Nursing as a profession   by Aaron Rubin

Nursing is a highly regarded profession with high standards of honesty and ethics amongst various other professions. Nursing has emerged as the largest health care occupation with over 2.7 million jobs. With over 100,000 vacant positions and a ever-growing need for health care workers, the career outlook is excellent for the nursing field. National Center for Workforce Analysis, an agency of the U.S. Department of Health and Human Services predicts a shortage of 808,416 nurses by the year 2020. Such an analysis and prediction is backed by very strong reasoning and findings. Advancement in technology and medical field has resulted in an increased life span. Elderly population is now living longer and more of them will require care and nursing. With more elderly people in need of such care, demands rise for nursing force that can meet such needs. Also, the need for more skilled nurses is growing. With insurance companies stepping into the medical field to reduce the cost of health care expenditure, demand for nurses, outside the hospital setting has also risen. Not to forget that the current nursing workforce is aging and many are expected to retire over next 10-15 years only to create a void, adding to the shortage further. So, nurses with a BSN degree can expect a securer career and better job prospects.

Nurses blend knowledge of science and technology with the art of care and compassion. Nursing provides opportunity to save and improve lives, care for the sick and debilitated, educate patients and people towards achieving good health and above all, the feeling of helping someone in their hour of illness and need. There is no greater service than caring for the sick and needy. Nurses are required to deliver basic duties, which includes but is not limited to providing treatment, health education, emotional support, record maintenance, operating medical equipment in addition to counseling patient and their family about the management of their illness. Registered Nurses (RNs) also run general health screening and immunization clinics, organize public seminars, motivate blood donation drives, etc. Three out of five nurses in the United States work in hospitals. Most of the others work in clinics, home health, extended care settings, schools, colleges, universities, the public health services, and nonprofit agencies throughout the United States and many other countries. Nursing can be a challenging job with continuous exposure to grief and suffering, stress, work pressures, little or excessive patient contact and occupational hazards including but not limited to infectious diseases, radiation exposure, accidental needle sticks, chemicals, anesthesia, back injury and emotional stress. Role autonomy and independence, innovativeness, technical knowledge, and teamwork are characteristics of this job, in addition to personal satisfaction and professional rewards.

The nursing schools are a gateway to this profession and almost all of them require a high school diploma in addition to sound academic standing in English, Algebra, Biology, Chemistry, and Psychology with a GPA score of atleast 3. Computer experience is an asset. Leadership and organization skills are vital to this profession. Most schools shall still require you to clear the National League for Nursing (NLN) Pre-admission exam besides the SAT exam. Over 1,500 nursing programs in the US provide three different educational paths towards becoming a Registered Nurse (RN). Bachelor of Science in Nursing (BSN) is a four-year program offered at colleges and universities. An associate Degree in Nursing (ADN) is a two-year program offered at many community and junior colleges. Some hospital schools of nursing and universities offer an ADN degrees. Hospital Diploma is a two to three year program based in hospital settings. Many diploma schools are affiliated with junior colleges where students take basic science and English requirements. Opportunities are maximum with a BSN degree. BSN is a requirement for obtaining a master's degree or becoming an Advanced Practice Nurse (APN). The American Association of Colleges of Nursing (AACN) recognizes the BSN degree as the minimum educational requirement for a professional nursing practice. Even though graduates can begin practice as an RN with an ADN or diploma, the BSN degree is a must for nurses seeking to assume roles as case-managers or supervisors or move across employment settings. Tuition fee depends on your college and state of residence, but financial aids and scholarships are available to take care of such needs. There are technical and vocational schools as well, which provide one-year course towards becoming a Practical Nurse or a Vocational Nurse. Once graduated, the next important thing is to obtain licensure for practice in the State of your preference. Eighteen states participate in the Nurse Licensure Compact Agreement (NCLA) which permits a licensed nurse to practice in any of the other seventeen states, if they have obtained license to practice in one of the states. License can be obtained by passing national licensing exam NCLEX-RN for becoming a Registered Nurse and NCLEX-PN for becoming Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) as in Texas, California. LPN and LCN provide care for sick, injured and disabled under direct supervision of physicians and RNs.

Nursing career is full of opportunities for those who want to specialize and pursue higher education. A few popular specialties are AIDS Care Nurse, Ambulatory Care Nurse, Cardiac Rehabilitation Nurse, Case Management, Correctional Nurse, Enterostomal Therapy Nurse, Gastroenterology/Endoscopy Nurse, Genetics Nurse, Infection Control Nurse, Intravenous Therapy Nurse, long-term Care Nurse, Managed Care Nurse, Nephrology Nurse and more, the list does not end here. Most of the specialties do welcome RNs with a BSN degree only. In addition, there is increasing demand for APNs. APNs are primary health care practitioners, working independently or in collaboration with physicians. In most states, they are permitted to prescribe medications. The four specializations for APNs include Clinical Nurse Specialist (CNS) providing expert consultation in any of the above mentioned specialties; Nurse Anesthetists (CRNA) administer anesthesia and monitor patient's vital signs during surgery in addition to providing post-anesthesia care; Nurse Midwives (CNM) provide primary care to females covering aspects like family planning, prenatal care, neonatal care and assist delivery; and Nurse Practitioners (NP) who provide basic preventive health care to patient. NPs are primary as well as specialty care providers in medically underserved areas. APNs are lower cost primary care providers in comparison to physicians.

Advanced degrees available to nurses are masters (MSN), doctoral degree (Ph.D., EdD, DNS) and post-doctoral programmes. Doctoral degrees can provide placements as a senior policy analyst, researcher, health system executive and as a nursing school dean.

RNs may work as a staff nurse or become APNs. Also exisins are a few positions involving little or no direct patient contact. Such positions include Case Managers, Forensic Managers (applying knowledge of nursing for legal enforcement, like treating and investigating a victim of assault or abuse and similar), Infection Control Nurses, Legal Nurse Consultants (assist lawyers in medical cases by interviewing patient, organizing records, and educating lawyers about medical conditions), Nurse Administrators, Nurse Informatics, Health Care Consultants, Public Policy Advisors, Medical editors and writers.

Career and job prospects are bright as mentioned above and with increasing demand and difficulty to hold up nurses in hospitals, many hospitals and corporate sectors have now started offering incentives like signing bonuses, subsidized training, open shift bidding. Open shift bidding is an emerging concept where nurses can find vacant shifts at premium wages and bid for same online. This also reduces mandatory overtime that many nurses have to do otherwise. Many employers now provide family friendly work schedules and flexibility, again an indication of demand in such places.

RNs are earning anywhere from $37,300 to greater than $74,760 depending upon qualifications and experience, besides job locations. Median salary can be appreciated as $52,330 annually. Entry level RN can earn from $30,000 to $45,000 annually. All this comes with benefit packages including health insurance, holiday pay, college tuition reimbursement, childcare, pension plans and much more. Expected shortage of nurses over coming years is going to tilt the situation more in the favor of nurses and they can look forward to a securer future with brighter prospects and rewards.

Becoming a nurse is not just about money but dedicating your life to service mankind, caring for the sick and to be able to support them and their family in difficult times. The potential is enormous and specialization options aplenty. Nursing as a profession is full of personal satisfaction and professional rewards.