1. CAREER OPPORTUNITY
INTRODUCTION
There is a strong demand for nurses today, career prospectes are good
& possibilities are plentiful. Nurses are needed not only in hospital, but in health
agencies, long term care facilities such as nursing home ,managed care centers &
in community health . Educating patients & their families in preventing care is
highly important. Demands for advance practice nurses are growing in the many
areas. Never before has nursing been so axciting; taday new graduates has a
variety of job opportunities available. The job opportunity for the LPN have
expanded & now extended beyond those in the long term care facility and
hospital.
There are many job opportunities for nurses such as-
Hospitals
Long term care facilities
Home health
Physicians office or clinic
Insurance company
Temporary agencies
Travel opportunity
Pharmaceutical sales
Other medical sales
Outpatients hotel
Military nursing
Adult day care
School nurse
Public health
Out patient surgery
Private duty nursing
2. Government nursing
Industrial nursing
Rehabilitation nursing
Psychiatric nursing
Hospice nursing
Clinicians
Advance practice nurses
Clinical nurse specialist
Nurse practitioner
Certified nurse midwife
Certified registered nurse anesthetist
Nurse educator
Nursing administrator
Nurse researcher
Nurse entrepreneur
HOSPITALS:
Employment of LPN in hospital setting is a high level, because of health care
economics, hospitals are responsible for providing quality care as economically
as possible. Under the supervision of an RN the LPN is able to provide most
bedside care to patient in the hospital setting. The overall management of unit is
the responsibilities of a RN salary in a hospital setting typically include shift
differential & extra pay for holidays & perhaps weekends benefits tend to be good
in the hospitals. Nurses have the opportunity to function on hospital committies
.there may be unique positions such as working in infection control or employee
health .there a number of different types of hospitals to be considered, some
hospitals are trauma centers, specialized surgery, some hospitals have specialized
services with different departments.
LONG TERM CARE FACILITIES:
The LPN/LVN is the backbone of long term care facilities, they can advance to
change nurse & supervisory capacity with RN supervision. They must be used in
3. staff development , recruitment, & and all types of committee work. The nurse
management & leadership skills have ample opportunity for development in the
long term care setting. Salary are typically higher in long term care facilities than
in hospitals, but this is not necessary the case in all situation. Typically shift
differential pay and scheduling alternative are possible. Benefit packages might
also be good in the long-term care setting. The long term care facility is just that a
facility for those who require long term care. Hospitals no longer are available to
patints past the must acute period. Alternative include rehabilitation hospitals if
patints qualification are met, home health or a long term care facility. In
rehabilitation canters physical, speech occupation & other therapies are available,
many patients receive therapy & are able to retun home.
Home health
The degree to which home health opportunities are available to LPNs/LVNs ,
varies in different part of the united state. The LPNs is capable of providing much
of the care required , but RN supervision must be available . the advance of home
health care are a more relaxed atmosphere, decreased patient load and a
primarily day time schedule. The nurse may be paid on a per case basis, the travel
expenses are reimburse, the salary can be good for individual who put in a lots of
hours. Continuity of care and a degree of independence are advantages of this
type of position. There is also scheduling flexibility, which is hard to find in other
position.
Physicians office or clinic-
Many physician’s choose to employ an LPNs/LVNs for their office, they prefer to
have some with the educational background available to assist them. Salary in
offices tends to be lower than that in hospitals and long term care facilities. The
benefits package may not be as complete as in the other settings. However the
schedule of primarily days with minimal weekends is a definite advantage. There
is an opportunity to focus on prevention in these settings & opportunity for
patients teaching are also available . Less manual dexterity is required, which
might be advantages for some individuals.
4. Insurance companies:
Many insurance companies employ LPNS/LVNs in their pre admission & claims
departments. The position are office position with few manual dexterity
requirements. Companies usually require experience in medical- surgical nsg
before employment. Salary tends to be lower than in hospitals & long term care
facilities. However the scheduleis usually days with no holidays or weekend work
required.
Temporary agencies:
There are opportunities available to work for staffing agencies. These agencies
provide nurse to meet the staffing needs in a variety of health care facilities. The
salary is usually very good but the benefits package may be limited. must be a
highly flexible person to be able to adjust to various work settings.
Advantages of employment with a temporary agency are the right to
refuse and the wealth of variety available. When employed by an temporary
agency, have the right to say “no” on a given day when they call and ask you to
work. This provides more flexibility in personal schedule.
Travel opportunities:
After having some experiences, if interested the nurse can explore opportunity to
travel & work for specified period in areas in need of nurses through a type of
temporary agency with an expanded area of service. These agencies match
employer’s needs with nurses experiences& interest in living in that area for a
period of time .Lording is provided in addition to salary. This offers nurses who
have the flexibility to travel the chance to visit an area of work for a period of
time.
Pharmaceutical sales:
5. Some might be interested in the field of pharmaceutical sales. After having
some experience, this might be a field of interest. These companies usually
require experience in specific area & an expertise in science & pharmacology.
Salary is usually based on sales. There is no direct patient care. Contacts are made
with physicians, pharmacist & nurse in various clinical settings to present the
advantages of products & to teach about side effects & precautions.
Other medical sales:
Opportunities are also available for nurses with companies selling medical
supplies. Responsibilities & compensation are similar to those in pharmaceutical
sales. Nurses may do in –service programs at facilities to demonstrate product
use. Products vary widely, from such items as incontinence products to surgical
equipment.
Out patient hotels:
In some areas opportunities might be available in hotel settings owned by a
hospital. The patient guests stay in type hotel while they undergo testing before
surgery. The nurse is available for patient teaching and to assist the guests in any
preparation required for the tests. The nurse is also available in case of an
emergency. Salary and benefits are the same as those of the hospitals.
Adult day care:
Some communities may provide adult day care facilities that require nursing
supervision. These facilities are designed for individuals who require medical
supervision while their family members work or take a break from the
responsibility of care, the place is relaxed & the schedule is excellent the
opportunity such a facility affords to the adult requiring the service & their family
members can provide a rewarding experience for the nurse.
School nurse:
Opportunities may be available in some communities to work as a school health
nurse. Health screening, emergency care & health teaching are the major
responsibilities. The nurse may function in one school or travel to different
6. schools. Working only during the school year might be an advantages for the
nurse who would like to be off summers & can afford to do this.
Public health:
There may be opportunities for nurses in community with the public health
department. Responsibilities may include working in clinics & home visits. The
nurse may also participate in the health inspections. Teaching is a major area of
responsibility. The focus is on prevention. Day schedules are usually available.
Salaries tend to be lower than in hospitals & long term care facilities.
Outpatient surgery:
A large number of out patient facilities are available especially for out patient
surgery. TheLPN/LVN may be employed to preparepatient for surgery , as a scrub
nurse, or to work in the recovery room under. The supervision of an RN. The
facility may be free standing or a part of a hospital complex.
Private duty nursing:
The private duty nurse gives total care to one patient. This type of nsg is totally
independent nsg care service. Private duty nsg may take place in the hospital,
home or other facilities and while travelling abroad or in the united state. When
doing private duty nsg, the nurse has to accept not only patient but the family as
well . the nurse is paid directly by the patient or responsible person. When the
setting for private duty nsg is in a health care facility, the nurse is expected to
follow the policies & procedures of that facility. When doing private duty nsg. The
nurse are legally responsible for their own actions. The nurse should keep
continuous, accurate records of the worked days & payments received.
Advantageof private duty nursing is that she may work as many days , she like or
may accept a case for as long period of time as she desire
Government nursing: (civil nursing)-
7. The LPNs/LVNs may work in a vitreous administration hospital or other govt.
hospitals. Advantages are good salary, good insurance & retirement plans. The
disadvantages is that the ratio of nurses is sometime low.
Industrial nursing:
The focus in industrial nursing is on promoting wellness & preventing accidents.
Safety is emphasized & usually the nurse is first-aid oriented. The industrial nurse
may do physical assessment, health surveys, insurance forms preparation and
health education as well as nursing intervention for patients injured in industrial
accidents. The LPNs/PVNs will work under the supervision of an RN or a physician
dependent on the size of the industrial site, this type of nursing may offer shifts
and benefits different from those of other career opportunities. In the field the
nurse should have patients, understanding, observational skills and current first
aid techniques & principles able to adjust all types of situations.
Rehabilitation nursing :
This field requires responsibility for guiding the patient toward health &
independence. Advantages are steady employment ,a less formal environment &
an opportunity to provide good care.
Psychiatric nursing:
Psychiatric nursing requires a mature person (not in years) to handle the
responsibilities of the job. This type of nursing may be done in an open unit in a
general hospital, outpatient clinic , mental health agency, psychiatric hospital, or
institution, advantages are a good salary & advancement in leadership areas.
Hospice nursing:
Hospice nsg offers are to terminally ill patients in either an institution or a home
setting, usually under the auspices of home health nsg. The qualifications for a
8. hospice nurse are to have a clear understanding of his or her own feelings
concerning death and to understand the philosophy of the hospice setting. The
nurse closely supports the patient & family without interfering with family
interpersonal relationships. Advantages of hospice nursing are steady
employment . less formal environment & opportunity ti provide good bedside
care that is concerned with pain relief & comfort measure. Disadvantages are
always caring dying patient and the possibilities of having to travel to more than
one home each shift.
Clinician:
Most nurses enter the profession with the goal of providing direct care. The
Nurse providing direct client care accounts for The majority for of practicing
nurse. There are increased opportunity for nurses to provide direct in the clients
home. The clinical nurse provides direct care to the client , using the nsg process
& critical thinking skills. The clinical nurse provides education to the client &
family to promote health maintenance & self care In the hospital nurses choose
to practice in hospitals such as transplantation rehabilitation, ontology longer
medical centers offer mire opportunity to concentrate practice in a single area.
Opportunity in the military nursing;
Opportunities are available for LPN/LVN in military service. Use of LPN/LVN is
increasing in the military just as it is civilian life . active duty & the reserve are
options. Benefits in the military are generous. One major benefits is in the area of
educational opportunities. Assistance may be given to healp repay loans & may
be eligible for assistance with tuition for additional education.
Advanced practice nurse:
The advance practice nurse (APN ) is generally the most independent functioning
nurse. An APN has a master’s degree in nursing, Advanced education in
pharmacology & physical assessment & certification & expertise in a specialized
area of practice. The advanced practical nurse may work in primary, acute
restorative care settings. The advanced practical nurse function as a clinician
9. educator, case manager, consultant& researcher within his/ her areas of practice,
to plan or improve the quality of nursing care for the client & family.
Clinical nurse specialist:
the clinical nurse specialist is an advanced practice nurse with nsg expertise in a
specialized area of practice & may work in any practice setting. traditionally The
clinical nurse specialist has practical most often in the hospital setting. The clinical
nurse specialist may specialized in a specific disease, such as dm cancer cardiac
problems or in a specific field, such as pediatric. The clinical nurse specialist
function as an expert clinician, educator ,case manager & researcher to plan or
improve the quality of care provided to the client & family.
Nurse practitioner:
clinicalnursespecialist nursepractitioner certifiednursemidwife
certifiedregisterednurse
anesthesist
nurseresearcher nurseadminstrator
nurseeducator nurseentrepreneur
10. A nurse who has an advanced education & is a graduate of a nurse practitioner
program. These nurses are certified by the American nurses credentialing center
in area such as adult nurse practitioner, family nurse practitioner, school health
nurse practitioner,etc. the y are employed in health care agencies or community
base settings . They usually deal with non emergency acute or chronic illness &
Provide primacy ambulatory care.
Certified nurse midwife:
A certified nurse midwife is an RN who is also educated in wildlife and is certified
by the American college of nurse midwife. The practical of nurse midwifery
involves providing independent care for women durig normal pregnancy, labor &
delivery: as well as care for the newborn. It may include some gynecological
service such as routine, pap smear, family planning & treatment for minor vaginal
infections. A certified nurse midwife practice with a health care agency that
provides medical consultation, collaborative management & referral.
Certified registered nurse anesthetist:
A nurse who has completed advanced education in an accredited program in
anesthesiology. The nurse anesthetist carries out proper active visit &
assessments & administers generalanesthetics for surgery under the super- vision
of a physician prepared in anesthesiology. The nurse anesthetist also assess the
post operative status of clients.
Nurse researcher:
Nurse researcher investigate nursing problems to improve nsg care & to refine &
expand nsg knowledge. They are employed in academic institution, teaching
hospitals & research centers such as the national institution for nursing research
in Bethesda, Maryland. Nurse researchers usually have advanced education with
at lest a master’s degree in nsg and at the doctorate level.
Nurse administrator:
11. The nurse administrator manages client care, including the delivery of nsg
services. The administrator may have a middle management position, such as
head nurseor supervisor or a more senior management position, such as director
of nsg services. The functions of nurse administrator include budgeting, staffing &
planning programs. Theeducational preparation for nurse. Administrator position
is at least a B.Sc.(N) degree in nsg & freqently a master or doctoral degree.
Nurse entrepreneur:
A nurse who usually has as advanced degree and manages a health related
business. The nurse may be involved in education consultation or research etc
Professional Advancement
The Nursing Professional Advancement System or Clinical Ladder is a 4-tiered
performance-based career advancement system that provides a professional
framework for developing, evaluating, promoting and rewarding RNs who are in
direct patients care.
Purpose
Provideopportunity for nurses havechoice to move beyond entry level role
based on interest in professionaldevelopment& increasing responsibility &
accountability for leading nursing practice& care delivery.
Objectives
Enhance the professionalgrowth & development.
Providerecognition for professionalcontributions.
Encourageinvolvement of bedside nursein decisions that support/
enhance patient care outcome.
Providemotivation for direct care nurses to pursuehigher education ,
certification other professionalachievements.
Professional Growth
Nursing has programs in place to encouragelife-long learning and long-term
professionalgrowth.
12. Nursing Orientation
Educational Opportunities
InternshipProgram
SharedLeadershipCouncils
Local, Regional and National Conferences
National Certification
Nursing GrandRounds
Professional AdvancementProgram(Clinical Ladder)
Fellowships
SimulationLearning Center
Nursing Orientation
Each nursereceives an introduction and overview to the goals, policies,
procedures, and traditions of the Departmentof Nursing. This allows for
successfulintegration into the nursing culture and systemof patient care delivery
Educational Opportunities
The Department of Nursing offers a broad rangeof educational activities and
events at the hospitalto provideresearch and evidence-based information on
relevant patient care and health services-related topics. The department also
provides opportunities for nurses to attend educational programs at institutions
of higher learning to further their professionalgoals.
SharedLeadershipCouncils
Shared Leadership Councils within the Department of Nursing and at the
unit/department level provide the opportunity for staff nurses to take part in
shared decision making. Shared decision making benefits all parties—staff nurses,
leadership nurses, physicians, and mostimportantly our patients.
Local, Regional and National Conferences
Nurses at Children’s can apply to attend local, regional and national professional
conferences to enhance personaland professionaldevelopment and to share
information with their peers.
National Certification
nurses areencouraged to seek national specialty certification fromaccredited
nursing organizations. Thesecertifications validate that an RN is practicing
excellent patient carewith exceptional patient outcomes.
13. Nursing GrandRounds
These clinical development programs help registered nurses build clinical
knowledgeand skills. The programs aretargeted toward but not limited to
registered nurses who work on inpatient units.
Professional AdvancementProgram(Clinical Ladder)
The professionaldevelopment clinical ladder allows nurses to advancein their
career without leaving the bedside, and therefore is a means by which RNs can
continue to advancetheir clinical skills and be promoted. The program
acknowledges the value of the expert nurseat the bedside and how they can
positively affect patient outcomes.. Itprovides for an additional level of prestige,
respect, and job satisfaction for the bedside RN.
Fellowships
The Neonatal Critical Care Fellowship Program, CriticalCare Nursing Fellowship
Programand Perioperative Nursing Fellowship Programareavailable to those
seeking advanced clinical experiences tailored to specific interests and learning
needs. The length of the fellowships varies depending on the specialty.
The SimulationLearning Center
Clinical Simulation is a practical and necessary method of teaching/learning and
evaluating competence. Simulation allows the adult learner to be self-paced,
receive immediate feedback and develop critical thinking skills, and provides for
knowledgereinforcement. Simulation facilitates learning through enactment and
imitation of a condition or situation using computer driven manikins that mimic
human symptoms and provides responses to caregiver actions.
SimulationTechnology Instructor Development
Best use of simulation technology is accomplished when educators fully
understand the application of the technology as well as the methods for
development of clinical ‘scenarios’. Thelearning site consistof 9 modules: (1)
Designing and Developing Simulations, (2) Debriefing and Guided Reflection, (3)
Guidelines for Simulation Research, (4) Teaching and Learning Strategies (5)
Integrating Concepts into Simulations, (6) Evaluating Simulations, ( 7) Curriculum
Integration (8) Programming a High-Fidelity Simulator, (9) Designing a Simulation
Center.
14. Professionaladvancementmodel
The ProfessionalAdvancementModel is designed to recognizeand reward nurses
based on their professionalcontributions to advancing the practice and
profession of nursing. TheModel focuses on the continuing professionalgrowth
and development of the nursewith emphasis on involvement at the unit level and
contributions within the medical center and beyond. Advancement requires the
nurseto meet defined criteria related to clinical practice/care delivery,
professionaldevelopment, quality/safety, and unit operations.
Model Components
The ProfessionalAdvancementModel contains four roles:
1. Clinical NurseI (CN I);
2. Clinical NurseII (CNII);
3. Senior Clinical NurseI (SCNI), and
4. Senior Clinical NurseII (SCNII).
Professional AdvancementModel Roles
ROLES General Description Core Requirements
Clinical
Nurse I
This role is reserved for the
new grad or nursewith less
than 12 months
experience. The nursewill
utilize this time to learn the
institution and nursing
practice. Itis expected that
a nursein this role
successfully pass the
probationary period within
6 months (12 months
maximum with a defined
action plan developed with
New hire/new graduate
15. manager).
Clinical
Nurse II
This role is considered the
minimum role for all nurses
who have greater than 12
months experience. This
nursewill be competent in
the skills/knowledge
required and fully
participate in unit
governance. He/shewill
practice and adhere to the
guidelines specified in the
ProfessionalNurseJob
Charter.
“Competent” evaluation with successful
passing of probation; currenton all
mandatory classes/training
Member of a professionalorganization.
Note: For all roles, continuing education
can be achieved through conferences,
in-services, formalunit education,
JournalClubs, Nursing Grand Rounds,
nursing college classes, etc.
Sr. Clinical
Nurse I
This role is aimed for the
nursewho is a clinical and
professionalleader at the
unit level. He/she advances
evidence based practices,
leads unit governance
initiatives, and mentors
others to achieve and grow
in the role of the
professionalnurse.
Member of a professionalorganization.
Demonstrated evidence of professional
growth and development through:
enrollment in degree program, specialty
certification, teaching in formalhospital
programs or outsideof hospital, board
member of professionalassociation,
etc.
Senior
Clinical
Nurse II
This role is designed for the
nursewho has achieved
expertise and leadership in
the clinical and professional
role, within the unit and
beyond. He/she leads and
Member of a professionalorganization.
Bachelor’s degree required.
- musthave a Bachelor’s * degree or
active enrollment with graduation
within 5 years of promotion
16. evaluates evidence based
practice, actively
participates and/or leads
organizationalinitiatives,
mentors and coaches
nurses and other
disciplines, exemplifies the
role of the professional
nurses and demonstrates
active involvement in
clinical and professional
nursing beyond the walls of
the unit and/or
organization.
- External candidates must haveBSN.
In addition to Bachelor degree, must
have one of the following:
Specialty certification (active)
Master’s degree or enrollment in
Master’s Programwith graduation
Roles and Functions of the Nurse
A nurse is a health care professional who is engaged in the practice of nursing.
Nurses are responsible—along with other health care professionals—for the
treatment, safety, and recovery of acutely or chronically ill or injured people,
health maintenance of the healthy, and treatment of life-threatening
emergencies in a wide range of health care settings. Nurses may also be involved
in medical and nursing research and perform a wide range of non-clinical
functions necessary to the delivery of health care1
.
The Roles and Functions of a Nurse
Extended role of a nurse
17. • Care Provider
• Communicator
• Teacher
• Counselor
• Client Advocate
• Change Agent
• Leader
• Manager
• Researcher
• Case Manager
• Collaborator
Caregiver/ Care provider –
the traditional and most essential role
functions as nurturer, comforter, provider
“mothering actions” of the nurse
provides direct care and promotes comfort of client
activities involves knowledge and sensitivity to what matters and what is
important to clients
shows concern for client welfare and acceptance of the client as a person
.Communicator/Helper
The nurse communicates with clients, support persons and colleagues to
facilitate all nursing actions.
18. Teacher –
provides information and helps the client to learn or acquire new knowledge
and technical skills
encourages compliance with prescribed therapy.
promotes healthy lifestyle
interprets information to the client
Counselor-
helps client to recognize and cope with stressful psychologic or social
problems; to develop an improve interpersonal relationships and to
promote personal growth
provides emotional, intellectual to and psychologic support
focuses on helping a client to develop new attitudes, feelings and behaviors
rather than promoting intellectual growth.
encourages the client to look at alternative behaviors recognize the choices
and develop a sense of control.
Change agent-
initiate changes or assist clients to make modifications in themselves or in
the system of care.
Leader
The nurse through the process of interpersonal influence helps the client
make decisions
in establishing and achieving goals to improvehis well-being.
Client advocate-
involves concern for and actions in behalf of the client to bring about a
change.
promotes what is best for the client, ensuring that the client’s needs are
met and protecting the client’s right.
19. provides explanation in clients language and supportclients decisions.
Manager –
makes decisions, coordinates activities of others, allocate resources,
evaluate care and personnel
plans, give direction, develop staff, monitors operations, give the rewards
fairly and represents both staff and administrations as needed .
Researcher –
participates in identifying significant researchableproblems
participates in scientific investigation and must be a consumer of research
findings
must be awareof the research process, languageof research, a sensitive to
issues related to protecting the rights of human subjects.
Communicator/Helper
The nursecommunicates with clients, supportpersons and colleagues to
facilitate all nursing actions.
Case Manager
The nursecoordinates the activities of other members of health care team,
Such as nutritionists and physicaltherapist, when managing a group of
client’s care.
Collaborator
The nurse works in a combined effort with all those involved in delivery, for
a mutually acceptable plan to be obtained that will achieve common goals.
The nursing initiates nursing actions within the health team.
Expanded role of the nurse
20. 1 Clinical Specialist
2. Nurse Practitioner-
3. Nurse-midwife
4. Nurse anesthetist
5. Nurse Educator-
6. Nurse Entrepreneur-
7. Nurse administrator
8. nurse researcher
1 Clinical Specialists-
is a nursewho has completed a master’s degree in specialty and has considerable
clinical expertise in that specialty. Sheprovides expert care to individuals,
participates in educating health care professionals and ancillary, acts as a clinical
consultantand participates in research.
2. Nurse Practitioner-
is a nursewho has completed either as certificate programor a master’s degree
in a specialty and is also certified by the appropriatespecialty organization. She is
skilled at making nursing assessments, performing P. E., counseling, teaching and
treating minor and self- limiting illness.
3. Nurse-midwife-
a nursewho has completed a programin midwifery; provides prenataland
postnatal care and delivers babies to woman with uncomplicated pregnancies.
4. Nurse anesthetist-
a nursewho completed the courseof study in an anesthesia schooland carries
out pre-operativestatus of clients.
5. Nurse Educator-
21. A nurseusually with advanced degree, who beaches in clinical or educational
settings, teaches theoretical knowledge, clinical skills and conductresearch.
6. Nurse Entrepreneur-
a nursewho has an advanced degree, and manages health-related business.
7. Nurse administrator- a nursewho functions at various levels of
management in health settings; responsiblefor the management and
administration of resources and personnelinvolved in giving patient care
CAREER OPPORTUNITIES
Content
Career opportunity
Introduction
There are many job opportunities for nurses such as-
Hospitals
Long term care facilities
Home health
Physicians office or clinic
Insurance company
Temporary agencies
Travel opportunity
Pharmaceutical sales
Other medical sales
Outpatients hotel
Military nursing
Adult day care
School health nurse
Public health
22. Out patient surgery
Private duty nursing
Government nursing
Industrial nursing
Rehabilitation nursing
Psychiatric nursing
Hospice nursing
Clinicians
Advance practice nurses
Clinical nurse specialist
Nurse practitioner
Certified nurse midwife
Certified registered nurse anesthetist
Nurse educator
Nursing administrator
Nurse researcher
Nurse entrepreneur
Professional advancement
Introduction
Purpose
Objectives
Professional growth
Professional advancement model
Model component
Role & scope of nursing education
Extended nursing role
Expanded nursing role
Summary