Become a Registered Nurse

Registered nurses provide medical care, education, and emotional support to patients. Employment for nurses is expected to increase by 19% from 2010 to 2022, which is a faster growth rate than most other occupations. This is a rewarding field that will make a real difference in your community and has a wide array of options for advancement.

Steps

Understanding Nursing

1. Understand the profession. According to the American Nurses Association, nursing today is designed for the protection, promotion and optimization of health and the prevention of illness and injury. Nurses are advocates in the care of individuals, families and communities. The standardized education of today’s registered nurses, in contrast to the past, reflects the high expectations communities and physicians have on the men and women who fill these roles. In recent years, the employment of nurses has grown and will continue to grow in part because of the aging of the baby boomer population and the associated growing rate of chronic conditions like diabetes.
   • The nursing profession is not just for women; there are over a hundred thousand registered male nurses working in the US.
   • People with chronic diseases, such as heart and lung disease, are living longer than ever, which equates to sicker patients living longer and requiring skilled medical services.
2. Determine if the roles and responsibilities of nursing interest you. The foundation of all nursing practice is based in human anatomy and physiology. The chief mission of the nursing field is to protect, promote and optimize health. Key responsibilities for nurses include (but are not limited to):
   • Triaging and assessing injury levels in emergency situations.
   • Performing physical examinations and taking medical and family histories.
   • Providing counseling and education about health promotion and injury protection.
   • Administering medication and providing wound care.
   • Coordinating care and collaborating with other professionals including doctors, therapists and dietitians.
   • Directing and supervising care and providing education to patients and family, which enables patients to be discharged sooner.
3. Know the skills and qualities involved in nursing. Beyond having a breadth of knowledge in medicine (and being someone who does not get squeamish easily!), a nurse must also be skilled in other areas. In this sense, nursing is like any other profession in that there are specific individual qualities that make the job easier and a more natural fit for some people. It's important to determine whether your personality and abilities can accommodate the various responsibilities and tasks that come with being a nurse. Key qualities include:
   • Interpersonal and communication skills: Being a nurse requires working with people every day—doctors, other nurses, technicians, patients, caregivers, and others. To communicate information clearly and do their jobs effectively, nurses need strong interpersonal skills, patience, and the ability to break down complex information into something that is accessible for ordinary people (i.e., non-specialists).
   • Compassion: Caring and empathy are valuable when taking care of individuals who are sick or injured. Remember that patients may be scared or in pain and need to be comforted, reassured, and motivated to fight through their illnesses.
   • Critical thinking: Registered nurses must be able to assess changes in the health status of their patients and make a quick referrals.
   • Detail-oriented and organized: Nurses often work with multiple patients and healthcare professional at a time and so they need to be able to keep track of what has been done and what needs to be done. In addition, attention to detail is key; medication needs to be given on time and emergency protocols must be followed to the letter.
   • Stamina: Nurses are often required to perform physical tasks, such as lifting patients, and also work long shifts of between eight and 12 hours, which may include night shifts.

Obtaining the Correct Education and Credentials

1. Get a high school diploma. Admission into a school of nursing requires a high school diploma or, alternately, passing the General Education Development (GED) test. If you want to be a nurse, pay attention to your performance, skill, and interest in courses like biology, physiology, and chemistry throughout high school. The knowledge from these courses will be important in your post-secondary education.
   • A good foundational knowledge and understanding of how the human body works is necessary in the field of nursing and begins already in high school.
   • Don't get discouraged if these subjects don't come easily to you. Consider hiring a private tutor to help you in your math and science courses in order to improve and develop effective study and learning strategies.
2. Undertake post-secondary education in nursing. There are three ways to become a registered nurse. Whatever path you choose, the coursework involved will include physiology, biology, chemistry, nutrition, and anatomy.
   • Bachelor's degree in nursing (BSN). This level of education is like a bachelor’s program in all other fields. It is awarded by a college or university and usually takes four years to complete. Classes will include community health, pharmacology, health assessment, microbiology, chemistry, human development and clinical practice. In addition, bachelor's programs usually include more training in social sciences than other nursing programs. You may take courses in sociology, communications, leadership, and critical thinking.
   • Associate's degree in nursing (ADN). This is the most common way to obtain a registered nursing license and involves a two-year program at a community or junior college. Many students transition to BSN programs after having completed an ADN and holding an entry-level nursing position. In these cases, nurses are able get further education using an employer's tuition assistance program; they're also able to work and earn an income while getting the next level of education.
   • Diploma from an accredited nursing program. You can also be eligible for licensure by completing a vocational nursing program. These accredited programs are often associated with a hospital and vary in length, though they are typically up to three years long. In this program, classroom learning, clinical practice, and on-the-job training are combined. This education path is on the decline since hospitals have placed a limit on the number of diploma graduates they can hire due to recommendations by the National Advisory Council on Nursing Education.
3. Make sure your school is accredited. The national accreditation agency for nursing schools is the Commission on Collegiate Nursing Education. This agency ensures the quality and integrity of bachelor, graduate, and residency programs in nursing. Accreditation is voluntary but ensures that colleges and schools providing nursing education are operating at the same professional level and educating future nurses in a manner which ensures that they can provide effective and standardized care.
4. Get licensed. Registered nurses must have a nursing license. Take the National Council Licensure Examination — Registered Nurse (NCLEX-RN) once you have graduated from your accredited program and thus have completed the appropriate education requirements. This test is the nationally recognized licensing exam for registered nurses.
   • Prerequisites to and fees for the exam may differ between states. Check with the requirements for your state, or for the state you plan on practicing in.
   • Note the following requirements in order to sit the licensure examination:
     • Application for the examination must include a U.S. social security number.
     • Individuals must be accompanied by a recent passport-style photograph.
     • Application must identify the school from which the applicant graduated. Transcripts must be forwarded to prove that the individual met all educational requirements.
5. Find a job as a nurse. There are more than two million nurses in the United States, making the position the largest in the healthcare field. There are a variety of settings in which a nurse can work, including hospitals, physician's offices, elderly care homes, prisons, college campuses and schools.
   • Newly certified nurses should consider working in a specialty unit, as the patients in these facilities are more homogeneous. Examples of specialty units include orthopedic and pediatrics units.
   • Nurses with a bachelor's degree have better employment prospects than those who do not; they are recognized as having capabilities from their curriculum that prepare them for management, case management and leadership roles.

Growing in the Field

1. Decide what specialty interests you. There are a variety of fields for nurses to practice, including pediatrics, adults, OB/GYN, geriatrics, community health, occupational health, rehabilitation, surgery, neonatal, intensive care, and emergency. You will likely have already started thinking about this during your RN educational training. Each RN program gives their nursing students clinical rotations through which they gain experience in these various areas of the hospital and community.
   • Nursing students may have a full semester in a particular clinical rotation, such as pediatrics, adult or community health. They will also experience several hours in an intensive care unit, emergency room and neonatal unit. Not all schools will give nurses rotations through a physical rehabilitation unit for patients following strokes or spinal cord injuries. Most schools will expect that nurses get experience with geriatric care while caring for adults.
   • Once you know what field of nursing you'd like to work in, you can apply for jobs in that field.
2. Stay up-to-date with your practice. Even after completing the required education and certification, nurses should continue to read medical journals, be aware of the policies of the healthcare organization they work for, and take additional courses in medicine. Scientific and medical knowledge and technologies are constantly changing and evolving and so staying up-to-date is key to providing effective healthcare.
3. Consider becoming an advanced practice registered nurse (APRN). The term advanced practice registered nurse is an umbrella term used for nurses who have achieved at least a master’s degree in nursing (MSN). The academic program to become an advanced practice nurse is one to two academic years, depending upon the specialty, school, and your previous work experience. There are four main advanced practice settings in which nurses can practice under this APRN umbrella:
   • Clinical Nurse Specialist. These nurses typically work in hospitals, clinics and nursing homes. They handle a wide variety of physical and mental health problems and may work within the fields of research, education and administration.
   • Nurse Practitioner. These advanced practice nurses may work in clinics, and nursing homes, hospitals or private offices. They see a wide range of primary and preventative health patients. In most states, nurse practitioners can prescribe medication, diagnose illness, and treat minor injuries.
   • Certified Nurse Midwife. These nurses provide gynecological and low risk obstetrics care in hospitals, homes and birthing centers.
   • Certified Registered Nurse Anesthetist. This is the oldest of the advanced practice nursing specialists. Each year certified registered nurse anesthetists provide more than 65% of the anesthetics given to patients in hospitals and outpatient settings.
4. Be aware of other career paths. Some nurses move into management positions, which are increasingly requiring a graduate degree in nursing. Other nurses move into the business aspects of healthcare, while still others opt to work outside the healthcare setting directly by becoming instructors in colleges and universities.
   • All in all, the nursing field is varied and offers a huge number of opportunities for individuals interested in health and wellness.

Warnings

• Do your research. Only attend schools with an accredited nursing program in order to obtain your degree and take the required examination for licensing.

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