Nurses are with patients at every step of the healthcare experience, working hard to understand what each person needs while striving to treat everyone as an individual. As well as being dedicated to clinical excellence and remaining compassionate, nurses must continue learning throughout their careers. Keeping up to date with the latest digital advances and medical innovations means they can ensure the best patient outcomes.
How many registered nurses work in the USA?
Over three million people work as nurses in the US part-time and full-time. In each healthcare facility, the nursing team encompasses a diverse range of professionals. They come from various parts of the globe, with many backgrounds and cultures represented in the average hospital workforce.
Where do nurses work?
Nurses work in many different settings across the healthcare system and beyond. Most are employed in surgical or general medical hospitals, although many work in physician’s offices. There are also positions in outpatient nursing facilities, homecare agencies, schools, and government departments. Nurses at all practice levels can choose where they work; some are even employed by the legal profession as nurse lawyers, acting as expert witnesses during a trial.
Is the nursing process the same for all?
In each area of nursing, the method used to deliver patient care is the same. Often referred to as the nursing process, it consists of five basic steps that should be carried out in sequence. The first step is assessment. Here nurses evaluate their patients on several levels; these include their lifestyle and their economic, social and physiological situation. Next, after considering the patient’s behavior and physical symptoms, they move to a diagnosis. Once that is complete, they map out their patient’s recovery. Remaining realistic, they establish goals for improvement that are regularly monitored. The fourth step is implementation. Nurses put the plan they consistently made into practice while documenting their work. Finally, they take a step back and evaluate. They consider how effective the care plan was and how the patient responded and make adjustments to ensure the best possible outcome.
The work of registered nurses
Registered nurses provide healthcare services wherever needed at the frontline of nursing across the United States. They carry out physical examinations and study a patient’s health history to do this effectively. They also provide medications or administer other forms of treatment and educate their patients about a healthy lifestyle. They are licensed to make some of the critical decisions which have a considerable impact on a patient’s healthcare journey.
Finally, depending on the setting, RNs are often asked to coordinate aspects of a patient’s care by collaborating with a wider team of clinical professionals. Graduates in a different field hoping to become registered nurses can take the accelerated nursing program at Elmhurst University and qualify in 16 months. This course equips students with the knowledge and experience they need to provide exceptional patient care by combining a supported clinical placement with an online study.
Advanced practice registered nurses.
By choosing to take a master’s degree after their bachelor’s degree, experienced nurses can become advanced practice registered nurses. Once trained and assessed, their scope of practice expands to include many additional responsibilities. These include delivering primary and preventative care to all ages. However, as they have worked to acquire expert clinical knowledge and competencies, they have more authority in assessing and treating patients. Their work is likely to include the autonomous management of chronic diseases and conditions, although they will also work with other clinicians or make referrals.
Educators and researchers
Advanced practice registered nurses is also expected to take on an advisory role that benefits patients, their families, and their carers. This extends to teaching and training colleagues in new practices and methods which could improve patient outcomes. Finally, some APRNs choose to undertake research linked to their role in the hospital or clinic.
Specialist roles in advanced practice
Within advanced practice nursing, there are several specialisms that graduates can follow. In each, these more senior registered nurses perform quite different daily tasks.
Nurse practitioners
Someone working as a nurse practitioner might diagnose their patient’s condition and prescribe the medication they need. They will treat the illness a person has and tend to their injuries. Alternatively, they may refer patients to a senior consultant or order diagnostic tests. They often manage a patient’s general care single-handedly, along with providing information on lifestyle choices and healthy living. They work in most areas of healthcare, practicing in their clinic, schools, hospitals, and public health departments.
Clinical nurse specialists
Clinical nurse specialists manage patients with mental or physical health problems. They will also work on research projects and may help control the healthcare provision in their facility. They are found in almost every area of general medicine, from the pediatric ward to pain management and oncology.
Certified registered nurse anesthetists
Certified registered nurse anesthetists practice in all 50 states; of the 26 million anesthetics given to US patients over a year, they administer around 65%. They can also work as educators and researchers or assist with managing a department.
Certified nurse-midwives
Registered nurses who are certified nurse-midwives deliver obstetrical and gynecological care. They may also work alongside obstetricians to assist male and female patients experiencing reproductive problems or suffering from sexually transmitted diseases.
What is a typical day for nurses across the healthcare system?
There are many roles for senior and general RNs in the US healthcare system. Here’s a look at what some of them do.
Primary care nurse
Often considered a general health role, nurses need a comprehensive knowledge base to work in primary care. Over a working day, they must remain highly organized and prioritize their tasks to work efficiently. Each day can be different from the last, and the ability to adapt is crucial. Post-COVID-19, they often help patients over the phone without a visual assessment. That means asking the right questions and choosing whether to refer a patient for further treatment. Their work also includes administering specific treatments, such as childhood immunizations or IV therapy. As part of this process, they act as an advocate for patients and can provide resources to educate them and their families. Once a care plan has been established, they ensure it is individualized for the patient and evaluate how well it works.
Visiting patients in the community
Working face-to-face with patients is part of the job for many primary care nurses. This could take rolling out vaccination programs to all ages or holding a hypertension clinic in a rural facility. While they are out, nurses teach patients more about their condition and give them tips on managing it themselves. Medical reconciliation is another crucial part of their work; this involves talking with patients about their prescriptions, providing advice, and ensuring the medicines are taken correctly. Finally, so patients can avoid lengthy hospital visits, primary care nurses can carry out screening tests, suture cuts, and manage wounds.
Coordinating a care package
When patients are first discharged from the hospital, they often need to be monitored. Primary care nurses work to coordinate any additional care services they need and make a follow-up call within 48hrs to ensure they are doing well. This phone call represents far more than a chat, as nurses need to use all their experience to educate patients on self-care to reduce their risk of being readmitted. They can also advise patients on accessing a Meals on Wheels service or home help where appropriate.
Communicating with the team
As in any big organization, teamwork ensures that day-to-day processes remain efficient. In primary care, nurses need to support professionals from other departments to provide patients with the best possible treatment. As they explain more about each patient, they need excellent communication skills to ensure nothing is missed and there is no break in care.
Acute care nurse
Acute care nursing is sometimes referred to as secondary care because patients have already been through primary care. It is a highly specialized field that centers on caring for patients with complex and severe conditions. Most of the people treated by acute care nurses will also be under the watch of a senior consultant. They work mainly in an inpatient setting, such as a hospital or specialist clinic. That is because their patients need intensive care of some sort, even though their vital signs are stable. People admitted to the hospital suffering from pneumonia, cancer, broken bones, or sudden bouts of infection will all be placed in an acute care ward.
Assisting in an emergency
Each day acute care nurses will perform many different tasks. These include assessing and monitoring a patient’s condition, adapting a care plan, and administering medication. Using ventilators, monitors, and other specialist equipment, they will check a patient is responding well. This means they are often the first person on the scene when a patient becomes better or starts feeling worse. They must be confident in giving emergency first aid or calling a family to report an improvement, so the ability to switch between roles quickly is essential.
Communicating with patients and professionals
This is a fluid role in which nurses must think quickly and provide accurate information to their colleagues, often in stressful situations. Moreover, they meet numerous patients who may feel nervous or distressed, so showing compassion is vital. Finally, they may also be asked to help patients who are experiencing a mental health crisis or those who have dementia. In both cases, they need to understand what is wrong and try to communicate effectively with the patient.
Mental health nurses
Registered mental health nurses provide medical and clinical care to patients experiencing various problems. These include eating disorders, social anxiety, personality disorders, and depression. Many situations they face daily are challenging, but their verbal and non-verbal communication skills allow them to care for distressed patients.
Delivering care in a crisis
When patients are first brought into the facility, they are screened and evaluated as part of the triage process. They work with individuals and as part of a team to help each patient reach their recovery goal. Nurses will also work with interdisciplinary teams to establish treatment regimens and then administer these to the patient. They may have to stage a crisis intervention if a patient deteriorates to help them to stabilize.
Educating and empowering patients
Once a patient begins to heal, mental health nurses remain engaged by providing self-care education and helping those in their care manage their condition. They can also assist the family and community around a patient by providing educational materials and guidance. As well as working in hospitals and the community, they can be employed in outpatient facilities, mental health clinics, and residential care homes.
Developmental disability Nurses
Occasionally referred to as special needs nurses, developmental disability nurses deliver care to patients with intellectual challenges and various developmental disabilities. They are trained to help patients with mobility, communication, and nutritional needs. As well as providing direct care regarding bathing, eating, and bodily functions, they manage cases and ensure appropriate care plans. They work with all ages, doing so in coordination with other healthcare providers, so patients enjoy continual care as required.
Being an advocate
Developmental disability nurses work in hospitals, home healthcare, and specialist facilities. Patients with developmental disabilities can be vulnerable, so nurses in this field are skilled advocates. They listen to and educate the patient and their family regarding care options to ensure the outcomes are as positive as possible.
Ensuring schools are inclusive
Many schools have a special needs nurse to identify how students living with a disability can be accommodated. They work with a team to develop educational action plans and remove any barriers to learning a student may have. These RNs can also help train assistants and teachers to carry out the action plan. Finally, depending on the young person’s needs, they may also give medication or manage a feeding tube. Occasionally one nurse is assigned to a single student to work their care closely.
Pediatric Nurses
Pediatric nurses take care of children from the time they are born until they reach the age of eighteen. Their skills in dealing with children set them apart from other healthcare professionals. As children cannot always articulate what is wrong, nurses need expertise, patience, and empathy. Caring for sick children can be emotionally challenging, but it is also highly satisfying. Daily, pediatric nurses will carry out direct care tasks such as assessing their young patients, administering medicine, and offering standard bedside care. They monitor temperature, blood pressure, and pulse rate and may also need to take a blood or urine sample.
Helping to rehabilitate younger patients
Pediatric nurses give advanced rehabilitation and therapeutic care when patients have chronic illnesses. This could include speech, physical or occupational therapy. Alternatively, they might set up the equipment needed to support a child, such as a ventilator or an oxygen tank. In this field, as in others, communication skills are essential. They need to give worried children plenty of emotional support, keep the family up to date on the treatment plan and work closely with other professionals to maintain the standard of care high.
A special kind of nursing
Pediatric RNs perform the same tasks as other ward nurses, but as they work with children, they must take extra care. They must treat each patient age-appropriately and speak in a way they will understand. Hospitals can intimidate adults so that the experience can be particularly confusing for children. A nurse’s role is to reassure each child and adapt care to the patient’s unique needs.
Every role in nursing is different.
Throughout their training, nurses are taught a complex range of skills and often go on to become certified in one of many specialties. Therefore, there is no straightforward answer regarding what nurses do. Each professional nurse has specific areas of expertise, knowledge, and personal strengths. In line with these, their responsibilities can range from vaccinating children at school to making decisions about emergency treatments. However, a few characteristics unify all working and retired nurses. Primarily, they have the passion and the motivation required to do the job. Secondly, they have enough ambition to complete the extensive education needed to qualify as a registered nurse.
