Expanding the Career Option Decisions of New Graduates

By Rose O. Sherman, EdD, RN, FAAN

“Research in psychology has revealed that our decisions are disrupted by an array of biases and irrationalities. We are overconfident. We seek information that supports us and downplay information that doesn’t.” Chip and Dan Heath

Nurse managers I talk with are frustrated that so many new graduates come to their units with a short-term plan of returning to school to become a nurse practitioner. When I ask if they have done any career coaching with their new nurses, the answer is usually no. As a faculty member, I can see how new graduates arrive at this decision. The majority of faculty that they are exposed to in their nursing programs have NP preparation. The role is heavily promoted in our academic environments as offering independence, greater professional responsibility and higher pay than other nursing positions. What is usually not discussed is the level of accountability expected of ARNPs, heavy patient caseloads and long work hours. For some students, the NP role is the right choice but not for all. What is missing in the career planning of many new graduates today is broadening the options beyond the NP role. Many new graduates have told me that they moved into NP education because so many of their classmates were doing it.

In their book, Decisive: How to Make Better Choices in Life and Work, well-known leadership authors Chip and Dan Heath suggest that our thinking is often flawed and we fail to consider a range of options. The Heaths argue that humans are hampered by four “enemies” of decision-making rooted in our unconscious behavior: narrow focus, confirmation bias, short-term emotion and overconfidence in the outcome. Too many of us just look at the information in front of us and trust our guts too much in making decisions. A partial solution to the frustration felt by managers is career coaching to expand the thinking of new graduates. You can coach new nurses to use the 4 step wrap model to make career decisions.

The 4 Step WRAP Model

Widen Your Options-

In our decision making, we often turn our choices into either/or without expanding our options. The Heaths suggest that you ask yourself the question – If I could not choose either one of these options, what else would I do? – to avoid narrowing your options. This is a good question to ask new graduates to determine what other options they have considered. You might be surprised to find out that they have not explored other career paths. Suggest that they expand their options to at least five different roles that they might be interested in based on their strengths.

Reality Test Your Assumptions

Many of us regularly consult rating sites such as Amazon, trip advisor or yelp before we buy a product, use a hotel or visit a restaurant. Unfortunately, we don’t always test our assumptions in the same way in making career decisions. We need to seek and listen closely to dis-confirming opinions. Has the new graduate interviewed or spent time with an NP? Have they talked with students currently enrolled in NP programs to assess what types of experiences they are having and what the job market is like in your geographic area? Have they considered the costs of attending a fulltime graduate program especially if they still have undergraduate student loans?

Add Distance Before Deciding

Suggest that they put some time between how they feel now and how they might feel in 6 months or a year to take the short-term emotion out of it. We can be too easily influenced by what feels familiar to us and our potential loss aversion. If it is a very important decision, ask yourself how you will feel about a potential choice in 10 minutes, in 10 months and in 10 years.

Prepare to be Wrong

Even when taking the three above steps, not every decision that you make will be the right one. We all do need to prepare to be wrong about some of the decisions being made today. As a nurse leader coach, you can share times when you have been wrong in a decision you made.

I am a strong believer that a great nurse manager can have a profound impact in shaping the careers of young nurses. This won’t happen unless you do some coaching a pushback on career decisions made prior to even starting work. Having a process to help your new graduates in career decision making is important. Advise them to pay close attention to dis-confirming information. The process described by the Heaths in their book doesn’t guarantee a good outcome. But it sets guardrails to keep new graduates from falling into common decision-making traps.

Rose Sherman’s first book, The Nurse Leader Coach: Become the Boss No One Wants to Leave, will be published in January 2019.

Read to Lead

Heath, C. & Heath, D. (2013). Decisive: How to make better decisions in Life and Work. New York: Crown Books.