Nurse

From Freepedia

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).

A nurse is a health care professional who is engaged in the practice of nursing. Nurses are men and women who are responsible (along with other health care professionals) for the safety and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research.

Image:Altenpflegerin D1824.jpg

Contents

Overview

Nurses develop a plan of care, often working collaboratively with physicians, therapists, the patient, the patient's family and other team members. In the US, advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe medications and other therapies. Nurses may help coordinate the patient care performed by other members of a health care team such as therapists, medical practitioners, dietitians, etc. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.

According to the US Department of Labor's revised Occupational Outlook Handbook (2000), "Registered nurses (R.N.s) work to promote health, prevent disease, and help patients cope with illness. They are advocates and health educators for patients, families, and communities. When providing direct patient care, they observe, assess, and record symptoms, responses, and progress; assist physicians during treatments and examinations; administer medications; and assist in convalescence and rehabilitation. R.N.s also develop and manage nursing care plans; instruct patients and their families in proper care; and help individuals and groups take steps to improve or maintain their health."

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.

In various parts of the world, the educational background for nurses varies widely. In some parts of eastern Europe, nurses are high school graduates with twelve to eighteen months of training. In contrast, Chile requires any Registered Nurse to have at least a bachelor's degree.

At the top of the educational ladder is the doctoral-prepared nurse. Nurses may gain the PhD or another doctoral degree such as Doctor of Nursing Science (DNSc) or Doctor of Nursing Practice (DNP), specializing in research, clinical nursing, etc. These nurses practice nursing, teach nursing and carry out nursing research. As the science of nursing has advanced, so has the demand for doctoral-prepared nurses.

Australia

Image:Wiki letter w.png It is requested that this article (or a section of this article) be expanded.

Please remove this notice after the article has been expanded. Details
are elsewhere on this talk page or at Wikipedia:Requests for expansion.

Canada

Image:Wiki letter w.png It is requested that this article (or a section of this article) be expanded.

Please remove this notice after the article has been expanded. Details
are elsewhere on this talk page or at Wikipedia:Requests for expansion.

Education

Most provinces in Canada prefer any registered nurse to have at least a bachelor's degree. Many practicing nurses are still college graduates but those entering nursing now are required or encouraged to enter at the university level.

New Zealand

Image:Wiki letter w.png It is requested that this article (or a section of this article) be expanded.

Please remove this notice after the article has been expanded. Details
are elsewhere on this talk page or at Wikipedia:Requests for expansion.

UK

Education

Since the 1990s, UK nurses are now educated to diploma or bachelor's degree level. They undertake their training at universities and in placements in healthcare settings. Following a common foundation programme, nurses then choose to specialise in a branch programme that reflects the area of nursing in which they wish to work. On qualification all nurses take the title of Registered Nurse.

Titles

  • RGN - Registered General Nurse
  • RMN - Registered Mental Nurse
  • RSCN - Registered Sick Childrens' Nurse
  • (S)EN - (State) Enrolled Nurse
  • RN - Registered Nurse (Applies to Adult, Child, Mental Health or Learning Disability nurses)

Pre-Project 2000

Student Nurses

Prior to the implementation of Project 2000, nurse education was the responsibilty of teaching hospitals and local Schools of Nursing. Student nurses were salaried members of the health service during their training. For example, for student RGNs, this would involve what was known as "rotational" or "modular" training, where the student would go to different areas (e.g. paediatrics, medical, surgical etc). With RSCNs specifically placed in areas dealing with children, and also for RMN - with persons with a mental disability. At the end of their three (or two) years training, nurses were eligible to regsiter with the United Kingdom Central Council of Nursing and Midwifery (UKCC), and were then legally able to practice as a nurse within the United Kingdom.

Registered Nurses

There were (and still are) two levels of nurse; 1st levels are nurses trained for 3 years (RGN, RMN, RSCN, RN {all branches]} whereas 2nd level nurses are the SENs, who trained for two years. Formerly, SENs worked under the direction of 1st level nurses, although nowadays this distinction is less clear.

Project 2000

Student Nurses

Under the Thatcher government a report by the UKCC was produced to radically change the face of nurse training within the United Kingdom. Students were to be given supernumerary status, and were no longer employed directly by the hospital trusts. The education was moved in to classroom, with colleges and "new" post-1992 universities training nurses. The diploma or degree in nursing, is the only way to register as a nurse in the UK. The three [or four] year full-time course is 50/50 theory and practice. The clinical practice is in local hospitals, community health centres etc. Students follow in their first year a "Common Foundation Programme" that is taught to all student nurses irrespective of their future branch. The next two years are the branch specific programme, where students are taught the skills for their chosen branch, be it adult, childrens, mental health or learning disabilities. At the end of year 3, students can register with the NMC [which replaced the UKCC].

Regsitered Nurses

All nurses, that qualify in Britain currently belong to one of the four branches of nursing. Adult, Children's, Mental Health, Learning Disabilities. All have an RN qualification within their specific branch and are registered as such on the NMC register

Legal regulation

All UK nurses are listed on a register and are regulated by the Nursing & Midwifery Council (NMC). Nurses need to re-register every three years and are required in this time to have demonstrated that they have kept up-to-date by undertaking a set number of hours of professional development and nursing practice.

There are 672,897 registered nurses and midwives on the NMC's register, including non-practising nurses and midwives within the UK who have maintained their registration. Approximately 11% of registrants are male and the percentage is steadily increasing year on year. As of August 2005, the NMC register is split into three distint parts, Nurses, Midwives and Specialist Community Public Health Nurses. There are 'sub-parts' that the nurse or midwife is registered to practice in and the old version is still valid. These are:

Pre-Project 2000 Nurses

  • 1 - First level nurses trained in general nursing [RGN]
  • 2 - Second level nurses trained in general nursing (England and Wales)
  • 3 - First level nurses – mental illness [RMN]
  • 4 - Second level nurses – mental illness (England and Wales)
  • 5 - First level nurses – learning disabilities [RNLD]
  • 6 - Second level nurses – learning disabilities (England and Wales)
  • 7 - Second level nurses (Scotland and Northern Ireland)
  • 8 - Nurses – children [RSCN]
  • 9 - Fever nurses [Obsolete]
  • 10 - Midwives [RM]
  • 11 - Health visitors [HV]

Project 2000 Nurses

  • 12 - First level nurses – adult nursing [RN]
  • 13 - First level nurses – mental health [RN]
  • 14 - First level nurses – learning disabilities [RN]
  • 15 - First level nurses – children [RN]

US

Education

Registered Nurses generally receive their basic preparation through one of three basic avenues:

  1. Graduation from an associate's degree-granting nursing program (approximately three years of college level study with a strong emphasis on clinical knowledge and skills)earning the degree of ASN/AAS in Nursing.
  2. Graduation with a three-year (diploma) certificate from a hospital-based school of nursing (non-degree). Few of these programs remain in the US and the proportion of nurses practicing with a diploma is rapidly decreasing.
  3. Graduation from a university with a bachelor's degree in nursing (a four - five year program conferring the BSN/BN degree with enhanced emphasis on leadership and research as well as clinically-focused courses).

There are also special programs for "LPN to RN", for people who hold undergraduate degrees in other disciplines, and for paramedics or military medics. Graduates of all programs, once licensed, are eligible for employment as entry-level staff nurses.

A typical course of study at any level typically includes such topics as:

All pathways into practice require that the candidate undergo clinical training in nursing. Care is delivered by the student nurses under academic supervision in the hospital and in other practice settings. Clinical courses typically include:

While in clinical training, student nurses are identified by a special uniform to distinguish them from licensed professionals.

It is common for RNs to seek additional education at the master's degree or doctorate level to prepare themselves to assume leadership or advanced practice roles within nursing. Management and teaching positions increasingly require candidates to hold an advanced degree in nursing. Many hospitals offer tuition reimbursement or assistance to nurses who want to continue their education beyond their basic preparation.

Many nurses pursue voluntary specialty certification through professional organizations and certifying bodies in order to demonstrate advanced knowledge and skills in their area of expertise.

All US states and territories require RNs to graduate from an accredited nursing program which allows the candidate to sit for the NCLEX-RN, a standardized examination administered through the National Council of State Nursing Boards. Successful completion of the NCLEX-RN is required for state licensure as an RN.

Nurses from other countries are required to be proficient in English and have their educational credentials evaluated by an association known as the Council of Graduates of Foreign Nursing Schools prior to being permitted to take the US licensing exam.

Legal regulation

Government regulates the profession of nursing to protect the public.

In the US, the individual states have authority over nursing practice. The scope of practice is defined by legislative and regulatory laws which are administered by State Nursing Boards.

Many states have adopted the Model Nursing Practice Act and Model Nursing Administrative Rules created by the National Council of State Nursing Boards (NCSNB). In addition, many State Nursing Boards model their licensure requirements on the Uniform Core Licensure Requirements which set forth competency development and competency assessment principles.

Nurses may be licensed in more than one state, either by examination or endorsement of a license issued by another state. In addition, the states which have adopted the Nurse Licensure Compact allow nurses licensed in one of the states to practice in all of them through mutual recognition of licensure.

Licenses must be periodically renewed. Some states require continuing education in order to renew licenses.

Types of nurses

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.

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.

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

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.

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.

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.

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.

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.

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

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.

Non-nurses

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

  • 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.

See also

Look up Nurse on Wiktionary, the free dictionary

External links

Retrieved from "http://en.freepedia.org/Nurse.html"


Views
Personal tools
In other languages
Similar Links