- Nature of the Work
- Training, Other Qualifications, and Advancement
- Job Outlook
- Job Prospects
- Registered nurses (RNs) constitute the largest healthcare occupation, with 2.8 million jobs.
- Employment of registered nurses is projected to grow 16 percent from 2014 to 2024, much faster than the average for all occupations.
- About 61 percent of RN jobs are in hospitals.
- The three typical educational paths to registered nursing are a bachelor's degree, an associate degree, and a diploma from an approved nursing program; advanced practice nurses—clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners—need a master's degree.
- Overall job opportunities are expected to be excellent, but may vary by employment and geographic setting; some employers report difficulty in attracting and retaining an adequate number of RNs.
Nature of the Work
Registered nurses (RNs), regardless of specialty or work setting, treat patients, educate patients and the public about various medical conditions, and provide advice and emotional support to patients' family members. RNs record patients' medical histories and symptoms, help perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation.
RNs teach patients and their families how to manage their illnesses or injuries, explaining post-treatment home care needs; diet, nutrition, and exercise programs; and self-administration of medication and physical therapy. Some RNs may work to promote general health by educating the public on warning signs and symptoms of disease. RNs also might run general health screening or immunization clinics, blood drives, and public seminars on various conditions.
When caring for patients, RNs establish a care plan or contribute to an existing plan. Plans may include numerous activities, such as administering medication, including careful checking of dosages and avoiding interactions; starting, maintaining, and discontinuing intravenous (IV) lines for fluid, medication, blood, and blood products; administering therapies and treatments; observing the patient and recording those observations; and consulting with physicians and other healthcare clinicians. Some RNs provide direction to licensed practical nurses and nursing aides regarding patient care. (See the statements on Licensed Practical and Licensed Vocational Nurses; Nursing Assistants and Orderlies; and Home Health Aides elsewhere in the Handbook). RNs with advanced educational preparation and training may perform diagnostic and therapeutic procedures and may have prescriptive authority.
Specific work responsibilities will vary from one RN to the next. An RN's duties and title are often determined by their work setting or patient population served. RNs can specialize in one or more areas of patient care. There generally are four ways to specialize. RNs may work a particular setting or type of treatment, such as perioperative nurses, who work in operating rooms and assist surgeons. RNs may specialize in specific health conditions, as do diabetes management nurses, who assist patients to manage diabetes. Other RNs specialize in working with one or more organs or body system types, such as dermatology nurses, who work with patients who have skin disorders. RNs may also specialize with a well-defined population, such as geriatric nurses, who work with the elderly. Some RNs may combine specialties. For example, pediatric oncology nurses deal with children and adolescents who have cancer. The opportunities for specialization in registered nursing are extensive and are often determined on the job.
Training, Other Qualifications, and Advancement
There are three typical educational paths to registered nursing—a bachelor's of science degree in nursing (BSN), an associate degree in nursing (ADN), and a diploma. BSN programs, offered by colleges and universities, take about 4 years to complete. ADN programs, offered by community and junior colleges, take about 2 to 3 years to complete. Diploma programs, administered in hospitals, last about 3 years. Generally, licensed graduates of any of the three types of educational programs qualify for entry-level positions as a staff nurse. There are hundreds of registered nursing programs that result in an ADN or BSN; however, there are relatively few diploma programs.
Individuals considering a career in nursing should carefully weigh the advantages and disadvantages of enrolling in each type of education program. Advancement opportunities may be more limited for ADN and diploma holders compared to RNs who obtain a BSN or higher. Individuals who complete a bachelor's degree receive more training in areas such as communication, leadership, and critical thinking, all of which are becoming more important as nursing practice becomes more complex. Additionally, bachelor's degree programs offer more clinical experience in nonhospital settings. A bachelor's or higher degree is often necessary for administrative positions, research, consulting, and teaching.
Many RNs with an ADN or diploma later enter bachelor's degree programs to prepare for a broader scope of nursing practice. Often, they can find an entry-level position and then take advantage of tuition reimbursement benefits to work toward a BSN by completing an RN-to-BSN program. Accelerated master's degree in nursing (MSN) programs also are available. They typically take 3-4 years to complete full time and result in the award of both the BSN and MSN. Advanced practice nurses—clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners—need a master's degree in nursing.
All nursing education programs include classroom instruction and supervised clinical experience in hospitals and other healthcare facilities. Students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology and other behavioral sciences, and nursing. Coursework also includes the liberal arts for ADN and BSN students. Supervised clinical experience is provided in hospital departments such as pediatrics, psychiatry, maternity, and surgery. A number of programs include clinical experience in nursing care facilities, public health departments, home health agencies, and ambulatory clinics.
Licensure and Certification
In all States, the District of Columbia, and U.S. territories, students must graduate from an approved nursing program and pass a national licensing examination, known as the National Council Licensure Examination, or NCLEX-RN, in order to obtain a nursing license. Other eligibility requirements for licensure vary by State. Contact your State's board of nursing for details.
As the largest healthcare occupation, registered nurses held about 2.8 million jobs in 2014. Hospitals employed the majority of RNs, with 61 percent of such jobs. About 7 percent of jobs were in offices of physicians, 7 percent in nursing and residential care facilities, 6 percent in home healthcare services, and 6 percent in government services. The remainder worked mostly in public health and social assistance agencies, and educational services.
Overall job opportunities for registered nurses are expected to be excellent, but may vary by employment and geographic setting. Some employers report difficulty in attracting and retaining an adequate number of RNs. Employment of RNs is expected to grow much faster than the average and, because the occupation is very large, 439,300 new jobs will result by 2024, among the largest number of new jobs for any occupation. Additionally, hundreds of thousands of job openings will result from the need to replace experienced nurses who leave the occupation.
Employment change. Employment of registered nurses is expected to grow by 16 percent from 2014 to 2024, much faster than the average for all occupations. Growth will be driven by technological advances in patient care, which permit a greater number of health problems to be treated, and by an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly.
Job Prospects For Registered Nurses
Overall, job opportunities for registered nurses are expected to be good. However, the supply of new nurses entering the labor market has increased in recent years. This increase has resulted in competition for jobs in some areas of the country. Generally, registered nurses with a Bachelor of Science degree in nursing (BSN) will have better job prospects than those without one. Employers also may prefer candidates who have some related work experience.
Job opportunities should be good because of the need to replace workers who retire over the coming decade and because of the growing number of people with access to healthcare services.
Summary courtesy of Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016-17 Edition, Registered Nurses, on the Internet at http://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited August 05, 2016).