A registered nurse (" RN "), is a health care professional responsible for implementing the practice of nursing through the use of the nursing process in conjunction with other health care professionals. Registered nurses work as patient advocates for the care and recovery of the sick and maintenance of their health. In their work as advocates for the patient, RNs use the nursing process to assess, plan, implement, and evaluate nursing care of the sick and injured. RN's have a significantly expanded scope of practice, education and clinical training compared to that of licensed practical nurses.
Nurses scope of practice is determined by each state's Nurse Practice Act. It oulines what is legal practice for registered nurses and what tasks they may or may not perform. Nurse Practice Acts also dictate the scope of practice for nurse practitioners (NPs). An example is prescriptive authority for NPs. In some states, NPs can practice completely autonomously and prescribe any category of medications. In other states, NPs cannot prescribe controlled substances and may only practice with the collaboration of a physician.
United Kingdom
Main article: Nursing in the United Kingdom
To practice lawfully as a registered nurse in the United Kingdom, the practitioner must hold a current and valid registration with the Nursing and Midwifery Council. The title "registered nurse" can only be granted to those holding such registration. This protected title is laid down in the Nurses, Midwives and Health Visitors Act, 1997.First level Nurses First level nurses make up the bulk of the registered nurses in the UK. They were previously known by titles such as RGN (registered general nurse), RSCN (registered sick children's nurse), RMN (registered mental nurse) , RNLD (registered nurse learning disabilities)
Second level nurses
Second level nurse training is no longer provided, however they are still legally able to practice in the United Kingdom as a nurse. Many have now either retired or undertaken conversion courses to become first level nurses.
Specialist nurses
The NHS employs a huge variety of specialist nurses. These nurses have many years of experience in their field, in addition to extra education and training (see below).
They split into several major groups:
- Nurse practitioners - These nurses obtain advanced practice training. They often perform roles similar to those of Physicians and Physician Assistants, but they are not qualified to write orders or prescribe most medications. They commonly work in primary care (e.g. GP surgeries) or A&E departments, although they are increasingly being seen in other areas of practice.
- Specialist community public health nurses - traditionally district nurses and health visitors, this group of practitioners now includes many school nurses and occupational health nurses.
- Clinical nurse specialists - nurses undertaking these roles commonly provide clinical leadership and education for the staff nurses working in their department, and may also have special skills or knowledge which ward nurses can draw upon.
- Nurse consultants - these nurses are similar in many ways to the clinical nurse specialist, but at a higher level. These practitioners are responsible for clinical education and training of those in their department, and many also have active research and publication activities.
- Lecturer-practitioners - these nurses work both in the NHS, and in universities. They typically work for 2-3 days per week in each setting. In university, they train pre-registration student nurses (see below), and often teach on specialist courses for post-registration nurses (e.g. a Lecturer-practitioner in critical care may teach on a Masters degree in critical care nursing).
- Lecturers - these nurses are not employed by the NHS. Instead they work full time in universities, both teaching and performing research.
Managers
Many nurses who have worked in clinical settings for a long time choose to leave clinical nursing and join the ranks of the NHS management. This used to be seen as a natural career progression for those who had reached ward management positions, however with the advent of specialist nursing roles (see above), this has become a less attractive option.
Nonetheless, many nurses fill positions in the senior management structure of NHS organisations, some even as board members. Others choose to stay a little closer to their clinical roots by becoming clinical nurse managers or modern matrons
Nurse education
Pre-registration
In order to become a registered nurse, and work as such in the NHS, one must complete a program recognised by the Nursing and Midwifery Council. Currently, this involves completing a degree or diploma, available from a range of universities offering these courses, in the chosen branch speciality (see below), leading to both an academic award and professional registration as a 1st level registered nurse. Such a course is a 50/50 split of learning in university (i.e. through lectures, essays and examinations) and in practice (i.e. supervised patient care within a hospital or community setting).
These courses are three (occasionally four) years' long. The first year is known as the common foundation program (CFP), and teaches the basic knowledge and skills required of all nurses. The remainder of the program consists of training specific to the student's chosen branch of nursing. These are:
- Adult nursing.
- Child nursing.
- Mental health nursing.
- Learning disabilities nursing.
Midwifery training is similar in length and structure, but is sufficiently different that it is not considered a branch of nursing. There are shortened (18 month) programmes to allow nurses already qualified in the adult branch to hold dual registration as a nurse and a midwife. Shortened courses lasting 2 years also exist for graduates of other disciplines to train as nurses. This is achieved by more intense study and a shortening of the common foundation program.
Student nurses currently receive a bursary from the government to support them during their nurse training. Diploma students in England receive a non-means-tested bursary of around £6000 per year (with additional allowances for mature students or those with dependent children), whereas degree students have their bursary means tested (and so often receive less). Degree students are, however, eligible for a proportion of the government's student loan, unlike diploma students. In Scotland, however, all student nurses regardless of which course they are undertaking, receive the same bursary in line with the English diploma amount. In Wales only the Degree level course is offered and all nursing students therefore receive a non-means-tested bursary.
Before Project 2000, nurse education was the responsibility of hospitals and was not based in universities; hence many nurses who qualified prior to these reforms do not hold an academic award.
Post-registration
After the point of initial registration, there is an expectation that all qualified nurses will continue to update their skills and knowledge. The Nursing and Midwifery Council insists on a minimum of 35 hours of education every three years, as part of its post registration education and practice (PREP) requirements.
There are also opportunities for many nurses to gain additional clinical skills after qualification. Cannulation, venepuncture, intravenous drug therapy and male catheterisation are the most common, although there are many others (such as advanced life support) which some nurses will undertake.
Many nurses who qualified with a diploma choose to upgrade their qualification to a degree by studying part time. Many nurses prefer this option to gaining a degree initially, as there is often an opportunity to study in a specialist field as a part of this upgrading. Financially, in England, it is also much more lucrative, as diploma students get the full bursary during their initial training, and employers often pay for the degree course as well as the nurse's salary.
In order to become specialist nurses (such as nurse consultants, nurse practitioners etc.) or nurse educators, some nurses undertake further training above bachelors degree level. Masters degrees exist in various healthcare related topics, and some nurses choose to study for PhDs or other higher academic awards. District nurses and health visitors are also considered specialist nurses, and in order to become such they must undertake specialist training (often in the form of a top up degree (see above) or post graduate diploma).
All newly qualifying district nurses and Health Visitors are trained to prescribe from the Nurse Prescribers' Formulary, a list of medications and dressings typically useful to those carrying out these roles. Many of these (and other) nurses will also undertake training in independent and supplementary prescribing, which allows them (as of May 1 2006) to prescribe almost any drug in the British National Formulary. This has been the cause of a great deal of debate in both medical and nursing circles.
United States
The scope of practice of registered nurses is the extent to and limits of which an RN may practice. In the United States, these limits are determined by a set of laws known as the Nurse Practice Act of
College of Registered Nurses of Manitoba: RN Journal
Manitoba RN Journal (formerly Nurscene) is published quarterly (January, April, July and October) by the College of Registered Nurses of Manitoba.
Britania RN College : RN and the Environment : RN Life : Training and ...
Lesser Horshoe bat The Britannia Royal Naval College, designed by Sir Aston Webb and built in the early 1900s on the banks of the beautiful River Dart.
RN BSN Program - College of Nursing - University of Massachusetts ...
RN-BSN Program (effective Sept, 2006 for new RN students only!) Eligibility: The options are offered to registered nurses who hold current RN licensure in Massachusetts and
Best Registered Nurse (RN) College School Registered Nurse (RN) Degree ...
Home >Health Care >Registered Nurse (RN) Registered Nurse (RN) Degree College Program. Nursing is one of the nation's fastest-growing careers, and there are many job options to ...
Differential Equation: Linear Equation « RN COLLEGE
Differential equation: Discrete 1. Linear Equation Persamaan differensial adalah persamaan untuk memecahkan suatu fungsi dengan turunannya yang tidak diketahui.
Betty Baluski RN - College of the Desert > Home
Betty Baluski RN - College of the Desert is committed to protecting your privacy and developing technology that gives you the most powerful and safe online experience.
College Nursing Program Tips - RN Colleges - RN College Instructors
When considering different nursing colleges and universities, consider the admission requirements for each one. There are more males enrolling in rn colleges now than ever.
Betty Baluski RN - College of the Desert > Home
AGREEMENT BETWEEN USER AND Betty Baluski RN - College of the Desert The Betty Baluski RN - College of the Desert Web Site is comprised of various Web pages operated by Betty ...
RN:College of Nursing:SUNY Upstate Medical University
Syracuse, New York region's only Level-1 trauma center (University Hospital) with more than 80 specialty clinics and four colleges.
Curry College - RN to BS
In a period when the health care industry is focused on managed care, community health, and health promotion/disease prevention, the role of nurses takes center stage.