsibilities which only further commits us to the wheel.  

How to Pivot: The First Step is Stopping Limited Thinking

You don’t need to enroll in a new program. You don’t need to earn a certificate. You don’t need to see more patients. You don’t need a preceptor, but you should have a mentor. Yes, you. You need to take a break with purpose. You need to find time, request PTO, or use your next vacation and use that time to explore other interests with intention. Use idle time to absorb free information in the form of audiobooks, podcasts, articles, and videos (YouTube, webinars, and virtual events). Idle time is anytime your ears are free:

- On the toilet

- In the car

- Cleaning

- Cooking

- Charting

- Traveling

- Working out

- Waiting in line

- Walking the dog

- Brushing your teeth

- Waiting for a meeting 

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#readinghack

The time you invest will add up quickly. You will begin the process of shifting your thought process and changing limited thinking into actionable steps. Shift your timeframe from 12 months to 12 weeks. Begin to set goals and evaluate them on a quarterly basis. Start by listening to The 12 Week Year and The Four-Hour Work Week. By clicking on the links, you can learn more about the wealth of resources each author provides. Both books can also be purchased on Amazon or Audible. Additionally, you can purchase the e-book on Amazon which tends to be cheaper and then use the Alexa app (on your phone or other mobile device) and listen to the audio that way, it’s free.

Time is Your Greatest Asset

Making a successful pivot requires time. You need time to explore and be creative. The people who get paid to think, get paid the most. It affords you time and energy to work on your business - the business of your life or your profession - instead of in it, finding more ways to increase revenue and reach. I know the thought is scary. Change is not easy, but it is doable. Walking away feels risky, until you do it. Rest assured, if you walk away, the job will still be there. You’ll always be able to find a job in nursing.

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Kimberly Madison, DNP, AGPCNP-BC

Kimberly Madison is a new dermatology nurse practitioner with a passion for writing, entrepreneurship, financial literacy, and mentorship. I created this blog to share my journey as I become a dermatology nurse practitioner and entrepreneur. Most importantly, I’m looking forward to helping nurse practitioners and aspiring students to better understand the field of dermatology and their role to improving access to care, providing culturally competent care, and advancing education.

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