Registered Nurse (RN)

Registered nurses (RNs) treat patients, advise patients and provide emotional support to patients and their family members during difficult times. RNs document patients' medical histories and symptoms, help doctors perform diagnostic tests, administer treatment and medications, and follow-up with patients during rehabilitation.

RNs instruct patients and their families about post-treatment illness or injury management, making nutrition and exercise program recommendations. Some RNs promote public health by educating the public about disease symptoms. RNs often organize health screening or immunization clinics and blood drives.

When working with patients, RNs establish a care plan. Plans could include the monitoring and administration of prescription drugs, setting up and monitoring (IV) lines for fluid, coordinating treatments, patient observation, record keeping, and discussing patient care with doctors. Some RNs instruct licensed practical nurses and nursing aids about patient care. RNs with advanced educational training may perform diagnostic tests and prescribe some medication.

RNs can specialize in certain types of patient care. RNs can work in a certain setting, such as perioperative nurses, found in operating rooms. RNs may specialize in certain disease treatment, such as diabetes management nurses, who help patients with diabetes. Some RNs specialize in particular organ systems, such as dermatology nurses, who help with patients with skin disorders. RNs also can choose to work with a specific type of people, such as geriatric nurses, specializing in treating the elderly. RNs may combine specialties, such as pediatric oncology nurses, who work with children cancer patients.

There are many opportunities for nurses that specialize. Ambulatory care nurses provide preventive care and treat patients in physicians' offices or in clinics. Some ambulatory care nurses are involved in telehealth, using telecommunications technology to provide health care. Critical care nurses provide care to patients with serious or life threatening injuries that require close monitoring. Emergency, or trauma, nurses work in emergency rooms, providing initial observations and care for patients in critical condition. Transport nurses, treat patients transported by helicopter or airplane to a hospital. Holistic nurses treat patients using natural remedies such as herbs or acupuncture. Home health care nurses assist patients recovering from injuries in their homes. Hospice and palliative care nurses work with terminally ill patients. Infusion nurses specialize in administering fluids or medications through injections into patients' veins. Long- term care nurses provide health care services to patients in long-term care facilities. Medical-surgical nurses assist patients scheduled to have surgery or those with other medical diagnoses. Occupational health nurses specialize in preventing work site injuries. Perianesthesia nurses provide preoperative and postoperative care to patients receiving anesthesia during and after surgery. Perioperative nurses assist surgeons by handling surgical tools, controlling bleeding, and suturing incisions. Some nurses work with plastic and reconstructive surgeons. Psychiatric-mental health nurses work with patients afflicted with mental illness. Radiology nurses work with patients being treated or diagnosed with equipment that emits radiation. Rehabilitation nurses assist people with temporary and permanent disabilities. Transplant nurses care for people who have received organ transplants or are awaiting transplants. They monitor people recovering from transplants for organ rejection.

RNs also specialize in specific diseases and health conditions. Addictions nurses care for patients struggling with alcohol, drug, and other addictions. Intellectual and developmental disabilities nurses provide care for the disabled. Diabetes management nurses help diabetics to manage their diabetes. Genetics nurses provide early detection screenings and consult people predisposed to certain diseases. HIV/AIDS nurses care for people with HIV and AIDS. Oncology nurses care for cancer patients. Wound, ostomy, and continence nurses treat patients that rely on alternative methods to eliminate bodily wastes, as well as treat patients with urinary and fecal incontinence.

Some RNs specialize in treating problems associated with a particular organ system. Cardiovascular nurses treat patients with coronary heart disease and those who have had heart surgery. Dermatology nurses specialize in helping people with skin disorders. Gastroenterology nurses assist patients with digestive and intestinal disorders. Some gastroenterology nurses utilize specialized procedures such as endoscopies, instruments that permit doctors and nurses to look inside the gastrointestinal tract. Gynecology nurses provide care to women with reproductive system problems. Nephrology nurses care for patients with kidney disease. Neuroscience nurses care for patients with nervous system disorders. Ophthalmic nurses care for people with eye problems. Orthopedic nurses work with patients suffering from muscular and skeletal problems. Otorhinolaryngology nurses assist patients with ear, nose, and throat disorders.

Respiratory nurses help people with respiratory disorders. Urology nurses care for patients suffering from disorders of the kidneys, urinary tract, and male reproductive organs.

Some RNs specialize in working with people from certain age groups or certain settings. For example, some nurses specialize in working with newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). Certain RNs work with people outside of hospital settings such as in the military or a summer camp. Some RNs travel around the country and the world providing care to patients in areas with health professional shortages.

Most RNs work as staff nurses. However, some RNs become advanced practice nurses, who work independently, or team up with doctors providing primary care services. Clinical nurse specialists provide patients with direct care and expert consultations. Nurse anesthetists provide anesthesia before and after surgery, as well as administer pain medication to people suffering from chronic pain. Nurse-midwives provide gynecological care and assist women during labor and delivery. Nurse practitioners provide primary and specialty care. Most nurses specialize in family practice, women's health, pediatrics, acute care, neonatology, mental health, and geriatrics. Advanced practice nurses can prescribe medication in every state and the District of Columbia.

Some nurses do not directly care for patients, they are still required to maintain an active RN license. Case managers assure patients with severe injuries and illnesses receive the necessary treatments. Forensics nurses treat the victims of violent crimes or serious accidents, as well as investigate the circumstances of the crime or accident. Infection control nurses identify, track, and control infectious disease outbreaks and develop plans to deal with the outbreak. Legal nurse consultants work with lawyers handling medical related cases. Nurse administrators perform administrative duties. Nurse educators develop and coordinate curricula to professional develop student nurses and RNs. Nurse informaticists specialize in improving communication among consumers, patients, nurses, and other health care professionals. RNs also work as medical writers and editors, salespersons, researchers, public policy experts, and health care consultants.

Work Environment
Most RNs work in well-lit, cozy health care facilities. Home health and public health nurses travel to meet with patients in their homes, schools, or other public locations. RNs jobs can be physically demanding. Nursing working in hospitals and nursing homes work many night and weekend hours since these patients require 24-hour care. Many RNs must constantly be on call. Nurses who work in facilities that do not provide 24-hour care are more likely to work 40 hour weeks. In 2006, 21 percent of RNs worked part time and 7 percent had at least 2 jobs.

Nursing can be dangerous since they work with individuals afflicted with infectious and communicable diseases. Nurses also handle toxic, harmful, or potentially hazardous solutions and medications. RNs follow safety procedures to protect themselves against diseases, radiation, needles, and chemicals. RNs are susceptible to back injuries when moving patients, electric shock from electrical equipment, and hazards posed by compressed gases. RNs sometimes experience emotional stress since they witness so much human suffering, and many nurses experience work stress, since they must make quick decisions and work in situations where peoples' lives are at stake.

Education and Training
To qualify for the licensing exam to become a registered nurse, you must earn one of the following degrees:

  • Certificate from a hospital school of nursing
  • Associate's Degree in Nursing (ADN)
  • Bachelor's Degree in Nursing (BSN)

It takes about 3-4 years to earn a bachelor's degree in nursing. Some schools sponsor accelerated programs for students with bachelor's degrees in other fields. Although you can be licensed as a registered nurse with an associate's degree, many organizations are lobbying for all registered nurses to hold bachelor's degrees. Registered nurses with master's degrees will enjoy better job prospects and earning potential.

Additional information about nursing programs can be obtained from the American Association of Colleges of Nursing (AACN).

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The median annual wage for registered nurses working in the United States is roughly $66,000 - about half of all nurses earned more and half less. The lowest 10 percent of nurses earn less than $45,000 a year, while the top 10 percent make over $95,000 a year. Those at the top end of the pay scale are usually registered nurse specialists and practitioners.

The following are the median annual wages for registered nurses on a per industry basis:

Government $68,000
Hospitals $67,000
Home health $62,000
Nursing homes and care facilities $59,000
Doctor's offices $58,000
In addition to an annual salary, employers offer nurses other benefits including educational reimbursement, childcare and bonuses.

Job Outlook
Of all the career fields in the United States, nursing is projected to be one of the most attractive over the next decade. The industry has a projected growth rate of 19% through 2022 and there will 500,000 new nurses hired during this time. The phenomenal growth this industry will experience is due to a number of reasons.

Due to an aging population, demand for healthcare services as whole is projected to increase for many years to come. The elderly experience many chronic conditions, such as dementia, arthritis, diabetes, and obesity. Nurses will be needed to care for this aging population. Due to new federal health insurance regulations and guidelines a much larger percentage of people will now have access to health insurance and health care. As the number of insured rises, so will the demand for nurses.

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