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Career Guide: Registered Nurse

Career Guide: Registered Nurse

Bureau of Labor Statistics

Most RNs work as staff nurses as members of a team providing critical health care . However, some RNs choose to become advanced practice nurses, who work independently or in collaboration with physicians, and may focus on the provision of primary care services. Clinical nurse specialists provide direct patient care and expert consultations in one of many nursing specialties, such as psychiatric-mental health. Nurse anesthetists provide anesthesia and related care before and after surgical, therapeutic, diagnostic and obstetrical procedures. They also provide pain management and emergency services, such as airway management. Nurse-midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. Nurse practitioners serve as primary and specialty care providers, providing a blend of nursing and health care services to patients and families. The most common specialty areas for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and geriatrics. However, there are a variety of other specialties that nurse practitioners can choose, including neonatology and mental health. Advanced practice nurses can prescribe medications in all States and in the District of Columbia.

Some nurses have jobs that require little or no direct patient care, but still require an active RN license. Case managers ensure that all of the medical needs of patients with severe injuries and severe or chronic illnesses are met. Forensics nurses participate in the scientific investigation and treatment of abuse victims, violence, criminal activity, and traumatic accident. Infection control nurses identify, track, and control infectious outbreaks in health care facilities and develop programs for outbreak prevention and response to biological terrorism. Legal nurse consultants assist lawyers in medical cases by interviewing patients and witnesses, organizing medical records, determining damages and costs, locating evidence, and educating lawyers about medical issues. Nurse administrators supervise nursing staff, establish work schedules and budgets, maintain medical supply inventories, and manage resources to ensure high-quality care. Nurse educators plan, develop, implement, and evaluate educational programs and curricula for the professional development of student nurses and RNs. Nurse informaticists manage and communicate nursing data and information to improve decision making by consumers, patients, nurses, and other health care providers. RNs also may work as health care consultants, public policy advisors, pharmaceutical and medical supply researchers and salespersons, and medical writers and editors.

Work environment. Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients’ homes, schools, community centers, and other sites. RNs may spend considerable time walking, bending, stretching, and standing. Patients in hospitals and nursing care facilities 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. Nurses who work in offices, schools, and other settings that do not provide 24-hour care are more likely to work regular business hours. About 21 percent of RNs worked part time in 2006, and 7 percent held more than one job.

Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may be in close contact with individuals who have infectious diseases and with toxic, harmful, or potentially hazardous compounds, solutions, and medications. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs also may suffer emotional strain from caring for patients suffering unrelieved intense pain, close personal contact with patients’ families, the need to make critical decisions, and ethical dilemmas and concerns.


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