Registered Nurse Salary
As the most in-demand healthcare occupation, and one of the fastest growing careers in the nation, registered nurses can expect to see their salaries, and other benefits, grow in 2009. More and more employers are offering sweet incentives such as sign-on bonuses, tuition reimbursement, and more flexible hours in order to entice nurses to work in their facilities.
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Registered nurse
A registered nurse (“RN”), is a health care professional responsible for implementing the practice of nursing through the use of the nursing process in concert with other health care professionals. Registered nurses work as patient advocates for the care and recovery of the sick and maintenance of their health. In their work as advocates for the patient, RNs use the nursing process to assess, plan, implement, and evaluate nursing care of the sick and injured. RNs have more training than licensed practical nurses.
The scope of practice of registered nurses is the extent to and limits of which an RN may practice. In the United States, these limits are determined by a set of laws known as the Nurse Practice Act of the state or territory in which an RN is licensed. Each state has its own laws, rules, and regulations governing nursing care. Usually the making of such rules and regulations is delegated to a state board of nursing, which performs day-to-day administration of these rules, qualifies candidates for licensure, licenses nurses and nursing assistants, and makes decisions on nursing issues. It should be noted that in some states the terms “nurse” or “nursing” may only be used in conjunction with the practice of a Registered Nurse(RN)or licensed practical or vocational nurse (LPN/LVN).
The scope of practice for a registered nurse is wider than for an LPN/LVN because of the level and content of education as well as what the Nurse Practice Act says about the respective roles of each.
In the hospital setting, registered nurses are often assigned a role to delegate tasks performed by LPNs and unlicensed assistive personnel such as nursing assistants.
RNs are not limited to employment as bedside nurses. Registered nurses are employed by physicians, attorneys, insurance companies, private industry, school districts, ambulatory surgery centers, among others. Some registered nurses are independent consultants who work for themselves, while others work for large manufacturers or chemical companies. Research Nurses conduct or assist in the conduct of research or evaluation (outcome and process) in many areas such as biology, psychology, human development, and health care systems. The average salary for a staff RN in the United States in 2007 was over $50,000.
Educational and licensure requirements
Two-year college degree
In the United States, there are three routes to initial licensure as a registered nurse. The shortest path (and the most widely utilized) is a two-year Associate of Science in Nursing, a two-year college degree referred to as an ADN; this is the most common initial preparation for licensure in the U.S. Often in competitive metropolitan areas within the US, two-year programs can require several prerequisite courses which ultimately stretch out the degree-acquiring process to about 3 or, sometimes, even 4 years.
Hospital diploma program
Another method is to attend a diploma program, which lasts approximately three years. Students take between 30 and 60 credit hours in anatomy, physiology, microbiology, nutrition, chemistry, and other subjects at a college or university, then move on to intensive nursing classes. Until 1996, most RNs in the US were initially educated in nursing by diploma programs.
The Bachelor of Science in Nursing
The third method is to obtain a Bachelor of Science in Nursing, a four-year degree that also prepares nurses for graduate-level education. For the first two years in a BSN program, students usually obtain general education requirements in the same manner as ADN and diploma graduates; they spend the remaining time in nursing courses. Advocates for the ADN and diploma programs state that such programs have a more “hands-on” approach to educating students, while the BSN is an academic degree that emphasizes research and nursing theory. Nursing schools must be accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).
The Master’s Entry Program
There is a relatively new method to obtain an RN, through a Master’s of Science in Nursing program. This type of program combines the state Board of Registered Nursing (BRN) education requirements to obtain an RN with the education necessary to receive an MSN. The requirements to enter this type of program are that a student has an undergraduate degree in a nursing or related field and has completed the prerequisites required by a standard RN program. The student graduates with the ability to take the state boards to receive an RN, a Master’s degree and often an advanced practice certification.
Licensure examination
Completion of any one of these three educational routes allows a graduate nurse to take the NCLEX-RN, the test for licensure as a registered nurse, and is accepted by every state as an adequate indicator of minimum competency for a new graduate. However, controversy exists over the appropriate entry-level preparation of RNs. Some professional organizations believe the BSN should be the sole method of RN preparation and ADN graduates should be licensed as “technical nurses” to work under the supervision of BSN graduates. Others feel the hands-on skill of diploma and ADN graduates makes up for any deficiency in theoretical preparation. Regardless of this debate, it is highly unlikely that the BSN will become the standard for initial preparation any time soon, because of the nursing shortage and the lack of faculty to teach BSN students.
Graduate nursing opportunities
Advanced education in nursing is done at the masters and doctoral levels. A Master of Science in Nursing or a Master of Nursing takes about three years of full-time study to complete and prepares the graduate for specialization as a nurse practitioner, a clinical nurse leader (CNL), a certified registered nurse anesthetist (CRNA), or a clinical nurse specialist (CNS). Nurse practitioners work in fields as diverse as midwifery, family practice, psychiatry, gerentology, or pediatrics, while a CNS usually works for a facility to improve patient care, do research, or as a staff educator. Doctoral programs in nursing prepare the student for work in nursing education, health care administration, clinical research, or advanced clinical practice. Most programs confer the Ph.D in nursing, but some confer the Doctor of Nursing Science (DNS or DNSc), Doctor of Nursing Practice (DNP), Doctor of Science in Nursing (DSN), or the Doctor of Education (Ed. D.). Doctoral programs take from three to five years of full-time study to complete.
Nursing board certification
Professional nursing organizations, through their certification boards, have voluntary certification exams to demonstrate clinical competency in their particular specialty. Completion of the prerequisite work experience allows an RN to register for an examination, and passage gives an RN permission to use a professional designation after their name. For example, passage of the American Association of Critical-care Nurses specialty exam allows a nurse to use the initials ‘CCRN’ after his or her name. Other organizations and societies have similar procedures.
The American Nurses Credentialing Center, the credentialing arm of the American Nurses Association, is the largest nursing credentialing organization and administers more than 30 specialty examinations.