Becoming a Registered Nurses

Careers in Registered Nursing Today and in the Future

The need for registered nurses has never been greater. In today's healthcare environment, cost and quality, as well as an organization's ability to delivery positive outcomes, will largely determine its success. Further, rapid developments in science and new community responsibilities require new approaches to nursing today. In addition, and perhaps even more importantly, Americans are getting older faster, and the demands on the healthcare system to provide for timely and appropriate levels of care for this growing segment of the population will require innovative approaches to healthcare delivery, including expanded roles for registered nurses. This paper examines the current status of registered nursing in the United States including typical wages and benefits, followed by a description of the types of duties and responsibilities generally encountered in healthcare settings. An analysis of current and future trends for registered nurses is followed by a summary of the research in the conclusion.

Review and Discussion

Background and Overview. "Nurses' work has both sacred and profane aspects. Day after day, nurses participate in the human events of suffering, healing, and dying" (Robinson 1988:x). Some hospitals use nurse-midwives in maternity departments. Registered nurses who occupy specialty position often work in a number of other areas as well, such as medical, surgical, obstetric, pediatric, psychiatric, and rehabilitative; these nurses frequently cross over to other fields as consultants (Scarborough 2004). For example, registered nurses ease patients' transition when returning home and assure planned continuity of health care; a few registered nurses provide ombudsman, or patient-advocate, services and still others perform research aimed at solving problems and at devising improved ways of caring for patients (Scarborough 2004). The healthcare community in general has responded to market reforms over the past few years with a number of economic initiatives; in this price-driven setting, physicians are passing more tasks along to registered nurses. For instance, in surgical and medical cases, nurses start and monitor intravenous infusions, catheterizations, the dressing of wounds, and other matters; under broad surveillance, RNs also administer anesthesia, as a nurse anesthetists. "They help with childbirths, even though they may not be trained in midwifery. They also operate X-ray, electrocardiograph, and laboratory equipment" (Roemer 1991:25). In settings outside of hospitals, an increasing number of registered nurses are being demanded by public health agencies and visiting nurse associations. Registered nurses are also being used in expanded roles in the treatment of the elderly and chronically ill patients in their homes, and they are called on to provide home care through a variety of healthcare programs. Roemer adds, "Industries expand their nursing service, to meet the pressures of factory employment. Nurses are sought by physicians or dentists as office attendants. (This less demanding work may serve as an alternative to the heavy requirements of bedside nursing or supervision.)" (1991:26). Finally, RNs are assuming increasingly important roles in psychiatric and other mental health settings as well (Roemer 1991).

Wages and Benefits. According to the data cited by DiscoverNursing's website from the American Nurses Association, the average staff nurse in the U.S. working in all settings earned $35,212; hospital staff nurses reported $36,618. Registered nurses who occupied administrator positions (a fairly small segment at 6.2%) earned $45,071; an even smaller segment, instructors (3.5%) earned $36,896 and supervisors (5%) earned $38,979. The ANA also reports that the average clinical nurse specialist earns $41,226, nurse practitioners on average earn $43,636, Nurse Anesthetists: $76,053 (Nursing: A Career with Unlimited Potential 2004:2). Average salaries for RNs compared to other types of nurses is shown in Figure 1 below.

Figure 1: 2001 Average Salary by Position in the U.S. - 2005-2020 [Source: (Nursing: A Career with Unlimited Potential 2004)].

Current and Future Trends. According to DiscoverNursing's website (2004), the job market may be tough in some industries in the United States, but one job continues to be high in demand: registered nursing. "Did you know," they say, "that well-paying jobs for registered nurses are available in almost every city in America? But it's not just the job market that makes nursing a good career choice. As a nurse, you have the opportunity to touch lives, to comfort, and to care -- every day" (1). There are over 100,000 vacant positions for registered nurses in the U.S. today and the demand continues to grow; consequently, the career outlook is excellent. Because of the increasing need for nurses, some hospitals are offering signing bonuses of up to $14,000 for experienced nurses (Nursing: A Career with Unlimited Potential 2004:4). Furthermore, the future for careers in registered nursing appears even brighter, since by the year 2020, there will be an estimated shortage of 434,000 nurses. "With the world population living longer and needing more care, the healthcare field is one of the best places to get a job, and will likely stay that way for many years to come" (Nursing: A Career with Unlimited Potential 2004:2).

Figure 2: Number of Projected Open RN Positioned in the U.S. - 2005-2020 [Source: (Nursing: A Career with Unlimited Potential 2004)].

According to Milton I. Roemer (1991), "Over the years, the scope of functions that nurses have been expected to perform has steadily broadened. The great majority of professional (fully educated) nurses in all countries work in hospitals, and here their technical services have increased with advances in medical diagnosis and treatment. Intensive care units (ICUs) in large hospitals require many more highly trained nurses than the general wards, and such ICU units are increasing. The aging of the population, as people survive into the later decades of life, contributes to this increase. In addition, more institutional beds in almost all countries are being reserved for patients needing long-term care. Although much of this care is given by assistant nurses, regulations and custom demand their supervision by professional nurses. Future trends for registered nurses include expanded roles