Nurses help prevent disease and injury and care for the sick and injured, but within these
parameters, there are no limits to what the job can entail. “Nursing offers you the opportunity
to do a million different things, in a million different places,” as one survey respondent put
it. Nurses work in hospitals, long-term care facilities, clinics, schools, corporations, and sometimes
even in businesses of their own. While there are many different areas of specialization,
some individuals are general nurses, who assist doctors by performing a variety of tasks as
needs arise, and will often have secretarial duties as well if they work in HMOs or private
offices. More specialized nurses include surgical nurses, who
ensure the sterility of instruments and assist doctors during
surgery; obstetric-gynecological nurses, who help to deliver
babies; neonatal nurses, who care for newborns and teach new mothers how to feed their
babies; nurse anesthetists, who work with anesthesiologists to provide proper sedation for
patients; or psychiatric nurses, who care for patients with mental or emotional disorders.
Occupational health nurses work at factories or other worksites to offer preventive education,
and community or public health nurses spend time on the road to instruct various groups in
their community on diverse health-related topics. Another variety of nurse is the private duty
nurse, who has only one patient in his or her charge and works in the patient’s home or in
the hospital. Some are also hospice nurses (refer to page 62 of this section).
These days, nurses with more advanced degrees handle many things that were once the
sole province of physicians, such as treating some ailments and setting fractures. Nurse practitioners
can even make diagnoses and write prescriptions. Clinical nurse specialists also
have additional patient responsibilities in such areas as geriatrics or pediatrics, depending on
the nurse’s specialty. Nurses can advance to become department heads or supervisors, overseeing
other nurses as well as caring for patients. Each facility also has a director of nursing,
who establishes standards of patient care, composes the department’s budget, and advises
other hospital employees on nursing issues.
Nurses generally work in eight-hour shifts day and night, although some hospitals have
recently been experimenting with having nurses work 10 or 12-hour shifts on three or four
days a week. Communication skills are critical—nurses must listen well and be able to give
clear directions to patients and aides.
People who want to become nurses can choose among four educational programs. The
two-year program takes place in a junior or community college combined with some hospital
training. The diploma program, run entirely by a hospital or school and based solely on
nursing, takes three years to complete. The longest is the BSN program, which awards candidates
a bachelor’s degree of science after four or five years of study at a college or university.
None of these programs qualifies the nurse for practice, though. To practice, every nurse
must pass a national licensing exam. After completing any of these programs and passing the
exam, the nurse becomes an RN, or registered nurse. The fourth and quickest option is to
become an LPN, or licensed practical nurse, which requires only one year of training. While
for most beginning jobs the RN license opens the door, a BSN is necessary to be eligible for
some supervisory positions. For the highest managerial positions or to teach in a nursing
school, a master’s degree in nursing is the norm. Some specialties even require a doctorate
A background in science and liberal arts will serve future nurses well. Nursing programs
place a large amount of emphasis on science and math for obvious reasons, but liberal arts
courses are also helpful, since nurses spend much of their time educating patients and staff.
Registered nurses from all three programs can rise to become supervisors, directors of
nursing, and other managerial roles. Codes that define the scope of nurses’ practices are
defined independently from state to state.
Some nurses go on to become instructors of nursing at hospitals and universities.
Another burgeoning nursing-related profession is midwifery. After having been forced out of
the field by doctors in the nineteenth century, midwives are returning to their centuries-old
role of delivering babies. Now, midwives who are certified nurses actually deliver babies in
hospitals, birthing centers, or the mother’s home. Midwives also offer care to pregnant
women and educate new mothers. Many women prefer their care to that of obstetricians.