Career
Center Resources
Nature of the Work|Working
Conditions|Employment|Training,
Other Qualifications, and Advancement| Significant
Points Registered nurses (RNs) work to promote health,
prevent disease, and help patients cope with illness. They are advocates
and health educators for patients, families, and communities. When
providing direct patient care, they observe, assess, and record
symptoms, reactions, and progress; assist physicians during treatments
and examinations; administer medications; and assist in convalescence
and rehabilitation. RNs also develop and manage nursing care plans; instruct patients
and their families in proper care; and help individuals and groups
take steps to improve or maintain their health. While State laws
govern the tasks that RNs may perform, it is usually the work setting
that determines their daily job duties. Hospital nurses form the largest group of nurses.
Most are staff nurses, who provide bedside nursing care and carry
out medical regimens. They also may supervise licensed practical
nurses and nursing aides. Hospital nurses usually are assigned to
one area, such as surgery, maternity, pediatrics, emergency room,
intensive care, or treatment of cancer patients. Some may rotate
among departments. Office nurses care for outpatients in physicians'
offices, clinics, surgicenters, and emergency medical centers. They
prepare patients for and assist with examinations, administer injections
and medications, dress wounds and incisions, assist with minor surgery,
and maintain records. Some also perform routine laboratory and office
work. Nursing home nurses manage nursing care for residents
with conditions ranging from a fracture to Alzheimer's disease.
Although they often spend much of their time on administrative and
supervisory tasks, RNs also assess residents' health condition,
develop treatment plans, supervise licensed practical nurses and
nursing aides, and perform difficult procedures such as starting
intravenous fluids. They also work in specialty-care departments,
such as long-term rehabilitation units for patients with strokes
and head-injuries. Home health nurses provide periodic services
to patients at home. After assessing patients' home environments,
they care for and instruct patients and their families. Home health
nurses care for a broad range of patients, such as those recovering
from illnesses and accidents, cancer, and childbirth. They must
be able to work independently, and may supervise home health aides. Public health nurses work in government and private
agencies and clinics, schools, retirement communities, and other
community settings. They focus on populations, working with individuals,
groups, and families to improve the overall health of communities.
They also work as partners with communities to plan and implement
programs. Public health nurses instruct individuals, families, and
other groups regarding health issues, disease prevention, nutrition,
and childcare. They arrange for immunizations, blood pressure testing,
and other health screening. These nurses also work with community
leaders, teachers, parents, and physicians in community health education. Occupational health or industrial nurses provide
nursing care at worksites to employees, customers, and others with
minor injuries and illnesses. They provide emergency care, prepare
accident reports, and arrange for further care if necessary. They
also offer health counseling, assist with health examinations and
inoculations, and assess work environments to identify potential
health or safety problems. Head nurses or nurse supervisors direct nursing
activities. They plan work schedules and assign duties to nurses
and aides, provide or arrange for training, and visit patients to
observe nurses and to ensure the proper delivery of care. They also
may see that records are maintained and equipment and supplies are
ordered. Nurse practitioners - at the advanced level -
provide basic primary healthcare. They diagnose and treat common
acute illnesses and injuries. Nurse practitioners also can prescribe
medications(but certification and licensing requirements vary by
State. Other advanced practice nurses include clinical nurse specialists,
certified registered nurse anesthetists, and certified nurse-midwives.
Advanced practice nurses must meet higher educational and clinical
practice requirements beyond the basic nursing education and licensing
required of all RNs. Most nurses work in well-lighted, comfortable healthcare facilities.
Home health and public health nurses travel to patients' homes,
schools, community centers, and other sites. Nurses may spend considerable
time walking and standing. They need emotional stability to cope
with human suffering, emergencies, and other stresses. Patients
in hospitals and nursing homes require 24-hour care; consequently,
nurses in these institutions may work nights, weekends, and holidays.
RNs also may be on-call(available to work on short notice. Office,
occupational health, and public health nurses are more likely to
work regular business hours. Almost 1 in 10 RNs held more than one
job in 2000. Nursing has its hazards, especially in hospitals, nursing homes,
and clinics where nurses may care for individuals with infectious
diseases. Nurses must observe rigid guidelines to guard against
disease and other dangers, such as those posed by radiation, chemicals
used for sterilization of instruments, and anesthetics. In addition,
they are vulnerable to back injury when moving patients, shocks
from electrical equipment, and hazards posed by compressed gases. As the largest healthcare occupation, registered nurses held about
2.2 million jobs in 2000. About 3 out of 5 jobs were in hospitals,
in inpatient and outpatient departments. Others were mostly in offices
and clinics of physicians and other health practitioners, home healthcare
agencies, nursing homes, temporary help agencies, schools, and government
agencies. The remainder worked in residential care facilities, social
service agencies, religious organizations, research facilities,
management and public relations firms, insurance agencies, and private
households. About 1 out of 4 RNs worked part time. In all States and the District of Columbia , students must graduate
from an approved nursing program and pass a national licensing examination
to obtain a nursing license. Nurses may be licensed in more than
one State, either by examination, by endorsement of a license issued
by another State, or through a multi-State licensing agreement.
All States require periodic license renewal, which may involve continuing
education. There are three major educational paths to registered nursing:
associate degree in nursing (A.D.N.), bachelor of science degree
in nursing (B.S.N.), and diploma. A.D.N. programs, offered by community
and junior colleges, take about 2 to 3 years. About half of the
1,700 RN programs in 2000 were at the A.D.N. level. B.S.N. programs,
offered by colleges and universities, take 4 or 5 years. More than
one-third of all programs in 2000 offered degrees at the bachelor's
level. Diploma programs, administered in hospitals, last 2 to 3
years. Only a small number of programs offer diploma-level degrees.
Generally, licensed graduates of any of the three program types
qualify for entry-level positions as staff nurses. Many A.D.N. and diploma-educated nurses later enter bachelor's
programs to prepare for a broader scope of nursing practice. They
can often find a staff nurse position and then take advantage of
tuition reimbursement programs to work toward a B.S.N. Individuals considering nursing should carefully weigh the pros
and cons of enrolling in a B.S.N. program because, if they do so,
their advancement opportunities usually are broader. In fact, some
career paths are open only to nurses with bachelor's or advanced
degrees. A bachelor's degree is often necessary for administrative
positions, and it is a prerequisite for admission to graduate nursing
programs in research, consulting, teaching, or a clinical specialization. Nursing education includes classroom instruction and supervised
clinical experience in hospitals and other health facilities. Students
take courses in anatomy, physiology, microbiology, chemistry, nutrition,
psychology and other behavioral sciences, and nursing. Coursework
also includes the liberal arts. Supervised clinical experience is provided in hospital departments
such as pediatrics, psychiatry, maternity, and surgery. A growing
number of programs include clinical experience in nursing homes,
public health departments, home health agencies, and ambulatory
clinics. Nurses should be caring and sympathetic. They must be able to accept
responsibility, direct or supervise others, follow orders precisely,
and determine when consultation is required. Experience and good performance can lead to promotion to more responsible
positions. Nurses can advance, in management, to assistant head
nurse or head nurse. From there, they can advance to assistant director,
director, and vice president. Increasingly, management-level nursing
positions require a graduate degree in nursing or health services
administration. They also require leadership, negotiation skills,
and good judgment. Graduate programs preparing executive-level nurses
usually last 1 to 2 years. Within patient care, nurses can advance to clinical nurse specialist,
nurse practitioner, certified nurse-midwife, or certified registered
nurse anesthetist. These positions require 1 or 2 years of graduate
education, leading to a master's degree or, in some instances, to
a certificate. Some nurses move into the business side of healthcare. Their nursing
expertise and experience on a healthcare team equip them to manage
ambulatory, acute, home health, and chronic care services. Healthcare
corporations employ nurses for health planning and development,
marketing, and quality assurance. Other nurses work as college and
university faculty or do research. Job opportunities for RNs are expected to be very good. Employment
of registered nurses is expected to grow faster than the average
for all occupations through 2010, and because the occupation is
very large, many new jobs will result. Thousands of job openings
also will result from the need to replace experienced nurses who
leave the occupation, especially as the median age of the registered
nurse population continues to rise. Some States report current and projected shortages of RNs, primarily
due to an aging RN workforce and recent declines in nursing school
enrollments. Imbalances between the supply of and demand for qualified
workers should spur efforts to attract and retain qualified RNs.
For example, employers may restructure workloads, improve compensation
and working conditions, and subsidize training or continuing education. Faster than average growth will be driven by technological advances
in patient care, which permit a greater number of medical problems
to be treated, and an increasing emphasis on preventive care. In
addition, the number of older people, who are much more likely than
younger people to need nursing care, is projected to grow rapidly. Employment in hospitals, the largest sector, is expected to grow
more slowly than in other healthcare sectors. While the intensity
of nursing care is likely to increase, requiring more nurses per
patient, the number of inpatients (those who remain in the hospital
for more than 24 hours) is not likely to increase much. Patients
are being discharged earlier and more procedures are being done
on an outpatient basis, both in and outside hospitals. However,
rapid growth is expected in hospital outpatient facilities, such
as those providing same-day surgery, rehabilitation, and chemotherapy. Employment in home healthcare is expected to grow rapidly. This
is in response to the growing number of older persons with functional
disabilities, consumer preference for care in the home, and technological
advances that make it possible to bring increasingly complex treatments
into the home. The type of care demanded will require nurses who
are able to perform complex procedures. Employment in nursing homes is expected to grow faster than average
due to increases in the number of elderly, many of whom require
long-term care. In addition, the financial pressure on hospitals
to discharge patients as soon as possible should produce more nursing
home admissions. Growth in units that provide specialized long-term
rehabilitation for stroke and head injury patients or that treat
Alzheimer's victims also will increase employment. An increasing proportion of sophisticated procedures, which once
were performed only in hospitals, are being performed in physicians'
offices and clinics, including ambulatory surgicenters and emergency
medical centers. Accordingly, employment is expected to grow faster
than average in these places as healthcare in general expands. In evolving integrated health care networks, nurses may rotate
among employment settings. Because jobs in traditional hospital
nursing positions are no longer the only option, RNs will need to
be flexible. Opportunities should be excellent, particularly for
nurses with advanced education and training. Median annual earnings of registered nurses were $44,840 in 2000.
The middle 50 percent earned between $37,870 and $54,000. The lowest
10 percent earned less than $31,890, and the highest 10 percent
earned more than $64,360. Median annual earnings in the industries
employing the largest numbers of registered nurses in 2000 were
as follows: Personnel supply services $46,860 Many employers offer flexible work schedules, childcare, educational
benefits, and bonuses. Workers in other healthcare occupations with responsibilities and
duties related to those of registered nurses are emergency medical
technicians and paramedics, occupational therapists, physical therapists,
physician assistants and respiratory therapists. For information on a career as a registered nurse and nursing education,
contact: For a list of
B.S.N. and graduate nursing programs, write to: Registered Nurse
Job Outlook|Earnings|Related
Occupations|Sources of Additional
Information
Nature of the Work
Working Conditions
Employment
Training, Other
Qualifications, and Advancement
Job Outlook
Earnings
Hospitals 45,780
Home health care services 43,640
Offices and clinics of medical doctors 43,480
Nursing and personal care facilities 41,330 Related Occupations
Sources of Additional Information
National League for Nursing
61 Broadway
New York, NY 10006
Internet: http://www.nln.org
American Association of Colleges of Nursing
1 Dupont Circle NW., Suite 530
Washington, DC 20036
Internet: http://www.aacn.nche.edu
Information on registered nurses also is available from:
American Nurses Association
600 Maryland Ave. SW.
Washington, DC 20024-2571
Internet: http://www.nursingworld.org/
