Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their families.

Duties

Registered nurses typically do the following:

  • Assess patients’ conditions
  • Record patients’ medical histories and symptoms
  • Observe patients and record the observations
  • Administer patients’ medicines and treatments
  • Set up plans for patients’ care or contribute information to existing plans
  • Consult and collaborate with doctors and other healthcare professionals
  • Operate and monitor medical equipment
  • Help perform diagnostic tests and analyze the results
  • Teach patients and their families how to manage illnesses or injuries
  • Explain what to do at home after treatment

Most registered nurses work as part of a team with physicians and other healthcare specialists. Some registered nurses oversee licensed practical nurses, nursing assistants, and home health aides.

Registered nurses’ duties and titles often depend on where they work and the patients they work with. For example, an oncology nurse works with cancer patients and a geriatric nurse works with elderly patients. Some registered nurses combine one or more areas of practice. For example, a pediatric oncology nurse works with children and teens who have cancer.

Many possibilities exist for working with specific patient groups. The following list includes some examples:

Addiction nurses care for patients who need help to overcome addictions to alcohol, drugs, and other substances.

Cardiovascular nurses care for patients who have heart disease or heart conditions and people who have had heart surgery.

Critical care nurses work in intensive-care units in hospitals, providing care to patients with serious, complex, and acute illnesses and injuries that need close monitoring and treatment.

Genetics nurses provide screening, counseling, and treatment for patients with genetic disorders, such as cystic fibrosis.

Neonatal nurses take care of newborn babies who have health issues.

Nephrology nurses care for patients who have kidney-related health issues stemming from diabetes, high blood pressure, substance abuse, or other causes.

Public health nurses promote public health by educating people on warning signs and symptoms of disease or managing chronic health conditions. They may also run health screenings, immunization clinics, blood drives, or other community outreach programs.

Rehabilitation nurses care for patients who have temporary or permanent disabilities or have chronic illnesses.

Some nurses do not work directly with patients, but they must still have an active registered nurse license. For example, they may work as nurse educators, healthcare consultants, or hospital administrators.

Clinical nurse specialists (CNSs) are a type of advanced practice registered nurse (APRN). They provide direct patient care in one of many nursing specialties, such as psychiatric-mental health or pediatrics. CNSs also provide indirect care by working with other nurses and medical staff to improve the quality of care that patients receive. They often serve in leadership roles and may educate and advise other nursing staff. CNSs also may conduct research and may advocate for certain policies.

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Work Environment

Registered nurses held about 3.1 million jobs in 2018. The largest employers of registered nurses were as follows:

Hospitals; state, local, and private 60%
Ambulatory healthcare services 18
Nursing and residential care facilities 7
Government 5
Educational services; state, local, and private                   3

Ambulatory healthcare services includes industries such as physicians’ offices, home healthcare, and outpatient care centers. Nurses who work in home health travel to patients’ homes; public health nurses may travel to community centers, schools, and other sites.

Some nurses travel frequently in the United States and throughout the world to help care for patients in places where there are not enough healthcare workers.

Injuries and Illnesses

Registered nurses may spend a lot of time walking, bending, stretching, and standing. They are vulnerable to back injuries because they often must lift and move patients.

The work of registered nurses may put them in close contact with people who have infectious diseases, and they frequently come into contact with potentially harmful and hazardous drugs and other substances. Therefore, registered nurses must follow strict guidelines to guard against diseases and other dangers, such as accidental needle sticks and exposure to radiation or to chemicals used in creating a sterile environment.

Work Schedules

Nurses who work in hospitals and nursing care facilities usually work in shifts to provide round-the-clock coverage. They may work nights, weekends, and holidays. They may be on call, which means that they are on duty and must be available to work on short notice.

Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to work regular business hours.

Education and Training

Registered nurses usually take one of three education paths: a bachelor’s degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program. Registered nurses must be licensed.

Education

Nursing education programs usually include courses in anatomy, physiology, microbiology psychology, and other social and behavioral sciences, as well as in liberal arts. Bachelor of science in nursing (BSN) degree programs typically take 4 years to complete; associate’s degree in nursing (ADN), associate of science in nursing (ASN) degree, and diploma programs usually take 2 to 3 years to complete. Diploma programs are typically offered by hospitals or medical centers, and there are far fewer diploma programs than there are BSN, ADN, and ASN programs. All programs include supervised clinical experience.

Bachelor’s degree programs usually include additional education in physical and social sciences, communication, leadership, and critical thinking. A bachelor’s or higher degree is often necessary for administrative positions, research, consulting, and teaching.

Generally, licensed graduates of any of the three types of education programs (bachelor’s, associate’s, or diploma) qualify for entry-level positions as a staff nurse. However, employers—particularly those in hospitals—may require a bachelor’s degree.

Registered nurses with an ADN, ASN, or diploma may go back to school to earn a bachelor’s degree through an RN-to-BSN program. There are also master’s degree programs in nursing, combined bachelor’s and master’s programs, and accelerated programs for those who wish to enter the field of nursing and already hold a bachelor’s degree in another field. Some employers offer tuition reimbursement.

Clinical nurse specialists (CNSs) must earn a master’s degree in nursing and typically already have 1 year or more of work experience as an RN or in a related field. CNSs who conduct research typically need a doctoral degree.

Licenses, Certifications, and Registrations

Registered nurses must have a nursing license issued by the state in which they work. To become licensed, nurses must graduate from an approved nursing program and pass the National Council Licensure Examination (NCLEX-RN).

Other requirements for licensing, such as passing a criminal background check, vary by state. Each state’s board of nursing provides specific requirements. For more information on the NCLEX-RN and a list of state boards of nursing, visit the National Council of State Boards of Nursing.

Nurses may become certified through professional associations in specific areas, such as ambulatory care, gerontology, or pediatrics. Although certification is usually voluntary, it demonstrates adherence to a specific level of competency, and some employers require it.

In addition, registered nursing positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS), or advanced cardiac life support (ACLS) certification.

CNSs must satisfy additional state licensing requirements, such as earning specialty certifications. Contact state boards of nursing for specific requirements.

Advancement

Most registered nurses begin as staff nurses in hospitals or community health settings. With experience, good performance, and continuing education, they can move to other settings or be promoted to positions with more responsibility.

In management, nurses may advance from assistant clinical nurse manager, charge nurse, or head nurse to more senior-level administrative roles, such as assistant director or director of nursing, vice president of nursing, or chief nursing officer. Increasingly, management-level nursing positions require a graduate degree in nursing or health services administration. Administrative positions require leadership skills, communication ability, negotiation skills, and good judgment.

Some nurses move into the business side of healthcare. Their nursing expertise and experience on a healthcare team equip them to manage ambulatory, acute, home-based, and chronic care businesses. Employers—including hospitals, insurance companies, pharmaceutical manufacturers, and managed care organizations—need registered nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance.

Some RNs may become nurse anesthetists, nurse midwives, or nurse practitioners, which, along with clinical nurse specialists, are types of advanced practice registered nurses (APRNs). APRNs need a master’s degree but many have a doctoral degree. APRNs may provide primary and specialty care, and in many states they may prescribe medications.

Other nurses work as postsecondary teachers or researchers in colleges and universities, which typically requires a Ph.D.

Personality and Interests

Registered nurses (RNs) typically have an interest in the Helping and Organizing interest areas, according to the Holland Code framework. The Helping interest area indicates a focus on assisting, serving, counseling, or teaching other people. The Organizing interest area indicates a focus on working with information and processes to keep things arranged in orderly systems.

If you are not sure whether you have a Helping or Organizing interest which might fit with a career as a registered nurse (RN), you can take a career test to measure your interests.

Registered nurses (RNs) should also possess the following specific qualities:

Critical-thinking skills. Registered nurses must be able to assess changes in the health state of patients, including when to take corrective action and when to make referrals.

Compassion. Registered nurses should be caring and sympathetic, characteristics that are valuable when caring for patients.

Detail oriented. Registered nurses must be responsible and detail oriented because they must make sure that patients get the correct treatments and medicines at the right time.

Emotional stability. Registered nurses need emotional stability to cope with human suffering, emergencies, and other stresses.

Organizational skills. Nurses often work with multiple patients with various health needs. Organizational skills are critical to ensure that each patient is given proper care.

Physical stamina. Nurses should be comfortable performing physical tasks, such as helping to lift and to move patients. They may be on their feet for most of their shift.

Speaking skills. Registered nurses must be able to talk effectively with patients to assess their health conditions. Nurses need to explain how to take medication or to give other instructions. They must be able to work in teams with other health professionals and communicate the patients’ needs.

Pay

The median annual wage for registered nurses was $73,300 in May 2019. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $52,080, and the highest 10 percent earned more than $111,220.

In May 2019, the median annual wages for registered nurses in the top industries in which they worked were as follows:

Government $79,790
Hospitals; state, local, and private 75,030
Ambulatory healthcare services 70,330
Nursing and residential care facilities 66,250
Educational services; state, local, and private                          63,690

Nurses who work in hospitals and nursing care facilities usually work in shifts to provide round-the-clock coverage. They may work nights, weekends, and holidays. They may be on call, which means that they are on duty and must be available to work on short notice. Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to have regular business hours.

Job Outlook

Employment of registered nurses is projected to grow 12 percent from 2018 to 2028, much faster than the average for all occupations. Growth will occur for a number of reasons.

Demand for healthcare services will increase because of the aging population, given that older people typically have more medical problems than younger people. Nurses also will be needed to educate and care for patients with chronic conditions, such as arthritis, dementia, diabetes, and obesity.

The financial pressure on hospitals to discharge patients as soon as possible may result in more people being admitted to long-term care facilities and outpatient care centers and in greater need for healthcare at home. Job growth is expected in facilities that provide long-term rehabilitation for stroke and head injury patients and in facilities that treat people with Alzheimer’s disease. In addition, because many older people prefer to be treated at home or in residential care facilities, registered nurses will be in demand in those settings.

Growth is also expected to be faster than average in outpatient care centers, where patients do not stay overnight, such as those that provide same-day chemotherapy, rehabilitation, and surgery. In addition, a large number of procedures, including sophisticated procedures previously done only in hospitals, are now done in ambulatory care settings and physicians’ offices.

Job Prospects

About 210,400 openings for registered nurses are projected each year, on average, over the decade.

Many of those openings are expected to result from the need to replace workers who exit the labor force, such as to retire, and from the need to replace workers who transfer to different occupations.

Overall, job opportunities for registered nurses are expected to be good. However, there may be competition for jobs in some areas of the country. Generally, registered nurses who have a bachelor of science degree in nursing (BSN) will have better job prospects than those without one. Employers also may prefer candidates who have some related work experience or certification in a specialty area, such as gerontology.

For More Information

For more information about registered nurses, including credentialing, visit

American Nurses Association

For more information about nursing education and being a registered nurse, visit

American Society of Registered Nurses

Johnson & Johnson, Discover Nursing

National League for Nursing

National Student Nurses' Association

For more information about undergraduate and graduate nursing education, nursing career options, and financial aid, visit

American Association of Colleges of Nursing

For more information about the National Council Licensure Examination (NCLEX-RN) and a list of individual state boards of nursing, visit

National Council of State Boards of Nursing

For more information about clinical nurse specialists, including a list of accredited programs, visit

National Association of Clinical Nurse Specialists

CareerOneStop

For a career video on registered nurses, visit

Registered Nurses

 

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