Registered Nurses (RN) assist patients, educate the public about healthcare problems, and offer emotional support to family members of recovering patients. RNs document patients’ medical conditions and histories, assist with diagnostic tests, evaluate results, operate technology, administer medications and medical treatments, and follow-up with patients and assist with rehabilitation.
Registered Nurses educate patients and their loved ones about injury and disease management, explain exercise, nutrition, and post-treatment rehabilitation needs, and they teach patients how to properly take medications and complete physical therapy. Certain RNs promote public health by teaching people about disease symptoms and warning signs. RNs also frequently organize immunization and health screening clinics, public health conferences, and blood drives.
During patient care, registered nurses develop care plans and add to existing ones. Plans often include multiple activities, including medication administration and dosage review to prevent dangerous drug interactions, beginning, monitoring, and discontinuing intravenous fluid, drug, and bloodlines, supervising medical treatments and therapies, monitoring patients and documenting observations, and meeting with doctors and other medical specialists. Some RNs direct nursing aides and licensed practical nurses performing routine patient care. RNs with advanced training often conduct diagnostic and medical procedures, and some are permitted to prescribe medication.
Specific job duties differ among RNs. Job responsibilities are typically determined by patient population treated and work environments. RNs often specialize in certain areas of patient care.
4 Ways Registered Nurses Can Specialize
- Setting: RNs can be employed in a specific setting where certain treatments are administered. For example, perioperative nurses assist surgeons during surgery.
- Health problems: RNs can also specialize in certain health problems, such as diabetes management nurses, who treat patients struggling with diabetes.
- Body systems or organs: some RNs specialize in certain body systems and organs. For example, dermatology nurses treat patients struggling with skin disorders.
- Patient populations: RNs can also specialize in patient populations. For example, geriatric nurses treat elderly patients. Some RNs have multiple specialties, such as pediatric oncology nurses, who treat child and adolescent cancer victims.
Registered Nurse Work Environment
RNs typically work within brightly-lit and comfortable medical clinics. Public and home healthcare nurses frequently travel to schools, homes, community clinics, and other facilities. RNs often spend a lot of standing, bending, walking, and stretching. Patients receiving care within assisted living facilities and hospitals require around the clock care; therefore, nurses are frequently required to work evenings, weekends, and holidays. RNs are also frequently required to remain on call-show up to work with little notice. Nurses employed at schools, offices, and other facilities where around the clock care is not provided typically work 9-5 shifts.
RNs frequently encounter people with infectious diseases, and they also work in close proximity to toxic and hazardous chemicals. RNs must adhere to strict and standardized regulations to protect against disease and health hazards caused by radiation, unsterile equipment, anesthetics, and needles. Additionally, they can injure their backs while moving patients.
Training and Education Requirements
RNs usually hold either certificates from certified nurse training programs or associate or bachelor’s degrees in nursing. They typically begin their careers after acquiring an associate or bachelor’s degree. After earning a degree, RNs are required to become nationally certified by passing a licensing exam. Advanced specialists, such as clinical nurse specialists, nurse-midwives, nurse practitioners, and nurse anesthetists are required to hold a master’s degree.
Education and training. Most RNs begin their careers by earning an Associate Degree in Nursing (ADN), bachelor’s degree in nursing (BSN), or a professional certificate. Colleges and universities offer BSN programs, which typically take 4 years to finish. Junior and community colleges offer ADN programs, which take about 2-3 years to finish. Hospitals typically offer professional certificate programs, taking about 3 years to complete. Typically, licensed graduates of any of the aforementioned programs can find entry-level jobs as staff nurses. Hundreds of associate and bachelor’s degree programs in nursing are available nationwide, but there are few professional certificate programs.
Aspiring nurses should thoughtfully weigh the pros and cons of any nurse education program. RNs holding ADNs usually have fewer advancement opportunities than those holding bachelor or graduate degrees. Nurses with bachelor’s degrees complete more training to develop analytical, leadership, and communication skills, which are crucial skills as nursing has become more complicated. Likewise, students enrolled in bachelor’s degree programs receive more clinical experience within non-hospital environments. A bachelor’s or graduate degree is usually required for administrative, consulting, teaching, and research jobs.
RNs with professional certificates or ADNs often obtain bachelor’s degrees to learn new skills and enhance job opportunities. They frequently obtain entry-level jobs to obtain tuition assistance and enroll in RN to BSN degree programs. Many also return to school to complete accelerated nursing master’s degrees (MSNs). These programs usually take 2 years to finish.
Many educational programs are also available for individuals making career transitions into nursing. Those with bachelor’s degrees in other disciplines can complete accelerated bachelor’s in nursing programs. It typically takes a year to year and a half for individuals with bachelor’s degrees to complete accelerated BSN programs. Additionally, individuals with bachelor’s degrees in other disciplines can earn accelerated master’s degrees in nursing, typically taking 2 years to complete.
Every nursing training program includes supervised clinical training at hospitals and other medical clinics and classroom instruction. Students are required to complete courses in anatomy, microbiology, physiology, nutrition, chemistry, behavioral sciences, psychology, and nursing. Students earning ADNs and BSNs are required to complete liberal arts courses.
Supervised clinical training is conducted at hospitals in the pediatric, maternity, surgery, and psychiatry units. Clinical training often occurs within assisted living facilities, public health facilities, ambulatory clinics, and the homes of patients receiving in-home care.
Registered Nurse Licensure and Certification
To become licensed as a registered nurse in every state, the District of Columbia, and all U.S. territories, nurses must graduate from an accredited nurse education program and receive a satisfactory score on a national licensing test called the National Council Licensure Examination (NCLEX-RN). Individual states often have additional licensure requirements. For additional details, contact the nursing board in your state.
Other RN Qualifications
Nurses must be empathetic, caring, detail-oriented, and responsible. They must have the ability to manage others, properly evaluate patients’ health, and know when consultation is needed. They must also be able to manage stress effectively since they frequently assist patients struggling with chronic pain, dying, and under extreme emotional duress.
RNs should be lifelong learners since state nursing boards and healthcare providers frequently require them to periodically complete continuing education. RNs spend their entire careers learning new skills and knowledge.
Many nurses become licensed specialists in ambulatory care, informatics, gerontology, pediatrics, and many other fields. The National League for Nursing, the American Nursing Credentialing Center, and other organizations offer professional credentialing for RNs. Even though obtaining a professional credential is often not required to obtain jobs, many healthcare organizations prefer hiring nurses with them since it demonstrates commitment to high professional standards.
RNs typically begin their careers as staff nurses within hospitals, and after demonstrating competency and acquiring some experience, they receive promotions with additional responsibilities and find jobs in other healthcare settings. RNs employed in management positions can get promoted to head nurse, assistant unit manager, and senior-level administrative positions, including chief of nursing, vice president, director, and assistant director positions. In most cases, administrative-level nursing jobs can only be obtained with a graduate degree in health services administration or nursing. Those employed in administrative jobs must be effective leaders, decision-makers, negotiators, and communicators.
Certain RNs train for advanced practice nurse positions, where they work closely with doctors, offer primary care, and practice independently.
4 Types of Advanced Practice RNs
- Clinical nurse specialists – offer direct care and expert advice in numerous nursing specialties, including psychiatric and mental health.
- Nurse practitioners – specialize in primary and specialty care, offering a blend of medical and nursing services to patients and their family members.
- Nurse-midwives – specialize in primary care services for women, such as neonatal care, labor and delivery assistance, prenatal care, family planning services, and gynecological exams.
- Nurse anesthetists – – administer anesthesia and related services prior to surgical, obstetrical, diagnostic, therapeutic, and diagnostic procedures. Additionally, they offer emergency and pain management services, including airway management.
To practice as any of the aforementioned specialists, you must obtain a master’s degree at a minimum. Additionally, every state has different or additional licensure and practice requirements. Some advanced practitioners are permitted to prescribe medicine in certain states. Additional regulation and practice details can be obtained from the board of nursing in your state.
Many nurses find opportunities in the business side of medical care. Their experience providing patient care and working with other medical specialists prepare them to manage chronic care, home-based, acute, and ambulatory clinics. Healthcare providers and companies, including managed care organizations, pharmaceutical companies, insurance companies, hospitals, and other organizations rely on RNs for policy development, quality assurance, consulting, marketing, and healthcare planning. Many nurses work at colleges and universities as researchers and teachers.
In 2016, about 2.9 million registered nurses were employed nationwide. Most RNs work at hospitals, with 58 percent of these specialists employed in these facilities. Nearly 7 percent of RNs work in doctors’ offices, 6 percent at home healthcare companies, 6 percent at nursing care facilities (skilled nursing facilities), and 3 percent at outpatient care centers. The rest are employed by government agencies, educational institutions, and social service agencies.
Job Outlook for Nurses
Overall registered nursing job opportunities are projected to be good, but job opportunities differ by geographic location and healthcare organization. Some healthcare organizations struggle to recruit and retain enough RNs to meet organizational needs. Job growth for RNs is projected to increase quicker than average projected growth in other professions. In fact, it’s estimated that 438,100 new RN jobs will be created between 2016-26. Likewise, hundreds of thousands of positions will become open as current RNs begin to retire in large numbers.
Industry Employment and Job Growth
RN employment happens in multiple industries. The following industries employ the largest amount of registered nurses.
|General medical and surgical hospitals||1,649,480|
|Offices of physicians||196,540|
|Home health care services||179,280|
|Nursing care facilities||157,530|
|Outpatient care centers||128,180|
Job growth for registered nurses is projected to increase by 15% through 2026, much faster than average projected growth in other professions. Growth will be spurred by technological changes and improved patient care procedures, making it possible for more medical conditions to be treated, and increased focus placed on preventive care. Additionally, more elderly people will require medical care, increasing the need for RNs nationwide.
Employment is projected to grow slower at hospitals, the biggest healthcare facilities, than at other medical clinics. While nursing care will continue to be in demand at hospitals, requiring additional nurses to meet demand, patients receiving inpatient care (patients housed at hospitals for multiple days) is projected to decrease. Patients are staying for shorter periods of time and more outpatient treatments are being administered within hospitals and other medical clinics. Rapid job growth is projected at hospital outpatient clinics, including those offering rehabilitation, chemotherapy, and same-day surgery services.
More advanced procedures, previously performed exclusively at hospitals, are now being offered at doctors’ offices and outpatient care facilities, such as emergency and surgical centers. As a result, job growth is projected to increase quicker in these facilities as demand for healthcare increases.
Job growth at nursing care facilities is projected to increase as the population continues to age and rely on long-term assistance. Many elderly individuals prefer to receive care at residential care centers or their homes, spurring demand for RNs within these settings. The need to cut costs has motivated many hospitals to discharge patients quickly, which is spurring demand for RNs within the assisted living, residential care, and home healthcare clinics. Job growth is also projected within units where long-term care and rehabilitation for Alzheimer’s, head injury, and stroke victims are provided.
Job growth at home healthcare providers is projected to increase as more elderly patients receive home care, consumers opt to receive treatment at home, and technology changes enable care providers to provide more complex treatments at patients’ homes. This care will have to be provided by RNs capable of providing complex treatments.
Overall job prospects for RNs are projected to be excellent in the near future. Many healthcare organizations in certain regions of the country struggle recruiting and retaining enough RNs to meet their demands since many nurses are retiring and not enough trained nurses are available to fill vacant positions. Qualified individuals applying to nursing schools are being rejected because of faculty shortages nationwide. Demand for nursing instructors will increase as many teachers get closer to retirement.
Despite slower job growth at hospitals, job prospects are still expected to be good because of high nursing turnover within hospitals. To recruit and retain skilled nurses, hospitals are offering flexible work schedules, tuition reimbursement, and signing bonuses.
Although faster job growth is expected at doctors’ offices and outpatient care facilities, RNs will probably experience greater competition for jobs at these facilities since they typically offer normal working hours and more comfortable work settings. Typically, RNs with bachelor’s and graduate degrees have better job opportunities than their colleagues without them. Likewise, nurse anesthetists, midwives, practitioners, and specialties will be in demand, especially within rural areas and inner cities with few available medical services. RNs specializing in these fields typically provide medical care at lower prices than physicians.
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