From our television screens, to the aisles of Halloween costume shops, to the corridors of our clinics and hospitals, nurses are some of the most interesting and recognizable members of society. These cherished caregivers give so much to their patients, and yet so much about their crucial professions remains unknown. Read on to get an eye-opening glance into the secret world of nursing.
1. Why All the Initials?
Like most jobs in the medical field, nurse job titles are often abbreviated to just a series of letters. For people not involved in this world, the variety of initialed titles can be a confusing alphabet soup of letters. One of the most common abbreviations in the nursing world are the letters R, and N.
RN refers to “registered nurse” and is awarded to nurses who have studied for two or more years. RNs can receive their degree at a traditional college or university, or study in a specialized vocational school. Upon completing their degree, these nurses must also pass state-specific board exams. Once certified, they can work in physicians’ offices, long-term care facilities, schools, and of course, hospitals.
2. It Pays To Care
According to the United States Bureau of Labor Statistics, becoming a Registered Nurse (RN) is a smart career move. The median salary, according to a 2019 study, was $73,300, which comes out to about $35 per hour. RNs working in outpatient care centers make the most on average, followed by nurses working in general medical and surgical hospitals.
RN salaries are largely dependent on geographical location as well. The top five with the highest salaries are California, Hawaii, the District of Columbia, Massachusetts, and Oregon. RNs in these places make more than $90,000 a year on average, and RNs in California make an annual mean wage of $113,240. For RNs, it pays to head west; nurses in the Californian cities of San Jose, Santa Clara, San Francisco, and Santa Cruz make upwards of $134,000 annually.
3. The Faster Route To Nursing
For those wishing to enter the field of nursing faster, there are several routes that do not require many years of study. One of the most common direct-entry positions to nursing is by becoming a nursing assistant. The amount of available nursing assistant positions are numerous, and require much less training compared to becoming an RN.
Many common titles of nursing assistants include: Registered Nursing Assistants (RNAs), Certified Nursing Assistant (CNAs), and Licensed Nursing Assistants (LNAs). Nursing assistants are also sometimes referred to as care or home assistants, or direct care workers. They help patients with everyday tasks, as well as with paperwork. Most nursing assistant training programs range from a few weeks, to a few months. At the end of training, prospective nursing assistants must take a state-specific test in order to become certified.
4. A More Hands-On Approach to Nursing
Another way to start a career in nursing is by becoming a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse. While these titles may differ, according to state, the job requirements are typically the same. LPNs are the most common designation. These are usually the first nurse that patients see after checking into a facility. These nurses take and record vital signs, and may help with dressing wounds or catheter insertion.
LPNs serve as the “point of contact” and are typically the type of medical practitioner most often seen by patients while they’re at a long-term facility or hospital. LPN programs are generally a year long, and students must undergo clinical training. After finishing their program, LPNs must also pass the Board of Nursing exam required in their state.
5. It Makes “Cents” To Study More
While there are many shorter courses available to those interested in nursing, the highest paid nursing positions are awarded to those who hold master’s degrees. Many of these nurses typically become specialized nurses called Advanced Practice Registered Nurses (APRNs) and work as nurse anesthetists, nurse midwives, or as nurse practitioners. APRNs typically earn the highest wages in the nursing industry.
Nurse anesthetists, or nurses who administer anesthesia for surgeries or medical procedures, earn an average of $167,950. Nurse practitioners and nurse midwives also make a salary of above $100,000 on average. The employment for APRNs is expected to continue growing: research projects a growth of 26 percent over the next decade, a rate faster than the average for most other occupations.
6. Where Do Most Registered Nurses Work?
The majority (60%) of registered nurses work in hospitals. These hospitals can be state hospitals, local hospitals, or private. Less than 20% work in ambulatory healthcare service, less than 10% work in nursing and residential care, five percent work for the governments, and three percent work in educational services.
While most registered nurses work in hospital settings, there are many job opportunities in other locations. Some nurses can work in camps, schools, correctional facilities, or can help patients traveling in an emergency vehicle while being transferred to a critical care facility. Some nurses prefer more personalized relationships with their patients, and become live-in nurses. These nurses help their patients with everyday tasks and living skills, and provide them with appropriate medical care.
7. The Perfect Nursing Career For Fans of Crime Shows
With the popularity of crime shows on television, a newfound appreciation for forensics has emerged. Forensic science involves applying science to criminal and civil laws during criminal investigations, according to the legal standards regarding evidence and criminal procedure. Forensic nurses can use their medical knowledge, as part of a team of investigators, in order to help victims seek justice.
Forensic nurses help care for victims of abuse, neglect, or violent crime. They help collect vital evidence which can be used in courts, and support law enforcement. They sometimes work alongside pathologists, specialists who study disease and injury through thorough examination of a patient’s organs, tissues, and other body parts. Forensic nurses also work alongside coroners in order to make sure vital statistics were recorded accurately, and that the cause of death was also accurately identified.
8. The Ancient Roots of A Modern Day Practice
While there is some debate as to when the nursing profession began, historians believe the concept originated in ancient India. Around 232 BCE, a Buddhist ruler in India built hospitals along routes popular with travelers. He insisted that skillful physicians help administer medicine made of minerals, vegetables, herbs, roots, and fruits.
This system of public hospitals continued until the fall of Buddhist rule, hundreds of years later. During the early years of Christianity, St. Paul sent a nurse to Rome. Early Christianity encouraged its followers to help the sick and needy, regardless of their patient’s religion, a belief that would continue into modern-day nursing.
9. History Shows How Important Nurses Are
As Christianity spread, so did the establishment of hospitals across the Roman Empire. Hospitals became more advanced, as did the creation of a system of nurses to care for those injured in war, or for helping battle widespread diseases. Special teams of medical practitioners were gathered to help care for lepers, or other specific illnesses, such as smallpox.
Hospitals were being built in most towns, and doctors began keeping records of their medical notes in libraries. These hospitals also began training programs, using detailed manuscripts of their medical knowledge. Medical wards, similar to what exist in modern hospitals today, were erected to treat specific illnesses. Hospitals also became more systemic, employing doctors, nurses, and orderlies.
10. Nursing Becomes A Religious Act
Medieval medical care continued to be heavily intertwined with religion, with most monks and nuns providing care. Hospitals were often referred to as hôtel-Dieu or “hostel of God”. They were often a part of a monastery, though others were independent. Not all medieval hospitals cared for sick patients: some existed to help the poor, or orphaned children, and many were created to support travelers such as pilgrims.
Houses of worship became an important part of modern healthcare, and hospitals in Europe were commonly attached to cathedrals, churches, and monasteries. Churches were able to apply money collected from taxes in order to expand, and improve, their hospitals. Nuns frequently doubled as nurses, providing care for the needy. Their work was highly praised and was considered an honorable, and prestigious, role for a woman.
11. The Profession of Nursing Almost Disappears
Many historical hospitals were funded by Catholics, who believed that by performing good works, they would be admitted to Heaven. In regions where Catholicism was heavily practiced, nursing continued and became even more advanced. Nuns worked not only as nurses, but as physicians, surgeons, and ran their own apothecaries.
But as Protestantism began to spread, the concept of nursing came under attack. Unlike Catholics, early Protestants did not believe that funding charitable institutions like hospitals would help the rich gain entry to Heaven. Because of this, many monasteries and convents were closed, leaving nuns unable to serve as nurses. Most hospitals were closed, since many had been attached to houses of worship, and the system of nursing threatened to come to an end.
12. Women Helping Women
As nursing became less common, given the closure of many monasteries, another role for women working in medical care emerged: deaconess. This ancient role, once mentioned in the New Testament, was revived in Western Europe in the early 1800s. Deaconesses were women who helped other women by training them in child care and nursing, and prepared them for marriage.
The idea soon spread from Germany to England, to Scandinavia, and even to the United States. By the early 20th century, 62 deaconess training schools had been opened in the United States. As the women’s rights movement grew, enrollment in deaconess schools dropped, as more women preferred to enroll in formal nursing schools, or state universities.
13. War Marks the Founding of Modern Nursing
In the mid-1800s, the Crimea War erupted, pitting Russia against the Ottoman Empire, Sardinia, France, and the United Kingdom. More than half a million people perished, the vast majority of whom weren’t even from the battlefield — but instead, as a result of preventable disease. Yet from this darkness of war, came something positive. English nurse Florence Nightingale, who had been helping soldiers on the frontline, laid the foundations for modern-day professional nursing.
“The Lady with the Lamp” spent days and nights caring for those injured in battle. Nightingale, who was an experienced nurse and had managed and trained other nurses, found conditions in the British hospital bases utterly unacceptable. The British hospital base in Turkey was appalling, filled with pests, lacking hygiene, and generally filthy. Nightingale knew she had to do something if she wanted to save the soldiers.
14. “The Lady with the Lamp” Shines a New Light on Nursing
While stationed in modern-day Turkey, English nurse Florence Nightingale established the standards, and philosophies, that would define modern nursing. The lack of hygiene and filthiness of hospitals often resulted in patient deaths. Excrement from rodents and other vermin often made for a dangerous environment for patients already struggling to survive.
Many supplies and even food and water were limited. Nightingale understood the connection between hygiene and safety, immediately organizing a deep cleaning for the hospital. She enacted basic hygienic procedures still used today, such as hand-washing, to halt the spread of dangerous pathogens. Thanks to her innovative changes to health care, death rates in the hospital dropped. Not only were lives saved, but more people understood the importance of properly trained nurses.
15. Those Who Can, Teach
As the Crimean War ended, news of Nightingale’s heroic efforts spread. In 1855, as a reward for her work in modernizing battlefield hospitals, the Nightingale Fund was created. Several years later, £45,000 was raised through private donations. Nightingale used the majority of the fund’s money to create the first secular nursing school, founded on scientific principles.
The Nightingale School of Nursing opened in 1860, at the St. Thomas’ Hospital in London. Using the standards that Nightingale had implemented during her time on the battlefield, the school helped to standardize nursing practices. Her school also helped make nursing an attractive profession for women who wanted to pursue a career.
16. The World of Nursing is Changed Forever
Following the opening of her training school, a focus on the importance of hygiene emerged. British rulers had been horrified by Nightingale’s notes on the filthy conditions that plagued British hospital bases. Queen Victoria soon created the Royal Victoria Hospital to train army medical personnel and care for patients.
The reform continued through the creation of the Army Nursing Service (ANS), which monitored military nurses. Florence Nightingale was also an accomplished writer and statistician. She helped pioneer the use of info-graphics such as pie charts in order to communicate complicated medical information. Her Coxcomb chart, which resembles a pie chart, is still used today in order to assess risk and mortality.
17. Notes On Nursing
Published in 1859, Notes on Nursing became the base for the curriculum taught in Nightingale’s nurse training school. Not only was the information in the book used by the students in Nightingale’s school; it was also used by other nursing schools and by the general public.
Calling it “every day sanitary knowledge”, Nightingale’s book emphasized the importance of hygiene, and helped introduce the public to the basics of nursing. The groundbreaking book became a hit, changing the public’s perception of nursing. Before Nightingale’s standardized approach to nursing, most nurses were poorly trained and thought of as incompetent. In British workhouses, places where the poor could receive housing and employment, the sick were often cared for by other untrained workhouse members.
18. Nightingale’s Vision Spreads
The medical knowledge imparted by Florence Nightingale’s teaching soon spread across the world. Her work inspired nurses serving on the battle fields of the American Civil War, and Nightingale helped mentor “America’s first trained nurse”, Linda Richards. Richards, who had already been working as a nurse, enrolled in Nightingale’s intensive nurse training program in England.
After finishing the program, Richards was able to bring her newly acquired knowledge to nursing schools across the United States. Richards also became a pioneer in the profession of nursing through her introduction of individualized medical records for patients. She later took her medical knowledge to Japan, where she established the country’s first nurse training program.
19. Women On the Front Lines
Beginning in the early 1900s, nursing became an emerging viable career path for women. It wasn’t until World War II, however, that interest in nursing soared, largely attributed to nationalism. During the war, becoming an army or navy nurse became highly desirable. This was heavily fueled by positive representations of nurses in pop culture and film.
In wartime, nurses began to take on more responsibilities and power. The American Nurses Association (ANA) helped campaign for higher pay, and better working conditions. Hospitals were also changing, becoming larger and hiring a variety of medical professions such as aides and practical nurses to help support the registered nurses.
20. Modern Nursing’s Connection to Asia
Starting in 1965, and continuing for about two decades, close to 100,000 nurses immigrated to the United States. Many of these trained nurses were from The Philippines. Although many Filipino nurses had arrived in the United States after World War II, it wasn’t until 1965 that changes in American immigration law allowed for hospitals to recruit international nurses and issue them green cards.
Nursing schools in the Philippines adopted a curriculum based on the American standards, and English language courses became popular. Today, Filipino nurses are an important part of the American nursing profession. In an effort to assist nurses from this community, a group was created called the National Federation of Philippines Nurses Associations in the United States.
21. Dressed To Help
Most visitors to a hospital can easily spot medical professionals by their often colorful scrubs, the sanitary garments worn by health care workers which usually consist of a T-shirt and pants. Modeled closely after a nun’s habit, the standard uniform of a nurse was once a dress, an apron, and a hat.
Changes in nursing uniforms changed as advancements in fabric technology, and hygiene practices were made. Disposable caps and plastic aprons soon became the norm, before they were eventually phased out following the popularity of simple scrubs and tunics. In many countries, nurse uniforms are now gender-neutral, but some men still prefer wearing scrubs in colors like blue or green. Nurses do not often wear jewelry for hygienic reasons, or because it could interfere with work activity.
22. Nurses On the Small Screen
An intimate look into the world of nursing has been a popular theme for many television shows. Because nurses are often put in life or death situations, these caregivers make the perfect characters for a scripted drama. Some of the most popular shows about nursing include Scrubs, House, Nurse Jackie, M*A*S*H, ER, and Grey’s Anatomy.
In these dramas, nurses are generally portrayed as strong characters advocating on behalf of their patients. They are often seen as battling against fellow medical professionals, and navigating the chaos that often overwhelms their hospitals. While these shows are extremely popular with viewers and television critics, many in the nursing field complain that their fictional depictions are highly inaccurate.
23. Hollywood Nurses
While the world of nursing may make for some interesting television story lines, for some celebrities, the medical world was their reality. Before Bonnie Hunt was starring in Emmy-nominated television shows, she was working as an oncology nurse for five years while part of an improv troupe.
Tina Turner moonlighted as a nursing aide before beginning her singing career. Naomi Judd also spent her days making the rounds on the hospital floors as an ICU nurse before pursuing music. Reality show veterans, like Kate Gosselin, and Real Housewives stars Kim Zolciak-Biermann and Luann de Lesseps, all traded in their scrubs for red carpet dresses.
24. Got Stethoscope, Will Travel
One of the least well-known career paths in nursing is working as a travel nurse. Travel nurses are registered nurses who can work domestically or internationally. Travel nurses relocate to areas that are experiencing a shortage of medical staff. They are often offered higher salaries, paid housing, and their relocation costs are typically covered.
Travel nurses are usually assigned short-term contracts for less than two years. International travel nurses typically work in areas experiencing an outbreak of disease, or affected by natural disaster. These nurses provide medical care to rural populations that are often underserved by the local medical community. Some travel nurses decide to stay, and travel, within the United States. Popular options for these domestic travelers include Hawaii, California, New York, Massachusetts, and New York.
25. Nurses Can Find Job Possibilities Below Deck
Having wanderlust and wanting to pursue a nursing career do not have to be mutually exclusive. An emerging area of nursing can be found aboard yachts and cruises, providing medical care for passengers. Yacht nurses are certified nurses who not only provide general care, but must be able to provide care in the event of a medical emergency.
Because boats are often docked far away from the closest hospitals, it may take hours for rescue helicopters or boats to arrive. For this reason, cruise ships often maintain a staff of nurses and other medical care providers. Nurses who work on cruise ships must be trained to provide care for a variety of trauma or emergencies that can occur onboard. These nurses are typically nurses with extensive experience working in emergency rooms and Intensive Care Units (ICU).
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