Elizabeth Newman

In long-term care, we talk a lot about recruitment and retention. What we don’t discuss as much about are promotions: How to encourage people to work toward them, and how to achieve them ourselves.

This was a theme in the National Association of Directors of Nursing Administration in Long Term Care conference this week. A panel of executive nurses discussed how they landed in their current job, and other nurses spoke with me one-on-one. All offered insightful tips and gave context to what is a big challenge for many nurses looking to take the next step.

Executive and regional nurses “travel — they travel overnight, and you have to be able to do that,” said Karen McDonald, BSN, RN, vice president and chief clinical officer with Mission Health Communities in Durham, NC .

“I had to make a decision 27 years ago to take a job that would travel with a 2-year-old, 5-year-old and a 7-year-old at home,” she told attendees. “Our family dynamics changed overnight and I needed my husband’s support.”

Today, one of her nurses flies between South Carolina and Minnesota every week. That’s not a job for everyone.

To be fair, constant travel is also true for long-term care executives in national companies. Cathy Murray, the chief operating officer at Life Care Centers of America, told me recently that she is on the road 80% of the time, but loves visiting facilities to make an impact.

Blake Gillman, now a vice president at Life Care Services, told me that when he ran a therapy company he was on the road constantly, often missing out on seeing his three children grow up. Both discussed how their spouses and families allowed them to grow in their careers.

But beyond being willing and able to be home less, executive nurses at NADONA also gave practical tips for those who want something bigger. First up: Tell your supervisors about your long-term goals, and where you see yourself headed, as well as when you want a specific job that opens up.

Next, almost every person I spoke with at NADONA discussed the need for additional education. That can mean additional certifications, with wound care being especially needed.

Education doesn’t necessarily mean another degree, Annie Smith, RN, Director of Nursing at the Memphis Jewish Home, told me. “There are lots of things out there for people who are trying to advance their career. It’s more about making sure you are educated about what field you want to pursue in nursing.”

Volunteering with a local NADONA chapter leads to networking. Another strategy is projects or events that help the facility, noted Gail Sheridan, RN, the vice president and chief clinical operations officer at Tealwood Senior Living in Minnesota.

“Make yourself available for mock surveys,” she advised. “It helps you see how other employees are.”

Nurses often “underestimate their value,” said Jennifer Pettis, RN, CNE, WCC, the Associate Director of Long-Term Care Program with Nurses Improving Care for HealthSystem Elders (NICHE).

Nurses “need to feel free to brag about themselves, their work and their team’s work. Nurses often don’t see their work as innovation and excellence, and they need to feel free to do so,” she advised.

Finally, young nurses should look at the demographics, McDonald said. At her company, the majority of those in the clinical services group are over age 60.

“My directors of nursing needs to know we are going to retire sooner than later,” she said. “You have to let us know you want [a position], and then we can help prepare you for that.”

Follow Senior Editor Elizabeth Newman @TigerELN.