In medicine, nursing, and healthcare, a differential diagnosis refers to the process of differentiating between two or more conditions sharing similar signs and symptoms. In the context of your nursing career, this process can be equally elucidating. Is there a careful career examination in your future? If so, what would your differential diagnosis be?

make the differential diagnosis of your career

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On April 16th, 2018, I published a blog post entitled “Your Nursing Career’s Differential Diagnosis“. Please see the original post for the full text, but here are some highlights and excerpts that I expanded upon here on episode 155 of The Nurse Keith Show. (And here’s a link to the blog post about Sisyphus that I mentioned on the show, and also an episode of The Nurse Keith Show that address the same myths and stories as they relate to our careers.)

It All Begins With Assessment

Whether you’re examining a patient or dissecting the state of your own nursing career, you always begin with an assessment. The gathering of data is the first step in the nursing process, of course, and it’s the same thing in almost any situation: you need accurate and timely information in order to make a diagnosis and proceed to the development of a plan of intervention or treatment.

The “problems” with your nursing career may specifically lie with your employer, the institution where you work, the team as a whole, or the workplace culture. The problem may also be more internal — you may be unhappy simply because this particular area of practice no longer calls your name and you need a fresh professional pasture in which to graze.

Making the Diagnosis 

This process calls for honesty, clarity, and an intrinsically curious nature that truly seeks answers, no matter how uncomfortable they may be. Avoiding looking for cancer because you’re afraid to find it is a fool’s errand, and we all know that catching cancer early is good preventive care. In your career, being open to whatever diagnosis raises its ugly head will allow you to make decisions about a treatment plan that will hopefully deliver the outcome you’re seeking. 

Whatever your diagnosis, make it count and make it real, and then come up with a treatment plan and execute it with an eye towards a positive outcome and openness to a change in course if things go south. 

Treat or Amputate? 

If you treat the symptoms of a disease without going for the root of the problem, you may assuage the symptoms for a while, but the disease may crop up again when you’re otherwise engaged. The same with your career — you can use Bandaids, or you can do some more comprehensive surgery once you have the diagnosis nailed down. After all, if your car has a battery that has to be jump-started every morning, it would be smart to replace the battery rather than waste precious time and energy jumping the battery on a daily basis.

If you’re slogging away in a workplace that’s rife with bullying, gossip, back-stabbing, poor management, high nurse-patient ratios, and low morale and employee attrition, you have a few choices to make. On the one hand, you can put your head down, place your nose on the proverbial grindstone, and attempt to just miserably survive and do your job without losing your mind (or your nursing license). This is always a choice, and many nurses seem to make it every day for a variety of reasons. Financial duress, ennui, or lack of confidence regarding finding a new position can all deter the distressed nurse from saying “enough is enough” and exiting, stage left.

Consistently Reevaluate and Recalibrate

We all know that the course of treatment can change over time based on what we’re assessing in terms of signs and symptoms and the reaction to the initial treatment. A tumor may first respond to one chemotherapy regimen, but the patient may not be able to tolerate that treatment for long. So, when the symptoms or side effects become untenable, we have to come up with a new game plan.

Similarly, your career and life situations are fluid, and things can change. A boss is replaced, a new CEO comes on board, your personal life improves in a significant way, or some other factor shifts. Keep your finger on the pulse and consider if you need to recalibrate your original plan.

There’s no cookie-cutter solution to any one problem, and no treatment plan will work 100% of the time. Be nimble, curious, and creative, and be willing to ask the tough questions. And then sit back, observe, gather more data, and take inspired action when your heart and mind know that action is called for.


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Keith Carlson, RN, BSN, NC-BCIn case you didn’t already know, Nurse Keith is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, keynote and motivational speaker, and popular career columnist. With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses.

From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

As of May of 2018, Keith is the host of Mastering Nursing, an interview-style podcast showcasing inspiring, forward-thinking nurse thought leaders and innovators.

Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. Keith can be found on Facebook, Twitter, LinkedIn, and Instagram—as well as at NurseKeith.com.

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