After earning an MD, she’s headed back to school — to become a nurse

This is one in a series of occasional updates on the lives of people featured by STAT during our first year.

They have MDs to their names, but they can’t treat patients. Now Dr. Heidi Schmidt — and others like her — are heading to nursing school to fulfill the dreams that were quashed when they failed to match with a residency program after medical school.

Schmidt, who’s 47, is one of thousands who have graduated from medical school yet failed to match with a residency, the post-graduate training doctors need in order to practice medicine in the United States. STAT wrote about her in March, when more than 29,000 applicants matched to a residency but 8,640 applicants failed to get an offer through the main matching process. This number includes hundreds of students in their final year at US medical schools, as well as foreign nationals and US citizens from international medical schools.

Many failed applicants reapply after spending a year doing research or a fifth year in medical school. Others join the “Dropout Club,” a group for doctors and scientists who leave their intended professions for alternate paths.

This is one in a series of occasional updates on the lives of people featured by STAT during our first year.

They have MDs to their names, but they can’t treat patients. Now Dr. Heidi Schmidt — and others like her — are heading to nursing school to fulfill the dreams that were quashed when they failed to match with a residency program after medical school.

Schmidt, who’s 47, is one of thousands who have graduated from medical school yet failed to match with a residency, the post-graduate training doctors need in order to practice medicine in the United States. STAT wrote about her in March, when more than 29,000 applicants matched to a residency but 8,640 applicants failed to get an offer through the main matching process. This number includes hundreds of students in their final year at US medical schools, as well as foreign nationals and US citizens from international medical schools.

Many failed applicants reapply after spending a year doing research or a fifth year in medical school. Others join the “Dropout Club,” a group for doctors and scientists who leave their intended professions for alternate paths.

Looming question for medical students: Will they be shut out of advanced training?
Though they have medical degrees, doctors who don’t do residencies can’t treat patients, or even work as nurses or medical assistants, without further training. Some in the medical profession say that’s a good thing, because there’s a reason — such as poor performance on board exams — that these new MDs didn’t make the cut. But others call it an outrage that doctors’ skills are going to waste amid a shortage of primary care physicians, just because there aren’t enough residency spots to go around.

Schmidt, who graduated from American University of the Caribbean School of Medicine in 2010, had been hoping to take advantage of a 2014 Missouri law that will allow unmatched medical school graduates to work with a collaborating physician in medically underserved areas. But implementation has dragged: The Missouri Board of Registration for the Healing Arts doesn’t anticipate accepting applications until early 2017, according to a spokesman.

Kansas and Arkansas have passed similar laws — over the objection of groups such as the Association of American Medical Colleges, which contends that it’s not safe to let doctors bypass the traditional residency, which lasts at least three years. Kansas, whose special permits are restricted to graduates of the University of Kansas School of Medicine, has not had any takers so far. Arkansas, which limits applicants to those with ties to the state, just issued its first two special permits in October.

Top Highest Paying States for Commercial Pilots

As of 2014, the average Commercial Pilots brought home just shy of $76,150 a year, according to the Bureau of Labor Statistics. Commercial Pilots salaries vary depending on such factors as credentials, geographic location, industry, experience, job tasks, etc..
Salary (annual): $34,800 – $147,890
Min. Education: Typically need a high school diploma or equivalent, Requires Commercial Pilot certificate
Job Outlook 2014-24: 5% (As fast as average)
Related Careers:  Flight Attendants, Air Traffic Controllers, Water Transportation Workers

State Salary (annually)
 1. Connecticut $116,960
 2. Delaware $103,020
 3. Illinois $102,760
 4. California $100,230
 5. Pennsylvania $100,150

Sources: U.S. Bureau of Labor Statistics, Data extracted on November 25, 2016

Highest Paying States for Applied Behavior Analyst

As of 2014, the average Applied Behavior Analysis (ABA) Therapist brought home just shy of $70,580 a year, according to the Bureau of Labor Statistics. Behavior analyst’s salaries vary depending on such factors as level of BCBA certification, geographic location, industry, etc..
Salary (annual): $19.68 – $56.23
Min. Education: Behavior analysis training programs are available as both undergraduate and graduate degree programs. Some behavior analysts choose to complete an undergraduate program in a related field, such as psychology or education, before earning a master’s degree in behavior analysis. These programs often include coursework in behavioral assessment, research methods, interventions, ethics in psychology, and behavioral consultations.
Job Outlook 2014-24: 16% (Much faster than average)
Related Careers:  Social and Community Service Managers, Psychologists, Health Educators and Community Health Workers

State Salary (hourly)
 1. District of Columbia $43.60
 2. New Jersey $43.52
 3. Connecticut $42.90
 4. New York $41.74
 5. California $41.50

Sources: U.S. Bureau of Labor Statistics, Data extracted on November 25, 2016

Highest Paying States for Air Traffic Controllers

As of 2014, the average Air Traffic Controllers brought home just shy of $122,950 a year, according to the Bureau of Labor Statistics. Commercial Pilots salaries vary depending on such factors as credentials, geographic location, industry, experience, job tasks, etc..
Salary (annual): $66,780 – $172,590
Min. Education: Typically need a Associate’s degree
Job Outlook 2014-24: -9% (Decline)
Related Careers:  Police, Fire, and Ambulance Dispatchers, Airline and Commercial Pilots, Cartographers and Photogrammetrists

State Salary (hour)
 1. New Hampshire $67.11
 2. Virginia $67.11
 3. Georgia $65.16
 4. Minnesota $65.13
 5. New York $63.96

Sources: U.S. Bureau of Labor Statistics, Data extracted on November 25, 2016

Lesser Known Registered Nursing Specialties

Most of us are at least familiar with registered nursing specialties such as school nursing, medical-surgical nursing (sometimes shortened to “med-surg”) and pediatric nursing. If you watch much television or many movies, you’ve surely also noticed flight nurses in action. Wikipedia lists over 60 nursing specialties, and the American Nurses Credentialing Center offers 27 specialty certifications.

What about the many lesser-known, but often growing, nursing specialties you don’t likely come across as regularly? Let’s summarize some of those.

Informatics Nursing

Informatics nurses are responsible for system implementation and optimization. They incorporate information technology into their workplaces and train other staff on new technology. They may manage and communicate patient and hospital data as well. Many in this field hold an advanced degree. According to the Healthcare Information and Management Systems Society, the average annual salary for a nurse informaticist is $100,717. If you are good at working with technology and data, this is a great specialty with growing opportunities.

Lactation Nursing

The CDC’s 2013 US Breastfeeding Report Card states that 77% of US infants now begin breastfeeding, with 49% still breastfeeding at six months (up from 35% in 2000). As more and more babies are breastfed, the demand for lactation education and support has increased. Lactation nurses generally provide this kind of consultation and education for new mothers and families. You should consider this specialty if you like working with new mothers and newborns.

What is it like to be an ER nurse? … Where do I begin?

You are dealing with people on, possibly, one of the worst days of their lives

You see cardiac arrests, toe pain, overdoses, lacerations, strokes, vaginal discharge, difficulty breathing and everything in between

You have had every bodily fluid you can think of end up on your shoe
(whether you know it or not… but most times, you know it)

You never get used to the terrible feeling of doing chest compressions on a frail old woman with broken ribs

You know how to put up “the wall” to keep from crying

You wash your hands before AND after potty breaks

You don’t really get potty breaks, so you’ve learned to hold it

You put the needs of others before your own

You bribe kids with suckers, stickers, and anything else that you can think of, but almost always end up holding, wrapping, and tying them down to get the job done. It sucks

You bend over backwards for those patients who treat you with respect

You clean up a lot of poop, but you’re used to it

You wish you had more time to spend with each patient

You can keep a straight face while your patient explains how they “fell” on the object that is now stuck in their colon

You swap stories

You understand that some people are just jerks, no matter what you do for them

You will always get the feeling of your stomach dropping when you hear the call that a pediatric code blue is 5 minutes out

You get slapped, pinched, scratched, kicked, and called every name you can think of
(and more, people get very creative with their name calling)

You can make your dinner companions throw up after being asked, “How was your day at work?”

You laugh, a lot

You know to ask the heroin addict patient what veins you can use for an IV. Work smarter, not harder.

You get a tear in your eye when you care for a sweet, old lady who reminds you of your grandma

You realize that having a packed waiting room, working a difficult code with another on the way and running around trying to get caught up on all your orders makes working as a team crucial. If you’re lucky, as I have been, your co workers become a family.

Patient Safety Cheatsheet

If I was forced to sum up the NCLEX and the job of a nurse into one word it would be: SAFETY
Keeping our patients safe is central to everything we do from administering meds, preventing infection, aiding in recovery . . .and everything else.
This cheatsheet covers several points of patient safety:

Patient Safety Cheatsheet