What to expect from nursing school
Programs for registered nurses can cover anatomy, biology, microbiology, physiology, nutrition and psychology as well as some liberal arts subjects. Bachelor's degree (BSN) programs can include even more material, such as communication, leadership, and in-depth studies on anatomy and the physical sciences, according to the Bureau of Labor Statistics (BLS.gov, 2012).
Registered nurses must study nursing at an accredited nursing school, but they have alternative courses of study -- they can earn an associate or bachelor's degree, or complete a diploma program. Nursing degree programs generally last between two and four years, depending on the type of degree (BLS.gov, 2012). A BSN program seeks to provide a comprehensive education and is typically required for enrollment in a master's of nursing program, which can provide specialty education for advanced practice nurses.
All states require registered nurses to be licensed, which typically involves passing the National Council Licensure Examination for Registered Nurses, or NCLEX-RN, and graduating from an approved nursing school. NCLEX candidates must meet state eligibility requirements for licensure before taking the exam. Nursing programs should be accredited by government-approved organizations such as the National League for Nursing Accrediting Commission, Inc. (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).
Real-world training for nurses
Nursing programs require an on-site clinical practicum as either a capstone or thesis-like subject or as part of the general curriculum. The practicum can give students the experience of working in a fast-paced clinical setting, caring for patients and administering medication.
Some prospective students may qualify for accelerated nursing programs (for those with a bachelor's degree in a different major) or "bridge" options for practicing nurses seeking further education. In specialized programs like these, or in graduate programs, online courses may be an option. RNs may also find online continuing education courses to help them maintain their licensure. However, the hands-on practicum required by nursing programs cannot be completed through distance learning. It's important to check on state regulations, since only credits from state-approved schools count toward a student's education requirements for licensure. Currently, California does not accept credits from online nursing schools.
Nursing is not a profession for everyone. In addition to the required training and qualifications, qualities such as the following may be beneficial for prospective nurses, as reported by the BLS (BLS.gov, 2012):
- Attention to detail
- Emotional stability
The BLS also notes that critical thinking, interpersonal speaking and organizational skills can be helpful, as the practice of nursing is becoming more complex.
Tools and technology for nurses
In recent years, the health care industry has gone through an explosion of technological innovation, much of it involving the daily activities of nurses, as they are the primary contact with both the patient and front-line health care providers. Modern technology could potentially help decrease the cases of failure-to-rescue (preventable deaths that could have been avoided if the patient was monitored) or help to free up a nurse's time by automating information systems. The following are technologies registered nurses may encounter while working in a hospital or clinical environment:
- Real-time location systems: These systems can help doctors and nurses keep track of patients and each other. The tool is designed so that when an emergency occurs, medical staff can be quickly found to provide care. The goal is also to make it easier to track inventory and materials to prevent losses and achieve savings.
- Wireless patient monitoring systems: Systems of this type can be installed under mattresses or attached directly to a patient and can help nurses monitor activity even while not directly observing the patient.
- Electronic medication tracking software: This software was created with the goal of helping to prevent possible overdosages of medicine and expedite the updating of patient records. Another aim is to reduce the time needed to locate medications, which could take up to 48 percent of a nurse's time, according to the California HealthCare Foundation (CHCF.org, 2008).
- Mobile medical scanners: With smartphone applications and peripherals, nurses can carry around technology that echoes the sci-fi medical tools of "Star Trek." They can read a patient's vital signs such as heart rate and blood-oxygen level and even take ultrasounds without the need for bulky devices.
(Perhaps we should add "tech savvy" to the list of desirable qualities for nursing candidates.)
What's this I hear about a nursing shortage?
With the effort to supply nurses before the onset of a projected nursing shortage under way, nursing schools have seen record enrollments in recent years. This enrollment boom has resulted in some nursing schools turning away prospective applicants, as well as an abundance of freshly educated nurses who lack experience. Also, hospitals and clinics may prefer to hire nurses with work experience.
The BLS expects faster-than-average employment growth for RNs in the U.S. between 2010 and 2020 (BLS.gov, 2012). Opportunities vary according to education, experience and location, and the brightest opportunities are projected for those holding at least a BSN degree.
Where the jobs are for registered nurses
Becoming a registered nurse opens up a variety of employment possibilities (BLS.gov, 2012). Registered nurses may choose to work outside of the hospital or clinic by specializing in fields such as addiction, genetics or rehabilitation. Another option is a graduate degree in nursing and a career as an advanced practice registered nurse, with a concentration such as clinical nurse specialist, nurse anesthetist or nurse practitioner. These specialty nurses help to fill in areas underserved by health care providers and they may be able to prescribe medication, make diagnoses and even run their own practices.
As of May 2011, the median annual wage for registered nurses was $65,950, nationally, with the highest and lowest 10 percent earning annual median wages of $96,630 and $44,970, respectively (BLS.gov, 2012). Salaries may differ based on training, work background, geography and other considerations.
The states with the highest employment of RNs in 2011 were California, New York, Texas and Florida. The employment settings with the highest numbers of RNs in 2011 included the following:
- General medical and surgical hospitals
- Physicians' offices
- Home health care services
- Nursing care facilities
- Outpatient care facilities
The BLS reports that from 2010 to 2020, the employment opportunities for registered nurses could grow by up to 26 percent nationally (BLS.gov, 2012). Demand is projected to be higher than average in outpatient care facilities (where patients do not stay overnight), senior residential homes and home health care services (for older patients who may prefer to be treated at home, for example). Overall, strong job opportunities are expected, depending on a candidate's training and experience.
Sources and further reading:
U.S. Bureau of Labor Statistics, Occupational Employment Statistics, Registered Nurses, 2011
U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Registered Nurses, 2012
Commission on Collegiate Nursing Education
Equipped for Efficiency: Improving Nursing Care Through Technology, California HealthCare Foundation, December 2008
National League for Nursing Accrediting Commission, Inc.
NCLEX Candidate FAQs, National Council of State Boards of Nursing
California Board of Vocational Nursing, Unapproved Nursing Programs, 2011