More About RNs and Advanced Practice RNs
Where do RNs work?
As members of the nation’s largest health care profession, registered nurses practice wherever people need nursing care, including such common sites as hospitals, homes, schools, workplaces, and community centers, and uncommon areas such as children’s camps, homeless shelters, and tourist sites. Over 2.4 million of the nation’s 2.9 million RNs were employed in 2004, about one-quarter of them on a part-time basis.
About 56 percent of nurses currently work in hospitals. Hospital unit settings include intensive care, operating/recovery room, stepdown, emergency room, labor and delivery, and outpatient units.
The median salary of a staff nurse working full-time in hospitals in 2005 was $56,880.
Other settings where registered nurses work include:
Community/public health 14.9%
Ambulatory care 11.5%
Nursing homes 6.3%
Nursing education 2.6%
Advanced practice registered nurses
Advanced practice registered nurse (APRN) is an umbrella term given to a registered nurse who has met advanced educational and clinical practice requirements, at a minimum of a Master’s level, beyond the basic nursing education and licensing required of all RNs and who provides at least some level of direct care to patient populations. Under this umbrella fit the principal types of APRNs (numbers of APRNs based on 2004 data):
• Nurse practitioner (NP) – Working in clinics, nursing homes, hospitals, or private offices, more than 141,000 nurse practitioners are qualified to provide a wide range of primary and preventive health care services, prescribe medication, and diagnose and treat common minor illnesses and injuries.
• Certified nurse-midwife (CNM) –Almost 14,000 CNMs provide well-woman gynecological and low-risk obstetrical care. In 2002, CNMs attended more than 300,000 of U.S. births that year, in hospitals, birth centers, and homes.
• Clinical nurse specialist (CNS) –Working in hospitals, clinics, nursing homes, private offices, and community-based settings, some 72,000 CNSs handle a wide range of physical and mental health problems, and also work in consultation, research, education, and administration.
• Certified registered nurse anesthetists (CRNA) – The oldest of the advanced nursing specialties, CRNAs administer more than 65 percent of anesthetics given to patients each year. There were about 32,000 CRNAs in practice in 2004.
A move in nursing is currently underway to shift the standard for qualification to be an APRN to that of a Doctorate in Nursing Practice (DNP) by 2015. While still providing the direct care to patient populations, the shift demonstrates the comparability of the APRN with other such advanced roles, ie Doctorate in Physical Therapy, Doctorate in Pharmacy.
There are other nursing roles that are usually filled by master’s prepared registered nurses as well, including nursing administration, nursing education, patient and staff education. Yet another master’s level role currently being introduced into educational programs is the Clinical Nurse Leader (CNL) role. This role expects to act as a system facilitator for nursing care delivery.
Clearly, there are many opportunities for those prepared as registered nurses to advance their education and careers in a way that interests the individual and utilizes their strengths and areas of expertise.
To a healthier future
There are well over 200,000 advanced practice nurses in the United States today, helping to bring needed primary health care services to the population and paving the way for increased use of such nurses in the future. In 2006, advanced practice nurses reported an average annual salary of $69,200.
Baccalaureate and advanced education prepares nurses for the independent clinical judgement necessary in an increasingly complex work environment. While in 1977, only 18 percent of RNs had a bachelor’s degree, by 2004, over 34 percent of nurses had at least a BSN, and in 2005 nearly 35 percent of all new nursing students were enrolled in four-year programs. More than 124,000 students—almost 11 percent of them men—were enrolled in BSN programs in 2005.