Nursing Career Overview
This article provides an overview of nursing careers and the requirements to become a nurse. There are two types of nurses discussed in this article: Registered Nurses (RNs), and Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs).
While the two positions are similar, there are substantial differences in educational requirements and job responsibilities. RNs constitute the larger of the two occupations and the single largest healthcare occupation in the United States with in excess of 2.3 million jobs. In contrast, there are a little over 700,000 LPNs in the United States.
This article will outline both nursing professions, their job duties, salary levels, and employment prospects, as well as discuss the career's necessary skills, training, educational requirements, and licensing requirements to become a nurse.
Job Duties
The RN and LPN jobs are very similar. They work in the same types of healthcare facilities. Their job functions can also become very similar. In general, though, RNs have more responsibility and authority than do LPNs. Some of the more common job duties for RNs include:
- Providing direct patient care including observing, assessing, and recording symptoms and progress in patients.
- Assisting doctors during surgeries, treatments, and examinations.
- Diagnosing and treating common illnesses and injuries.
- Administering medications.
- Prescribing medications depending on state certification and licensing requirements.
- Developing and implementing care plans.
- Educating patients on specific health care tasks and/or educating groups on steps to improve or maintain their health.
- Supervising LPNs and nurses aides.
- Supervising nursing activities, planning work schedules, and assigning duties. These activities are common for head nurses or nurse supervisors, but not all nurses in general.
LPNs tend to handle more of the basic patient healthcare needs under the direction of doctors and RNs. The job duties of an LPN include:
- Basic bedside care and monitoring of patients, including taking vital signs (temperature, blood pressure, pulse, and respiration) and monitoring food and fluid intake and output.
- Collecting samples for testing and performing routine laboratory tests.
- Helping to feed patients.
- Helping to keep patients comfortable by performing massages or alcohol rubs, and assisting with personal hygiene needs, such as bathing or dressing.
- Administering medications, and starting intravenous fluids in states where this allowed.
- Developing and implementing care plans.
- Supervising nurses aides.
Many of the specific daily responsibilities of a nurse will be dictated by their specific work setting.
- Hospital nurses make up the largest group of nurses. Hospital nurses are usually assigned to one department. They are responsible for bedside nursing care and carry out healthcare regimens.
- Offices nurses work in outpatient facilities such as physicians' offices, clinics, ambulatory care facilities, surgical centers, and emergency medical centers. Their duties are more oriented toward preparation for and assistance with examinations, administration of medications and injections, dressing of wounds, assistance with minor surgery, and records maintenance.
- Nurses that work within nursing care facilities manage care for residents, ranging from those recovering from fractures or other disabling injuries, to elders or those with Alzheimer's disease. They assess and monitor resident's health, and develop and monitor treatment plans. Their duties may also include a fair amount of administrative and supervisory work.
- Home health nurses provide nursing care for patients in their homes dealing with a very wide range of health issues.
- Public health nurses work in the government, schools, clinics and other community settings where they tend to populations, working to improve the overall health of the community at large.
- Occupational health nurses work at work sites. They give emergency care, prepare accident reports, and arrange for additional necessary care.
- Head nurses or nurse supervisors manage nurses and nurses aides. They plan work schedules and assign duties, deliver or arrange for training, and observe nurse/patient interactions. They also make sure that records are kept in an accurate and timely manner and may have responsibility for ordering supplies.
Job Skills
Nursing is a physically and emotionally demanding job. Nurses need to be caring, sympathetic, and able to empathize with patients. They also need to be able to deal with the stress of critical and demanding situations and the emotional strain of dealing with sick, injured, and even dying patients. Nurses require good observational skills, communication skills, and the ability to make decisions based on the assimilation and evaluation of information.
Nurses also need management skills to, at a minimum, be able to manage nurses aides. Head nurses and nurse supervisors require additional leadership and administrative skills as well as negotiating skills and, potentially, budgeting and financial skills.
Income
As of 2002, salaries for RNs were around $48,090, with the top 10% earning more than $69,670. Salaries for LPNs were around $31,440 with the top 10% earning more than $44,040. Earnings for nurses (both RNs and LPNs) vary by industry segment with the median annual incomes for the industries employing the largest number of nurses being:
Industry Median Salary
for RN Median Salary
for LPN
Employment services $55,980 $40,550
Medical and surgical hospitals $49,190 $30,310
Home health care services $45,890 $32,850
Physicians offices $44,870 $28,710
Nursing care facilities $43,850 $32,220
Many nursing employers also offer bonuses, flexible work schedules, childcare, and education benefits. About 1 in 5 RNs works part time.
Training and Education Required
LPN training programs last about 1 year and include both classroom study and supervised clinical practice (caring for patients). In 2002, there were approximately 1,100 State-approved LPN training programs. The majority of LPNs get their training from technical or vocational schools. All 50 states and the District of Columbia require that LPNs pass a licensing examination (NCLEX-PN from The National Council of State Boards of Nursing or NCSBN). States require that LPN licenses be renewed. The time frame for renewal varies by state. Many states also have continuing education requirements as a requirement for license renewal. States may also have other state-specific requirements. Individuals interested in becoming an LPN should contact the Board of Nursing for their state to better understand the licensing requirements.
The requirements to become a Registered Nurse are more rigorous. All 50 States and the District of Columbia require that Registered Nurse candidates obtain a nursing degree from an approved nursing program. There are three educational paths that students may take to obtain a nursing degree:
1. A bachelor of science degree in nursing (BSN). Bachelor of science degree in nursing programs typically take 4 years to complete. In 2002, there were 678 nursing schools in the United States that offered BSN degrees. There are also more than 110 accelerated BSN programs for individuals who already have a bachelor's or higher degree in another field. These programs typically last 12 to 18 months.
2. An associate degree in nursing (ADN). Associate degree in nursing programs, which are typically offered by community and junior colleges, take about 2 to 3 years to complete. In 2002, there were about 700 such programs in the United States.
3. A diploma. Diploma programs are offered in hospitals and typically last about 3 years. There are only a small and declining number of such programs.
Advancement opportunities are typically broader for graduates of BSN programs. Many positions, such as nursing management positions, require a bachelor of science degree in nursing. There are RN-to-BSN programs allowing practicing RNs to complete a bachelor of science degree in nursing program while they are already working in the field. Taking such a route to a bachelor of science degree in nursing may allow an individual to take advantage of employer education reimbursement programs.
All Registered Nurse programs require both classroom study and supervised clinical experience in hospital departments. All 50 states and the District of Columbia require that RNs pass a licensing examination (NCLEX-RN from The National Council of State Boards of Nursing or NCSBN). States require that Registered Nurse licenses be renewed. The time frame for renewal varies by state. Many states also have continuing education requirements as a requirement for license renewal. States may also have other state-specific requirements. Individuals interested in becoming an registered nurse should contact the Board of Nursing for their state to better understand the licensing requirements.
Increasingly, advanced degrees are becoming a requirement for those who are seeking management level nursing positions.
Many different colleges and universities provide the training required to become a nurse. A good list of such institutions can be found on this page of college and universities offering information on Nursing Schools and related training.
Employment
There are a very large number of people employed as nurses in the United States. In 2002, there were 2.3 million Registered Nurses and about 702,000 LPNs. Of that, the largest percentage work in hospitals with almost 60% of RNs and 26% of LPNs working in hospital settings. The other big employers of nurses include nursing care facilities, home health care services, and doctor's offices.
Outlook
Through most of the next decade, the need for LPNs is expected to grow about as fast as the need for all other occupations. The outlook for Registered Nurses is more promising. Throughout most of the next decade the need for RNs is very good with employment expected to grow faster than the average for all occupations. In fact, according to the Bureau of Labor Statistics, more new jobs are expected to be created for Registered Nurses than any other occupation.
The outlook for nursing job growth does vary by industry segment. Growth by industry segment can be expected as follows:
* Hospitals - Nursing job growth in hospitals is expected to be slower than other segments of the healthcare industry. It is expected that the number of hospital jobs for LPNs will actually decline.
* Hospital outpatient facilities - Facilities such as those that provide same-day surgery, rehabilitation, and chemotherapy are expected to see rapid growth in nursing jobs.
* Free-standing outpatient facilities and physicians offices - Since more sophisticated procedures are now being performed outside of the traditional hospital setting, nursing job growth in this segment is expected to be higher than average.
* Nursing care facility - With the aging of the US population, the availability of nursing jobs in nursing care facilities is expected to grow rapidly.
In general, one can expect the need for nurses to expand dramatically for the foreseeable future.
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