As a profession with an illustrious history and the great respect of the general public, nursing is a career that calls both men and women to its ranks. But even as nurses gain increasing clinical autonomy and the ability and vision to launch their own businesses, the nursing game hasn't necessarily changed for those who still feel stuck.

Even as more doors open for nurses to pursue their dreams, many find themselves caught in a trap of feeling pigeonholed and unable to break free of their current work style in pursuit of something new. This trap is created by the profession itself, as well as by individuals who have yet to remove their blinders and see the nursing forest for the trees.

In nursing schools, the desirability of hospital-based positions is often stressed, and professional development education is often lacking in terms of educating students about their options outside of acute care. Such indoctrination leads to many nursing school graduates feeling that they have few choices when it comes to employment.

Beyond the hospital

As a career coach, I hear from many nurses who simply cannot see a clear path to leave acute care and pursue other professional interests. Nurses frequently reach out to me about feeling trapped and claustrophobic in their careers. They feel the need to find a way out of a self-imposed hole.

There is a common myth within the profession that nurses who work outside of the hospital are not "real" nurses. Some find happiness in the ER or the ICU, and still others enjoy the thrill of flight nursing and rescues in extreme as situations. While this may illustrate the sexier and more exciting side of nursing, there is of course much more to the profession.

While school or public health nursing may not seem exciting, nurses are needed in a variety of settings.

For a nurse who has worked 30 years on the floor, escaping acute care for a desk job in public health or research might be the ticket to a new lease on life and career. Likewise, a nurse uninterested in acute care but keenly cognizant of the need for progressive and forward-thinking educators might pursue a career in nursing education following some years in clinical practice.

According to the American Association of Colleges of Nursing, approximately 58 percent of nurses work in acute medical-surgical facilities. Therefore, a full 42 percent of nurses are employed in sites and facilities far beyond the hospital walls.

Nursing's expansion continues

The aforementioned increase in autonomy for APRNs has created endless opportunities for nurses to pursue a variety of career paths.

Nurse practitioners in states with progressive scope-of-practice laws can provide care without the direct supervision of a physician, paving the way for remunerative concierge and home-based nursing care, stand-alone clinics or offices staffed solely by APRNs.

With the benefit of online marketing, social media and other technological advances, some nurses choose to engage in other specialized services, such as freelance medical writing or health coaching. The online world provides nurses with access to large audiences, and nurse entrepreneurs use podcasts, social media, blogs, YouTube, micro-blogging sites and other platforms to reach audiences around the world.

Dreaming beyond the myth

The myth of the nurse confined to the hospital setting is indeed a myth, yet many a nurse sadly holds onto that old story. Nurses must open their eyes to the many opportunities within the profession for specialized practice, innovative career paths and entrepreneurial ventures.

There is no doubt that nurses are needed in acute care. However, there are students, home care and hospice patients, dialysis patients, potential customers and clients, and others who would benefit endlessly from the presence and care of a nursing professional, no matter the setting.

Nurses can dream big in the 21st century. Some dreams may require a great deal of creativity and out-of-the-box thinking, while others simply require a willingness to stretch beyond the bedside. A nurse's dream can become a reality when the myth has been broken and the nurse can see her future path more clearly.