Nurses work in a variety of environments depending on their employer and their specialty. They may work in hospitals or long-term care facilities such as rehabilitation centers and nursing homes. They may work in private homes, hospice centers, schools, corporate offices, charitable organizations, community centers, or nursing schools. There are numerous types of nursing jobs, including registered nurses, licensed practical and vocational nurses, nurse anesthetists, nurse midwives, and nurse practitioners. Nursing specialties include acute care nurses, advanced practice psychiatric nurses, clinical nurse specialists, and critical care nurses. There are also nurse assistants and orderlies.
Registered nurse is the most popular job in the nursing field, with nearly 3.1 million employed in the United States in 2018, according to the Department of Labor. Approximately 60 percent of all registered nurses work in state, local, and private hospitals, and the rest work in nursing and residential care facilities, physicians’ offices, home healthcare services, and governmental agencies. Nurses may also serve in the military. Home health nurses work in patients’ homes and public health nurses work in schools and community centers. Registered nurses typically work with physicians and health care specialists to help diagnose and treat patients. Their general duties include keeping patients’ medical histories, administering medicines, setting up plans for treatment, consulting with doctors and other health care professionals, operating and monitoring medical equipment, and discussing the health care plans with patients and their families. Some registered nurses work part time.
Registered nurses may have a bachelor’s or associate’s degree, or a diploma from an approved nursing school; however, many employers require a bachelor’s degree through a registered nurse program. A nursing license is required to practice nursing in all states, the District of Columbia, and U.S. territories.
Registered nurses often specialize within certain patient groups. Examples of these specializations: addiction nurses, who help patients overcome substance abuse; cardiovascular nurses, who help heart disease patients; critical care nurses, who work in intensive care units in hospitals; genetics nurses, who help patients with genetic disorders such as cystic fibrosis; neonatology nurses, who care for newborn babies; nephrology nurses, who care for patients with kidney-related health problems; and rehabilitation nurses, who help treat patients with permanent or temporary disabilities.
Registered nurses may also work in the public health field, teaching the public about health conditions. They may work in community outreach programs and immunization clinics, and help run blood drives, health screenings, or health clinics in schools. Some nurses write about the field and work as public policy advisors. Advanced practice nurses work in specialties such as pediatrics or psychiatric-mental health.
The nurse anesthetist, nurse midwife, and nurse practitioner field, also known as advanced practice registered nurse (APRN), is a smaller field in the nursing industry, with only about 45,000 nurse anesthetists, 6,500 nurse midwives, and 189,100 nurse practitioners employed in the United States in 2018. A master’s degree from an accredited program is required for these specialty nursing jobs. The largest employers of these types of nurses are physicians’ offices, employing nearly 50 percent of all APRNs, hospitals (27 percent), outpatient care centers, educational facilities, and the offices of other health care practitioners.
Nurse anesthetists, midwives, and practitioners may work independently or collaborate with doctors and other health care professionals. Nurse anesthetists administer anesthesia and other related care to patients before, during, and after surgical and other medical procedures, and monitor patients’ vital signs to adjust anesthesia if needed. Nurse midwives provide care to women, including gynecological exams, family planning services, prenatal care, and assistance in delivering babies. Nurse practitioners provide advanced nursing services, including discussing health care strategies with patients and their families. They may specialize in adult, geriatric, or pediatric health, or psychiatric or mental health.
The Department of Labor reported that nearly 728,900 licensed practical and licensed vocational nurses (LPNs and LPVs) worked in the United States in 2018. The largest employer of these types of nurses is skilled nursing and residental care facilities, employing 38 percent of all LPNs and LPVs. Completion of a state-approved educational program and passing the licensing exam are required for work as a licensed practical or licensed vocation nurse. Tasks vary depending upon state rules and regulations and the setting in which LPNs and LPVs work. They report to registered nurses and doctors, and their duties generally include monitoring patients’ health and providing basic care, such as checking blood pressure, changing bandages, and inserting intravenous drips, as well as discussing patients’ health with nurses and doctors. LPNs and LPVs with more experience may become supervisors and oversee the work of less experienced or unlicensed medical staff members. Approximately 20 percent of LPNs and LPVs work part time.
There were about 1.5 million nursing assistants and about 51,000 orderlies working in the United States in 2018. About 38 percent of nursing assistants worked at nursing care facilities. Many also worked in hospitals and continuing care retirement communities and assisted living facilities for the elderly. The majority (79 percent) of orderlies worked for hospitals in 2018, and the rest worked for nursing care facilities, ambulatory health care services, government agencies, and retirement and assisted living facilities for the elderly. Most assistants and orderlies work full time, with long hours and often physically demanding tasks. They provide basic care to patients, including moving them from beds and wheelchairs, helping them in the bathroom, feeding them, taking vital signs, and talking with patients about their health concerns and conveying this information go nurses. They may also be responsible for changing linens and stocking supplies, and cleaning facilities and equipment. Nursing assistants and orderlies are usually supervised by licensed practical or licensed vocational nurses.