Nursing Specialties & Careers

Nursing careers are varied with high demand in all areas. In as little as one year you can start on the path to a rewarding career offering responsibility, job security, and attractive compensation. The American Nurses Association (ANA), defines nursing as: “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”

Healthcare industry analysts predict that the United States will experience a shortage of 800,000 nurses by the year 2020. This shortage results from a decrease in the number of nursing students (itself due to lack of nursing faculty), along with the high number of nurses who are leaving the profession for a career change or retirement. Advances in medical technology are also enabling people to live longer creating increased demand, along with new nursing specialties (e.g. nurse informatics).

Top Nursing Specialty Degrees

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Even with the shortage, the U.S. Bureau of Labor Statistics estimates that there are nearly 3 million nurses currently working in the field thereby constituting the largest clinical workforce within the healthcare industry.

Nurses work in close collaboration with physicians and are integral members of the health care team. While the physicians make diagnoses and decisions regarding treatment and medication, it is the responsibility of nurses to follow through on those orders and provide direct care to foster patient recovery. Specific duties include performing basis physical exams, including taking vital signs (heart rate, blood pressure), administering injections, setting up and monitoring IV fluids, educating patients and their families regarding medication usage and preventative health, and updating patient charts. Registered nurses with experience may supervise the work of LPNs.

Although there are a variety of nursing careers there is a common thread that runs through each, which is referred to as the “nursing process” by the American Nurses Association (ANA). The nursing process defines the steps nurses need to follow with regard to patient care. These five steps are: “assessment, diagnosis, [treatment] planning, implementation, and  evaluation (of patient outcomes).

Preparing for Nursing Careers

There are three categories of nurses, licensed practical nurses/licensed vocational nurses (LPNs/LVNs),  registered nurses (RNs), and advanced practice registered nurses (APRNs). Each category has distinct preparation requirements.

Educational preparing to begin a career as an LPN is the completion of a one year certificate program offered at hospitals, community colleges, and private vocational schools. Entry requirements include possession of a high school diploma or general equivalency diploma (GED). Some programs prefer those who have taken science coursework. Licensed practical nursing candidates will also need to pass a national certification licensure exam for practical nurses (NCLEX-PN) administered by the National League of Nursing Accreditation Commission (NLNAC).

There are three paths to begin a career as an RN. A two year diploma program offered by local hospitals, an associate’s degree in Nursing (ADN) offered by community colleges, or a bachelor of nursing degree (BSN) offered by four-year colleges. Diploma programs have fallen out of favor in recent years as most healthcare employers prefer to hire nursing candidates with a minimum of an associate’s degree and, preferably, a bachelor’s degree. Once nursing foundation courses have been satisfactorily completed, nursing candidates must then pass a certification exam (NCLEX-RN) before being granted a registered nursing license by their State Board of Nursing.

Advanced practice registered nurses (APRNs) are registered nurses with a master’s degree in a specific area of nursing practice. Graduate students develop advanced knowledge and skills in one area of nursing whether this is pediatrics  oncology, mental health, anesthesiology, or gerontology (elder care). Job titles include Nurse Practitioner (NP) Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), and Clinical Nurse Specialist (CNS).

Certification is obtained by passing a national certification exam administered by the American Nurses Credentialing Center (ANCC) which is part of the American Nurses Association. The ANCC administers specialty exams in over 30 practice areas.

Work Environments

Nursing careers may be found in all types of healthcare settings, including medical centers, rehabilitation hospitals, private physician offices, community clinics, nursing homes and long-term healthcare facilities, government and nonprofit agencies, home health agencies, as well as corporate health departments. As per the U.S. Bureau of Labor Statistics, about half of all nurses (LPNs and RNs) work within hospital settings.

Top Five Nursing Careers

While there is a nursing shortage in all areas, the five nursing careers listed below have been noted by analysts to be among the fastest growing specialties in the current job market.

1. Elder Home Care
With the growing elderly population this is a nursing career promising excellent employment opportunities over the long term. Many seniors prefer to remain in the comfort of their home while they recover from accident or illness. This is an area that provides opportunities for both LPNS and RNs. LPNs will provide a greater degree of direct patient care than RNs, such as administering medication, taking vital signs, helping with bathing, grooming, eating, and monitoring overall condition. LPNs may visit patients every day when patients are first discharged from hospitals or nursing homes but cut back to two or three times per week once the patient has stabilized.

Registered nurses supervise the work of LPNs and ensures that patients are taking medication according to schedule, performs basis physical exams, and evaluates the home environment to determine whether there is a need for assistive devices (e.g. shower rails or chairs).

The overall purpose of home care is to permit the patients sustain a certain level of independence and enjoy a better quality of life.

2. Pediatric Home Care Nurses
Pediatric home care nurses work with children and adolescents.  Pediatric nurses care for special needs children or those who have been newly released from hospitals or other care facilities. They perform basic physical examinations, conduct developmental screenings, and provide guidance to the family with regard to illness or disease management. Depending on their state of practice, pediatric home care nurses may be able to prescribe medications.

Pediatric home care nurses are advanced practice nurses who must possess a registered nurse license, along with a master’s degree.

3. Critical Care Nursing
Critical care nurses provide care to patients who are suffering from potentially life-threatening illnesses or injuries. The more critically ill the patient is the more vigilant will nursing care need to be. Critical care nurses provide patient assessment, along with intensive treatment and interventions. The majority of critical care nurses work in hospital settings in such departments as the emergency room, intensive care unit  (ICU), neonatal ICU, cardiac care unit (CCU), and telemetry unit (where patients are under constant electronic monitoring). Critical care nurses also work in home health care, as well as outpatient surgery clinics. Some critical care nurses work with emergency medical technician (EMT) teams and help transport patients to the hospital. Critical care nurses may also choose to focus on elder care either within hospitals, assisted living facilities, or nursing homes. Those interested in this nursing career need to possess an RN license.

4. Surgical Nursing Careers
Surgical nurses assist during all types of surgical procedures, from tonsillectomies to organ transplants and bypass surgery. Surgical nurses prepare patients for surgery, answer questions about the procedure, arrange needed instruments during the surgery, monitor vital signs during surgery,  chart patient recovery post-surgery, and remain an advocate for patients and their families throughout the procedure.  Surgical nurses are RNs with advanced clinical patient care skills

5. Travel Nursing
Here is a great nursing career for those who like to travel! From the beautiful shores of the Amalfi Coast in Italy, to the panorama of the Mid-west and quaint towns of New England, there are thousands of travel nursing opportunities for LPNs and RNs across the globe! Travel nursing offers nurses the opportunity to choose their location, nursing specialty, and length of assignment. With a shortage of nurses not only in the United States but around the world, travel nurses have no problem finding assignments ranging in length from two to six months at attractive salaries in the range of $20. to $50. per hour or more per hour depending on education, experience, and specialty. Many travel nurse agencies also provide such perks as health benefits, free housing, as well as sign-on bonuses. Perform some due diligence before signing up with any agency to ensure that they will assist you with obtaining assignments and help with the logistics of traveling from one assignment to the next.