Nursing-Explore

Explore Nursing

Field Overview

The American Nurses Association’s website describes nursing as: “The essence of nursing is that nurses combine the art of caring with the science of health care. Nursing places its focus not only on a particular health problem, but on the whole patient and his or her response to treatment. Care of the patient and a firm base of scientific knowledge are indispensable elements. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”
Nurses work in many different areas, but the common thread of nursing is the nursing process – the essential core of how a registered nurse delivers care. This process involves 5 steps:

 

  • Assessment: collecting and analyzing physical, psychological and sociocultural data about a patient.
  • Diagnosis: making a nursing diagnoses based on a patient’s physical, social and behavioral symptoms.
  • Planning: creating with the help of other medical professionals a plan of care and goals for a patient’s recovery.
  • Implementation: supervising and carrying out the actual treatment plan while documenting the patient’s progress.
  • Evaluation: continuous assessment of the plan of care, and adjustments to improve patient outcome.

There is a wide variety of nursing specialty areas; examples include surgery, emergency room (ER), pediatrics, psychiatric, public health, and nurse-midwifery. Note: some specialty areas may require additional experience, study or certification.

 

Work Setting

Due to the various levels of education a nurse can receive, nurses can work in a variety of settings like hospitals, physicians’ offices, home healthcare services, and nursing care facilities. Others work in correctional facilities, schools, or serve in the military.

Related Careers

Medicine, physician assistant, dental hygiene, public health, hospital administration.

 

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As a career, nursing offers great flexibility, allowing early entry into the workforce, continued professional development, and advancement through retraining and attaining higher degrees. Consequently, there is no “typical” timeline: students can combine education and work into unique paths that suit their lives. Students can complete a degree, work, and then return to complete a higher degree. Over a lifetime’s career span, a student who began as a nurses’ aide could eventually complete a doctorate. And a nurse who, for example, began in family medicine could choose later to work in  surgery, internal medicine, or geriatric nursing. The exact scope of a Nurse’s practice will vary depending on state and license level. Each degree level allows greater opportunities for new assignments, promotion, administrative/managerial work, responsibility, and potentially higher salaries. The most widely available nursing qualifications include:

  • CNA, Certified Nurse’s Aide or Nursing Assistant (8-12 weeks)
  • LPN, Licensed Practical Nurse (1-1 ½  years)
  • RN, Registered Nurse (2-5 years)
  • APRN, Advanced Practice Registered Nurse (MSN)
    • Clinical Nurse Specialist (CNS)
    • Nurse-Midwife
    • Nurse Practitioner (NP)
    • Nurse-Anesthetist
  • Doctoral degree in Nursing (DNP or PhD)

CNAs, sometimes called hospital attendants, work under the direct supervision of a RN or LPN and assist with the routine daily care of patients, making beds and maintaining patients’ environments; helping patients eat, bathe, dress, and walk; responding to patients’ calls for assistance; collecting samples for testing; taking vital signs; and transporting patients. They work in a variety of setting including home health, hospitals, and nursing homes.

LPNs, sometimes called licensed vocational nurses (LVNs), work under the supervision of an RN and provide bedside care, such as taking vital signs, feeding and bathing patients, dressing wounds,  giving injections and vaccinations, administering medications and treatments, collecting samples for testing, assessing patients status, providing ongoing education, and assisting physicians. LPNs also carry out a variety of administrative chores.They are responsible for providing direct patient care and for carrying out treatments ordered by physicians. They can work in a variety of settings from home health, doctors offices, to nursing homes.

RNs are vital members of the health care team. They are responsible for providing direct patient care and for carrying out treatments ordered by physicians. They take medical histories, help perform diagnostic tests and analyze results, administer treatments and medications, assist physicians with medical procedures, administer and monitor IVs, give injections and vaccinations, educate and provide support for patients and their families, and help with patient follow-up and rehabilitation. RNs also supervise staff. RNs work in all areas of health care – family medicine, internal medicine, pediatrics, obstetrics and gynecology, surgery, geriatrics, and so on. Consequently, there are many different types of nurses as well: private duty nurses, operating room nurses, critical-care nurses, office nurses (who work for physicians, dental surgeons, etc.), school nurses, community health nurses, occupational health nurses, public health nurses, nurse educators, and so on.

Advanced degrees. RNs who hold bachelor’s degrees can earn advanced degrees at the master’s or doctorate levels, which bring increased opportunities, responsibilities, and higher salaries. Advanced degrees also allow RNs to work as nurse administrators or nurse educators. Advanced practice registered nurses (APRNs) are highly trained nurses with training in one of four areas: clinical nurse specialist (CNS), nurse-midwife, nurse practitioner (NP), or nurse-anesthetist. Advanced degrees are usually required for university teaching and research.

  • CNSs (clinical nurse specialists) complete advanced training in specific areas of expertise: cancer, cardiac, neonatal, mental health, etc. CNSs also train and mentor nursing students, perform research, practice in a clinical setting, and provide consultation and management. The advanced education requirements of a clinical nurse specialist better equip them to diagnose and provide treatment for a wide range of illnesses.
  • Nurse-midwives, or midwives, care for women throughout pregnancy, labor, delivery, and post-delivery. They also provide routine gynecological care and counseling on family planning. Midwives serve only carefully screened women whose pregnancies are unlikely to present complications and work closely with obstetricians and other specialists to provide a wide net of support for their patients. Midwives focus on maintaining the well-being of mother and child and on educating patients on nutrition, exercise, breastfeeding, childcare, and family care. Midwives usually work in private practice but are often affiliated with a hospital.
  • NPs (nurse practitioners) handle a wide range of activities, including taking medical histories, conducting physical exams, diagnosing and treating common injuries and illnesses. NPs order and interpret laboratory tests, advise patients, and perform routine procedures such as injections, immunizations, and wound care. The duties of an NP are similar to those of a physician assistant, but NPs are more autonomous, working independently or cooperatively with physicians. Currently, in 21 states including Hawaii, NPs do not need require any physician oversight when prescribing, treating and diagnosing patients.
  • Nurse-anesthetists administer anesthesia to patients under the general supervision of an anesthesiologist, who is a physician. Nurse-anesthetists differ from anesthesiology assistants in that assistants work under the direct supervision of an anesthesiologist whereas nurse-anesthetists work independently. They select and administer the appropriate anesthetic and dosage for each procedure and monitor patients under anesthesia. They may also assist in the surgical, obstetric, or dental procedure.

Matriculation statistics for the 2015-2016 admission cycle.

 ApplicantsMatriculantsPercentage of Applicants
that Matriculate
National Applicants48,45019,25039.73%

Based on data acquired by the National Association of Academic Advisors for Health Professions (NAAHP).

Doctoral degrees in nursing include the Doctor of Nursing Practice (DNP) and the Doctor of Philosophy (PhD). The DNP is a clinical degree that prepares students for careers in advanced clinical practice, nursing education, and administration; in such capacities, DNPs are well-equipped to implement advancements in nursing research in the clinical setting. The PhD is a research degree that prepares students for careers in administration, health care policy, and as nursing faculty who conduct research and teach at the university level.

Matriculation statistics for the 2015-2016 admission cycle.

 ApplicantsMatriculantsPercentage of Applicants
that Matriculate
National Applicants14,5868,43457.82%

Based on data acquired by the National Association of Academic Advisors for Health Professions (NAAHP).

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A wide variety of nursing programs are available in Hawai`i. UHM offers nursing degrees at the bachelor’s, master’s, and doctorate levels. Students interested in nursing that do not have a nursing background can apply to the Graduate Entry Program in Nursing (GEPN), which is a program that culminates in a Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), or a PhD in Nursing.

CNACertified Nurse’s Aide
Kapi`olani Community College
Leeward Community College
Kaua’i Community College
Maui College
Windward Community College
Approved Programs List
LPNLicensed Practical Nurse
Hawai`i Community College
Kapi`olani Community College
Kaua`i Community College
Maui College
RN (ADN)
Registered Nurse (Associate of Science in Nursing)
Hawai`i Community College
Kapi`olani Community College
Kaua`i Community College
Leeward Community College
Maui College
RN (BSN)
Registered Nurse (Bachelor of Science in Nursing)Chaminade University
Hawai`i Pacific University
University of Hawai`i at Hilo
University of Hawai`i at Mānoa
(More information: UHM’s BSN)
APRN (MSN)Master of Science in Nursing
Hawai`i Pacific University
University of Hawai`i at Mānoa
DNPDoctor of Nursing Practice University of Hawai`i at Hilo
University of Hawai`i at Mānoa
PhDDoctor of Philosophy (Not admitting students till fall 2018)University of Hawai`i at Mānoa

 

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In Hawai`i, there are 11 pathways to a nursing degree.

  • ASN/ADN
  • High School Direct Entry to BSN
  • BSN
  • ADN to BSN
  • BSN to MSN
  • GEPN (Non-Nursing Bachelors to MSN/DNP/PhD)
  • MSN to PMC (certificate)
  • MSN to DNP
  • MSN to PhD
  • PMC (certificate) to DNP
  • PMC (certificate) to PhD

More information about UHM’s Bachelors of Science in Nursing can be found here: UHM’s BSNNote: Each program has its own specific admission requirements. 

UHM’s School of Nursing is a part of the Hawaiʻi State Nursing Consortium with Kauaʻi Community College, Maui College, and Kapiʻolani Community College.

Upon completing the ADN program at Kauaʻi, Maui, or Kapiʻolani, the student is eligible to apply to the School of Nursing to complete the final year of the BSN program via distance learning. The student must complete all of UH Manoa’s School of Nursing’s pre-requisites, some of which may not be required for the ADN programs, and must pass the state licensure exam to become certified RNs before they can apply to the consortium.

More information about UHM’s Nursing Consortium ADN Program can be found here: UHM’s Nursing Consortium

UHM’s School of Nursing introduced a High School Direct Entry Program for academically talented high school seniors interested in pursuing a career nursing. This program provides entry into the nursing program upon admission to UH Mānoa. For more information, refer to the High School Direct Entry page here or website: www.nursing.hawaii.edu/.

All RNs, whether at the associate’s or bachelor’s level, take the same licensing exam, work in the same jobs, and receive similar salaries.

The main differences are that RNs with BS degrees:

  • are more competitive for hiring and promotion
  • are more flexible in being reassigned
  • are more eligible for administrative positions
  • may have training in research
  • are eligible to work in the military, and
  • are eligible to pursue advanced degrees

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