Considering the ongoing need for high-quality healthcare delivery, nursing will always retain its fundamental role in addressing the core needs of the patients. The primary responsibility of a registered nurse (RN) implies “providing, leading, and coordinating care that is compassionate, evidence-based, and person-centered” (NMC, 2018, p. 3). They significantly contribute to the encouragement of health, its maintenance, as well as to the prevention of a poor state of health. Registered nurses take a leading role in care delivery for people of all age groups and different origins, cultures, and beliefs.
RN deliver medical assistance for patients with complex mental, physical, cognitive, and behavioral care needs, including individuals with dementia, older people, and patients at the end of their life. They are obliged to provide care in various settings, including home, community, hospital, or any healthcare facility where patients’ needs are set as a priority and properly managed. Such an occupation requires oneself to work in terms of perpetual change, challenging conditions, different types of medical care, demographic shifts, alteration, and rapid technological advancements. Registered nurses would be required to agree upon the limitations and be actively involved in interdisciplinary groups within the increased integration of health and social care provision. Considering the core qualities of the professional RN, one must nurture and develop confidence, critical thinking, and implement knowledge and skills. Most importantly, a registered nurse must deliver skilled, evidence-based, immediate nursing care, which is a central focus of all registered nursing practice.
Taking into account the ethical concerns, every nurse must ensure a respectful attitude toward every individual they interact with and adhere to the Code of Ethics. It is a practical guide that identifies ethical obligations and philosophical ideals for everyday nursing practice. As part of the moral deliberation process, ethics is an integral part of nursing that provides the basis of the ways nurses must treat their patients, healthcare coworkers, profession, as well as each other. According to Klugman (2017), seven tenets of nursing ethics assist in making an ethical decision, including “virtue, caring, beneficence, nonmaleficence, and autonomy” (p. 4). The nurses should sustain professional, considerate, and respectful relationships with their colleagues, and undertake the equal treatment, transparency, integrity-upholding compromise, and the most optimal conflicts settlement method. As such, the main focus for RN is to create an ethical and civilized environment among the colleagues and patients and be alert to take the necessary steps in terms of unethical, inept, and illegal cases. A registered nurse must ensure a safe environment, including orientation, professional growth, licensure, certification, lifelong learning, and measures to promote patient and nurse safety.
The nursing field implies a considerable amount of educational attainment, which is further transformed into evidence-based practice and professional development. Nursing education should comply with the changes in the healthcare system that emerge from scientific and technological advances. With that said, the most common way to become a registered nurse in the United States is through the finalizing of an associate or baccalaureate degree program (Potter, Perry, Hall & Stockert, 2016). Following this, the graduates are qualified to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a registered nurse in the targeted state for practice.
The associate diploma program lasts for two years and is offered by a university or community college. It incorporates the fundamental sciences, as well as theoretical and clinical training. The baccalaureate degree study implies a four-year program in college or university and additionally includes the “courses in the social sciences, art, and humanities to support nursing theory” (Potter et al., 2016, p. 9). Moreover, the IOM (Institute of Medicine) requires all nurses with an associate degree to continue their studies to get a baccalaureate degree. The academic development of RN promotes “critical thinking, translational research, leadership skills, understanding of changes and importance of quality care, improved decision making and job opportunities” (Hofler & Thomas, 2016, p. 134). The next step a RN can take is to pursue graduate education resulting in a master’s or doctoral degree in nursing. A master’s degree in nursing is a requirement for an APRN (Advanced Practice Registered Nurse).
From the financial point of view, the costs of nursing education vary according to the chosen degree and program. The ADN-RN programs are about $12,000-35,000, the cost range of the BSN-RN programs is about $25,000-120,000 or more, and the APRN Programs will cost $63,000 in total, considering the bachelor’s degree program. Notwithstanding the educational preparation, the testing for RN is identical in every state. A registered nurse in the United States is obliged to pass the NCLEX-RN, which ensures a standardized minimum skills base for nurses. Apart from NCLEX-RN, there are certain types of certification offered for nurses who pursue certification in the particular field of nursing practice, such as medical-surgical or geriatric nursing. The certification one receives is verified by continuing training and medical practice.
The crucial moment every nurse experience is the transition from a student to a registered nurse. One needs time to adjust to changing identity, roles, responsibilities, and a new setting of the real world where nurses take full responsibility for their actions and are required to take care of their patients. Wong et al. (2018) define eight interrelated challenges of the transition period, such as “workload, lack of knowledge, communication, expectations, change of role, working atmosphere, support, and blame/complaint culture” (p. 32). Furthermore, the ninth aspect implies the personal attitude as a typical behavior that promotes overcoming these challenges. According to the Bureau of Labor Statistics, the average annual income for registered nurses was $71,730 in May 2018, with the employment rates expected to grow 12 percent from 2018 to 2028. NMC (2018) identified the core standards for nurses that provide new graduates with the knowledge needed in practice to meet their professional responsibility and promote ongoing education. These standards include:
- being an accountable professional,
- promoting health and preventing ill-health,
- assessing needs and planning care,
- providing and evaluating care,
- leading and managing nursing care and working in teams,
- improving safety and quality of care,
- coordinating care.
The ongoing expansion and advancement of the healthcare system led to the emergence of new nursing roles. Considering the unlimited professional development, nurses might regularly change their career roles. The variety of career opportunities within a nursing field includes “advanced practice registered nurse (APRN), nurse researcher, nurse risk manager, quality improvement nurse, consultant, and even business owner” (Potter et al., 2016, p. 4). The growth trends in nursing are evidence-based practice, quality and safety education measures, emerging technologies, genomics, and its influence on the politics and health system.
Professional organizations address the issues of importance within a specific profession, and aim at advancing the standards of practice, increasing roles in nursing, enhancing the nurses’ well-being. Masters (2015) states that nurses should actively participate in professional nursing initiatives within the nurse’s healthcare agency and professional organizations to manage and improve personal career. As a student, one may engage in the National Student Nurses Association (NSNA) in the US and Canadian Student Nurses Association (CSNA) in Canada. They are primarily focused on the career development and preparing for licensing. In addition, the continuing nursing education is critical for maintaining the skills and gaining new knowledge. CE programs are offered by universities, hospitals, state nurses associations, professional organizations, and healthcare institutions.
Reflection/Personal Career Plan
My decision to become a registered nurse was motivated by the will to make a valuable contribution to public health and provide high-quality nursing care. As such, career planning is an essential approach to work on during education to achieve the desired career. My choice of profession is to become an advanced practice registered nurse (APRN), which is the most autonomously functioning type of nursing. Following the ideas of Peate (2016), the advanced level nurses “promote public health and well-being,” and better understand the impact of social, economic, and political aspects on the healthcare system (p. 115). My strategy implies gaining experience before pursuing an advanced graduate degree in nursing. After that, I aim at participating in professional organizations and obtaining state license and certification to evolve in the targeted specialization. With that said, nursing is a knowledge-based occupation that requires ongoing education for updating the skills in the specialized area and their successful implementation in nursing practice.
Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handbook, Registered Nurses, Web.
Hofler, L., & Thomas, K. (2016). Transition of new graduate nurses to the workforce: Challenges and solutions in the changing health care environment. North Carolina Medical Journal, 77(2), 133-136. Web.
Klugman, C. M. (2017). Recognizing ethical terms, theories and principles. In C. Robichaux (Ed.), Ethical competence in nursing practice: Competencies, skills, decision-making (pp. 3–22). New York, NY: Springer Publishing Company.
Masters, K. (2015). Role development in professional nursing practice (4th ed.). Burlington, MA: Jones & Bartlett Publishers.
NMC (2018). Future nurse: Standards of proficiency for registered nurses. Web.
Peate, I. (2016). The essential guide to becoming a staff nurse. Chichester, England: John Wiley & Sons.
Potter, P., Perry, A., Hall, A., & Stockert, P. (2016). Fundamentals of nursing (9th ed.). St. Louis, MO: Elsevier Health Sciences.
Wong, S., Che, W., Cheng, M., Cheung, C., Cheung, T., & Lee, K. et al. (2018). Challenges of fresh nursing graduates during their transition period. Journal of Nursing Education and Practice, 8(6), 30. Web.