Careers in
Nursing
Nursing
Shortage
The United
States is in the midst of a nursing shortage that is likely
to intensify. More nurses are needed to care for the
growing population, particularly elderly people and
acutely-ill, hospitalized patients. Nurses are needed in
every aspect of health care from high-tech operating rooms
to community healthcare centers to home care. Physicians
have less time with patients, so nurses are needed even
more for direct care. With the spiraling cost of care,
nurses and other health professionals are doing tasks that
were once almost exclusively in the physicians’ domain. The
high cost of care has resulted in shorter hospital stays
for patients, so nurse specialists are needed to oversee
patients’ ongoing care in their home or a lower level
facility, such as a nursing home.
Unfortunately, at this time of great need for nurses,
significant numbers of nurses and nursing educators are
retiring. The shortage of nursing educators, in turn, means
that schools can’t enroll enough nurses to meet the
projected demand for nurses.
Job Opportunities
Not
surprisingly, the job market for nurses is excellent.
According to the U.S. Bureau of Labor
Statistics, registered
nursing is among the Top Ten Occupations with the
largest job growth. The bureau projects that through the
year 2018, employment for registered nurses (RNs) will
grow faster than most other occupations.
However, since a growing number of nursing tasks require a
high level of responsibility and a wide area of skills,
many employers are seeking nurses who have at least a
bachelor’s degree in nursing (BSN). In fact, nationally
there is a movement to require all nurses to hold a BSN
rather than the three-year RN degree. Graduate level nurses
(e.g., advance practice nurses, nurses practitioners, and
PhDs) are also needed.
Indigenous
Wisdom Needed
Of the more
than 2.9 million registered nurses in the United States,
only 0.5% are American Indian or Alaska Native.
Karine Crow, Cherokee,
PhD, RN, says, “Educated, culturally re-enforcing
indigenous nurses are particularly needed for programs
that serve the American Indian and Alaska Native people.
Inclusion of the Elders and the medicine people within
the plan of care promotes a more culturally appropriate
and holistic approach.”
Like many other indigenous nursing educators, Crow feels
that the goal of high-quality care for indigenous people
requires nurses with high-level educational and clinical
skills. “Because of the nursing shortage some new nurses
advance quickly. The added value of a bachelor’s degree
provides them with leadership, research, and critical
thinking skills as well as a public health background on
which Indian Health Service is founded. American Indian and
Alaska Native nurses with master’s and doctoral level
degrees are also needed. Currently there are less than 20
of us with doctoral level degrees in nursing.”
The perspectives and wisdom of indigenous people are also
needed nationwide to help create a high-quality healthcare
system that is more holistic and humane as well as
available and accessible to all people.
Nursing Roles and Opportunities
Nurses
typically work as part of a team, but they do not simply
assist physicians and other health care provides. They work
within their own scope of practice that includes health
promotion and disease prevention, direct patient care,
supervising the care provided by others, case management,
developing and monitoring quality assurance procedures, and
directing complex systems of care
Advance practice nurses (also called APNs) are independent
practitioners with the authority to diagnose, prescribe
medications, and manage their own practices. APNs include
nurse practitioners, nurse midwives, nurse anesthetists,
and nurse specialists.
Some nurses with masters and doctoral level degrees work in
administration, management, research, and in the education
of future nurses and other health professionals.
Work
Settings
More than half
of all employed RNs work in hospitals, but nurses at all
levels of education work in a variety of settings,
including hospitals, private practices, clinics, public
health agencies, outpatient surgicenters, health
maintenance organizations (HMOs), mental health agencies,
home health care, community health centers, nursing homes,
hospices, rehabilitation centers, businesses, schools and
universities, the military and even churches.
This
article was originally published in the Summer 2007 issue
of
Winds of Change. This
information was updated in 2010. (The cover artist is Bunky
Echo-Hawk, Yakama/Pawnee.)