Nurse

:This article focuses on the training and regulation of nurses. See the article Nursing for more information on the practice of nursing. For information on the television show Nurses, see Nurses (TV series).

Types of nurses (and non-nurses)

The nursing career structure varies considerably throughout the world. Typically there are several distinct levels of nursing practitioner, distinguished by increasing education, responsibility and skills. The major distinction is between task-based nursing and professional nursing.

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US

Licensed Practical Nurses (LPNs) are also known as Licensed Vocational Nurses (LVNs) in California and Texas and as Registered Practical Nurses (RPNs) in Ontario. These individuals usually have eighteen months to two years of training in anatomy and physiology, medications, and practical patient care. They must pass state or national boards and renew their license periodically.

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LPNs can perform simple as well as complex medical procedures but must operate under the supervision of either a Registered Nurse or a physician. They can administer most medications (usually with the exception of IV push medications), perform measurements (blood pressure, temperature, etc.), keep records, perform CPR, maintain sterile and isolation conditions, and administer basic care.

Related Topics:
IV push - CPR

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LPNs are often found working under the supervision of physicians in clinics. In long term care facilities, they sometimes supervise nursing assistants and orderlies.

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The Bureau of Labor Statistics estimates that there were about 700,000(1) persons employed as Licensed Practical Nurses and Licensed Vocational Nurses in the US in 2004.

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Registered Nurses (RNs) are professional nurses who often supervise the tasks performed by LPNs, orderlies and nursing assistants. They provide direct care and make decisions regarding plans of care for individuals and groups of healthy, ill and injured people. They have a Diploma, Associate Degree, or Bachelors Degree in Nursing at entry level, and after passing state board examininations are granted the title Registered Nurse. Regardless of degree, RNs have many hours of clinical experience before they are graduated.

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RNs are the largest group of healthcare workers in the US. The Bureau of Labor Statistics estimates that there were about 2.3 million (1) persons employed as Registered Nurses in the US in 2004.

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Research has shown that RNs are the first-line defense of hospitalized patients against disability or death from infection, cardiopulmonary arrest, and other serious complications. Higher ratios of registered nurses to patients have been shown to decrease certain complications of illness and mortality rates. Registered Nurses are educators, managers, executives, therapists, intensive care experts, symptom managers, professional mentors, researchers and community members. In hospitals, registered nurses perform diverse roles such as writing policies, responding to emergencies, managing professional, technical and ancillary staff, determining budgets, performing strategic planning, and supervising construction projects.

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Advanced practice nurses (APNs) are Registered Nurses with advanced education, knowledge, skills, and scope of practice. APNs possess a master's or doctoral degree in nursing and may also sit for additional certification examinations. APNs may function as a Certified Nurse Midwife (CNM), nurse practitioner (NP), clinical nurse specialist (CNS) or Certified Registered Nurse Anesthetist (CRNA). They perform primary health care, provide mental health services, diagnose and prescribe, carry out research, and educate the public and other professionals. Some APNs diagnose illness and prescribe medication.

Related Topics:
Advanced practice nurse - Certified Nurse Midwife - Nurse practitioner - Clinical nurse specialist - Certified Registered Nurse Anesthetist

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All advanced practice credentials have requirements such as continuing education and periodic re-examination to maintain the credential.

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Advanced Practice Nurses can expect to earn above-average salaries, especially as the population of ages and the demand for highly-skilled healthcare workers grows proportionally.

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Non-nurses

Health care settings generally involve a wide range of health care workers other than nurses. Examples include:

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• Nursing assistants, orderlies, and patient care assistants are not nurses. In acute-care hospitals, their duties are limited to tasks delegated by the RN or LPN. Most orderlies are trained to perform heavy patient-movement or other muscular tasks. Certified nursing assistants assist nurses by taking vital signs, administering hygienic care, assisting with feeding, giving basic psychosocial care, and similar duties. See also candystriper and hospital volunteers.
• Technicians may wear uniforms similar to those of nurses and perform some duties traditionally associated with nurses, but are not nurses. For example, certified medication aides are trained to administer medications in a long-term care setting, but have no training in nursing decision-making; thus, their use is controversial. There are also phlebotomy technicians, who draw blood; surgical technologists, who are more or less equivalent to a Registered Nurse in the first scrub role during a surgery; and technicians trained to operate most kinds of diagnostic and laboratory equipment, such as X-ray machines, electrocardiographs, and so forth.
• Medical practitioners (medical doctors) and allied health professionals (such as speech therapists, occupational therapists and physical therapists), are not nurses. Whilst they may work closely with nurses, they are members of their own separate professions, with distinct training, licensing, skills and roles.