Thursday, February 26, 2009

Nursing specialties

A Registered Nurse (RN) can specialize in one or more of the patient care specialties as per job requirements or personal preferences. The most common specialties have been divided into four main categories, on basis of:

Work setting or types of care provided,
Disease for which care is provided,
Body organ or the system for which care is provided, and
the section of population for which care is provided.
RNs may look towards specializing in any of the following popular specialties, with major emphasis on work settings and types of care they plan to provide.

Ambulatory Care Nurses provide health needs of individuals and families in diverse settings on outpatient basis. Emerging trend is "Telehealth" where care is provided by means of Internet or other communications in media. Stress involved is lesser than inpatient settings. Certified by "American Nurses Credentialing Center (ANCC)", employers are usually ambulatory providers such as Primary Care Offices, HMOs, clinics, mobile health units etc.

Burn Care Nurses are employed in hospitals with burn departments or clinics providing such services. It can be physically and psychologically draining.

Critical Care Nurses are one of the in-demand health care professionals due to their ability to make quick decisions and stay calm, when lives are at stake. They provide care to patients with cardiovascular, respiratory or pulmonary failure, in intensive care hospital units.

Emergency/Trauma Nurses are in demand for their ability to make quick decisions about patients' condition and stay clam while dealing with potential life-threatening conditions caused by accidents, strokes, and heart attacks. Stress and grief pose challenge, while role autonomy, and team work are the characteristics. Certified by "Board Of Certification For Emergency Nurses", employers are acute-care and specialty hospitals, and emergency medical systems. In addition, they may become Flight nurses providing medical care to patients who are air-lifted for transportation to nearest the medical facility.

Holistic Nurses attend to all aspects of wellness and health of a holistic nature, where connection between mind, body and spirit is acknowledged and whole person is treated, rather than caring for just a disease or a symptom. Acupressure, Acupuncture, Massage, Aroma therapy, Yoga, and Biofeedback are performed by a Holistic Nurse.

Home Healthcare Nurses provide at-home care to patients in post-operative, post-partum stages or when recovering from accidents.

Hospice and Palliative Care Nurses provide care for terminally ill patients outside of hospitals with objective to ease their pain and suffering. They care for physical and emotional needs of dying patients and their family with interventions like pain management, palliative care, symptom management and emotional support. Certified by "National Board for Certification of Hospice and Palliative Nurses", employers are usually hospices, home health, hospitals and long-term care facilities. Dealing with deaths of all your patients is a big challenge in itself but the feeling of taking care of a dying patient and the opportunity to practice holistic nursing are motivational factors for many.

Infusion Nurses provide intravascular medications, fluids, blood products and assess their impact on the condition of patients. Certified by "Intravenous Nurses Certification Corporation", they are employed by hospitals, home health agencies and in physician offices. Irregular schedules, excessive paper work, and stress are the challenges. While role autonomy in addition to technical mastery are a few of the plus points.

Long-term Care Nurses provide nursing, psychosocial and personal care services on a recurring basis to patients with chronic physical or mental disorders. Increasing patient acuity can be a drawback for some but the lesser pressure and chaos is a plus.

Medical-Surgical Nurses provide basic health care to patients in all health settings.

Occupational Health Nurses work towards Primary Prevention and keeping the workforce healthy by combining concepts of public health and nursing, besides working towards realizing standards set by Occupational Safety and Health Act, maintaining records, providing care to the ill or injured employees. Certified by ""American Board for Occupational Health Nurses"", employers are usually in business establishments, factories, or mills.

PeriAnesthesia Nurses prepare patients for a surgical experience, support safe transition out of anesthetized state and provide intensive care to patients until they are ready to be discharged from the perianesthesia care unit. Certification is done by"American Board Of PeriAnesthesia Nursing Certification"

Peri-Operative Nurses provide preoperative, intraoperative and postoperative care to patients and assist surgeons in the operation room by handling instruments, controlling bleeding and suturing incisions. Learning opportunities and teamwork are a plus, while frequent emergencies and exposure to human suffering may be a drawback for some. Certified by "CNOR and CRNFA Certification Board Perioperative Nursing", employers are usually in hospital surgical departments, ambulatory surgical centers, clinics, or a physician's offices.

Psychiatric Nurses care for patients with personality and mental disorders. Uncooperative or dangerous patients may be one of the drawbacks besides restrictive patient-care policies, excessive paper work and a conflict from misconceptions and mental illness. Certification is done by ANCC.

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Nursing Employment Game Plan, How to Find the Best Job and Salary in Your New Career

Considering the current the shortage of nurses, it would seem that finding your dream nursing job would be relatively simple. Unfortunately, that is not the case. Because of the competitive atmosphere in the health care industry, it takes time, energy and planning to find your perfect job. Taking a proactive stance in your career development is the best way to find your ideal position. Whether you are a recent graduate from nursing school or an established nurse, there are a variety of steps that you can take to build your perfect career.

  • Know exactly what you want. Of course, there is no guarantee that you will get it, but knowing what your dream job is, including the specialty, the shift and the pay, makes it much easier to decide if a posted job opening is the right one for you. You cannot expect the perfect job to fall into your lap, and by knowing what your goals are, you can make an educated choice when applying for a position.

  • Be ready to compromise. It is rare that one job that has everything an individual prefers. Even people that love their job have days when they do not want to put on their scrubs or dread heading to work. Your goal is to minimize those days, while still having a job that pays well and allows you to have a life outside your work. To effectively compromise, you have to know what is most important to you, and realize that this can change several times over your career. When you are fresh out of school, single, and ready to repay your student loans, money may be the most important factor. If so, working less desirable shifts that offer a shift differential can be very attractive and a smart decision. Ten years later, married and with children to shuttle to soccer practice or piano lessons, you may prefer less money but straight days and no overtime, again, a smart decision at the time. You cannot make these decisions, though, without having a clear set of priorities and the ability to compromise.

  • Develop a long term career path. While your long term plans may change over time, it is important to consider what you want out of life, and where you want nursing to take you. For some people, nursing is a stepping stone to a hospital management or supervisory role. For others, the hands-on nursing work is where their passions lie. Some individuals want to leave nursing and enter the nurse educator field, which is a fine career goal as well. Regardless of what your choice is, it will not happen overnight. Planning ahead is the best way to achieve your goal.

  • Continue your education. If you received your RN through a community college, and have an associate degree, you may want to consider taking courses to receive your B.S.N., if you have your B.S.N., you may want to take graduate level courses. With so many courses available over the internet and with limited class time, as well as the fact that many hospitals provide tuition reimbursement, it makes sense to continue your education.

  • Join local professional associations. The best way to stay up to date with what is happening in your industry is thorough local professional groups. They provide insider knowledge about what is going on at each hospital, and you will often find out about job openings before they are advertised. The benefit of networking with other professionals is understood in many industries, although the nursing industry has been slower to catch on. Networking provides you with the opportunity to make connections with many people that can later provide you with references, job leads or even emotional support.

  • Don't burn any bridges. No matter how much you hate your job, your coworkers or your boss, make sure to act professionally at all times. It doesn't matter if you promise yourself that you will never work for them again or even if you are sure that you will never see them again, it is important not to burn any bridges. The health care industry is a small world. People move around, to different floors, different hospitals, and what feels like righteous indignation to you may sound like bad behavior to others.

A career in nursing can provide a lucrative and secure future. By taking the time to formulate a game plan, negotiate the things that are important to you, and continue your education, you will find that you are in a position to take advantage of your ideal career opportunity when it presents itself. If you do not know what you want, or think that you will recognize the perfect job when you find it, you will be disappointed. People that take this approach to their career often find themselves moving from job to job with no clear progression.

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Nursing Does More Than Pay the Bills

I initially chose my career in nursing for financial reasons. One of my friends had become a registered nurse and was making a very comfortable living. When we would get together, I would often ask her questions about the time commitment involved with becoming an RN and what she liked and disliked about the job. Being a close friend, she tried her best to paint an accurate picture for me of what her daily work was all about and certainly didn't sugarcoat her position. While I was interested in what she had to say, I was much more interested in finding a way to quickly raise my earning potential. I enrolled in a nursing program and worked part time while I went to school. After graduation, I was able to get a job at a senior care facility. I was already prepared for the worst I might encounter and was looking forward to getting my first paycheck.

My first paycheck came and went, and while I was happy to be earning a high hourly wage, my focal point had shifted. You see, for the first time in my working life, I actually looked forward to going to work. It's not that I ever hated any particular previous job so much that I dreaded coming in, but more that I always viewed work as a necessary evil. Nursing changed that for me.
Everyday, I get to help people. I comfort them when they need to be comforted. I listen when they need someone to talk to. I have a very busy schedule, and not everything I do is rewarding or even pleasant, but there are aspects of this job that make me feel like I am really making a difference to someone. Three months after I started my job, one of our patients unexpectedly passed away. When his family came for the wake and funeral, they made a point to stop by the facility and thank me. Apparently, this man had told them several times of how kind I was to him and how much he appreciated it. Hearing this made me cry, but it also made me happy that my efforts were appreciated.

It's now been a few years since I first graduated from the nursing program. I'm going to earn an online bachelor's of science in nursing while I continue at my job. My hope is to eventually become head nurse, although I want to avoid moving into an administrative position. I like spending my workday caring for patients. The feeling I get from my job is worth more than any paycheck could ever be.

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Nursing as a profession

Nursing is a highly regarded profession with high standards of honesty and ethics amongst various other professions. Nursing has emerged as the largest health care occupation with over 2.7 million jobs. With over 100,000 vacant positions and a ever-growing need for health care workers, the career outlook is excellent for the nursing field. National Center for Workforce Analysis, an agency of the U.S. Department of Health and Human Services predicts a shortage of 808,416 nurses by the year 2020. Such an analysis and prediction is backed by very strong reasoning and findings. Advancement in technology and medical field has resulted in an increased life span. Elderly population is now living longer and more of them will require care and nursing. With more elderly people in need of such care, demands rise for nursing force that can meet such needs. Also, the need for more skilled nurses is growing. With insurance companies stepping into the medical field to reduce the cost of health care expenditure, demand for nurses, outside the hospital setting has also risen. Not to forget that the current nursing workforce is aging and many are expected to retire over next 10-15 years only to create a void, adding to the shortage further. So, nurses with a BSN degree can expect a securer career and better job prospects.

Nurses blend knowledge of science and technology with the art of care and compassion. Nursing provides opportunity to save and improve lives, care for the sick and debilitated, educate patients and people towards achieving good health and above all, the feeling of helping someone in their hour of illness and need. There is no greater service than caring for the sick and needy. Nurses are required to deliver basic duties, which includes but is not limited to providing treatment, health education, emotional support, record maintenance, operating medical equipment in addition to counseling patient and their family about the management of their illness. Registered Nurses (RNs) also run general health screening and immunization clinics, organize public seminars, motivate blood donation drives, etc. Three out of five nurses in the United States work in hospitals. Most of the others work in clinics, home health, extended care settings, schools, colleges, universities, the public health services, and nonprofit agencies throughout the United States and many other countries. Nursing can be a challenging job with continuous exposure to grief and suffering, stress, work pressures, little or excessive patient contact and occupational hazards including but not limited to infectious diseases, radiation exposure, accidental needle sticks, chemicals, anesthesia, back injury and emotional stress. Role autonomy and independence, innovativeness, technical knowledge, and teamwork are characteristics of this job, in addition to personal satisfaction and professional rewards.

The nursing schools are a gateway to this profession and almost all of them require a high school diploma in addition to sound academic standing in English, Algebra, Biology, Chemistry, and Psychology with a GPA score of atleast 3. Computer experience is an asset. Leadership and organization skills are vital to this profession. Most schools shall still require you to clear the National League for Nursing (NLN) Pre-admission exam besides the SAT exam. Over 1,500 nursing programs in the US provide three different educational paths towards becoming a Registered Nurse (RN). Bachelor of Science in Nursing (BSN) is a four-year program offered at colleges and universities. An associate Degree in Nursing (ADN) is a two-year program offered at many community and junior colleges. Some hospital schools of nursing and universities offer an ADN degrees. Hospital Diploma is a two to three year program based in hospital settings. Many diploma schools are affiliated with junior colleges where students take basic science and English requirements. Opportunities are maximum with a BSN degree. BSN is a requirement for obtaining a master's degree or becoming an Advanced Practice Nurse (APN). The American Association of Colleges of Nursing (AACN) recognizes the BSN degree as the minimum educational requirement for a professional nursing practice. Even though graduates can begin practice as an RN with an ADN or diploma, the BSN degree is a must for nurses seeking to assume roles as case-managers or supervisors or move across employment settings. Tuition fee depends on your college and state of residence, but financial aids and scholarships are available to take care of such needs. There are technical and vocational schools as well, which provide one-year course towards becoming a Practical Nurse or a Vocational Nurse. Once graduated, the next important thing is to obtain licensure for practice in the State of your preference. Eighteen states participate in the Nurse Licensure Compact Agreement (NCLA) which permits a licensed nurse to practice in any of the other seventeen states, if they have obtained license to practice in one of the states. License can be obtained by passing national licensing exam NCLEX-RN for becoming a Registered Nurse and NCLEX-PN for becoming Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) as in Texas, California. LPN and LCN provide care for sick, injured and disabled under direct supervision of physicians and RNs.

Nursing career is full of opportunities for those who want to specialize and pursue higher education. A few popular specialties are AIDS Care Nurse, Ambulatory Care Nurse, Cardiac Rehabilitation Nurse, Case Management, Correctional Nurse, Enterostomal Therapy Nurse, Gastroenterology/Endoscopy Nurse, Genetics Nurse, Infection Control Nurse, Intravenous Therapy Nurse, long-term Care Nurse, Managed Care Nurse, Nephrology Nurse and more, the list does not end here. Most of the specialties do welcome RNs with a BSN degree only. In addition, there is increasing demand for APNs. APNs are primary health care practitioners, working independently or in collaboration with physicians. In most states, they are permitted to prescribe medications. The four specializations for APNs include Clinical Nurse Specialist (CNS) providing expert consultation in any of the above mentioned specialties; Nurse Anesthetists (CRNA) administer anesthesia and monitor patient's vital signs during surgery in addition to providing post-anesthesia care; Nurse Midwives (CNM) provide primary care to females covering aspects like family planning, prenatal care, neonatal care and assist delivery; and Nurse Practitioners (NP) who provide basic preventive health care to patient. NPs are primary as well as specialty care providers in medically underserved areas. APNs are lower cost primary care providers in comparison to physicians.

Advanced degrees available to nurses are masters (MSN), doctoral degree (Ph.D., EdD, DNS) and post-doctoral programmes. Doctoral degrees can provide placements as a senior policy analyst, researcher, health system executive and as a nursing school dean.

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Nursing Degree - An Inside Look

People are living longer, mainly due to changes in lifestyles but also because of incredible advances in health care. One of the results is the need for more healthcare professionals, including nurses. One way the industry is changing is by offering career choices in the form of more educational opportunities and options.

The Associate's Degree in Nursing has only recently become an option, though it's quickly gaining favor in the health care industry. While there are naturally some differences in the training for an associate's degree as opposed to a bachelor's degree, many health care agencies - including hospitals and doctor's offices - are recognizing the fact that those graduating with associate's degrees can perform many of the same duties and handle many of the same responsibilities as those with bachelor's degree. But is there really a difference?

There has to be some difference simply by the difference in time requirements for the two degrees. An associate's degree is typically accomplished in two years. This is sometimes called a "fast track" and there are many associate's degree programs available. Most are available through community colleges or technical training schools, though some four-year universities are now offering fast track degrees as part of their training programs.

By comparison, a bachelor's degree in nursing usually takes four years. Some who go into college with at least a few hours of college behind them and a solid plan can accomplish it sooner, especially if summer school classes are used to hasten the process. But as a rule, it takes a full four years to complete college with a bachelor's degree in any field, including nursing.

If you can achieve an associate's degree in only two years, why would anyone go on for the bachelor's degree? Most health care facilities seem willing to accept either degree, but most make a pay differentiation. Those who have graduated with a bachelor's degree can often expect to be paid more than those with an associate's degree. One of the positive points is that a nurse with an associate's degree can usually go to work earning a good wage and pick up classes toward the bachelor's degree to increase their worth.

So what's the difference in the actual study required? One important point noted by proponents of the associate's degree is that the four-year university requires a "well rounded" education before conferring a degree. That means that graduates are required to complete requirements in history, communication, physical education and other subjects that some say aren't relevant to a nursing degree. There are also some math and science courses that are typically above those required for a two-year nursing degree.

By comparison, an associate's degree program will often use a "block" format. Instead of taking an algebra class and a chemistry class, those in the associate's degree program may take an afternoon class that combines the two, focusing on the way algebra and chemistry apply to their chosen field.

Some say there's no substitute for the bachelor's degree and that nurses should all be required to go through the full program. As long as there's a demand for nurses and others in the health care field, there's no doubt that faster training - as long as it's adequate - will be in demand.

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