About 193,100 openings for registered nurses are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Critical care nurses work in intensive-care units in hospitals, providing care to patients with serious, complex, and acute illnesses and injuries that need close monitoring and treatment.
Public health nurses promote public health by educating people on warning signs and symptoms of disease or managing chronic health conditions. They may also run health screenings, immunization clinics, blood drives, or other community outreach programs.
Some nurses do not work directly with patients, but they must still have an active registered nurse license. For example, they may work as nurse educators, healthcare consultants, or hospital administrators.
Clinical nurse specialists (CNSs) are a type of advanced practice registered nurse (APRN). They provide direct patient care in one of many nursing specialties, such as psychiatric-mental health or pediatrics. CNSs also provide indirect care by working with other nurses and medical staff to improve the quality of care that patients receive. They often serve in leadership roles and may educate and advise other nursing staff. CNSs also may conduct research and may advocate for certain policies.
The work of registered nurses may put them in close contact with people who have infectious diseases, and they frequently come into contact with potentially harmful and hazardous drugs and other substances. Therefore, registered nurses must follow strict guidelines to guard against diseases and other dangers, such as accidental needle sticks and exposure to radiation or to chemicals used in creating a sterile environment.
Registered nurses must have a nursing license issued by the state in which they work. To become licensed, nurses must graduate from an approved nursing program and pass the National Council Licensure Examination (NCLEX-RN).
Most registered nurses begin as staff nurses in hospitals or community health settings. With experience, good performance, and continuing education, they can move to other settings or be promoted to positions with more responsibility.
In management, nurses may advance from assistant clinical nurse manager, charge nurse, or head nurse to more senior-level administrative roles, such as assistant director or director of nursing, vice president of nursing, or chief nursing officer. Increasingly, management-level nursing positions require a graduate degree in nursing or health services administration. Administrative positions require leadership skills, communication ability, negotiation skills, and good judgment.
The median annual wage for registered nurses was $81,220 in May 2022. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $61,250, and the highest 10 percent earned more than $129,400.
Demand for healthcare services will increase because of the large number of older people, who typically have more medical problems than younger people. Registered nurses also will be needed to educate and care for patients with chronic conditions, such as diabetes and obesity.
Job growth is expected across most types of healthcare settings, including hospitals and outpatient care centers that provide same-day services, such as chemotherapy, rehabilitation, and surgery. In addition, because many older people prefer to be treated at home or in residential care facilities, registered nurses will be in demand in those settings.
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Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life.[1] Nurses can be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Nurses comprise the largest component of most healthcare environments;[2][3] but there is evidence of international shortages of qualified nurses.[4] Nurses collaborate with other healthcare providers such as physicians, nurse practitioners, physical therapists, and psychologists. There is a distinction between nurses and nurse practitioners; in the U.S., the latter are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications unlike the former. They practice independently in a variety of settings in more than half of the United States. Since the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.[5][6]
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family, and other team members that focuses on treating illness to improve quality of life. In the United Kingdom and the United States, clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe the correct medications and other therapies, depending on particular state regulations.[7] Nurses may help coordinate the patient care performed by other members of a multidisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals. In addition to providing care and support, nurses educate the public and promote health and wellness.[8]
Nursing historians face challenges of determining whether care provided to the sick or injured in antiquity is called nursing care.[9] In the fifth century BC, for example, the Hippocratic Collection in places described skilled care and observation of patients by male "attendants," who may have been early nurses.[10] Around 600 BC in India, it is recorded in Sushruta Samhita, Book 3, Chapter V about the role of the nurse as "the different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examining its different parts."
Before the foundation of modern nursing, members of religious orders such as nuns and monks often provided nursing-like care.[11] Examples exist in Christian,[12] Islamic,[13] and Buddhist[14] traditions amongst others. Phoebe, mentioned in Romans 16 has been described in many sources as "the first visiting nurse".[15][16] These traditions were influential in the development of the ethos of modern nursing. The religious roots of modern nursing remain in evidence today in many countries. One example in the United Kingdom is the use of the historical title "sister" to refer to a senior nurse in the past.[17]
During the Reformation of the 16th century, Protestant reformers shut down the monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe. Those nuns who had been serving as nurses were given pensions or told to get married and stay home.[18] Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church, were removed from their positions. The nursing profession suffered a major setback for approximately 200 years.[19]
Florence Nightingale worked by sub concepts of the environmental theory. She included five factors that helped nurses in her time of working in poor sanitation and with uneducated nurses. These factors included (1) fresh air, (2) clean water, (3) a working drainage system, (4) cleanliness, and (5) good light or sunlight. Nightingale believed that a clean, working environment were important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around the patient for the betterment of their health.[26]
Red Cross chapters, which began appearing after the establishment of the International Committee of the Red Cross in 1863, offered employment and professionalization opportunities for nurses (despite initial objections from Florence Nightingale).[29] Catholic orders such as Little Sisters of the Poor, Sisters of Mercy, Sisters of St. Mary, St. Francis Health Services, Inc. and Sisters of Charity built hospitals and provided nursing services during this period.[citation needed][30] In turn, the modern deaconess movement began in Germany in 1836.[31] Within a half century, there were over 5,000 deaconesses in Europe.[32]
Formal use of nurses in the modern military began in the latter half of the nineteenth century. Nurses saw active duty in the First Boer War, the Egyptian Campaign (1882),[33] and the Sudan Campaign (1883).[34]
Hospital-based training came to the fore in the early 1900s, with an emphasis on practical experience. The Nightingale-style school began to disappear. Hospitals and physicians saw women in nursing as a source of free or inexpensive labor. Exploitation of nurses was not uncommon by employers, physicians, and educational providers.[35]
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