Emerging Leaders: Recent Graduates Take Charge of Their Careers

Upon graduation from Columbia Nursing, a new reality intervenes. Speaking candidly about the “reality shock” experienced by newcomers to the nursing profession who have learned to navigate a workplace environment, several recent graduates recently participated in a “Real Talk” forum sponsored by the  Columbia University School of Nursing Alumni Association and the Office of Career Development, reflecting on how they transformed themselves as nurse leaders while still in the early stages of their careers.

Kristina Kordesch '11 '13, works as a NP in a surgical intensive care unit (SICU) step-down unit where she worked as a RN while still at Columbia Nursing.

“I got to know everybody from the aides to the administrators,” Kordesch says, who listened and assisted her co-workers regardless of their level of training or authority at the hospital. “If you help people with things that aren’t directly clinical, and listen to people who are older or have more experience, you learn more and you build relationships with people who will help when you need it.”

Columbia Nursing’s emphasis on evidence-based practice also helped her thrive in the position. Her experience of citing clinical research studies to support her patient care plans, in turn, led to an opportunity not often given to junior members of the nursing staff. She volunteered and was subsequently given the opportunity to write a mobility protocol.

Her unit was transitioning from having SICU patients sedated to helping them move around more. These critically ill patients may be sedated to relieve the pain and anxiety caused by I.V. lines, mechanical ventilation, and other interventions. But the immobility that accompanies sedation can contribute to complications such as bed sores and infections, and it can also delay recovery from surgery. Kordesch surveyed older nurses on the unit who had experience moving patients in and out of bed after surgery before sedation became the standard practice. The protocol included guidelines for helping patients out of bed, assisting patients with walking, and planning mobility at times of day when patients are most likely to be alert. “The protocol worked because I listened to people who were more experienced with this situation,” Kordesch says.

She advises current nursing students to cast a wide net in their job search. Kordesch went to work at a city hospital where the research expertise she gained at Columbia Nursing helped her stand out from her more clinically experienced peers. “I got this opportunity to step up and write this protocol because I was willing to go to a place where fewer academic projects were going on that lets somebody junior have this kind of leadership opportunity.”

Paige (Mackey) Bellinger  '10 '12, followed an untraditional path to her ideal job. Right out of school, she worked as an outpatient oncology nurse coordinator at a hospital. The job satisfied her desire to work with high acuity patients, but it left her wanting more autonomy and opportunities to focus on palliative and end-of-life care. “It was important for me to get my feet wet in oncology and see what happens when people are very aggressive with treatment and when people don’t want that,” Bellinger says.

A subsequent job, working as a clinician for UnitedHealthcare far better suited to her goals. She provides services for the insurance company’s Medicare Advantage enrollees at three long-term care facilities in Connecticut. She collaborates with patients, families, and other clinicians to ensure that treatment options are aligned with the patient and family’s goals. When patients have particularly complex needs, she can spend several hours with just one family.

As a new graduate, it took time to gain the respect of physicians at the nursing homes, Bellinger says. “What helps earn the respect of other clinicians is to have an open mind, and to acknowledge that right out of school you aren’t going to know everything,” she says. At the same time, having the confidence to speak up and advocate for patients is crucial. “Disagreements are unavoidable, but I focus on showing my priority is the patient. The patient’s wishes and goals are the most important thing.”

She urges current students to consider nursing jobs in non-traditional clinical settings, rather than hospitals or community clinics. Working for an insurer provides opportunities she wouldn’t have as an employee in a single facility, Bellinger says. “I have more autonomy, and I see the bigger picture about the health needs of the elderly in the state instead of just the population in a single nursing home.”

Connie Yip  '11 '13, started her job search like many of her psychiatric nurse practitioner classmates by lining up as many interviews as possible. She had four requirements: a job where she could make a positive impact and deliver a high standard of care; a place where she could grow and have supervision as a new NP; a culture compatible with her family life with a young daughter and a wife in an emergency medicine residency program at a hospital in the city; and a fair salary.

“After a lot of interviews, I decided that my dream job didn’t exist and I needed to find an alternative,” Yip says. She consulted with past professors and preceptors for advice and then, with their support, took what she describes as a series of calculated risks. She applied for part-time jobs, while also working to establish herself as a solo practitioner.

Today, Yip has successfully fashioned a nursing career meeting all four of her requirements; but it turned out to be three jobs instead of just one. She has a private practice with an office on Manhattan’s Upper East Side and another near Union Square, where she focuses on the LGBTQ community and caregivers of children with emotional, academic, and behavioral issues.

Yip also provides substance abuse and mental health services as a contractor for Bridging Access to Care in Brooklyn. And, she works part-time at a private practice, the Union Square Psychiatric Center. These jobs offer more contact with seasoned mental health professionals, and opportunities for mentoring and networking. “To get the career I wanted, I had to be honest about my goals, and transparent with potential employers about how prioritizing my family life was leading me to seek part-time jobs,” Yip says.

For Yip, the most valuable leadership skill she developed was how to seek the right input from the right people. She credits her success to the excellent guidance received from former classmates and instructors, who gave her the courage to consider solo practice as well as practical advice on how to cobble together a full-time income from several part-time jobs. “I cast a wide net to make my career work, going all the way back to the people who helped shape my clinical self as a student.”