In 1901, New Zealand became the first country in the world to pass legislation requiring registration for nurses. New Zealand native Ellen Dougherty, matron of Palmerston North Hospital, became the first Registered Nurse in the world on January 10th, 1902. Her medal is still kept at the Nurses Chapel in Wellington Hospital, the location where Dougherty earned her certificate in nursing. If you are interested in following Dougherty’s footsteps and helping those in need, becoming a registered nurse may be right for you.

Career Outlook for Registered Nurse

Registered Nurse National Average
Average Salary $73,550 $50,620
Projected Job Growth 14.8% 7.4%
Source: 2017 Occupational Employment Statistics and 2016-26 Employment Projections, Bureau of Labor Statistics, BLS.gov

Best States for Registered Nurse

Salary
California $102,700
Hawaii $96,990
District of Columbia $90,110
Massachusetts $89,330
Oregon $88,770
Job Growth
Kentucky 35.6%
Colorado 33%
Utah 32.6%
Texas 31.2%
Florida 25.3%
Source: 2017 Occupational Employment Statistics and 2016-26 Employment Projections, Bureau of Labor Statistics, BLS.gov

What is a Registered Nurse?

Registered nurses (also called RNs) are the backbone of the nursing field, and they can be found working at hospitals, schools, homes, schools, assisted living facilities and a variety of other healthcare settings. Although their responsibilities depend on the type of setting they work in, RNs usually administer medications, coordinate patient care plans, conduct diagnostic tests and analyze results, and educate patients on how to manage illnesses or injury after treatment. They may oversee workers like licensed practical nurses, nursing aides or home care aides, and they often support doctors and other healthcare professionals.

In addition to being able to perform medical duties, registered nurses should be compassionate and possess exceptional communication, teamwork, decision-making, and critical-thinking skills. RNs should also be ready to work odd hours. With emergencies happening all the time and patients that may require round-the-clock care, registered nurses may find themselves working shifts on days, nights, weekends and holidays. The hours can be grueling, but many nurses agree that the lives saved are a sweet recompense.

Registered Nurse Skills

Skill Name Importance Competence
Active Listening 4.12 4
Judgment and Decision Making 3.75 3.75
Monitoring 3.75 3.88
Service Orientation 4 4
Speaking 4 4
Source: O*NET® 22.1 Database, O*NET OnLine, National Center for O*NET Development, Employment & Training Administration, U.S. Department of Labor, onetonline.org

Step One: Earn Your Education

The path to becoming a registered nurse begins with graduating from an accredited nursing program. Students may choose a nursing diploma, associate’s degree, or bachelor’s degree, which requires them to take classes such as anatomy, microbiology, biochemistry, nutrition, chemistry, patient care and healthcare policy.

It is important to note that diploma programs are becoming increasingly rare and may not be acceptable to many nursing employers. Meanwhile, a bachelor’s degree program should open the most opportunities for nursing positions, but also takes the most time to complete. It’s important to make a careful, well-informed decision about which level of program to pursue. If you have a specific location that you would like to work at in mind, it is wise to contact that location and inquire about the level of education they might need or want from their applicants. Otherwise, check out our “Program” pages for more information about these various program levels.

Upon graduation from an accredited program, students should register with the National Council of State Boards of Nursing to sign up for the NCLEX-RN exam. This exam is taken on a computer, features an average of 119 questions, and must be completed within a six hour time period. Students who do not pass can retake the exam after waiting at least 45 days.

Once students pass the NCLEX-RN exam, the next step is to obtain a state license. Every state and territory as well as the District of Columbia requires registered nurses to have proper licensure in order to work. Since mandates vary by state, students should contact their state board of nursing to find out what steps they need to take to secure a state license.

Step Two: Earn Your RN Certification

There are many different kinds of certification available for RNs that can help them focus on specific aspects of registered nursing. Earning certification can be useful on a personal level — helping RNs to refine their practical skills and knowledge — and on a career level — as certifications can help an employer feel confident about the prowess and talent of a potential employee.

  • An HIV/AIDS Certified Registered Nurse (ACRN) has earned an understanding of HIV/AIDS nursing care and has passed an exam offered by the HIV/AIDS Nursing Certification Board (HANCB). Current licensure as a registered nurse is required, and at least two years of experience is recommended. There is also Advanced HIV/AIDS Certified Registered Nurse (AACRN) certification, which is also offered through the HANCB. Its requirements are much more stringent: an applicant must have current RN licensure; a master’s degree or higher in nursing; a minimum of three years of experience as an RN; and a minimum of 2,000 hours of HIV/AIDS nursing.
  • Certified Pediatric Nurse (CPN) is certified to provide specific care to pediatric patients such as conducting assessments, evaluating medications, and educating patients and their families. This credential is the gold standard for pediatric nursing and is awarded by the Pediatric Nursing Certification Board. To be eligible for CPM certification, registered nurses must have a minimum of 1800 hours of pediatric clinical experience completed within the past 24 months or a minimum of 5 years as an RN in pediatric nursing and 3,000 hours in pediatric nursing within the last 5 years with a minimum of 1,000 hours within the past 24 months.
  • An Advanced Oncology Certified Nurse (ACON) is a specialized nurse in oncology. They have the knowledge to provide care for patients who are facing complex problems associated with a cancer diagnosis. To sit for this exam, registered nurses must have worked at least 1000 hours from the last 2.5 years of your nursing work in oncology and completed 10 hours of oncology continuing education credits.

RN Specializations

Some certification for registered nurses does more than enhance an RN’s career. By earning specific certifications or passing certain examinations, a registered nurse may be able to specialize into a different variety of nursing career altogether, such as the following:

Travel Nurse

A travel nurse is hired to work in a specific location for a limited time frame. They usually work 13 weeks in one area, then move to another location. Travel nurses can explore the cities they are hired to during their time off, allowing them to see and experience many different places, cultures, experiences and entertainments. Since the cost of travel and living is paid for as part of the job, travel nurses are often able to enjoy an engaging lifestyle… and perhaps even get a sneak peek of where they may want to live when they eventually retire!

At the very least, travel nurses are registered nurses with at least one year of work experience. While holding a master’s degree in nursing may be beneficial for travel nurses, it is not a requirement.

Forensic Nurse

A forensic nurse specializes in caring for patients who are victims of violence, abuse and trauma. Most forensic nurses work in emergency room or urgent care departments and are interested in criminal justice, the legal system, and working as patient advocates. Since they are exposed to emotionally difficult cases, it is important for them to have a healthy work-life balance and support from their friends and family.

In addition to being registered nurses, many forensic nurses obtain certification in forensic nursing. The Sexual Assault Nurse Examiner-Adult (SANE-A) and/or the Sexual Assault Nurse Examiner-Pediatric (SANE-P) are highly recommended by the International Association of Forensic Nurses.

Critical Care Nurse

Also known as an ICU nurse, a critical care nurse cares for patients that are in critical condition in hospitals with intensive and critical care units. Critical care nurses usually service adults or children who are recovering from serious medical issues.

They should have excellent communication skills and be able to make quick decisions. Since critical care nurses are often faced with the reality of losing patients, they should also be able to deal with loss in an efficient and healthy manner — at least, as much so as is possible.

Critical care nurses are registered nurses with a few years of experience working in a traditional nursing setting. They can eventually sit for the Critical Care Registered Nurse certification exam, hosted by the Association of Critical Care Nurses.

Acute Care Nurse

An acute care nurse works with patients for a short time frame, providing care after a surgery or for a chronic illness. Acute care nurses usually specialize in a particular field such as surgery, geriatrics, oncology, or cardiac care and are often found within continuing care facilities or private clinics. They must be familiar with life support skills, as many of their patients are in severe conditions.

There are many certifications that can be earned to help a registered nurse make the leap into being an acute care nurse, such as Acute/Critical Care Nursing (CCRN), Tele-ICU Acute/Critical Care Nursing (CCRN-E), and Acute Care Nurse Practitioner in Adult Gerontology (ACNPC-AG).

Step Three: Continuing Education

The healthcare industry is ever-evolving. Therefore, no matter how good of a nursing education you receive, there are inevitably going to be new facts, new techniques, new technologies for you to learn about somewhere down the line. By participating in continuing education, nurses can refresh what they already know of nursing while also learning about discoveries and changes in the industry.

Most states require nurses to complete continuing education every two to three years to keep their license active. However, these requirements can change over time. To be aware of their continuing education requirements, nurses should check with their state.

Sources
  1. Bureau of Labor Statistics, Accessed May 2018, https://www.bls.gov/ooh/healthcare/registered-nurses.htm
  2. National Council of State Boards of Nursing, Accessed May 2018, https://www.ncsbn.org/index.htm
  3. O*Net Online, Accessed May 2018, https://www.onetonline.org/link/summary/29-1141.00
  4. Capital & Coast District Nurse Board, Accessed May 2018, https://www.ccdhb.org.nz/about-us/history/nursing-administration/1880-1920/ellen-dougherty-1888-1890/
  5. HIV/AIDS Nursing Certification Board (HANCB), Accessed June 2018, http://www.hancb.org/Index/index.php

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