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A Day in the Life of a Nurse

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.

Paying Your Dues

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 degree. 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.

Present and Future

While hospitals have, in some form, been in existence for many centuries, it wasn’t until the nineteenth century that Florence Nightingale transformed the nursing profession. During the Crimean War, she began a training program that taught citizens how to administer proper patient care, including sterilization, which was then a radical concept. Today, all nurses are trained, educated, and licensed professionals, and the field continues to grow, with more men entering this previously all-female profession every year. The outlook for the future is bright, as the demand for qualified nurses far exceeds the supply in the health care industry. One effort that some states have made to make it easier to hire nurses is to waive the licensing exam for nurses coming into a job from out of state, provided that the nurse has already passed the exam in his or her state of residence.

Quality of Life

PRESENT AND FUTURE

Very few nurses leave the field at this point. Entry-level salaries are relatively high, and most nurses are becoming oriented to their surroundings and finding gratification in their work.

FIVE YEARS OUT

More nurses leave the profession at this time. Our respondents cited frustration with budget cutbacks that have interfered with the quality of nursing care as their main reason for leaving. Individuals who stay still enjoy the challenges and flexibility the profession offers. As many as 32 percent of all nurses work part-time.

TEN YEARS OUT

Some veteran nurses find themselves making a lateral move from hospital to private care, which can ensure more regular hours and a stable atmosphere. After 10 years in the profession, many nurses have also advanced to higher-paying supervisory positions.