GHE's Complete Guide to Becoming a Nurse

Do you care about your fellow man and want to contribute positive results to your corner of the world? Consider becoming a nurse. Nursing is rewarding work and nurses leave their jobs each day knowing they have provided quality care to patients. When a patient smiles, a nurse has accomplished his/her mission.

Nurses have ranked at the top of the most trusted, honest, and ethical professionals for each of the past 17 years, according to a U.S. Gallup poll.[1] Moreover, a nursing license opens doors to many job opportunities. Nurses are seldom unemployed for long with the current and projected future nursing shortage.

What Is a Nurse?

A nurse is a college educated individual who graduated from an accredited, structured nursing curriculum. Nursing theory classes prepare one to be a professional nurse. Students learn to assess patients and understand the medical, surgical, and mental health illnesses and treatments for people of all ages. Science classes such as human anatomy, pathophysiology, chemistry, and bacteriology are crucial to understanding how illnesses and treatments affect a person’s health.

While a few two-year associates of arts (AA) degree programs can be found, most schools of nursing have upgraded to a bachelor of science in nursing (BSN) degree. A BSN degree requires four to five years and is considered the proper qualification for a nurse to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination. After graduating from an accredited nursing program, a nurse can opt to work as a graduate nurse (GN) until she/he successfully passes the NCLEX-RN examination. This exam is frequently referred to as the "nursing board" or "state licensure board.” After passing the NCLEX-RN exam, the graduate becomes a registered nurse and earns the RN credential.

A Master of Science in Nursing (MSN) degree requires two more years of advanced nursing education and research. An MSN degree has multiple concentrations and/or specialties.

Doctoral level degrees are the highest attainable level of advanced practice in nursing. Three degrees are available: a Doctor of Nursing Science (DNS), a Doctor of Nursing Practice (DNP) and a Doctor of Philosophy (Ph.D.) in Nursing. Nurses with doctorates teach nursing curriculum in university programs, work in research, participate in healthcare policymaking, and function as executives and in high-level administration of healthcare institutions.

What Traits Make a Great Nurse?

Nursing is a rewarding career. Some might consider it a calling. However, nursing is also demanding, necessitating long hours, total focus and 100% dedication. Consider the following personality traits required to do the job successfully:

• Honest, ethical and professional
• Excellent at communication and people skills
• Detail oriented
• Energetic
• Able to solve problems and take appropriate action
• Empathetic and compassionate
• A sense of humor

What Does a Nurse Do?

Nurses function in many roles. One function within the hospital/medical center includes administering medications ordered and overseeing patient care.

Nurses also assess their patients daily/nightly, incorporating these diagnoses into their care plans. The North American Nursing Diagnosis Association (NANDA) compiles and standardizes nursing diagnoses into an official lexicon. For example, one NANDA nursing diagnosis is “lack of knowledge”[6] This nursing diagnosis is useful in identifying a given patient's lack of knowledge about a recent diagnosis of diabetes mellitus, type 2. Applying the "lack of knowledge" nursing diagnosis, the nurses caring for this patient would know to further educate him/her and his/her family about techniques to better manage the diabetes and avoid medical complications. Each ensuing encounter with the diabetic patient would be viewed as an opportunity to further teach him/her about type 2 diabetes. The nurse would confer with his/her physician or nurse practitioner (NP), consult a dietitian, and/or recommend that the patient's family attend a diabetes education class.

Effective nursing care plans usually incorporate NANDA diagnoses, as the approved and standardized language is universally understood by trained nurses. Standardization of language helps to streamline patient care and potentially improve his/her medical outcome.

Why Choose to Become a Nurse?

Generally nursing is viewed as a "helping profession," a respected and trusted institution within the healthcare ecosystem. It’s common for nurses to be consulted by family and friends about whatever ails them. There is always a need for good nurses. Nursing is a recession-proof, secure career with numerous areas of specialty and many career paths available.

What Different Types of Nursing Degrees Are Available?

Master of Science in Nursing (MSN)—Nurses with a Master of Science degree are advanced practice nurses (APNs). They have completed advanced education and clinical work and/or research. Clinical work hones their skills to assess, teach disease prevention, diagnose, treat illness, and prescribe medications. Instead of clinical work, some Master’s level curricula involve research in addition to clinical hours. Students starting college with a goal of MSN degree should expect six years’ full-time college attendance. Depending on State regulations, APNs can work independently or under the supervision of a physician.

MSN-FNP (Family Nurse Practitioner)

Master of Science in Nursing—Family Practitioners are qualified, trained and licensed to provide primary care to families of all ages. This specialty emphasizes the health of both the family unit and the individual members of that family.

MSN-NP (Adult-Gerontology)

Master of Science in Nursing--Adult-Gerontology Practitioners deal with adults, especially during mid- and later life. Gerontology experts address physical, mental and social changes in adults as they age.

MSN-MBA (Master of Business Administration)

Master of Science in Nursing-Master of Business Administration is for nursing managers interested in the business and/or administrative side of healthcare. For example, many Director of Nurses (DONs) will hold either a dual degree of MSN-MBA or MBA with a BSN degree.

MSN-NE (Nurse Educator)

Master of Science in Nursing –Education Practitioner prepares teachers of future nurses and leaders, either in a hospital or academic setting. This specialty utilizes research and nursing informatics (electronic healthcare technology) to teach student nurses best practices and the necessary documentation for patient care and outcomes.  

Master of Mental Health Nursing

Master of Science in Nursing-- Mental Health Practitioner provides psychiatric and mental health services. MSN in Mental Health Nursing graduates practice in a variety of settings including psychiatric hospitals, mental health clinics, and private practice.  

RN to MSN (Masters of Science in Nursing)

This degree is for practicing, licensed nurses (RNs) who hold a lesser degree (AA) or diploma. These RNs return to college in an RN-to-MSN degree to increase their education and practice to a Master's level. Depending on the specialty, hundreds of hours of clinical work with preceptor oversight (practicum) and/or a research project (capstone) must be completed to achieve this master’s degree.      

RN to BSN (Bachelor of Science in Nursing)

This degree is for practicing, licensed nurses (RNs) with either a diploma or AA degrees. These RNs seek to increase their education and practice to a Bachelor's (undergraduate) level. This degree path involves both clinical and research hours.

How Long Does It Take to Become a Nurse?

A BSN degree requires approximately 120 college hours and takes four to five years full-time to complete, depending on the university curriculum. A Master of Science in Nursing (MSN) involves another 30-40 college hours and can take two to three more years, depending on schedule. Many nurses work full-time or at least part-time while pursuing advanced degrees. Many online nursing degree options are tailor-made for working nurses. Contact GlobalHealth Education for more information.

Which Nursing School Should I Attend?

Look for a university with an accredited nursing program. Accreditation is a voluntary review that universities undergo,, usually administered by a third-party organization such as the Commission on Collegiate Nursing Education (CCNE), which ensures the quality and integrity of baccalaureate, graduate, and residency programs in nursing. A degree from a properly accredited institution will increase students' marketability and widen the field of career options post-graduation. The U.S. Department of Education recognizes accrediting associations for their work examining college curricula and ensuring that students are enrolled in a quality education program.[10] A list of private accrediting organizations can be found at https://ope.ed.gov/dapip/#/agency-list.

Three accreditation organizations oversee nursing education:

• Accreditation Commission for Education in Nursing (ACEN)
  The ACEN (formerly the National League of Nursing Accrediting Commission) examines and credentials nursing education programs for all nursing degrees for the U.S and its territories
   
• Commission on Collegiate Nursing Education (CCNE)
  The CCNE is a national accreditation agency which evaluates and accredits universities offering nursing curriculum, including online programs
   
• Accrediting Bureau of Health Education schools (ABHE)
  The ABHE evaluates and accredits private university health education programs

Many colleges have multiple accreditations, especially for different career tracks

• The Higher Learning Commission (HLC) acts as one of six regional accrediting groups credentialing universities in 19 states
• The Distance Education Accrediting Commission (DEAC) evaluates and accredits on-line (distance or correspondence) programs [10]

Nursing School Requirements/How Can I Prepare for Nursing School?

Programs vary but nursing programs admission requirements may include:

• A high school diploma or an associate of arts (AA) college degree
• Total GPA of 2.75 and a minimum GPA of 2.5 for science classes
• Volunteer experience
• High school or college science classes including chemistry, organic chemistry, biology, anatomy, physiology, and microbiology[8] 
• Many university undergrads take science and general education prerequisites while applying for admission to nursing programs

Where Do Nurses Work?

Nurses work inside and outside of hospitals and medical centers. Their work in conventional venues focused on patient treatment and care, administration, and nurse management. More specifically, nurses serve a number of functions such as:

• Assist doctors in labor and delivery areas, oncology infusion centers, operating rooms, and neonatal units.
• Provide administrative leadership in hospital and medical center administration  
• Manage emergency rooms with triage and treatment of trauma victims and other patients
• Mentor new graduate nurses
• Care for acutely ill patients recovering from major surgeries in intensive care units

Nurses also work as specialists outside of the traditional medical environment. For example, nurses:

• Serve as wellness coordinators in corporations and provide screenings and health education to employees
• Work within the insurance industry to provide case management service for policyholders
• Act as administrators for nursing homes, rehabilitation centers, and hospice centers

In addition to providing medical and business services in different venues, nurses with Master’s degrees assume leadership roles, educate future nurses, and practice more advanced medical services than those who do not have a graduate degree. Advanced practice nurses with Master’s degrees:.

• Partner with specialized physicians and prescribe medications and treatments  
• See patients as primary care providers in outpatient clinics and medical office settings
• Teach in nursing programs for licensed practical nurses (LPNs) and BSN level nurses

In summary, nurses can play a myriad of roles in conventional medical venues and non-traditional business and academic settings alike.

How Much Do Registered Nurses (RN’s) Make?

According to a Medscape survey of 10,500 nurses, average RN earnings are climbing yearly with 2017 salaries at $80,000. Salaries may vary depending on location, population and average cost of living. Nursing salaries are listed by state here: https://nursesalaryguide.net/nurse-salary-by-state/ Certification may increase average annual salaries by $7000.

Masters of Science Advanced Practice Nurses make larger salaries averaging from $92,000 to $124,000 per year to compensate for additional education and responsibilities.7 The average salaries of nurse practitioners listed state-by-state can be found here: https://nursejournal.org/nurse-practitioner/nurse-practitioner-salary-statistics/

What Is the Job Outlook for Nurses in 2019?

According to the Bureau Labor Statistics, the demand for competent, trained nurses continues to increase. By 2020, job growth for nurses are projected to jump 26%.8 When surveyed in 2017, 48% of working nurses say the nursing shortage has increased in the last five years.[2]  Nursing shortages will continue to rise as an average of 60K working nurses retire every year.[2]    

Work Hours

Work hours vary by facility and department. Many hospital nursing unit staff work three 12-hour shifts per week (36 hours per week/72 hours per two-week pay period) with full-time benefits. Many nurses love having four days off every week. Some nursing jobs such as operating room nurses work five 8-hour days per week, with on-call night and weekend emergency hours if the facility doesn’t provide around-the-clock OR staffing. School nurses work school hours (8 to 3:30) five days a week with days off when school is not in session.

Nursing—Scope of Practice

Each state defines the “scope of practice” for nurses working in that state. For example, Missouri recognizes a registered nurse and a registered professional nurse as the same credential. Activities within a Missouri nurse’s scope of practice include:

• Proper patient assessment, nursing diagnoses, provision of nursing care, and counsel to ill and injured patients
• Administration of prescribed medications and treatments ordered by physicians and APNs
• Coordination with other healthcare providers to achieve an appropriate plan of care for each patient under her/his care
• Teaching health and prevention of illness as needed to patients and family
• Teaching and delegation of tasks to healthcare workers under their supervision [9]

What is a Preceptor?

A preceptor nurse is an experienced nurse who mentors newly graduated nurses or new nursing employees, teaching best practices in their areas of specialty. For example, the operating room is a unique environment where the patient is unable to speak for himself while under anesthesia and surgery. Preceptor nurses teach evidence-based practices and oversee the actions of the new nurse to ensure the patient’s safety.  

Nurse Residency Programs

Nursing residency programs are usually provided by the hospital/medical center hiring graduates. Residencies allow new nurses to practice their newly acquired skills in a safe and supervised environment. Classroom studies continue during residency, as well as hands-on training with preceptors during clinical hours.

Benefits of a nursing residency include: one-on-one mentoring with a more experienced preceptor, practicing new skills in a safe and supervised environment, developing communication skills around protecting the patient from harm, building confidence in assessing patients and making informed diagnoses.[3]

What Is the Difference Between Licensure and Certification?

Licensure requires a passing grade on a mandatory NCLEX-RN exam, which is administered by each state. A passing grade on the NCLEX-RN exam credentials the nurse as a Registered Nurse. This credential shows the nurse meets the standards set by that state’s board of nursing.

Several of the MSN specialties also require separate licensure. For example, the advanced practice FNP nurse must also pass the FNP licensure test before practicing as FNP.

Certification is not required for BSN nurses, but is an option for advanced nursing education in certain specialties. Many certifications require regular renewals and it is incumbent upon the BSN nurse to retake the exams to keep his/her certification current.

Some MSN nurse specialties offer certification. For example, certification is available to MSN-FNP nurses who pass the certification test. The certified MSN-FNP could use the credentials Family Nurse Practitioner-Board Certified (FNP-BC).  

Professional Organizations for Nurses

Fortunately, nurses have an array of professional organizations available for support, continued education and awards and recognition. The Health Occupation Students Association (HOSA) serves as a student nurses’ organization. The American Nurses Association (ANA) is an all-encompassing organization for all registered nurses in the U.S. Sigma Theta Tau International is an honor sorority dedicated to both nursing students who achieve academic excellence and to practicing nurses who display distinctive leadership and/or scholarship in their fields.

Professional nursing organizations provide the following to their members:

• Accredited continuing education for specialty nursing members
• Monthly peer-reviewed magazines/journals
• Meetings and annual conference
• Online classes and education
• Evidence-based guidelines for care of patients within that nursing specialty
• Collaboration with specialties’ certification board

An exhaustive list of professional nursing organizations can be found here: http://nursinglink.monster.com/education/articles/11850-the-ultimate-list-of-professional-associations-for-nurses

Nursing Conferences (US)

Nursing conferences provide both nursing leaders and practicing nurses an opportunity to develop professional relationships and attend classes on current practices and innovations. Many nursing specialties have annual conferences for members to attend.

Vendor fairs included in the conference give nurse attendees the opportunity to evaluate new technology and equipment. For example, nurses might be asked by their director of nursing (DON) to evaluate and compare new intravenous (IV) pumps at a conference vendor fair. These nurses would stop at different IV pump vendor stations and evaluate the operation, safety features and user-friendliness of the pump. After evaluating these pumps, the nurses make a recommendation to their DON, and help determine the best IV pump for his/her specific facility or application.

 

 

References:

1. American Hospital Association. (2019). For the 17th year in a row, nurses top Gallup’s poll of most trusted professionals. https://www.aha.org/news/insights-and-analysis/2019-01-09-17th-year-row-nurses-top-gallups-poll-most-trusted-profession

2. AMN Healthcare. Baby-Boomer Nurse Retirement Wave Hits, Magnifying Nurse Shortages for the Next Decade. https://www.amnhealthcare.com/latest-healthcare-news/nurse-retirement-wave-hits/

3. Bleich, M.R. (2012). In praise of nursing residency programs. American Nurse Today.7(5). https://www.americannursetoday.com/in-praise-of-nursing-residency-programs/

4. Lippincott Solutions. Nursing Salary Report 2018. http://lippincottsolutions.lww.com/blog.entry.html/2018/01/09/nursing_salary_repor-7Thk.html

5. Minority Nurse, 10 Qualities that Make a Great Nurse, https://minoritynurse.com/10-qualities-that-make-a-great-nurse/

6. NANDA, NANDA Nursing Diagnosis List. http://www.nandanursingdiagnosislist.org/

7. Nurse Journal. Nurse Practitioner Salary by State. https://nursejournal.org/nurse-practitioner/nurse-practitioner-salary-statistics/

8. Nurse Journal. Anatomy of a Nursing BSN Degree. https://nursejournal.org/bsn-degree/anatomy-of-a-bsn-degree/

9. State of Missouri Revisor of Statutes, Occupations and Professions,

http://revisor.mo.gov/main/OneSection.aspx?section=335.016

10. U.S. Department of Education. Database of Accredited Postsecondary Institutions and Programs.

https://ope.ed.gov/dapip/#/agency-list