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Nurses develop a plan of care and are often the only providers who do so collaboratively with physicians, therapists, the patient, and other team members. In the U.S., advanced practice nurses (APN's), such as clinical nurse specialists and nurse practitioners, diagnose problems and prescribe drugs or therapies. Nurses coordinate the patient care performed by other members of a health care team (therapists, dietitians, etc.). Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
According to the US Department of Labor's revised Occupational Outlook Handbook ( 2000), "Registered nurses (R.N.s) work to promote health, prevent disease, and help patients cope with illness. They are advocates and health educators for patients, families, and communities. When providing direct patient care, they observe, assess, and record symptoms, responses, and progress; assist physicians during treatments and examinations; administer medications; and assist in convalescence and rehabilitation. R.N.s also develop and manage nursing care plans; instruct patients and their families in proper care; and help individuals and groups take steps to improve or maintain their health."
In various parts of the world, the educational background for nurses varies widely. In some parts of eastern Europe, nurses are high school students with 12 to 18 months of training. In contrast, Chile requires any registered nurse to have at least a bachelor's degree.
Nurses in the United States exist on several distinct levels, distinguished by increasing education, responsibility and skills. The major distinction is between task-based nursing and professional nursing.
Nursing assistants, orderlies, and patient care assistants are not nurses. In acute-care hospitals, their duties are limited to tasks delegated by the registered or licensed practical nurse. Most orderlies are trained to perform heavy patient-movement or other muscular tasks. Orderlies were originally the " policeFor the band, see The Police. For the Polish town, see Police, Poland. Police forces are government organisations ostensibly charged with the responsibility of maintaining law and order. The word comes from the French, and less directly from the Greek pol" of hospitals, to keep the patients "orderly." Certified nursing assistants assist nurses by taking vital signs, administering hygienic care, assisting with feeding, giving basic psychosocial care, and similar duties. See also candystriper; hospital volunteers; nurse assistant skillsIn the United States, certified nurse assistants (CNAs) provide personal care to residents or patients under the supervision of a registered nurse (RN) or licensed practical nurse (LPN); see Nurse: Types of nurses (and non-nurses). The exact requirements.
Technicians may wear uniformThis page describes uniform in the sense of clothing. For other meanings, see uniform (disambiguation . A uniform is a set of standard clothing worn by members of an organisation whilst participating in that organisation's activity. People performing relis similar to those of nurses, but are not nurses. For example, certified medication aides are trained to administer medications but have no training in nursing decision-making. There are also blood collection technicians, and technicians trained to operate most kinds of diagnostic and laboratory equipment.
Medical practitioners ( medical doctors) and allied health professionals (such as speech therapistsSpeech therapy is the corrective or rehabilitative treatment of physical and/or cognitive deficits/ disorders resulting in difficulty with verbal communication. This includes both speech (articulation, intonation, rate, intensity) and language (phonology,, occupational therapists and physical therapists), are not nurses. Whilst they generally work together closely with nurses, they are members of their own separate professions, with distinct training, licensing, skills and roles.
Licensed Practical Nurses (LPN; they are known as Licensed Vocational Nurses, LVN, in California and Texas, and Registered Practical Nurses, RPN, in Ontario) exist in most states. These individuals usually have two years of training in body function & structure, drugs and practical patient care. They must pass state or national boards and renew their license periodically. They can perform simple as well as complex medical procedures and usually operate under the supervision of professional registered nurses (RNs) or physicians. They can administer most medications, perform measurements (blood pressure, temperature, etc), record-keeping, help with patient-care planning, first aid, CPR, sterile and isolation procedure and basic care. Licensed Practical Nurses are often found working under the supervision of physicians in clinics. In long term care facilities, they sometimes supervise nursing assistants and orderlies.
Registered Nurses are professional nurses who often supervise the tasks performed by LPNs, orderlies and nursing assistants. They provide direct care and make decisions regarding plans of care for individuals and groups of healthy, ill and injured people. They often have bachelor degrees or associate degrees in nursing, but in many states are not required to do so. Regardless of degree, they have many hours of clinical experience. They are the largest group of healthcare workers in the United States, numbering over 2.6 million. It is estimated that an additional 750,000 RNs will be needed by 2005 in the U.S. Much research has shown that RNs are the first-line defense of hospitalized patients against disability or death from infection, cardiopulmonary arrest, and other serious complications. Higher ratios of registered nurses to patients has been shown to decrease certain complications of illness including death in patients. Registered nurses are educators, managers, executives, therapists, intensive care experts, symptom managers, professional mentors, researchers and community members. In hospitals, registered nurses perform diverse roles such as writing policies, responding to emergencies, managing professional, technical and ancillary staff, determining budgets, performing strategic planning, and supervising construction projects.
Many nurses pursue voluntary specialty certification through professional organizations and certifying bodies. A registered nurse certified in critical care is a CCRN; in oncology the credential is OCN, and WOCN signifies certification in wound, continence and ostomy care, for example. Similar acronyms are used for certification in many other nursing specialties.
Advanced Practice Nurses perform primary health care, mental health services, diagnosis and prescribing, carry out research, and educate the public and other professionals. Some APNs diagnose illness and prescribe drugs. APNs possess a Masters' Degree or higher in Nursing, and may also sit for additional certification examinations. APNs may operate as a Certified Nurse Midwife (CNM), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS) or Certified Registered Nurse Anesthetist (CRNA).
All advanced practice certifications require continuing education and other requirements (such as periodic reexamination) to maintain the credential. Advanced practice nurses can expect to earn above-average salaries, especially as the population of the US ages and the demand for highly-skilled healthcare workers grows proportionally.
At the top of the educational ladder is the doctorally-prepared nurse. Nurses may gain the PhD or another doctoral degree (Doctor of Nursing Science, Nursing Doctor), specializing in research and/or clinical nursing treatment. These nurses practice nursing, teach nursing and carry out nursing research. As the science of nursing has advanced, so has the demand for doctorally-prepared nurses.