Activities	Assess health problems and needs of patients, develop and implement nursing care plans, and maintain medical records. Administer nursing care to ill, injured, convalescent, or disabled patients. May advise patients on health maintenance and disease prevention. Licensing or registration is required.
Outlook	Faster-than-average-job growth
Median Income	$62,500 per year in 2008
Work Context & Conditions	Most nurses work in well-lit, comfortable health-care facilities. Home health and public health nurses travel to patients’ homes, schools, community centers, and other sites.
Minimum Education Requirements	Associate's Degree
Skills	Social Perceptiveness, Learning Strategies, Monitoring, Critical Thinking, Instructing, Active Listening, Writing, Service Orientation, Time Management, Active Learning, Judgment and Decision Making, Coordination, Reading Comprehension, Speaking, Science
Abilities	Oral Expression, Speech Recognition, Deductive Reasoning, Problem Sensitivity, Written Comprehension, Speech Clarity, Inductive Reasoning, Written Expression, Oral Comprehension
Interviews	Jean Jenkins Keisha Potter Kelly Richards

Job Category		Healthcare Practitioners & Technical
Job Description		Registered nurses (RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating patients and the public about various medical conditions, and providing advice and emotional support to patients’ family members. RNs record patients’ medical histories and symptoms, help to perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation. RNs teach patients and their families how to manage their illness or injury, including post-treatment home care needs, diet and exercise programs, and self-administration of medication and physical therapy. Some RNs also are trained to provide grief counseling to family members of critically ill patients. RNs work to promote general health by educating the public on various warning signs and symptoms of disease and where to go for help. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions. RNs can specialize in one or more patient care specialties. The most common specialties can be divided into roughly four categories—by work setting or type of treatment; disease, ailment, or condition; organ or body system type; or population. RNs may combine specialties from more than one area—for example, pediatric oncology or cardiac emergency—depending on personal interest and employer needs. RNs may specialize by work setting or by type of care provided. For example, ambulatory care nurses, critical care nurses, emergency, or trauma nurses, holistic nurses (treat patients’ mental and spiritual health in addition to their physical health), home health care nurses, hospice and palliative care nurses, infusion nurses (administer medications), long- term care nurses, medical-surgical nurses, occupational health nurses, perianesthesia nurses, perioperative nurses (assist surgeons ), psychiatric nurses, rehabilitation nurses, and transplant nurses (care for both transplant recipients and living donors). RNs specializing in a particular disease, ailment, or condition are employed in virtually all work settings, including physicians’ offices, outpatient treatment facilities, home health care agencies, and hospitals. Examples are addictions nurses, developmental disabilities nurses, diabetes management nurses, genetics nurses (provide early detection screenings), HIV/AIDS nurses, oncology nurses, and finally, wound, ostomy, and continence nurses. RNs specializing in treatment of a particular organ or body system usually are employed in specialty physicians’ offices or outpatient care facilities, although some are employed in hospital specialty or critical care units. For example: cardiac and vascular nurses, dermatology nurses, gastroenterology nurses, gynecology nurses, nephrology nurses, neuroscience nurses, ophthalmic nurses, otorhinolaryngology nurses (care for patients with ear, nose, and throat disorders), respiratory nurses, and urology nurses. Finally, RNs may specialize by providing preventive and acute care in all health care settings to various segments of the population, including newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). RNs also may provide basic health care to patients outside of health care settings in such venues as including correctional facilities, schools, summer camps, and the military. Some RNs travel around the United States and abroad providing care to patients in areas with shortages of medical professionals. Most RNs work as staff nurses, providing critical health care services along with physicians, surgeons, and other health care practitioners. However, some RNs choose to become advanced practice nurses, who often are considered primary health care practitioners and work independently or in collaboration with physicians. For example, clinical nurse specialists provide direct patient care and expert consultations in one of many of the nursing specialties listed above. Nurse anesthetists administer anesthesia, monitor patient’s vital signs during surgery, and provide post-anesthesia care. Nurse midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. Nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. The most common areas of specialty for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and gerontology; however, there are many other specialties. In most States, advanced practice nurses can prescribe medications.
Working Conditions		Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients’ homes, schools, community centers, and other sites. RNs may spend considerable time walking and standing. Patients in hospitals and nursing care facilities require 24-hour care; consequently, nurses in these institutions may work nights, weekends, and holidays. RNs also may be on call—available to work on short notice. Nurses who work in office settings are more likely to work regular business hours. About 23 percent of RNs worked part time in 2006, and 7 percent held more than one job. Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may care for individuals with infectious diseases. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs who work with critically ill patients also may suffer emotional strain from observing patient suffering and from close personal contact with patients’ families.
Salary Range		Median annual earnings of registered nurses were $62,500 in 2008. The middle 50 percent earned between $51,600 and $76,600. The lowest 10 percent earned less than $43,400, and the highest 10 percent earned more than $92,200. Median annual earnings in the industries employing the largest numbers of registered nurses in 2008 were as follows: employment services ($68,160), general medical and surgical hospitals ($63,880), home health care services ($58,740), offices of physicians ($59,210) and nursing care facilities ($57,060). Many employers offer flexible work schedules, childcare, educational benefits, and bonuses.

Education Required		There are three major educational paths to registered nursing: A bachelor’s of science degree in nursing (BSN), an associate degree in nursing (ADN), and a diploma. BSN programs, offered by colleges and universities, take about 4 years to complete. Generally, licensed graduates of any of the three types of educational programs qualify for entry-level positions as staff nurses. There are hundreds of registered nursing programs that result in an ADN or BSN; however, there are relatively few diploma programs. Many RNs with an ADN or diploma later enter bachelor’s programs to prepare for a broader scope of nursing practice. Often, they can find a staff nurse position and then take advantage of tuition reimbursement benefits to work toward a BSN by completing an RN-to-BSN program. Accelerated BSN programs also are available for individuals who have a bachelor’s or higher degree in another field and who are interested in moving into nursing. Individuals considering nursing should carefully weigh the advantages and disadvantages of enrolling in a BSN program, because, if they do, their advancement opportunities usually are broader. In fact, some career paths are open only to nurses with a bachelor’s or master’s degree. A bachelor’s degree often is necessary for administrative positions and is a prerequisite for admission to graduate nursing programs in research, consulting, and teaching, and all four advanced practice nursing specialties—clinical nurse specialists, nurse anesthetists, nurse midwives, and nurse practitioners. Individuals who complete a bachelor’s receive more training in areas such as communication, leadership, and critical thinking, all of which are becoming more important as nursing care becomes more complex. Additionally, bachelor’s degree programs offer more clinical experience in non-hospital settings. All four advanced practice nursing specialties require at least a master’s degree. Most programs last about 2 years and require a BSN degree and some programs require at least 1 to 2 years of clinical experience as an RN for admission. All nursing education programs include classroom instruction and supervised clinical experience in hospitals and other health care facilities. Students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology and other behavioral sciences, and nursing. Coursework also includes the liberal arts for ADN and BSN students. Supervised clinical experience is provided in hospital departments such as pediatrics, psychiatry, maternity, and surgery. A growing number of programs include clinical experience in nursing care facilities, public health departments, home health agencies, and ambulatory clinics.
Recommended High School Courses		Biology, Mathematics, Chemistry, Health
Postsecondary Instructional Programs		Education and Training, English Language, Psychology, Sociology and Anthropology, Mathematics, Therapy and Counseling, Biology, Customer and Personal Service, Medicine and Dentistry
Certification and Licensing		In all States and the District of Columbia, students must graduate from an approved nursing program and pass a national licensing examination, known as the NCLEX-RN, in order to obtain a nursing license. Nurses may be licensed in more than one State, either by examination or by the endorsement of a license issued by another State. Currently 20 States participate in the Nurse Licensure Compact Agreement, which allows nurses to practice in member States without recertifying. All States require periodic renewal of licenses, which may involve continuing education.

Interest Area		Social Involves working and communicating with, helping, and teaching people.
Work Values		Achievement Get a feeling of accomplishment. Social Service Do things for other people. Security Have steady employment. Ability Utilization Make use of individual abilities. Co-workers Have co-workers who are easy to get along with. Activity Busy all the time.
Skills		Social Perceptiveness Be aware of others' reactions and understand why they react the way they do. Learning Strategies Use multiple approaches when learning or teaching new things. Monitoring Assess how well someone is doing when learning or doing something. Critical Thinking Use logic and analysis to identify the strengths and weaknesses of different approaches. Instructing Teach others how to do something. Active Listening Listen to what other people are saying and ask questions as appropriate. Writing Communicate effectively with others in writing as indicated by the needs of the audience. Service Orientation Actively look for ways to help people. Time Management Manage one's own time and the time of others. Active Learning Work with new material or information to grasp its implications. Judgment and Decision Making Be able to weigh the relative costs and benefits of a potential action. Coordination Adjust actions in relation to others' actions. Reading Comprehension Understand written sentences and paragraphs in work-related documents. Speaking Talk to others to effectively convey information. Science Use scientific methods to solve problems.
Abilities		Oral Expression Able to convey information and ideas through speech in ways that others will understand. Speech Recognition Identify and understand the speech of another person Deductive Reasoning Able to apply general rules to specific problems to come up with logical answers, including deciding whether an answer makes sense. Problem Sensitivity Able to tell when something is wrong or likely to go wrong. This doesn't involve solving the problem, just recognizing that there is a problem. Written Comprehension Able to read and understand information and ideas presented in writing. Speech Clarity Able to speak clearly so listeners understand. Inductive Reasoning Able to combine separate pieces of information, or specific answers to problems, to form general rules or conclusions. This includes coming up with a logical explanation for why seemingly unrelated events occur together. Written Expression Able to communicate information and ideas in writing so others will understand. Oral Comprehension Able to listen to and understand information and ideas presented through spoken words and sentences.

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Job Outlook		As the largest health care occupation, registered nurses held about 2.6 million jobs in 2008. About 60 percent were in hospitals, in inpatient and outpatient departments. Others worked in offices of physicians, nursing care facilities, home health care services, employment services, government agencies, and outpatient care centers. The remainder worked mostly in social assistance agencies and educational services, public and private. Job opportunities for RNs in all specialties are expected to be excellent. Employment of registered nurses is expected to grow much faster than average for all occupations through 2018, and, because the occupation is very large, many new jobs will result. In fact, registered nurses are projected to create the second largest number of new jobs among all occupations. Thousands of job openings also will result from the need to replace experienced nurses who leave the occupation, especially as the median age of the registered nurse population continues to rise. Much faster-than-average growth will be driven by technological advances in patient care, which permit a greater number of medical problems to be treated, and by an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly. Employers in some parts of the country and in certain employment settings are reporting difficulty in attracting and retaining an adequate number of RNs, primarily because of an aging RN workforce and a lack of younger workers to fill positions. Even though employment opportunities for all nursing specialties are expected to be excellent, they can vary by employment setting. For example, employment is expected to grow more slowly in hospitals—which comprise health care’s largest industry—than in most other health care industries. While the intensity of nursing care is likely to increase, requiring more nurses per patient, the number of inpatients (those who remain in the hospital for more than 24 hours) is not likely to grow by much. Patients are being discharged earlier, and more procedures are being done on an outpatient basis, both inside and outside hospitals. Rapid growth is expected in hospital outpatient facilities, such as those providing same-day surgery, rehabilitation, and chemotherapy. Despite the slower employment growth in hospitals, job opportunities should still be excellent because of the relatively high turnover of hospital nurses.To attract and retain qualified nurses, hospitals may offer signing bonuses, family-friendly work schedules, or subsidized training. A growing number of hospitals also are experimenting with online bidding to fill open shifts, in which nurses can volunteer to fill open shifts at premium wages. This can decrease the amount of mandatory overtime that nurses are required to work. More and more sophisticated procedures, once performed only in hospitals, are being performed in physicians’ offices and in outpatient care centers, such as freestanding ambulatory surgical and emergency centers. Accordingly, employment is expected to grow much faster than average in these places as health care in general expands. Employment in nursing care facilities is expected to grow faster than average because of increases in the number of elderly, many of whom require long-term care. Employment in home health care is expected to increase rapidly in response to the growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home. Generally, RNs with at least a bachelor’s degree will have better job prospects than those without a bachelor’s. In addition, all four advanced practice specialties—clinical nurse specialists, nurse practitioners, midwives, and anesthetists—will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. Relative to physicians, these RNs increasingly serve as lower-cost primary care providers.
More Information		American Association of Critical-Care Nurses (Houston Chapter) - Nurse Recruitment in Public Schools, American Association of Critical Care Nurses, American Association of Colleges of Nursing, National League for Nursing, American Nurses Association, ExceptionalNurse.com (Nursing Students with Disabilities)
References		Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Registered Nurses, on the Internet at http://www.bls.gov/oco/ocos083.htm O*NET OnLine, on the Internet at http://online.onetcenter.org/link/summary/29-1111.00