Occupational Outlook Handbook
Sample page
Registered Nurses
D.O.T. 075.124-010 and -014, .127-014, -026, -030 and -034, .137-010 and -014, .167-010 and -014, .264-010 and -014, .364-010, .371-010, .374-014, -018, and -022)
Nature of the work
Registered nurses (R.N.s) care for the sick and injured and help people stay well. They are typically concerned with the "whole person," providing for the physical, mental, and emotional needs of their patients. They observe, assess, and record symptoms, reactions, and progress; assist physicians during treatments and examinations; administer medications; and assist in convalescence and rehabilitation. R.N.s also develop and manage nursing care plans; instruct patients and their families in proper care; and help individuals and groups take steps to improve or maintain their health. While state laws govern the tasks R.N.s may perform, it is usually the work setting which determines their day-to-day job duties.
Hospital nurses form the largest group of nurses. Most are staff nurses, who provide bedside nursing care and carry out the medical regimen prescribed by physicians. They may also supervise licensed practical nurses and aides. Hospital nurses usually are assigned to one area such as surgery, maternity, pediatrics, emergency room, intensive care, or treatment of cancer patients or may rotate among departments.
- Office nurses assist physicians in private practice, clinics, surgicenters, emergency medical centers, and health maintenance organizations (HMOs). They prepare patients for and assist with examinations, administer injections and medications, dress wounds and incisions, assist with minor surgery, and maintain records. Some also perform routine laboratory and office work.
- Home health nurses provide periodic services, prescribed by a physician, to patients at home. They care for and instruct patients and their families. Home health nurses care for a broad range of patients, such as those recovering from illnesses and accidents, cancer, and childbirth. They must be able to work independently.
- Nursing home nurses manage nursing care for residents with conditions ranging from a fracture to Alzheimer's disease. Although they generally spend most of their time on administrative and supervisory tasks, R.N.s also assess residents' medical condition, develop treatment plans, supervise licensed practical nurses and nursing aides, and perform difficult procedures such as starting intravenous fluids. They also work in specialty-care departments, such as long-term rehabilitation units for strokes and head injuries.
- Public health nurses work in government and private agencies and clinics, schools, retirement communities and other community settings. They instruct individuals, families, and other groups in health education, disease prevention, nutrition, and child care. They arrange for immunizations, blood pressure testing, and other health screening. These nurses also work with community leaders, teachers, parents, and physicians in community health education.
- Occupational health or industrial nurses provide nursing care at worksites to employees, customers, and others with minor injuries and illnesses. They provide emergency care, prepare accident reports, and arrange for further care if necessary. They also offer health counseling, assist with health examinations and inoculations, and work on accident prevention programs.
- Head nurses or nurse supervisors direct nursing activities. They plan work schedules and assign duties to nurses and aides, provide or arrange for training, and visit patients to observe nurses and to insure that care is proper. They may also insure that records are maintained and that equipment and supplies are ordered.
- At the advanced level, nurse practitioners provide basic health care. They diagnose and treat common acute illnesses and injuries. Nurse practitioners can prescribe medications in some states. Other advanced practice nurses include clinical nurse specialists, nurse anesthetists, and certified nurse-midwives.
Working conditions
Most nurses work in well-lighted, comfortable medical facilities. Home health and public health nurses travel to patients' homes and to schools, community centers, and other sites. Nurses may spend considerable time walking and standing. They need emotional stability to cope with human suffering, emergencies, and other stresses. Because patients in hospitals and nursing homes require 24-hour care, nurses in these institutions may work nights, weekends, and holidays. They may also be on-call. Office, occupational health, and public health nurses are more likely to work regular business hours.
Nursing has its hazards, especially in hospitals, nursing homes, and clinics where nurses may care for individuals with infectious diseases such as hepatitis and AIDS. Nurses must observe rigid guidelines to guard against these and other dangers such as radiation, chemicals used for sterilization of instruments, and anesthetics. In addition, they face back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases.
Employment
Registered nurses held about 1,906,000 jobs in 1994. About 2 out of 3 jobs were in hospitals. Others were in offices and clinics of physicians, home health care agencies, nursing homes, temporary help agencies, schools, and government agencies. More than one-fourth of all R.N.s worked part time.