Job Responsibilities and Career Opportunities for Registered Nurses

A registered nurse (RN) is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing examination. An RN helps individuals, families and groups achieve health and prevent disease through advice, education and support. Regardless of the specialty or work setting, an RN’s scope of practice is determined by each state’s Nurse Practice Act (NPA). Each state outlines legal practices for RNs and what tasks they may or may not perform.

RN Specialties

Specific work responsibilities will vary from one RN to the next, depending on work setting or patient population. RNs can specialize in one or more areas of patient care. There generally are four ways to specialize:

Perioperative nurses assist surgeons by selecting and handling instruments, controlling bleeding, and suturing incisions. Some of these nurses also can specialize in plastic and reconstructive surgery.
Specific disease nurses may specialize in specific health conditions. RNs specializing in a particular disease, ailment, or healthcare condition are employed in virtually all work settings, including physicians’ offices, outpatient treatment facilities, home healthcare agencies, and hospitals. Types of diseases requiring nursing care include:
- Cardiovascular nurses treat patients with coronary heart disease and those who have had heart surgery, providing services such as postoperative rehabilitation.
- Dermatology nurses treat patients with disorders of the skin, such as skin cancer and psoriasis.
- Gastroenterology nurses treat patients with digestive and intestinal disorders, including ulcers, acid reflux disease, and abdominal bleeding. Some nurses in this field also assist in specialized procedures such as endoscopies, which look inside the gastrointestinal tract using a tube equipped with a light and a camera that can capture images of diseased tissue.
- Gynecology nurses provide care to women with disorders of the reproductive system, including endometriosis, cancer, and sexually transmitted diseases.
- Nephrology nurses care for patients with kidney disease caused by diabetes, hypertension, or substance abuse.
- Neuroscience nurses care for patients with dysfunctions of the nervous system, including brain and spinal cord injuries and seizures.
- Ophthalmic nurses provide care to patients with disorders of the eyes, including blindness and glaucoma, and to patients undergoing eye surgery.
- Orthopedic nurses care for patients with muscular and skeletal problems, including arthritis, bone fractures, and muscular dystrophy.
- Otorhinolaryngology nurses care for patients with ear, nose, and throat disorders, such as cleft palates, allergies, and sinus disorders.
- Respiratory nurses provide care to patients with respiratory disorders such as asthma, tuberculosis, and cystic fibrosis.
- Urology nurses care for patients with disorders of the kidneys, urinary tract, and male reproductive organs, including infections, kidney and bladder stones, and cancers.
Other RNs specialize in working with one or more organs or body system types, such as dermatology nurses, who work with patients who have skin disorders. RNs specializing in treatment of a particular organ or body system usually are employed in hospital specialty or critical care units, specialty clinics, and outpatient care facilities.
RNs who specialize by population provide preventive and acute care in all healthcare settings to the segment of the population in which they specialize, including newborns (neonatology), children and adolescents (pediatrics), adults, and the elderly (gerontology or geriatrics). RNs also may provide basic healthcare to patients outside of healthcare settings in such venues as correctional facilities, schools, summer camps, and the military. Some RNs travel around the U.S. and throughout the world providing care to patients in areas with shortages of healthcare workers.

RNs may even combine specialties; for example, pediatric oncology nurses deal with children and adolescents who have cancer. The opportunities for specialization in registered nursing are extensive and are often determined on the job.

Specializing is often one of the best ways to earn a higher salary, but not every program allows the option to specialize. If you are interested, consider obtaining an advanced degree after becoming an RN.

How Setting Affects Responsibilities

There are many options for RNs who specialize in a work setting or type of treatment. Settings vary, and some can be included in one facility, such as a hospital. Other settings may be secluded, such as in rural areas, where emergency care may consist of transport by helicopter to larger emergency care settings. Urban areas may be more conducive to holistic nurses or to school nurses, who may work in facilities or who may travel to offer care in more rural areas:

Ambulatory care nurses provide preventive care and treat patients with a variety of illnesses and injuries in physicians’ offices or in clinics. Some ambulatory care nurses are involved in telehealth, providing care and advice through electronic communications media such as videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Critical care nurses often work in critical or intensive care hospital units to provide care to patients with serious, complex, and acute illnesses or injuries.
Emergency, or trauma, nurses work in hospital or stand-alone emergency departments. Some emergency nurses may become qualified to serve as transport or flight nurses, who provide medical care to patients who are transported by helicopter or airplane to the nearest medical facility.
Holistic nurses provide care such as acupuncture, massage therapy, aromatherapy, and biofeedback, which are meant to treat patients’ mental and spiritual health in addition to their physical health.
Home healthcare nurses provide at-home nursing care for patients, often as follow-up care after discharge from a hospital or from a rehabilitation, long-term care, or nursing facility.
Hospice and palliative care nurses focus on maintaining quality of life for terminally ill patients, often in a home or hospice atmosphere.
Infusion nurses administer medications, fluids, and blood to patients through injections into patients’ veins.
Long-term care nurses provide healthcare services on a recurring basis to patients with chronic physical or mental disorders, often in long-term care or nursing facilities.
Medical-surgical nurses provide health promotion and basic medical care to patients with various diagnoses.
Occupational health nurses seek to prevent job-related injuries and illnesses, provide monitoring and emergency care services, and help employers implement health and safety standards. School nurses are considered as occupational nurses.
Perianesthesia nurses provide preoperative and postoperative care to patients undergoing anesthesia during surgery or other procedures.
Psychiatric-mental health nurses treat patients with personality and mood disorders.
Radiology nurses provide care to patients undergoing diagnostic radiation procedures such as ultrasounds, magnetic resonance imaging, and radiation therapy for oncology diagnoses.
Rehabilitation nurses care for patients with temporary and permanent disabilities.

Settings also can include the military, as each branch of military service contains medical services. Nurses can include men and women, and the military offers benefits and advancement just as any other career. For more information on military nursing, look to each service branch, such as Army, Navy, and Marines.

How Education Determines Responsibilities

RN responsibilities often are determined by education. The three typical educational paths to registered nursing are a bachelor’s degree, an associate’s degree, or a diploma from an approved nursing program; advanced practice nurses need a master’s degree. RNs who have a master’s degree can work as:

Clinical nurse specialists provide direct patient care and expert consultations in one of many nursing specialties, such as psychiatric-mental health.
Nurse anesthetists provide anesthesia and related care before and after surgical, therapeutic, diagnostic, and obstetrical procedures. They also provide pain management and emergency services, such as airway management.
Nurse-midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care.
Nurse practitioners serve as primary and specialty care providers, providing a blend of nursing and healthcare services to patients and families. The most common specialty areas for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and geriatrics. Nurse practitioners can also choose a variety of other specialties, including neonatology and mental health. Advanced practice nurses can prescribe medications in all states and in the District of Columbia.

Some nurses move into the business side of healthcare, as education and experience can equip them to manage ambulatory, acute, home-based, and chronic care businesses. Hospitals, insurance companies, pharmaceutical manufacturers, and managed care organizations, among others, also need RNs for health planning and development, marketing, consulting, policy development, and quality assurance. Other nurses work as college and university faculty or conduct research.

Advancement for RNs

Although most RNs begin their careers as staff nurses in medical facilities, experience and performance can open doors to more responsibilities. RNs who move into management positions also can advance their careers with more education. Senior-level administrative roles include assistant director, director, vice president or chief of nursing. Management-level nursing positions require a graduate or an advanced degree in nursing or health services administration.

Administrative positions require leadership, communication and negotiation skills, and good judgment. RNs have educational opportunities open to them to advance from associate’s degrees to doctoral degrees. Education and experience both can determine job responsibilities and opportunities in a field that is growing in demand for RNs.

Job Prospects for RNs

The future is bright for RNs, as employers in some parts of the county and in certain settings report difficulty in attracting and retaining RNs. Part of the reason for this shortage is the aging of the RN workforce and a lack of younger workers to fill positions. Also, the need for nursing faculty is expanding for the same reason, and more teachers are needed to educate new nurses.

Hospitals, which currently are the highest employers for RNs, may offer signing bonuses, family-friendly work schedules, or subsidized training to attract and retain nurses. Although faster employment growth is projected in physicians’ offices and outpatient care centers, RNs may face greater competition for these positions because they generally offer regular working hours and more comfortable working environments.

The following table, supplied by the Bureau of Labor Statistics, shows the industries with the highest published employment and wages for RNs. Across the board, hospitals remain in the lead for the highest employment rates, followed by physicians’ offices and home healthcare services. Personal care services, however, pay more than any other industry in this field:

In addition, all four advanced practice specialties — clinical nurse specialists, nurse practitioners, nurse-midwives, and nurse anesthetists — will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. Relative to physicians, these RNs increasingly serve as a low-cost option to primary care providers.

Getting Ahead

Job responsibilities and career opportunities for RNs vary, depending upon education, experience, and settings. It is an exciting time to become an RN, as job prospects are growing, and the field has expanded into numerous specialties. With the ability to acquire more education, a student RN can advance his or her career and open doors to possibilities such as opening a business or securing a senior-level position in administration. In rural or urban areas and across the world, the RN has vast choices in educating people on preventive care and helping those in distress.

Licensed practical nurses will eventually hit a ceiling in terms of job responsibilities and pay scale. For the LPN seeking a career advancement as a registered nurse, the right LPN to RN program can open doors to new opportunities within the nursing profession. Below are the best colleges offering LPN to RN and related nursing degree programs.

Top LPN to RN Online Degree Programs

LPN to BSN

Indiana State University >> The LPN to RN program offered by Indiana State University has excellent curriculum that gives students the ability to further their education without requiring them to quit their day jobs. This program is created for nurses that have busy schedules by offering the program online giving greater flexibility than other more traditional programs. This online RN/BSN training program is the only one of its kind, and offers distance learning courses enabling nurses to earn their baccalaureate job without requiring a full time commitment.

LPN to RN Bridge
LPN to BSN

The College Network >> The LPN/LVN to RN (ADN) program offers an exciting new way for nurses to earn their NLNAC accredited degree in half the time and cost of traditional programs with NO Campus Attendance. Nurses can earn their degree in 12-18 months with no waiting list and local clinicals. The College Network has worked with the National League for Nursing to develop and deliver these programs to assure they are up-to-date with current standards and regulations.

RN to BSN RN to MSN MSN - Nurse Admin MSN - Nurse Education	Kaplan University >> Kaplan University's RN to BSN and RN to MSN programs allow students to accelerate their degrees to the next level. The MSNs in Nurse Administration or Nurse Education teach advanced skills in nursing. Graduates of these programs pursue management or teaching positions. Kaplan is also among the largest online educators in the world.
BS in Nursing (BSN)	Walden University >> The BSN program from Walden University gives the education and skills necessary for students of nursing to keep pace with the rapidly changing health care industry by providing a strong foundation of core concepts and insights into the future development of this field. MSN programs are also offered in nurse education, nurse informatics, and nurse management.
BS in Nursing (BSN)	Liberty University >> Liberty University provides a RN to BSN program for registered nursing seeking to obtain their Bachelors of Science degree. This program goes beyond the framework taught for the registered nurse certification and gives a competitive edge that will enable advancement in health care fields. The MSN program in acute care develops the framework to provide health care services in more complex patient issues that arise.
BS in Nursing (BSN)	South University >> The MSN programs in General, Adult Health, and Nurse Education at South University provide excellent curriculum for top notch medical care. The adult health program focuses on providing adult health care for a wide range of medical needs while the nurse education program develops teaching and coaching skills to train future medical professionals. The school also offers RN to BSN and RN to MSN programs. These programs advance students' understanding of complex medical theory and also give the skills necessary for advancement into management.
BS in Nursing (BSN)	Utica College >> Small classes and a professionally-trained faculty known for their clinical experience and knowledge of the field give Utica College online RN to BSN students the foundation for the next stage of their educational and professional careers. In addition to those with associate's degrees, Utica College embraces transfer students, accepting up to 90 credits.
BS in Nursing (BSN)	Herzing University >> At Herzing University, the RN to BSN program gives registered nurses the education and knowledge they need to advance beyond their coworkers and become leaders in their organization. Masters of Science programs in Nurse Education and Nurse Management are developed to provide an excellent knowledge of nursing's complex health care areas necessary to lead and teach the future nursing talent that will provide healthcare in the nation's health care facilities.
BS in Nursing (BSN)	Grand Canyon University >> Grand Canyon University provides a dual degree in MBA/MSN. This program prepares candidates for a rewarding career in management of health care fields. The school also has an excellent RN to BSN program for registered nurses desiring to advance within their company or field. The course work greatly expands the student's knowledge of nursing concepts. A MSN in Nursing Education and Nursing Leadership is offered for professionals that desire to teach and shape the future of the health care industry.
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