Registered Nursing Careers --Present and Future
 
Exciting and rewarding career opportunities exist for men and women entering the profession. As healthcare access continues to be on the forefront of America's agenda, nursing will be increasingly called upon to help provide a broader range of services due to a variety of factors.
  • As healthcare delivery shifts from an illness focus to a health promotion focus, nurses will be providing care across the entire health continuum.
  • As healthcare technology advances, more individuals will be living with chronic conditions that require nursing care.
  • Hospitals and outpatient settings will have increasingly complex patient care demands that require RNs prepared with strong clinical judgment skills.
  • Expanding healthcare technology and scientific breakthrough will require increased patient care monitoring by RNs in diverse settings.
  • The explosion of healthcare knowledge brings specialization to the nursing role. There are over 50 specialties in which RNs can become certified.
  • A growing complexity of environmental and social problems creates an increased need for nursing services.
  • As life spans increase, more health services will be needed. It is projected 12% of the U.S. population will be over age 85 by the year 2030. The population age 65 years and older will double between 2000 and 2030. Average life expectancy has reached 75.5 years.
NURSING'S FOCUS
  • Nurses care for individuals who are healthy and ill, of all ages and cultural backgrounds, and who have physical, emotional, psychological, intellectual, social, and spiritual needs.
  • Nursing is a profession that combines physical science, social science, nursing theory, and technology in the care of others.
  • Nurses provide complex patient care monitoring and evaluation.
  • Nurses are the coordinators of patient care.
  • Nurses provide patient education.
  • Nurses apply research in practice.
NURSING'S PROFILE
  • Nursing is the nation's largest health care profession with 2.7 million nurses, 83% are employed in nursing.
  • The current RN workforce is aging. Retirements are expected to peak in the next decade adding to the demand for RNs.
  • Nursing students account for 52% of all health profession students in the United States.
  • Nurses comprise the largest single component of hospital staff, are the primary providers of hospital care, and deliver most of the nation's long-term care.
CAREER PATHS
 
Individual nursing practice is determined by the career path selected and is dependent upon education, experience, work setting and geographical location. The demand for master's and doctorally prepared nurses for advanced practice, clinical specialties, teaching, and research continues to increase.
 
Clinician
  • Clinical Staff Nurse - Provides scientific, psychological, and technological knowledge in the care of patients and families.
  • Advanced Practice Nurse - Provides primary care and specialized advanced nursing services to patients and families. Includes: Clinical Specialist, Nurse Practitioner, Nurse Midwife and Nurse Anesthetist
Educator - Utilizes educational methodologies to present current information in patient care settings, universities, and communities. Positions may include: instructor, professor, university or college administrator, chair or dean.
 
Researcher - Utilizes statistical methodologies to discover or establish facts, principles or relationships.
 
Administrator - Coordinates the use of human, financial, and technological resources to provide patient care services. Positions may include facilitator, manager, director, chief nurse executive, or vice president.
 
In addition, some nurses have combined two careers (i.e. nurse attorney). Others have served as consultants to businesses, schools, and health care institutions. Some are combining the field of nursing and computer technology (nursing informatics)
 
JOB MARKET
  • RN positions are open for new graduates and experienced nurses in a variety of settings and specialties.
  • Increasing inpatient days and ambulatory care delivery demand RN expertise.
  • Heightened recognition of the RN role leads to expanding opportunities.
SALARIES
 
Salaries are competitive with other professions and attracting more men and women into nursing.  Nationally, the average annual earnings of RNs employed full-time is $59,730. The nurse who works evenings, nights or weekends receives added compensation. Nurses choosing careers in advanced practice, administration, education and research may earn more, depending on the amount of responsibility associated with their role.
 
QUALIFICATIONS:
  • Knowledgeable, articulate, competent, caring and compassionate
  • Problem-solver, critical thinker, decision maker
  • Responsible, accountable, and adaptable
 
PHYSICAL AND PSYCHOLOGICAL DEMANDS
  • Good health and stamina
  • Excellent interpersonal skills
  • Developed coping skills, ability to work well under pressure and adaptable to change
WORK ENVIRONMENT
 
Working conditions have changed significantly in recent years. Nurses often can choose from a variety of flexible scheduling options, depending on the role and setting. Many hospitals utilize 12 hour shifts, partial shifts and weekend options.
  • Flexible work schedules; health, education, and retirement benefits
  • Progressive health care environments
  • State-of-the-art technology
  • Potential exposure to hazards, i.e. drugs, physical injuries, infectious diseases, environmental
HOSPITAL SETTINGS:
  • Critical Care
  • Emergency
  • Maternal/Child Care
  • Medical:
    • Cardiology, Diabetes, Gastroenterology, Gerontology, Nephrology, Neurology, Oncology, Pulmonary, Rehabilitation, Renal, Rheumatology, Urology
  • Operating Room/Recovery Room
  • Pediatrics
  • Psychiatric/Mental Health
  • Surgical:
    • Burn, Cardiovascular, Ear/Nose/Throat, Gastroenterology, Orthopedics, Plastic/Reconstructive, Transplant
NON-HOSPITAL SETTINGS:
  • Public/Community Health
  • Mental Health Agencies
  • Home Health Care
  • Physician's Office
  • Insurance
  • Occupational Health
  • Research Centers
  • Extended Care Facilities
  • Clinics/Health Centers
  • Outpatient Surgery Centers
  • Hospices
  • Community Schools, Day Care Centers
  • Military Branches
  • Independent Practice, Consultants
  • Schools of Nursing
  • Senior Centers, Shelters, Churches
 
CAREER DIVERSITY
 
There is no profession which offers as many opportunities for diversification as does nursing. With over 50 specialties and many emerging roles, RNs can easily follow their personal and professional interests. During clinical classes in nursing school, students are exposed to many of the specialties in various clinical areas. 
 
 CLINICAL AREAS AND SPECIALTIES IN NURSING
 
Medical
 
The profession of nursing is centered around maintaining and improving health as well as providing care to people with impaired health. Knowledge about medical illness and their prevention is essential in outpatient and inpatient settings.
 
Surgical
 
Nurses care for patients before and after operative procedures. Preparing the patient for surgery through education and physical means may be done before or during hospitalization. Following surgery, a patient will require nursing care at various stages-- critical care, post-surgical unit, doctor's office or clinic, and home settings.
 
Operating Room
 
Registered nurses in the operating room (OR) work with surgeons, anesthesiologists, other R.N.'s, and staff. Operating rooms have both scrub and circulating nurses as members of the surgical team. The scrub nurse passes surgical instruments and assists the surgeon with the instrumentation portion of the surgical procedure. The circulating nurse is accountable for the patient's care while in the operating room and monitors patient safety, equipment, and supplies. Immediately following surgery, the patient is closely monitored by a registered nurse in the post anesthesia care unit (PACU)
 
Critical Care
 
Nurses care for patients in critical or intensive care (ICU) settings where they interact with highly sophisticated life support and monitoring equipment. They apply knowledge from the other specialties while working side by side with physicians and other health care team members. Utilizing nursing diagnosis, the RN coordinates information from many sources.
 
Emergency
 
Emergency nurses care for patients of all ages and all levels of illnesseverything from a sprained ankle to a motor vehicle accident. ER nurses possess strong assessment and communication skills, and are also adept with sophisticated life support and monitoring equipment. Emergency nurses work in emergency centers and in ground and air transport vehicles
 
Maternal/Child
 
Registered nurses in this specialty care for women before, during, and after delivery (obstetrics), for newborn babies, and for all aspects of women's health (gynecology) from puberty through the post-menopausal age. Interesting subspecialties include high risk obstetric nursing, neonatal intensive care nursing, and lactation consultant.
 
Pediatric
 
Pediatric nurses provide care to children with medical, surgical, and psychological illnesses. In addition to providing skilled bedside nursing care for the sick and injured, R.N.'s teach young people and their parents about accident prevention and the promotion of good health which will positively affect them at all ages of life.
 
Gerontology
 
Many registered nurses study the medical, surgical, and psychological conditions of older adults and how age effects the mind and body, and apply this knowledge to their nursing practice. The number of Americans over 65 years will grow 76% between 1986 and 2020. Expanded life expectancies will require more nurses to specialize in gerontology
 
Psychiatric/Mental Health
 
Mental Health Nurses care for children, adolescents, and adults with chemical dependency, acute and chronic mental illness, behavioral disorders, and Alzheimer's Disease through assessment, monitoring, crisis intervention, counseling, pharmacological intervention, and education. Strong communication skills and an understanding of human behavior are primary tools in this specialty.
 
Community Health
 
Community health nurses care for patients in a variety of settings such as public health clinics, private work settings practices, public and private health centers, hospices, homes, schools, and work settings. As health care shifts from inpatient to outpatient settings, more registered nurses will be caring for patients in community settings. The approach of community nursing is holistic; that is, the nurse looks at the whole person and at the dynamics of the patient's interaction with his family and community.
 
Nursing Education
 
Registered nurses learn new skills, theories, treatment modalities, and other information by reading books, journals, and web-based material written by nurses. R.N.'s who specialize in education also teach at hospitals, universities, community settings, and business sponsored continuing education programs. Nurses need to be able to teach other nurses.
 
Nursing Research
 
It is imperative that registered nurses expand their knowledge and contribute to the profession. Clinical nurses, administrators, and educators utilize the scientific process to research and develop more information. The rapidly changing technological advances and demand for proficiency in clinical and administrative areas all require more nursing research. Baccalaureate degree programs include courses in research. Doctoral degree programs specifically prepare graduates to be scholarly researchers and add to the knowledge base in their specialty of clinical practice, administration, and education.
 
Nursing Administration
 
The registered nurse facilitates the clinical nursing team of R.N.'s, Licensed Practical Nurses, and other team members and coordinates the use of human, financial (budget), and technological resources to deliver patient care. The nurse manager collaborates with physicians, other managers, and administrators and works closely with the nursing staff to provide the resources needed for patient care. Experience and additional education in areas such as leadership theories, financial management, health policy, resource utilization, and information systems are required.
 
Nursing Informatics
The registered nurse combines nursing science, computer science, and information science into nursing practice. The informatics nurse integrates information to support patients, nurses, and other health care team members in decision-making.