Registered Nurse

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Principal activity: Providing skilled nursing care for sick patients
Work commitment: Usually full-time
Preprofessional education: High school diploma
Program length: 2 to 4 years
Work prerequisites: Diploma/degree/license
Career opportunities: Very favorable
Income range: $35,000 to $65,000

Patients often judge a hospital's quality by the nursing care they receive. This demonstrates the importance of this strongly people-oriented profession, which focuses on health recovery and maintenance. The field provides an opportunity for service in a wide range of settings and specialties and offers a high degree of career satisfaction. Registered nurses are directly responsible for carrying out treatment plans that have been ordered by physicians. This requires a combination of technical skills and knowledge of nursing procedures, along with an understanding of expected results.

Because nursing covers a broad spectrum of situations, we'll discuss its activities in terms of both hospital and nonhospital work settings.

In Hospitals
Hospital nurses determine patients' care needs in light of a physician's medical treatment plan. Based on their assessments, nurses formulate and execute care plans and then evaluate their effectiveness. These plans must provide for the patients' medical and physical needs. Nurses also lend emotional support that can facilitate the recovery and rehabilitation process. Because nurses are in close contact with patients for extended periods, they can provide valuable insights into their progress. Nurses document patients' charts and help prepare them for activities after discharge. A registered nurse may supervise LPNs and other junior nursing staff members.
- Private-duty nurses provide exclusive care for individual patients in a hospital or in their homes. These nurses are self-employed.
- Operating room nurses provide care before, during, and immediately after surgery. They help prepare patients for surgery, directly assist surgeons and other team physicians by providing them with needed instruments and supplies, and check on the postoperative state of patients. This area has various specialties, such as orthopedic, cardiac, and thoracic surgery nurses.
- Critical-care nurses care for patients who are in life-threatening situations. Their special training qualifies them to provide complicated nursing support services, recognize physiological changes in patients' conditions, and operate sophisticated medical equipment.
- Rehabilitation nurses serve both adults and children suffering from a reduction in their optimal functional potential due to accidents, birth defects, or diseases. They provide a variety of treatments, exercises, and emotional support that help their patients regain lost function and adapt to permanent disabilities. To prepare for this specialty, candidates must complete a post-RN course or a master's degree in rehabilitation nursing.
- Clinical nurse specialists hold advanced degrees (usually a master's) with specialized training. Their areas of expertise may be cancer, cardiac, neonatal, or mental health care. They may be directly involved in the delivery of nursing services as well as in education, administrative, or consultative activities. They also work in nonhospital settings.
- Advanced-practice nurses are highly trained specialists with one of four professional titles: Clinical Nurse Specialist, Nurse Anesthetist, Nurse Practitioner, or Nurse Midwife.

Outside Hospitals
- Office nurses work for physicians in all specialties as well as for dental surgeons, nurse-midwives, and nurse practitioners. They may perform routine laboratory tests and administrative functions.
- School nurses are engaged by boards of education to provide health and nursing services in individual schools or school districts. They provide emergency medical care, help administer physical exams, communicate with parents about students' physical and emotional problems, ensure that state health codes (especially regarding immunization) are implemented, and advise school constituencies on health issues.
- Community health nurses provide services to patients in nonhospital settings such as clinics, schools, and private homes. They teach groups about maintaining a healthy environment, proper nutrition, and preventive health measures. They also carry out physicians' plans and provide care for ambulatory patients. In addition, they initiate public-health programs that encourage immunization and provide information on alcohol, drugs, and infectious diseases.
- Occupational health nurses are engaged by corporations, factories, and government agencies to provide nursing care for their employees. This care may include treating minor diseases and injuries, providing physical examinations, and educating workers about health issues.
- Nurse educators typically are faculty members of nursing schools. They assist in the training of nurses and teach continuing education courses.

Work Settings
Registered nurses have a very wide choice of work settings and their services are in demand. These include hospitals of different types, nursing homes, schools, community health centers, public health offices, and industrial facilities.

With additional experience and training, a registered nurse may move into a supervisory, management, or administrative position such as head nurse. Other potential directions for advancement include specialty training, especially in one of the advanced-practice nursing specialties.

To gain admission to a nursing education program, candidates must have a high school diploma (or its equivalent) with a minimum C average.
Those entering this field should have good physical and emotional health, compassion, patience, a team-player mentality, and the ability to assume challenging medical responsibilities.

There are three educational routes to becoming a registered nurse:
- Two-year associate degree programs offered by community, junior, and technical colleges.
- Three-year diploma programs offered by hospitals.
- Four-year bachelor's degree programs offered by colleges and universities. These usually award the bachelor's of science in nursing (BSN) degree.
All three of these programs involve both classroom course work and supervised nursing practice. The basic curriculum is the same for each, but the programs vary in depth and scope, depending on the program's length. The basic courses cover anatomy, physiology, sociology, English, psychology, philosophy, microbiology, and nursing concepts and techniques. Those pursuing a bachelor's degree must also take courses in precalculus, chemistry (both general and organic), biology, anthropology, and epidemiology, as well as several advanced nursing courses. Within the bachelor's program there may be special tracks leading to specialty training, such as community health or school nursing. For some specialties, a master's degree is essential.

A nursing license is required in every state. Candidates obtain their license by passing a written state board examination after graduating from an accredited nursing school.

Career Potential
Recent decades have seen fluctuations in job opportunities for nurses. Consequently, projecting future opportunities with certainty is challenging. However, current projections are that employment of registered nurses is expected to grow faster than average for all occupations through 2012, and many jobs will result. The major factor is the change currently underway in the health-care system, especially in light of the growing population of elderly citizens. Most experts believe that, once the nature of health-care management has stabilized, job opportunities probably will be favorable. (See the 'Career Potential' discussion for Silver Spring, MD 20910 (, or the National League for Nursing, 61 Broadway, New York, NY 10006 ("]

Specialty Nursing Organizations
Air & Surface Transport Nurses Association
(National Flight Nurses Association)
9101 E. Kenyon Ave., Ste. 3000
Denver, CO 80237

American Academy of Nurse Practitioners
P.O. Box 12846
Austin, TX 78711

American Association of Critical-Care Nurses
101 Columbia
Aliso Viejo, CA 92656

American Association of Neuroscience Nurses
4700 W. Lake Ave.
Glenview, IL 60025

American Association of Nurse Anesthetists
222 S. Prospect Ave.
Park Ridge, IL 60068

American Association of Nurse Attorneys
7794 Grow Dr.
Pensacola, FL 32514

American Association of Occupational Health Nurses
2920 Brandywine Rd., Ste. 100
Atlanta, GA 30341

American Association of Spinal Cord Injury Nurses
75-20 Astoria Blvd.
Jackson Heights, NY 11370

American College of Nurse Midwives
8403 Colesville Rd.
Silver Spring, MD 20910

American College of Nurse Practitioners
1111 19th St. NW,
Ste. 404
Washington, DC 20036

American Nephrology Nurses Association
E. Holly Ave., Box 56
Pitman, NJ 08071

American Nurses Association
8515 Georgia Ave.,
Ste. 400
Silver Spring, MD 20910

American Organization of Nurse Executives
Liberty Place
325 Seventh St. NW
Washington, DC 20004

American Society of Ophthalmic Registered Nurses
P.O. Box 193030
San Francisco, CA 94119

American Society of Plastic Surgical Nurses
3220 Pointe Pkwy., Ste. 500
Atlanta, GA 30092

American Society of PeriAnesthesia Nurses
10 Melrose Ave., Ste. 110
Cherry Hill, NJ 08003

American Urological Association
(for urological nurses)
1000 Corporate Blvd.
Linthicum, MD 21090

Association for Professionals in Infection Control and Epidemiology
1275 K St., Ste. 1000
Washington, DC 20005

Association of Operating Room Nurses, Inc.
2170 S. Parker Rd., Ste. 300
Denver, CO 80231

Association of Rehabilitation Nurses
4700 W. Lake Ave.
Glenview, IL 60025

Association of Women's Health, Obstetric and Neonatal Nurses
2000 L St. NW, Ste. 740
Washington, DC 20036

Council on Cardiovascular Nursing
American Heart Association
7272 Greenville Ave.
Dallas, TX 75231

Dermatology Nurses Association
E. Holly Ave., Box 56
Pitman, NJ 08071

Emergency Nurses Association
915 Lee St.
Des Plaines, IL 60016

International Nurses Society on Addictions
P.O. Box 10752
Raleigh, NC 27605

National Association for Practical
Nurse Education and Service, Inc.
P.O. Box 25647
Alexandria, VA 22313

National Association of Orthopaedic Nurses
401 N. Michigan Ave., Ste. 2200
Chicago, IL 60611

National Association of Pediatric Nurse Practitioners
20 Brace Rd., Ste. 200
Cherry Hill, NJ 08034

National Association of School Nurses
P.O. Box 1300
Scarborough, ME 04070

National League for Nursing
61 Broadway
New York, NY 10006

Oncology Nursing Society
125 Enterprise Dr.
Pittsburgh, PA 15275

Society of Otorhinolaryngology and Head/ Neck Nurses, Inc.
116 Canal St., Ste. A
New Smyrna Beach, FL 32168


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