What is a registered nurse?

A registered nurse (RN) is a graduate from an accredited nursing degree program who has obtained a nursing license from a state board of nursing. Although most nurses choose to care for patients in a hospital setting, many pursue alternate career paths where they use their nursing expertise and training in other settings like business, law, case management or research. Being a nurse can mean almost anything.

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With over 3.8 million nurses in the United States workforce, nurses make up the largest part of the healthcare industry. Nurses are bedside caregivers, executives, academic researchers, writers and much more. For the 18th year in a row, polled Americans ranked nurses the highest among all careers for honesty and ethics. Registered Nurses form the foundation for our healthcare system.

What do registered nurses do?

Registered nurses are experts in healthcare management. Nurses are neither assistants nor ancillary providers but independent patient care providers. A nurse’s scope of practice – what they are allowed to do or not do — is defined by state-specific Nurse Practice Acts. Although nurses fulfill many different roles, these are a few core functions: assessment, education, skill performance, leadership and advocacy. 

Assessment: Nurses perform thorough assessments at every level from the individual patient to the larger population. They triage patients to decide their acuity of illness, taking vital signs (heart rate, blood pressure and respiratory rate) and interpreting them based on a patient’s appearance presentation. They assess specific body systems and make care decisions based on what we observe. Moreover, nurse-driven protocols allow nurses to use their own clinical judgement and assessments to make care decisions.  

But nurses also assess at a macro level—they are trained to recognize needs of larger populations or demographics to provide public health recommendations. 

Education: Nurses provide a significant amount of healthcare education to patients, their families, and the larger communities. Most nursing careers involve education, but some nurses choose to make teaching their specialty and become diabetes educators, CPR instructors, nursing school professors or unit-based educators who instruct staff nurses on best practices and skills.  

Skill performance: Nurses are required to learn many different practical skills including wound care, catheterization, phlebotomy and countless others while in nursing school. But skill-learning doesn’t stop after nursing school ends. New equipment, new techniques and new technology provide new ways of caring for patients. Nurses perform dialysis and many other forms of intense, life-saving therapies which all require million-dollar equipment, high level training and expert judgement. All of these technical skills integrate critical thinking to ensure patient safety. 

Leadership: Nursing has an extraordinary number of opportunities for leadership careers. Whether it’s as a charge nurse on an in-patient unit or heading up a hospital task force, you’ll find nurse leaders in every aspect of healthcare. Nurse executives sit in board rooms of hospitals, staffing companies and research firms. 

Advocacy: Nurses use their expertise to ensure patients have a voice in their care. When patients are unable to speak, nurses speak for them. Nurses often spend the most time with the patient, so it’s their job to recognize potential problems and alert the interdisciplinary team. Nurses promote care coordination by interfacing with many disciplines like social work or physical therapy. Because nurses are often the last line of defense against patient safety events, nurses often catch harmful situations and recognize “near miss” scenarios. Nurses are also often instrumental to the implementation of safety policies and quality assurance reporting.

How can you become a registered nurse?

Start by choosing the type of degree you want, and then choose a program that best suits your life. 

There are three main education options to become an RN: Associates Degree in Nursing (ADN), Bachelors of Science in Nursing (BSN) Degree or entry-into-practice Master’s Degree (MS/MSN). Some evidence suggests that many employers prefer new graduates to have a Bachelor’s degree or higher. 

Programs vary widely on:

  • Length of program: Some accelerated programs are as quick as 16 months while many BSN programs can take 4 years.
  • Schedule: Part-time or full-time commitment.
  • Method of instruction: Online vs. in-person.

After completing an accredited nursing program you are eligible to sit for the National Council of State Boards of Nursing’s National Council Licensure Examination (NCLEX). After passing the exam, you can apply for a license.

What does it mean to have a nursing license?

State boards of nursing regulate and confer RN licensures. Some state nursing boards have agreements with other states, meaning a nursing license is also valid in those states. These states are referred to as “Compact States.” A list of the current Nurse Licensure Compact states can be found here

An RN license can be used for many different types of careers as long as your role falls within the bounds of your licensure state’s Nurse Practice Act. 

After obtaining an RN license, nurses may choose to specialize in a particular field and obtain a certification to demonstrate their higher-level expertise. Many RNs choose to pursue higher level graduate, post-graduate or doctorate degrees to become Advanced Practice Registered Nurses (APRNs). Possible careers include clinical nurse specialist, nurse practitioner, hospital administrator, nursing school professor or certified registered nurse anesthetist (CRNA). Registered nursing is the foundation for all of these advanced degrees. 

How much do nurses make?

The Bureau of Labor Statistics reports that in 2019, registered nurse median pay was $73,300 per year or $35.24 per hour. Nurses are often paid hourly, but some places offer salaried positions. Many positions offer shift rate differentials — additional money on top of base rate — for evenings, nights, weekends and holiday hours. Nursing can be highly lucrative with options like agency and travel nurse jobs often paying more than the average nurse rates. 

Bottom line

Registered nursing is more than a degree and more than a license. Registered nurses promote the overall health of our communities. RNs are taught both empathy and critical thinking. They are taught concrete practical skills as well as the art of caring. A nurse’s approach to healthcare recognizes each person as a holistic being with complex needs. A registered nurse license opens the door to hundreds of career options from the bedside to the board room.

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