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Nursing's Focus
Nursing is a scientific profession directed toward caring for healthy and ill individuals who have physical, emotional, psychological, intellectual, social, and spiritual needs. The focus of the Registered Nurse (R.N.) is determined by the career path selected and is dependent upon the nurse's work setting, education, and experience. The career paths in nursing are Clinician, Educator, Researcher, and Administrator.
Many Options
There are many options within the single career of nursing. Once you earn the title of R.N., opportunities in several specialties are available. The diversity is extensive. For example, a Registered Nurse who cares for sick newborns and children may also plan a community health awareness project. In the emergency room, the R.N. can immediately administer intravenous medications to a patient whose heart has stopped and then a few hours later may be teaching high school students about alcohol related emergencies. A Diabetic Specialist not only educates classes of patients about nutrition, but also teaches students and newly employed nurses how to use the newest blood sugar monitoring equipment. A nurse manager works with a BSN nursing student in the morning and in the afternoon serves on a task group to make recommendations about expanding services to the elderly population. These are a few examples of many specialty roles available in nursing.
In Nursing School
During clinical classes in nursing school, the nursing student has learning experiences in many of the specialties. Each level (Associate, Baccalaureate, Master's, Doctorate) of formal nursing education provides additional exposure to clinical areas. Following graduation, students usually have identified which clinical areas interest them the most.
Specialty Certification
Registered Nurses gain their specialty knowledge through extensive clinical experience, self-study, staff development programs, and continuing education. Certification by examination is available to individuals who choose to specialize and provides formal recognition of the R.N.'s expertise. Certification signifies personal growth, professional achievement, and may contribute to career advancement.
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 (hospital and extended care facilities) to outpatient (ambulatory and home care), 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 certification is available in:
- Community Health Nursing
- Occupational Health Nursing
- School 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.
Certification is available in the subspecialties of:
- Cardiac and Vascular Rehabilitation
- Dermatology (skin)
- Diabetes
- Forensics
- Gastroenterology (digestive tract)
- Genetics
- HIV/AIDS
- Infection Control
- Nephrology (kidney)
- Neuroscience (nervous system)
- Nutrition and Infusion Therapy
- Oncology (cancer)
- Pain Management
- Rehabilitation
- Urology
Other medical subspecialties are:
- Allergy/Immunology
- Metabolic Disorders
- Pulmonary (lungs)
- Rheumatology
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 of varying intensities in critical care, a post-surgical unit, an office, and home settings. Certification is available in the following specialties:
- Medical-Surgical
- Enterostomal Therapy (intestinal surgery)
- Ophthalmic (eyes)
- Orthopaedic (muscular-skeletal mobility)
- Otorhinolaryngology and Head-Neck
- Plastic and Reconstructive Surgery
Surgical nurses also care for patients with the following surgical conditions:
- Burn
- Cardiovascular (heart and vessels)
- Gastroenterology (digestive tract)
- Gynecology (female reproductive system)
- Neurosurgical (nervous system)
- Thoracic (chest)
- Organ Transplant
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 monitered by a Registered Nurse in the Post Anesthesia Room (PAR).
Certification is available in:
- Perioperative Nursing
- Perianesthesia Nursing
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. Critical assessment and care of seriously ill patients also occurs in the emergency room, in emergency centers, and in air and ground transportation vehicles. Certification is available in:
- Flight Nursing
- Emergency Nursing
- Critical Care Nursing
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, pharmcological intervention, and education. Strong communication skills and an understanding of human behavior are primary tools in this specialty.
Certification is available in:
- Addictions Nursing
- Psychiatric and Mental Health Nursing
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. Certification is available in:
- Inpatient Obstetric Nursing
- High-Risk Obstetric Nursing
- Maternal Newborn Nursing
- Neonatal Intensive Care Nursing
- Low-Risk Neonatal Nursing
- Perinatal Nursing
- 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 effect them at all ages of life.
Certification is available in:
- Pediatric Nursing
- Pediatric Critical Care Nursing
- Pediatric Oncology
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.
Registered Nurses may become certified as:
Nursing Education
Registered Nurses learn new skills, theories, treatment modalities, and other information by reading books, journals, and computerized documents written by nurses. R.N.'s who specialize in education, also present current information at hospitals, universities, community settings, and business sponsored continuing education programs. Nurses need to be able to teach other nurses.
Certification is available in:
- Nursing Professional Development
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 demanding proficiency in clinical and administrative areas, 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 (equipment) resources to deliver patient care. The 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 are required in areas such as leadership theories, financial management, health policy, resource utilization, and information systems.
Certification is available in:
Nursing Informatics
The Registered Nurse combines nursing science, computer science, and information science into nursing practice. The Nurse Informatics Specialist integrates information to support patients, nurses, and other health care team members in decision-making. Certification is available in:
Other Nursing Team Members
L.P.N. - Licensed Practical Nurses (L.P.N.) or Licensed Vocational Nurses (L.V.N.) attend state approved programs offered by vocational and technological schools and colleges that are approximately one year in length. Graduates must pass a written state examination to become licensed as L.P.N.'s. Several L.P.N. to R.N. mobility educational programs exist in Indiana for individuals desiring to further their education (refer to Nursing 2000's LPN to RN Mobility Guide).
C.N.A. - Individuals seeking entry level positions as Certified Nurse Assistants (C.N.A.) attend an introductory course. The course, offered for several weeks in vocational and technical schools, includes classroom instruction and clinical experience. Graduates must pass a written state test and a skills exam to become certified.
Beyond R.N.
Certification Requirements
The eligibility requirements for certification can be obtained from the American Nurses Credentialing Center and from specialty organizations. (American Nurses Credentialing Center: Retrieved from http://www.nursingworld.org/ancc/.
Certification is reserved for those nurses who have met requirements for practice in a specialized field, pursued education beyond basic nursing preparation, and received the endorsement of their peers. After meeting these criteria, nurses take certification examinations based on nationally recognized standards of nursing practice to demonstrate their knowledge within the defined specialty. Following certification, credentials are added behind the R.N. initials.
Advanced Practice Nurses
As health care becomes more accessible to all U.S. citizens and residents through health care reform, there will be an increased need for Advanced Practice Nurses who provide primary care and advanced nursing services. Specialization and certification as an Advanced Practice Nurse (Nurse Practitioner, Clinical Specialist, Nurse Midwife, or Nurse Anesthetist) usually requires a Master's Degree or higher in nursing and state licensure.
Nurse Anesthetist
Nurse Midwife
Clinical Specialists:
- Acute Care
- Advanced Diabetes Management
- Adult Health
- Adult Psychiatric and Mental Health
- Child/Adolescent Psychiatric and Mental Health
- Gerontological
- Pediatric and Neonatal
- Public and Community Health
Nurse Practitioners:
- Acute Care Nurse Practitioners
- Adult Nurse Practitioners
- Adult Psychiatric and Mental Health Nurse Practitioner
- Advanced Diabetes Management Nurse Practitioner
- Family Nurse Practitioner
- Family Psychiatric and Mental Health Nurse Practitioner
- Gerontological Nurse Practitioner
- Neonatal Nurse Practitioner
- Pediatric Nurse Practitioner
- Women’s Health Care Nurse Practitionere
THE GENERAL AND SPECIFIC KNOWLEDGE REGISTERED NURSES HAVE IS EXTENSIVE
REFERENCES...
American Nurses Credentialing Center www.nursingworld.org/ancc
Nursing Center www.nursingcenter.com
National Certification Corporation www.nccnet.org
National League for Nursing www.nln.org
Nursing 2000 Central Indiana Region is funded by:
- Clarian Health Partners, Inc. -
Methodist * IU * Riley
- Community Hospitals Indianapolis
- St. Francis Hospital & Health Centers
- St. Vincent Indianapolis Hospital
- Wishard Health Services
Contributions by:
- Bloomington Hospital & Healthcare System
- Columbus Regional Health
- Dunn Memorial Hospital
- Hancock Regional Hospital
- Hendricks Regional Health
- Indiana Orthopedic Hospital
- Johnson Memorial Hospital
- Major Hospital
- Rehabilitation Hospital of Indiana
- Riverview Hospital
- St. Vincent Carmel Hospital
- Westview Hospital
- Witham Health Services
School of Nursing Affiliations:
- Indiana University
Ivy Tech Community College
Marion College
University of Indianapolis
Nursing 2000 Northern Indiana Region is funded by:
- Ls Porte Regional Healthcare System
- Memorial Hospital of South Bend
- Methodist Hospitals
- St. Anthony Memorial Health Center
- St. Joseph Regional Medical Centers
School of Nursing Affiliations:
- Ancilla College
- Bethel College
- Goshen College
- Indiana University Northwest
- Indiana University South Bend
- Ivy Tech Community College of Indiana at Gary
- Purdue University Calumet
- Purdue University North Central
- Saint Mary’s College
- Valparaiso University
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