Nursing is a medical profession focused on the care of young children, the sick or injured, often under the supervision of a physician. Nurses perform a wide range of clinical and non-clinical functions necessary to the delivery of health care and recovery of acutely or chronically ill individuals.
Duties differ according to a nurse's position, and their responsibilities increase as they become a higher-ranking nurse. A Licensed Practical Nurse (LPN) performs many of the basic duties commonly associated with nursing such as taking temperatures and blood pressure, administering shots and medication, and monitoring catheters, while Registered Nurses (RNs) and nurses in a particular specialty have more complex duties and responsibilities and spend less time performing the more basic tasks. Different types of nurses often have vastly different duties, work environments, and stress levels. For example, a nurse in an intensive care unit at a hospital deals with serious and life-threatening injuries and diseases and must work very quickly, while a school nurse has a more relaxed work environment and deals mainly with minor injuries and health education. However, nurses generally perform several main duties, including:
Assessment: Nurses begin by gathering data on their patient, including psychological, emotional, spiritual, family, and life-style factors in addition to the physical aspect.
Diagnosis: Nurses next determine the problems a patient is dealing with, such as pain; what effects the problem causes, such as emotional turmoil, anger, family conflict, etc.; and what complications may arise. They also monitor the patient's progress to see whether any changes need to be made in their care.
Planning: Based on the diagnosis, a nurse creates a care plan for their patient. Nurses work with their patients to set measurable goals for short and long-term improvement. They also plan ways to deal with the patient's needs, such as by administering pain medication, counseling, etc. Nurses must keep records of their care plans and goals so that other health professionals, such as the patient's physician and other nurses, can read them when necessary.
Implementation: Implementation is when the nurse puts the care plan into action. This includes administering prescribed medication, treatment, and therapies, as well as educating patients on how to properly care for themselves both in the hospital and when they return home. Implementation also needs to be documented for later reference.
Evaluation: Nurses track the patient's progress to determine how well the care plan is working and adjust the patient's care accordingly.
A nurse's duties extend far beyond just caring for sick or injured patients. Although that does comprise an important part of their responsibilities, nurses also deal with the patients' families; provide counseling and emotional support to patients and families; keep accurate records of the patient's care plan, treatment, and progress; and assist the patient's in recovery and rehabilitation after an illness or surgery. Nurses provide health information and education to the general public on topics such as nutrition, exercise, and disease prevention.
After becoming an RN, many nurses choose to specialize in a specific area. Whether a person wants to work with children or the elderly, at home or in a third world country, in a the emergency room or a retirement home, or in management or a support role, there is a nursing position for them. The range of specialties to choose from is virtually limitless. If a person can think of an area they would like to focus on, there is most likely already a specific type of nursing dedicated to it. Nurses can choose their focus based on the type of patient they wish to treat, a certain organ system they want to study, or a specific disease they wish to research. There are also nursing occupations that incorporate other fields as well. Forensic nurses, for example, work with law enforcement to gather evidence while treating patients at crime scenes, car accidents, and the like. Nurse legislators serve in all levels of government to introduce and promote public health bills in legislature. Some areas of nursing require a higher level of education than others. For example, advanced roles such as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists require a master's degree. Doctoral degrees are required for nurse researchers and professors of nursing. While all the areas of specialization cannot be listed here, a few include: ambulatory care nursing, camp nursing, cardiac care nursing, community health nursing, family nurse practitioner, geriatric nursing, HIV/AIDS nursing, home health care nursing, military nursing, oncology nursing, missionary and volunteer nursing, pediatric nursing, school nursing, and substance abuse nursing.
Those entering the field of nursing need to be ready for a rigorous and intellectually challenging education. This education does not end, even when a person graduates from nursing school. Medicine is constantly advancing as new discoveries are being made; new treatments, medications, and cures are being discovered all the time. Therefore, while it is not required by every state, all nurses should take continuing education courses after graduating to make sure they are familiar with the latest developments in research. Continuing education for nurses is offered by many hospitals and nursing associations such as the American Nursing Association.
A high school diploma (or GED) is required to enter nursing school, but aside from graduating, there are many ways in which students can prepare for a nursing career while in high school. Taking courses such as biology, chemistry, health, anatomy, algebra, English, and physics will give students a good knowledge base and a greater likelihood of being accepted by a nursing school in the future. Working hard in school and earning good grades will help students develop the study habits necessary for entering a nursing program and show nursing schools that they are disciplined, take their education seriously, and are prepared to pursue a degree in nursing. Some nursing schools require students to take a test, the National League for Nursing (NLN) Pre-Admission Exam, before applying.
Certified Nursing Assistant
There are many levels of nursing, depending on how far a person decides to progress in their education. Before even going to college, one can become a certified nursing assistant (CNA) by taking 6 to 12 weeks of training. During a CNA certification program, nursing students learn the basics of nursing and patient care, such as taking vital signs, drawing blood, nutrition, anatomy, and infection control. CNAs can work as orderlies, home health aides, and patient care technicians under the supervision of a nurse. Getting a CNA certificate allows prospective nurses to gain experience in the medical field and decide whether nursing appeals to them as a profession.
Licensed Practical Nurse
- Main Article: Licensed practical nurse
After obtaining a CNA certificate, the next level of nursing is the Licensed Practical Nurse (LPN). An LPN certification requires a one-year degree, often offered at technical or vocational schools. Students attend classes and learn how to administer medication and first aid treatment in addition to basic anatomy and nursing skills, and they also receive clinical experience through working at hospitals or other medical facilities such as a doctor's office. After finishing the LPN degree, students must pass a licensing program in their state to become an LPN. LPNs care for patients under the supervision of a physician or registered nurse.
- Main Article: Registered Nurse
To move on to the next step in nursing, a registered nurse (RN), a degree must be obtained from a nursing school accredited by the National League for Nursing Accrediting Commission. There are several different ways to do this, but the most common pathways are:
Associate Degree in Nursing (ADN): Junior and community colleges, as well as some hospital nursing schools and universities, offer a two to three year associate degree in nursing. This degree provides a more affordable way for students to learn patient care, and nurses with associate degrees can later transfer into a bachelor's degree program.
Hospital Diploma: Hospitals also offer two to three year programs for a hospital diploma, which can often be taken along with basic required classes (science, English, etc.) at a junior college, allowing students to earn their ADN at the same time.
Bachelor's of Science Degree in Nursing (BSN): The bachelor's degree in nursing is a four year degree offered at colleges and universities. Typically, the first two years focus on psychology, human growth and development, biology, microbiology, organic chemistry, nutrition, and anatomy and physiology, while the next two years cover adult acute and chronic disease, maternal and child health, pediatrics, psychiatric and mental health nursing, community health nursing, nursing theory, bioethics, management, research and statistics, health assessment, pharmacology, and pathophysiology. A BSN prepares nurses for work in any health setting, and provides the greatest range of job opportunities as well as the best potential to advance in the nursing field, which is why many nurses with an ADN or hospital diploma go on to earn bachelor's degrees. Registered nurses with their BSN can find jobs in nurse management, military nursing, case management, public health nursing, overseas and development nursing, forensic nursing, and school nursing, or as clinical nurse specialists, nurse practitioners, nurse educators, and nurse researchers. A bachelor's degree is also required for those wishing to pursue a master's degree in nursing.
Master's of Science in Nursing (MSN)
Master's degree programs for nursing last 18 to 24 months and allow nurses to study in a more specialized area. Requirements for entering an MSN program vary by school, but may include a BSN degree, an RN license, minimum GPA and GRE scores, and clinical work experience. Nurses with an MSN can obtain jobs with more responsibility and autonomy, such as nurse practitioners, clinical nurse specialists, nurse-midwives, nurse anesthetists, or nurse psychotherapists.
A doctoral degree offers the highest level of education for a nurse, opening the door for higher level jobs, especially in administration, research, college-level teaching, and advanced clinical practice. Depending on what a person chooses to specialize in, they may want to become a Doctor of Nursing Education (ND), Doctor of Nursing Practice (DNP), Doctor of Nursing Science (DNSc), or Doctor of Philosophy (PhD). An ND prepares nurses for roles in advanced nursing practice. Those wishing to open their own clinical practice may wish to earn their DNP, which prepares nurses for business and monetary responsibilities and system management in addition to patient care. DNSc degrees develop nursing scientists and prepare them for work in research positions. PhDs prepare nurses for roles in professional education and research. Nurses with doctoral degrees work at the forefront of their field in research, education, and policy setting, and they have the greatest ability to affect change in the nursing system and introduce improved methods of treatment, patient care, and organization.
Nursing can be a vastly rewarding job for a variety of reasons. Many are attracted to the field because they have a desire to help other people. Nursing certainly offers abundant opportunities to improve the quality of human life through healthcare and medical advances. Nurses have the chance to help those who are sick or injured and set them on the path to recovery.
Nursing is also a very exciting job, full of constant change. Each day provides new challenges as one deals with a wide range of patients. The field of medicine itself is constantly advancing, and those interested in research may get the chance to develop new procedures, medicines, and cures. The challenge carries its fair share of stress as well. Nurses work with precious human lives, and they must be very careful not to make errors. However, those willing to accept this level of responsibility find nursing to be a richly rewarding occupation.
Now more than ever, nurses are needed to fill the increasing number of positions opening up. Beyond the capacity of a hospital, nurses work in all areas of life, from schools to private clinics to emergency response vehicles to nursing homes to public health departments to nursing schools. With a limitless range of specialties available, a person can pursue whatever aspect of medicine interests them the most and find their niche in the world of nursing.
Nursing offers abundant opportunities for employment. Currently, there are not nearly enough nurses to fill all the positions available; countries all over the world, including the United States, the United Kingdom, Australia, and Canada are experiencing nursing shortages. In the U.S., there are now around 100,000 to 150,000 more nursing positions than there are nurses available to fill them. Many factors contribute to this deficit. One major contributor is the aging population. Baby boomers and many nurses are retiring from the workforce and need health care. Also, people in general are living longer due to advances in medicine, and they need medical attention as well. In addition to this, more and more nursing positions are opening up outside of hospitals and clinics. Nurses are needed to work at schools, camps, emergency response vehicles such as ambulances and helicopters, and a wealth of other capacities.
Due to the steadily increasing shortage of nurses, employers offer excellent salaries and benefits packages to their nurses. Almost any area of the world will have nursing jobs that need to be filled, and nurses can choose what hours they want to work. Most nurses work a 40 hour week, but they can choose to work part-time, or only on weekends, or work 36 to 40 hours in three to four days and get the next three to four days off, and overtime is almost always available for those who want it.
Nurses can work in a variety of environments depending on their specialty, including operating rooms, trauma centers, emergency rooms, hospital offices and records departments, X-ray units, intensive care units, hospital nurseries and neonatal intensive care units, psychiatric and drug treatment centers, laboratories, helicopters and ambulances, schools, camps, airplanes, rehabilitation centers, nursing homes, community health clinics, home care, nursing schools, insurance companies, pharmaceutical and biotechnology companies, the military, and international service organizations.
Salary and Benefits
Nursing salaries vary depending on a nurse's level of education and experience, the amount of time they have worked in a given field, the specialty they choose, and the location in which they live. At the lowest level of education, certified nursing assistants make around $23,000 to $28,000 per year. Next up, licensed practical nurses make from $35,000 to $43,000 a year. For registered nurses, the average annual wage (according to the U.S. Bureau of Labor Statistics) is $65,130. Wages increase for nurses with more experience, as well as for those who obtain higher level degrees (master's or doctoral). With a master's degree, nurses can work in advanced practice or management. Nurse administrators, who make around $47,000 annually; nurse practitioners, averaging $71,000 a year; clinical nurse specialists, earning around $41,200 a year; and nurse anesthetists, who earn roughly $113,000 a year, all fall under this category. Nurses with doctoral degrees can earn even more.
Due to the nursing shortage, nurses not only receive competitive wages, they also get excellent benefits. With the projected shortage estimated to get even worse, wages and benefits will likely increase. Additionally, the shortage ensures that there are plenty of jobs available for nurses wanting to enter the workforce, providing job security. Employers also often give their nurses with flexible hours, child care, educational benefits, and bonuses.
- What do Nurses Do? by NursingJobsHelp.com
- The Nursing Process: A Common Thread Amongst All Nurses by the American Nurses Association.
- Nursing Careers by Maryland Health Centers.
- Occupational Employment and Wages, May 2008: 29-1111 Registered Nurses by /the Bureau of Labor Statistics, United States Department of Labor, 5/4/09.
- Forensic Nurse by NurseWeek, Nurse.com
- Nurse Legislator by DiscoverNursing.com, Johnson & Johnson Services, Inc.
- Nursing Careers by DiscoverNursing.com, Johnson & Johnson Services, Inc.
- Health Career Guidebook: Registered Nurse (RN) Health Careers Guidebook, p.108-112.
- How to Become a Nurse by NursingJobsHelp.com
- Discover/nursing.com by Johnson & Johnson Services, Inc.
- How to Become a Nurse by CollegeCrunch, 3/18/09.
- Nursing School Education Resource Center by AllNursingSchools.
- Nursing Salaries List by CollegeCrunch, 12/18/08.
- Opportunities, Salaries, and Benefits by NursingJobsHelp.com.
- Occupational Outlook Handbook, 2010-11 Edition: Registered Nurses by the Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Registered Nurses.
- Defining Nursing by the Royal College of Nursing.
- Global Nursing Shortages by James Buchan.
- Nursing by the U.S. Department of Health and Human Services, Health Resources and Services Administration.
- Ten Steps to Becoming a Nurse by NursingLink.
- Becoming a Nurse by Bloomington Hospital.
- Becoming a Nurse by the Massachusetts Center for Nursing.
- Becoming a Nurse by Gene Grzywacz, Brute Force Study Guide.