Registered nurses

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Registered nurses promote health, prevent disease and help patients cope with illness. They are advocates and health educators. 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. Some RNs also develop and manage nursing care plans.

Hospital nurses form the largest group of nurses. Most are staff nurses, who provide bedside nursing care and carry out medical regimens. Hospital nurses usually are assigned to one area, such as surgery, maternity, pediatrics, emergency room, intensive care or treatment of cancer patients.

Office nurses care for outpatients in physicians' offices, clinics, surgicenters and emergency medical centers. They prepare patients for and assist with examinations, administer injections and medications, dress wounds and incisions, assist with minor surgery and maintain records.

Nursing home nurses manage nursing care for residents with conditions ranging from a fracture to Alzheimer's disease.

Home health nurses provide periodic services to patients at home. After assessing patients' home environments, they care for and instruct patients and their families.

Public health nurses work in government and private agencies and clinics, schools, retirement communities and other community settings. They instruct individuals, families and groups regarding health issues, disease prevention, nutrition and child care. They arrange for immunizations, blood pressure testing and other health screening.

Occupational health or industrial nurses provide nursing care at worksites to employees, customers and others with minor injuries and illnesses. They also offer health counseling, assist with health examinations and inoculations and assess work environments to identify potential health or safety problems.

Head nurses or nurse supervisors direct nursing activities. They plan work schedules and assign duties to nurses and aides, provide or arrange for training and visit patients to observe nurses and to ensure the proper delivery of care.

At the advanced level, nurse practitioners provide basic primary health care. They diagnose and treat common acute illnesses and injuries. Nurse practitioners can prescribe medications. Other advanced practice nurses include clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives.

Nurses may spend considerable time walking and standing. They need emotional stability to cope with human suffering, emergencies and other stresses. Many nurses work nights, weekends and holidays.

Training and qualifications

In all states and the District of Columbia, students must graduate from an approved nursing program and pass a national licensing examination to obtain a nursing license. All states require periodic license renewal, which may involve continuing education.

There are three major educational paths to registered nursing. Associate's degree in nursing (A.D.N.) programs, offered by community and junior colleges, take two to three years. Bachelor's degree in nursing (B.S.N.) programs, offered by colleges and universities, take four or five years. Diploma programs, administered in hospitals, last two to three years. Licensed graduates of any of the three program types qualify for entry-level positions as staff nurses, but graduates of a B.S.N. program generally have broader advancement opportunities.

Graduate programs preparing executive-level nurses usually last one to two years. Within patient care, nurses can advance to clinical nurse specialist, nurse practitioner, certified nurse-midwife or certified registered nurse anesthetist. These positions require one or two years of graduate education, leading to a master's degree or, in some instances, to a certificate.

Nurses should be caring and sympathetic. They must be able to accept responsibility, direct or supervise others, follow orders precisely and determine when consultation is required.

Job outlook

Job opportunities for RNs should be excellent, particularly for nurses with advanced education and training. Employment of registered nurses is expected to grow faster than the average for all occupations through 2010. Some states report current and projected shortages of RNs, which should spur efforts to attract and retain qualified RNs. For example, employers may restructure workloads, improve compensation and working conditions and subsidize training or continuing education.

Employment in hospitals, the largest sector, is expected to grow more slowly than in other health-care sectors because the number of inpatients is not likely to increase much. However, rapid growth is expected in hospital outpatient facilities.

Employment in home health care is expected to grow rapidly. Employment in nursing homes is expected to grow faster than average as the number of elderly grows. And with an increasing proportion of sophisticated procedures being performed in physicians' offices and clinics, employment is expected to grow faster than average in those places.

Earnings

As the largest health-care occupation, registered nurses held about 2.2 million jobs in 2000. About three of five jobs were in hospitals. Median annual earnings of registered nurses were $44,840 in 2000. Median annual earnings in the industries employing the largest numbers of registered nurses in 2000 were as follows:

Personnel supply services $46,860
Hospitals 45,780
Home health care services 43,640
Offices and clinics of medical doctors 43,480
Nursing and personal care facilities 41,330

Related links

For information on a career as a registered nurse and nursing education:

National League for Nursing, 61 Broadway, New York, NY 10006.

For information on registered nurses :

American Nurses Association, 600 Maryland Ave. SW, Washington, DC 20024-2571.

Adapted from the Labor Department's Occupational Outlook Handbook.