Nursing: A Dynamic Profession

Nursing Department Chairperson, Associate Professor, Interim Associate Dean of the School of Health Sciences, Saint Francis University

As a nurse, you will naturally find yourself at your patients’ bedsides, caring for and comforting people when they need it most. But what does the work really entail? Get ready to take a peek at the future of this rewarding, dynamic career.

To succeed in nursing, you need to be ready for a high-touch, high-caring, and high-tech profession where learning never stops. No matter the setting, as a nurse you will play a key role in a patient’s interprofessional health care team.

Preparing for a career in nursing takes tremendous dedication, yet the reward in terms of career growth and personal satisfaction is well worth the effort. Though most professional nurses (about 62%) work in hospital settings, the opportunities are truly vast. As a registered nurse you may choose to work in many types of settings, including hospitals, nursing homes, home health care, primary care clinics, outpatient surgicenters, schools, mental health agencies, hospice, military, education, or research centers.

Job outlook

The future of nursing is bright! Registered nurses comprise the largest segment of the health care workforce. There are more than 3.1 million registered nurses practicing in the United States. According to the American Association of Critical-Care Nurses (AACN), nursing is the top occupation in terms of job growth through 2020. The U.S. Bureau of Labor Statistics projects that employment for professional registered nurses will be the fastest-growing occupation through 2018.

However, that immense growth can be partially attributed to a widespread need for experienced nurses; they are in short supply, and that shortage is expected to last through 2030, particularly in the southern and western parts of the United States. Over the next 20 years, a large number of RNs will retire, leaving even fewer people to care for an increasingly aged population. As the baby boomer generation surpasses 60 years and hospitalized patients are older, acutely ill, and requiring more skilled care, the need for registered nurses to meet their growing health care needs will steadily increase.

Technological advances are also fueling the need for more skilled nursing care. While these advances are allowing people to live longer, it becomes critical that heath care facilities have the skilled staff on hand to handle the increased workload without threatening the quality of care. Many states are considering implementing minimum staffing laws, which would further increase the demand for nursing professionals. California passed a minimum nurse staffing law in 1999, and other states are considering such a law, which would mandate a minimum nurse-patient ratio, or a fixed number of nurses per patient.

In 2010, the Institute of Medicine, through the Robert Wood Johnson Foundation, released its landmark report, The Future of Nursing, which calls for increasing the number of baccalaureate-prepared nurses in the workforce to 80% while also doubling the number of nurses with doctoral degrees. The Bachelor of Science in Nursing (B.S.N.) is preferred in all health care settings because of the more complex demands of today’s patient care. Currently, professional nurses receive their training in diploma, associate degree, or baccalaureate nursing programs, and finish the program by taking the same national licensure examination, the NCLEX-RN® (National Council Licensure Examination). Many hospitals provide tuition remission for nurses to attain an advanced degree. No matter the initial route for professional licensure, all nurses should eventually aim for a baccalaureate degree.

A vital part of the health care team

The Institute of Medicine’s The Future of Nursing report also called for more teamwork among health care professionals. Interprofessional collaboration is vital to a safe health care system. Health care professions, including nurses, do not act separately at the bedside. Health care professionals continually interact with each other. Patients benefit from an interdisciplinary approach to their care. Nursing is at the forefront, with innovative strategies that improve this interaction and thus improve quality and safety.

Nursing, health care, and nursing education have experienced many changes in the past 50 years. The transformative changes in our health care system require more professional nurses. The system is increasingly rewarding providers for quality care and prevention of avoidable readmissions, complications, and mortality. Nurses are the vanguards of treating the patient, implementing these measures, and keeping costs at bay.

Opportunities abound for professional nurses to advance their degree to the master’s and doctoral levels. Advanced practice nurses include the following: nurse practitioners, clini-cal nurse specialists, certified nurse midwives, and certified registered nurse anesthetists. Nurse practitioners (NP) can conduct physical examinations, diagnose and treat common acute conditions, provide immunizations, manage chronic conditions such as hypertension and diabetes, order and interpret lab tests, and provide patient education. Clinical nurse specialists (CNS) can provide care in various specialty areas, such as pediatrics, oncology, cardiac, neonatal, neurological, and psychiatric areas. Certified nurse midwives (CNM) provide prenatal and postpartum care as well as deliver babies in normal healthy women. Certified registered nurse anesthetists provide more than 65% of all anesthetics given to patients each year and are the sole providers of anesthetics in approximately two-thirds of rural hospitals in the United States. Combined, advanced practice nurses can deliver the majority of health services at a lower cost and with good quality.

Nurses with advanced degrees can also fill a great need for nursing faculty. Many nursing programs turn students away because they do not have enough faculty to provide a safe and proper education. In order to meet the demand for registered nurses, schools need more competent nurse faculty with master’s or doctoral degrees.

The future of nursing

Immense growth in the nursing profession shows no signs of stopping. Not only are nurses in demand due to an aging nursing workforce and U.S. population, but transformative changes in the national health care system—with the Affordable Care Act—have further expanded opportunities for nurses. There will be an increased demand for advanced practice nurses for primary care, prevention, and cost-containment. Patients in the hospital are more acutely ill and require more specialized care combined with advanced technology. The aging nursing faculty requires the needs for further graduate education, and transformative changes in health care law have increased the need for more advanced practice nurses. These changes are also demanding that there be a reduction in patient readmissions, as well as preventable complications and infections. Nurses are taking the lead with patients and have been innovative in their evidenced-based practice to prevent these complications. Health care professionals continually interact with each other, and interdisciplinary collaboration is necessary for safe, quality patient care. Nurses have been innovative in their approaches to strengthening this collaboration.

This is a wonderful time to consider nursing. A nurse can begin a career working in pediatrics and then switch to caring for adults. A nurse can decide to work in a clinic or homecare instead of a hospital. There are many opportunities for advancement. Florence Nightingale’s legacy continues to this day, as nurses are on the frontlines with patients, both in quality and safety. They’re an important part of the team, and the opportunities are endless, but all revolve around a better experience for the patient.

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