“Many of our patients are with us for a long while and have limited families and friends, so we become their support system. It’s so gratifying to see patients able to leave the hospital and begin their next chapter.”
— Alyssa Konsavitch, RN, Tewksbury Hospital
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Charge Nurse
For nurses seeking a hybrid clinical-managerial position at DPH that allows for direct patient care, the charge nurse position may be a great fit. In this role, the charge nurse oversees a group of nurses to maintain the quality of care in a health care facility or program unit, and ensures patient and staff safety. Several charge nurses may work on a team, each responsible for a different shift.
Charge nurses oversee nursing policies and practice on a singular unit. They serve as a liaison between nurses, doctors, patients and families, and administrators. They ensure the goals for the unit and the organization are operationalized each shift.
At Western Massachusetts Hospital, for example, an RN1 new to nursing or one who is a recent graduate, can work their way up to the charge nurse position — and more responsibilities — after a year. This position is often tasked with “in-the-moment” staffing needs, such as staff call-outs. As Western Massachusetts Hospital charge nurses agree, this position affords increased autonomy with the fulfillment of caring for and getting to know patients and families. For those who enjoy a variety of rotating tasks, the charge nurse position offers a fresh, hybrid opportunity.
Nurse Manager
Whereas a DPH charge nurse handles both administrative and clinical responsibilities, a nurse manager role leans more heavily toward administrative duties and oversight of a wide range of employees. Nurse managers maintain 24/7 oversight and work with multidisciplinary departments to provide optimal patient care. They provide mentoring, coaching, and professional development for staff. They coordinate treatment planning and case management for patients and families, and they are advocates for their staff and unit.
Nurse managers at DPH hospitals are scheduled at varying shifts to ensure that leadership is available throughout hours of the day. At Lemuel Shattuck Hospital, for example, administrative managerial duties may include budgets, mentoring nursing staff, and coordinating meetings with a patient’s family. A nurse manager is never bored with a variety of duties and kinds of work throughout a shift.
Wound Care Nurse
This specialty nursing position assists in treating chronic and non-healing wounds and works to inform a patient's wound, ostomy, or incontinence care. A wound care nurse specializes in assessment, treatment, and monitoring of wounds, as well as in preventative measures for maintaining skin integrity. The wound care nurse is responsible for multidisciplinary collaboration to determine the proper course of treatment to promote healing and continually assess the patient's skin. At Western Massachusetts Hospital, nurses can earn their certification within the wound care nurse program.
Admissions Nurses
While many nurses provide bedside care of patients, admissions nurses provide care during the hospital admissions process. This role enables the unit nurses within DPH hospitals to focus more on patient care while the admissions nurse focuses on initial assessment, admission paperwork, and review and documentation of a patient’s medication list and medical history. At DPH hospitals, admissions nurses may be called on to provide patient education and other administrative duties.
“I am lucky enough to work with kids every day, which is always exciting and unpredictable. Their innocence and joy in the little things bring a smile to my face and keep things in perspective for me on a daily basis.”
— Jamie Moore, RN, Pappas Rehabilitation Hospital for Children
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Nurse Practitioner
Some DPH hospitals have integrated primary care facilities on-site, such as the Goldfarb Primary Care Clinic. One type of professional in this setting is a nurse practitioner. At DPH, NPs provide a full range of primary, acute, and specialty health care services. For those seeking a hybrid role combining acute care nursing with the authority similar to that of a physician (and for whom additional schooling isn’t a deterrent) a nurse practitioner can be a fulfilling role.
Medical-Surgical Nurse
This role is the most popular nursing specialty in the United States, likely because of its responsibility and variety. Within Lemuel Shattuck Hospital’s five operating rooms, “med-surg” nurses may be found assisting in inpatient surgeries, orthopedic surgeries, oral surgery, and other general and specialty surgical procedures. A med-surg nurse cares for patients across the lifespan who are preparing for or recovering from surgery, and duties vary widely to include medication administration, monitoring patient vitals, equipment operation (such as IV tubes, catheters, etc.), ordering or administering tests, and sometimes administrative tasks. These nurses monitor changing patient conditions and report concerns to charge nurses and/or the nurse manager.
Operating Room Nurse
Operating room (OR) nurses provide patient care before, during, and after surgery. These specialists may also be asked to ensure medical equipment is functioning properly, monitor patient vitals, educate patients and their families before or after the surgery, and provide other assistance as needed. Operating room nurse duties and the scope of the position may vary among DPH hospitals.
Under this umbrella term are other specialties such as pre-op nurse, intra-op nurse, and post-op nurse, who provide care at different stages of the surgical process. Because of the versatility of this role, OR nurses have the flexibility of working in different areas of DPH hospitals depending on their skill set.
Ambulatory Care Nurse
This specialty nursing role, sometimes referred to as outpatient nursing, provides patient education prior to discharge, collaborates with health care teams for overall wellness, and performs diagnostic tests. Ambulatory care at Lemuel Shattuck Hospital, for example, includes specialists and ambulatory nurses at Goldfarb Ambulatory Care Center, supplemented by specialty programs in such areas as cardiology, dermatology, endocrinology, geriatrics, and others. Ambulatory care nurses at DPH work together as a cohesive unit to provide the best possible outpatient care.
Nurse Educator
Nurse educators have completed advanced nursing education and in turn use their knowledge and experience to fortify the knowledge of other nurses. At DPH, nurse educators oversee the education of trainees at their hospital, and in compliance with regulatory requirements, coordinate initial and continuing education activities. This position manages the professional development of staff nurses, works with facility leadership to implement job aids and performance criteria, and develops staff education related to infection control, patient safety, and cultural competency in health care. Nurse educators often go on to work at a high level of health care administration at DPH.
Infection Control Nurse or Infection Preventionist
Description: Infection preventionists (IPs) seek to prevent infections among patients and fellow health care workers and prevent germs from spreading within health care facilities. They look for patterns of infection within a facility, observe practice, educate health care teams, advise hospital leaders, compile infection data, develop policies and procedures, and coordinate with local and national public health agencies. IPs at DPH collaborate with all hospital departments (clinical and nonclinical) to mitigate the risk of infection.
Telemetry Nurse
In telemetry nursing, care is provided to patients whose vital signs must be under close observation. While some DPH hospitals support telemetry in acute care settings, others have dedicated telemetry units. Telemetry duties and the scope of the position can vary. For example, at Lemuel Shattuck Hospital, telemetry is monitored in the intensive care unit (ICU) by ICU nurses trained to read telemetry/EKGs. Telemetry nursing includes monitoring machines that display blood pressure, oxygen levels, heart rhythms, and other vitals. Telemetry nurses provide critical patient care, often in the ICU.
Employee Health Nurse
An employee health nurse specializes in working with staff in an occupational setting. They identify risks and environmental hazards and promote overall health and well-being, and more. Their primary goal is to improve the health and safety of employees, thereby improving productivity and morale in the workplace.
At DPH hospitals, for example, employee health nurses develop vaccination programs, smoking cessation programs, fitness initiatives, tuberculosis surveillance, and fit testing for personal protective equipment. DPH employee health nurses may develop educational materials, provide emergency care to employees who become injured or sick on the job, make referrals to employee assistance programs, and other initiatives to maintain the safety and well-being of staff.
Nurse Informaticist
This position may have different names, including data analyst, and the individual may work in a non-clinical office setting, focusing on quality improvement. The crux of the position is ensuring quality of care and developing metrics to quantify patient safety. This position entails reviewing data reported by DPH-licensed facilities, publishing reports, sharing data with upper-level managers and making recommendations on policy. Instead of direct patient care, this important "behind-the-scenes" non-clinical role seeks to improve public health outcomes and safety.