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The purpose of this occupational guide is to provide you with useful information to help you make career decisions.
If you are searching for a job, please go to

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REGISTERED NURSES AND NURSE PRACTITIONERS

California Occupational Guide Number 29
Interest Area:    Medical or Health
2002

WHAT DO REGISTERED NURSES AND NURSE PRACTITIONERS DO?

REGISTERED NURSES (RN) constitute the largest group among all the health occupations. Most RNs work in acute care hospitals as hospital nurses. They care for patients at the hospital bedside, in private clinics, and in the patient's home. Nurses may also work to help prevent disease, to educate the public about health issues, to enhance public health, and to support ill patients both physically and mentally.

Hospital Nurses make up the largest group of nurses. They perform the following tasks:

  • Provide bedside care for hospital in-patients.
  • Monitor all aspects of patient care, including diet and physical activity.
  • Administer treatment and give medications to patients under the direction of physicians.
  • Observe the patient, assess and record symptoms, and note reactions and progress.
  • Develop and manage nursing care plans and instruct patients and caregivers in how to perform tasks they can do themselves.

Office Nurses work in doctor's offices, clinics, emergency care centers, and Health Maintenance Organizations (HMO). They perform the following tasks:

  • Prepare patients for and administer physical examinations.
  • Dress wounds, give injections or medicines, and assist in minor surgeries.
  • May help with the management of the office and supervise other staff.

Home Health Nurses provide health care in patient's homes. They perform the following tasks:

  • Travel to patient's homes and administer medications, check the physical and mental condition of patients, and instruct the patient on proper home care.
  • Educate the patient and family in various aspects of home health. Nurses may teach, counsel, and demonstrate skills.
  • Act as an intermediary between the physician, hospital, staff, and the patient.
  • May supervise other home health workers.

Public Health Nurses work for governmental agencies, schools, clinics, and retirement communities. They work to better the health conditions for the general public. Instead of administering care to the individual, their mission is to enhance the overall health of the community at large. They perform the following tasks:

  • Work in concert with local governments to remedy health problems that are present in the community.
  • They lecture groups on healthy living, disease prevention, nutrition, and how to identify health risks in the community.
  • Arrange immunization clinics, blood pressure testing, cholesterol level testing, and other health screening clinics.
  • Work with pregnant women to ensure proper prenatal care.
  • Work to decrease the incidence of infectious diseases and assist in quarantine efforts. Make field investigations and help in epidemiological health studies.

NURSE PRACTITIONERS are Registered Nurses with graduate level training in diagnostic and health assessment skills. Their training allows them to provide basic medical care. They relieve physicians of many time consuming tasks. Under the direction of a supervising physician, they perform the following tasks:

  • Interview patients, take medical histories, perform physical examinations, order laboratory tests, make tentative diagnoses, and prescribe appropriate treatments.
  • Prescribe medication and medical devices if they have a Nurse Practitioner Furnishing certificate.
  • Refer patients to physicians for consultation or to specialized health resources for treatment.

WHAT SKILLS ARE IMPORTANT?

Skills, knowledge, and abilities required and used by Registered Nurses and Nurse Practitioners include:

  • Speaking - Talking to others to effectively convey information.
  • Service Orientation - Actively looking for ways to help people.
  • Social Perceptiveness - Being aware of others' reactions and understanding why they react the way they do.
  • Reading Comprehension - Understanding written sentences and paragraphs in work related documents.
  • Oral Comprehension - The ability to listen to and understand information and ideas presented through spoken words and sentences.
  • Judgment and Decision Making - Weighing the relative costs and benefits of a potential action.
  • Medicine and Dentistry - Knowledge of the information and techniques needed to diagnose and treat injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health care measures.
  • Biology - Knowledge of plant and animal living tissue, cells, organisms, and entities, including their functions, interdependencies, and interactions with each other and the environment.
  • Customer and Personal Service - Knowledge of principles and processes for providing customer and personal services including needs assessment techniques, quality service standards, alternative delivery systems, and customer satisfaction evaluation techniques.
  • Chemistry - Knowledge of the composition, structure, and properties of substances and of the chemical processes and transformations that they undergo. This includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods.
  • Problem Sensitivity - The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
  • Critical Thinking - Using logic and analysis to identify the strengths and weaknesses of different approaches.

WHAT’S THE WORK ENVIRONMENT?

Nurses generally work in hospitals and clinics in a comfortable and well-lighted environment. Although most tasks are not strenuous, Nurses do need physical stamina to perform their duties. They also need emotional stability to cope with human suffering and frequent emergencies. Since they work as part of a closely-knit team, they must work well with others in a cooperative setting.

Dangers from infectious agents are also part of the work environment. Diseases such as AIDS, hepatitis, and tuberculosis present the possibility of infection to the RN. Strictly following procedures can lessen, but not eliminate disease transmission.

A few Registered Nurses work as members of emergency response teams. They may treat patients while enroute by helicopter to hospitals or at triage centers at disaster sites, such as earthquakes or floods.

Nurse-Midwives, licensed to provide care and treatment to pregnant women, often deliver babies in patients' homes. In addition to hospitals, Nurses work for doctors and medical groups, public health agencies, and home care services.

Union Membership

Registered Nurses may belong to a union. One such union is the California Nurses Association.

WHAT’S THE CALIFORNIA JOB OUTLOOK?

The following information is from the occupational projections produced by the Employment Development Department's Labor Market Information Division:

Estimated number of workers in 1998:
Estimated number of workers in 2008:
Projected Growth 1998-2008:
Est. openings due to separations by 2008:

172,100
221,200
28.5%
32,500

These figures do not include self-employment.

The number of jobs for Registered Nurses is expected to grow at a rate slightly above the average for all occupations through 2008 in California.

Trends

The State Board of Registered Nursing reports that there were about 250,000 licensed RNs in California in 2001. The Board also reports that there were slightly more than 9,500 Nurse Practitioners. Despite this large number, shortages still exist and shortages are expected to occur over the next 10 years. This is due to workers leaving and re-entering several times during their career. Hospital and clinics continue to have ongoing, active recruitment programs, some offering unique benefits, to attract applicants.

Some Health Maintenance Organizations employ Nurse Practitioners in addition to physicians. This trend, which has heightened the demand for Nurse Practitioners, should continue as HMOs become common. Competition may be keen for the higher paying jobs in large cities.

WHAT DOES THE JOB PAY?

California Earnings

Registered Nurses 2001 Wages


Hourly wages range from

$23.59 to $32.29

Average hourly wage

$27.82

Average annual wage

$57,855

Source: Occupational Employment Survey of Employers by EDD/LMID.

Hours

A Nurse's schedule varies. Nurses may work a morning shift one week and a night shift the next. Some emergency room staff work 24-hour shifts twice a week, while others work three 12-hour shifts weekly. Clinic staff usually works a five-day, 40-hour week. A variety of schedules may be available for less than full-time staff.

Benefits

Benefits may vary among employers. Most employees receive vacation, sick leave, medical, dental, vision insurance, and retirement benefits.

HOW DO I PREPARE FOR THE JOB?

Education and Training

Registered Nurses must be licensed to practice in California by the State Board of Registered Nursing. The license requirements are:

  • Completion of a board-approved nursing program.
  • A passing grade on the State Board examination.

Two types of Registered Nurse training programs are available in California: two-year community college associate degree programs and four-year bachelor's degree programs. Both programs include clinical experience in one or more hospitals and clinics in addition to classroom instruction. Most community colleges give Licensed Vocational Nurses (LVN) credit for their basic nursing course work and experience. LVNs can complete the requirements for an associate degree in nursing in two years. At that point, a LVN can work or transfer to a four-year college to obtain a bachelor's degree in nursing to be licensed as a RN. LVNs with associate degrees, or former military medical corps workers, may qualify for advanced placement in four-year bachelor's degree nursing programs. There are currently 22 schools that offer a baccalaureate degree in nursing, and over 70 schools in California that offer two-year degrees in nursing. Twenty-four schools offer Nurse Practitioner degrees. For more information about schools, go to the Website www.rn.ca.gov/schools/schools.htm.

Nurse Practitioners are licensed by the California State Board of Registered Nursing. The requirements are:

  • Possession of a valid RN license.
  • Completion of a program approved by the California Board of Registered Nursing.

The program is graduate-level training offered by hospitals and universities. Training lasts one to two years and leads to a certificate or master's degree.

In order to prescribe medication, Nurse Practitioners must be certified by the board. They must complete a pharmacology course and work six months under physician supervision.

High school students should take chemistry, biology, anatomy, and physiology, and other science and math courses to prepare for nursing school.

Prospective Nurses should exhibit leadership, self-confidence, and emotional stability. Other needed traits are a pleasant personality, patience, and an ability to deal with people of all cultures and social levels.

Licensing and Certification

An application fee of $75 and a fingerprint card fee of $32 are required for the licensure examination. An additional examinations fee of $120 is assessed. Examinations are given year-round at 24 locations around the state. RNs with active licenses from other states may also be granted California licenses.

Continuing Education

Registered Nurses must renew their California licenses every two years and complete 30 hours of continuing nursing education during each two-year period. The cost to renew is $80.

Nurse Practitioners must take 30 hours of continuing nursing education during each two-year period and renew their RN license every two years; this process automatically renews their Nurse Practitioner license.

HOW DO I FIND THE JOB?

Direct application to employers remains one of the most effective job search methods. Private firms are listed in the yellow pages under Hospitals, Nurse Registries, Medical Clinics, and Physicians and Surgeons. California job openings can be found at various online job-listing systems including CalJOBSSM at www.caljobs.ca.gov or at JobCentra National Labor Exchange at www.jobcentral.org.

For other occupational and wage information and a listing of the largest employers in any county, visit the Employment Development Department Labor Market Information Web page at www.calmis.ca.gov. Find further job search assistance from your nearest Workforce Services Office www.edd.ca.gov/Jobs_and_Training/Workforce_Services_Offices_by_County.htm or the closest One-Stop site, www.servicelocator.org/.

Nursing schools' graduate placement service links RNs and Nurse Practitioners with jobs. They should also apply directly to hospitals, clinics, and physicians. Newspaper ads also have job leads. State, county, city, and federal personnel administration offices provide announcements of jobs and requirements.

WHERE CAN THIS JOB LEAD?

Experienced RNs may advance from bedside nursing to supervisory positions or clinical specialist positions, such as Critical Care Nurse. Those with bachelor's degrees may become nursing administrators, consultants, educators, or Researchers. A growing number take special courses, often earning a master's degree, to become Nurse Practitioners.

A Registered Nurse may promote to become the Director of Nursing, who is responsible for hiring the nursing staff and overseeing all nursing functions.

Nurse Practitioners may advance into administration, but most view themselves as health care professionals trained to diagnose and treat patients for illnesses and injuries formerly treated only by doctors. Most Nurse Practitioners stay in this occupation throughout their career life.

OTHER SOURCES OF INFORMATION

California Board of Registered Nurses
P.O. Box 944210
Sacramento, CA 94244-2100
(916) 322-3350
www.rn.ca.gov

California Nurses Association
2000 Franklin Street
Oakland, CA 94612
(510) 273-2200
www.calnurse.org

American Nurses Association (ANA)
600 Maryland Ave SW, Suite 100 West
Washington, D.C. 20024-2571
(202) 651-7000
(800) 274-4262
Fax: (202) 651-7001
www.nursingworld.org

Employment Projections by Occupation
www.labormarketinfo.edd.ca.gov/?pageid=145

Employment and Wages by Occupation
www.labormarketinfo.edd.ca.gov/?pageid=152

RELATED OCCUPATIONAL GUIDES

 

Physical Therapists
Occupational Therapists
Licensed Vocational Nurses
Respiratory Therapists
Physician Assistants

No. 117
No. 143
No. 313
No. 454
No. 508

OCCUPATIONAL CODE REFERENCES

SOC  (Standard Occupational Classification)

 
Registered Nurses

29-1111

O*NET  (Occupational Information Network)

 

Registered Nurses

29-1111.00

OES  (Occupational Employment Statistics)

 

Registered Nurses

32502

DOT  (Dictionary of Occupational Titles)

 

Nurse Practitioner
Nurse Midwife
Nurse, General Duty

075.264-010
075.264-014
075.364-010

Note:  This is NOT a job opening. The purpose of This California Occupational Guide is to provide you with useful information to help you make career decisions. If you are searching for a job, go to:


California Employment Development Department   >>   Labor Market Information   >>   More Occupational Guides