Registered Nurses (RNs) are the largest group of healthcare workers in the United States, with over 2.6 million RNs. While nursing has a discrete body of knowledge characterized by how patients and families are cared for to restore them to optimal health and functioning, RNs work closely with all other members of the health care team (physicians, therapists, dietitians, etc.) to best meet care and health promotions needs, and draw from these professions as well. It is estimated that an additional 750,000 RNs will be needed by 2005.
What do RNs do?
According to the US Department of Labor's revised Occupational Outlook Handbook (2000), "Registered nurses (R.N.s) 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. R.N.s 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 R.N.s may perform, it is usually the work setting, which determines their day-to-day job duties."
Educational Preparation:
All US states and territories require RNs to graduate from an accredited nursing program which allows the candidate to sit for the NCLEX examination, a standardized examination administered through the National Council of State Boards of Nursing. Successful completeion of the NCLEX examination confers state licensure as an RN. Nurses may be licensed in more than one State, either by examination or endorsement of a license issued by another State. Licenses must be periodically renewed. Some States require continuing education for licensure renewal.
Nurses may receive their basic preparation for Registered Nursing through one of three avenues: graduation with a three-year (diploma) certificate from a hospital-based school of nursing (non-degree), graduation from an Associate-Degree nursing program (approximately 2 years of college level study with a strong emphasis on clinical knowledge and skills)earning the degree of ASN/AAS in Nursing (the most common means of entry into the profession as of this writing) or graduation from a University with a Bachelor's Degree in Nursing (a 4 - 5 year program conferring the BSN/BN degree with enhanced emphasis on non-clinical topics as well as clinically-focused courses). All pathways into practice require that the candidate complete some clinical training in nursing, and graduates of all programs, once licensed, are generally eligible for employment as entry-level staff nurses.
It is relatively common for RNs to seek additional education to prepare themselves to assume leadership or advanced practice roles within nursing. Management positions increasingly require candidates to hold an advanced degree in nursing. Many hospitals offer tuition remission or assistance to nurses who want to continue their education beyond their basic preparation.
Advanced Practice Nurses (APNs) are generally masters' prepared for education beyond the initial entry into practice level. APNs usually receive a Masters' Degree or higher in Nursing, and may sit for additional certification examinations allowing the APN to practice at a more advanced (sometimes independent) level in a specialty, based on their additional educational preparation as a Certified Nurse Midwife (CNM), Nurse-Practitioner (NP), Clinical Nurse Specialist (CNS) or Certified Registered Nurse Anesthetist (CRNA). All advanced practice certifications require ongoing continuing education as well as other requirements (such as periodic reexamination) to maintain the credential. Advanced practice nurses can expect to earn above-average salaries, especially as the population of the US ages and the demand for highly-skilled healthcare workers grows proportionally.
Where do RNs work?
While the majority of RNs work in a hospital setting, RNs also work in schools, home health care, in office and occupational/industrial health settings, free-standing clinics and physician offices, long-term care facilities, camps, and as advisors and consultants to the healthcare and insurance industries. Some RNs even work with attorneys as Legal Nurse Consultants, reviewing patient records to assure that adequate care was provided.
There are many different nursing specialties, encompassing care throughout the human lifespan and based upon patient needs. Many nurses who choose a specialty become certified in that specialty, signifying that they are recognized as providing exceptional care within that specialty. There are over 200 nursing specialties and sub-specialties. Certified nurses usually earn a salary differential over their non-certified colleagues, and studies from the Institute of Medicine have demonstrated that specialty certified nurses have higher rates of patient satisfaction, as well as lower rates of work-related errors in patient care.
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