NT.com member comment: To build on the previous question, what type of students do you have in leadership and the education tracks? Do you know what type of positions (other than obvious ones) those degrees can accomplish?

Dr. Garner: Any nurse can benefit from advanced education – learning to use evidence to change practice and learning to lead through change and conflict are skills that can be used anywhere.

NT.com member comment: It seems to be that since all the future roles are going to be management roles either in informatics, case management, or NP, we get away from the bedside. Will we have to utilize the volunteerism to continue bedside nursing?

Dr. Garner: No. We need smarter, more experienced, educated nurses at the bedside!

NT.com member comment: Regarding bedside nurses, I think there is a need for all of us. It just wasn't for me, and when the opportunity to do otherwise arose, I grabbed it. Communicating with MD's, patients, families, payers, and Medicare is just what I love to do.

Alice: Nurses at the bedside need to be independent, critical thinkers who will provide safe care and be on alert when patients' needs change, all the while supporting the patient and family.

NT.com member comment: I have experience as a case manager since the inception of PPS and now education is my focus in acute care. I have certification as a case manager and as an Administrator of Case Management. I thought this was an MSN program and might focus on leadership, program development, finance, etc.

Dr. Garner: Check our MSN in Organizational Management and Leadership track. We also have a DNP in Executive Leadership for those who already have a master's in health administration or nursing.

Alice: As a student in the executive leadership program, I can tell you that we all have diverse backgrounds. The skills we learn can be used in any setting from independent business to clinic management and hospital management.

Dr. Garner: The Clinical Nurse Leader is a relatively new role that recognizes the value of bedside nursing.

Alice: Time management and priority setting are important skills for the bedside nurse.

Dr. Garner: There are just so many opportunities for each of us to pursue our own interests and loves.

NT.com member comment: Dr. G, do you find advanced education tends to lead to the making of "bean counters" from good nurses attempting to take the human factor out of patient care?

Dr. Garner: It depends upon the organizational setting and the expectations of the role. That said, a good nurse manager is there as an advocate for quality patient care and stewardship of resources – all of which lead to satisfaction and good economics.

NT.com member comment: I don't have an MSN, but I am a seasoned case manager/RN. My hope was to be able to teach case management since health care reform is going to increase the need for nurses with strong clinical skills who can take it to this step.

Dr. Garner: Take our MSN in Education and go forth! I am really looking for good CM educators for our MSN program, but you need that MSN.

NT.com member comment: Dr. Garner, what do you think of the free clinics for uninsured patients that are staffed by nurses and doctors?

Dr. Garner: I loved working in these clinics. They add so much and provide more opportunities for creative approaches to care. I think sometimes the lack of resources helps you be more creative!

NT.com member comment: I would love to volunteer in one some time, but they aren't close to where I live.

Dr. Garner: Check out mission work that can be done a week at a time and volunteer your vacation time. Take your family and give them a sense of what the world needs.

NT.com member comment: Absolutely. It allows a nurse to be an advocate and be creative. It provides an opportunity for nurses to "pay it forward" by providing information and education to community members who are utilizing these clinics to prevent progression of chronic illness.

Dr. Garner: I did work in Honduras, and it was totally eye opening for my teenage boys to see how the world works.

NT.com member comment: There are a terrific number of organizations in need of health care workers to go on short trips for humanitarian work in developing countries. In California, there is Catholic Healthcare West, Flying Samaritans, Project Smile, and numerous others.

NT.com member comment: We had nurses go to El Salvador last year, and one practitioner went down to the Caribbean to "donate" a week or two of care. Their global nursing experience was invaluable to each of them. They came back transformed!

NT.com member comment: What opportunities are available for working with social media and public health care?

Dr. Garner: Blogs and tweets give us an opportunity to put a different face to nursing than "Hawthorne." Many health care organizations are looking for creative ways to use media to reach the public. Ask your PR department if they would like some help.

NT.com member comment: Dr. G, what about internet "clinics" or phone "clinics?" We live in such a computer age that many seek advice from WebMD first.

Dr. Garner: We have two DNP students who work in Walgreen's clinics. They do a lot of education and phone consulting.

NT.com member comment: I have found much reward working in the community at such events as the New York State Fair, etc. performing wellness checks and providing health prevention education.

NT.com member comment: That's great! Keep up the good work you are doing!

Dr. Garner: Well, it seems that there are many opportunities for nurses out there in a variety of roles and settings outside the hospital. Education is important for role preparation, so keep American Sentinel in mind. We also have an MBA-Healthcare for those who want to pursue the business side!

NT.com member comment: Dr. G, you have certainly discussed many opportunities for nursing in the future and volunteer opportunities galore. Do you have any idea about 3rd party reimbursement for these services?

Dr. Garner: The new health reform act has opened up reimbursement significantly for advanced nurse professionals. The new models of care like ACO's provide for revenue sharing also. Work with your state hospital and nursing organizations to make sure nursing gets its fair share of the pie!

Dr. Garner: Thank you for joining us today! Best of luck with your careers in nursing!

Alice: This has been very informative. Thank you, everyone.

Clik here for parts 1 and 2 of this series.