Becoming a Nurse
Bachelor of Science in Nursing
Graduates with
an associate degree or a hospital diploma can begin
practice as a registered nurse (RN) if they successfully
pass the state-licensing exam (NCLEX-RN). The bachelor of
science in nursing degree (BSN), however, is essential for
nurses seeking to move up the career ladder and provide
higher levels of care.
Typically during their first two years in college, BSN
students take general education courses. In their last two
years of college, they focus on nursing courses.
A variety of programs are available that enable licensed
practical nurses (LPNs) and registered nurses (RNs) to
complete their BSN degree. (See the All Nursing Schools and
the BestNursingDegree websites.)
For descriptions of a few the programs that recruit/support
American Indian and Alaska Native students, see
Schools/Programs.
Master
of Science in Nursing
Master’s degree
programs are 18 to 24 months in length and enable graduates
to specialize in areas such as advanced clinical training
or research. Most master’s degree candidates already have
their BSN, but there are programs that help people move
directly from the RN to the BSN to the MSN.
A master’s degree in nursing is needed by advanced practice
nurses (APNs). There are joint-degree programs, such as a
master's in nursing combined with a master’s degree in
business administration or public health, or hospital
administration. Master's degrees in nursing administration
or nursing education are also available. (See the
All Nursing Schools and
the BestNursingDegree websites.)
Nurse
Practitioners
Nurse
practitioners (NPs) are Advance Practice Nurses who provide
a range of services. They assess their patients’ needs by
talking with them, examining them and ordering and
interpreting various studies and tests. They work
collaboratively with patients in preventing illness,
promoting health, treating common acute illnesses and
injuries, and managing chronic problems. They focus both on
caring and curing.
NPs work in a wide range of settings and numerous fields,
such pediatrics, family health, women's health, and other
specialties. Some NPs have private practices. NPs can
prescribe medications in all states. In 25 states NPs can
practice independently without physician collaboration or
supervision.
Family nurse practitioners are in great demand in the
Indian Health Service (IHS). They provide basic primary
care in collaboration with the nursing, medical, and dental
staff as well as staff in the laboratories and pharmacies.
(For more information about nurse practitioners, see
the American Academy of Nurse
Practitioners and
the American College of Nurse
Practitioners.)
Clinical
Nurse Specialists
Clinical nurse
specialists (CNSs) are
Advanced Practice Nurses who have earned a master’s or a
doctoral degree in a specialized area of nursing practice,
such as pediatrics, geriatrics, women’s health, oncology,
diabetes, rehabilitation and mental health. CNSs practice
in a wide variety of health care settings assessing and
treating disease injury and disability. They also help
patients prevent and resolve illness. (For more information
see the website of the National Association of Clinical Nurse
Specialists.)
Certified
Nurse-Midwives
Working with physicians or on their own, certified
nurse-midwives (CNMs), who are Advanced Practice Nurses,
provide comprehensive care to healthy pregnant women. They
deliver babies in hospitals, birthing centers, and homes
and then follow-up with postpartum care. They help patients
with family planning and provide such gynecological
services as physical and breast exams and preventive health
screening. In most states, CNMs can prescribe medications.
CNMs in the IHS deliver babies and engage in all aspects of
perinatal care, including care for newborns. Most births
take place in IHS hospitals, often with family members and
friends in attendance. For more information see the website
of the American College of
Nurse-Midwives.
Certified
Registered Nurse Anesthetists
Certified
registered nurse anesthetists (CRNAs) administer more than
65 percent of anesthetics given to patients each year in
the U.S. In almost two-thirds of all rural hospitals, CRNAs
are the only providers of anesthesia.
CRNAs administer anesthesia for all types of surgery in
settings ranging from operating rooms and dental offices to
outpatient surgical centers. Because most IHS hospitals do
not have anesthesiologists, CRNAs within IHS work
independently or under the supervision of a surgeon or a
physician. (See the American Association of Nurse
Anesthetists website for
more information.)
Doctoral
Programs
Doctoral
programs prepare nurses for careers in advanced clinical
practice, clinical research, nursing education, and health
administration. The doctorate-level
degrees in nursing include: Doctor of Nursing Practice (DNP
or DrNP); Doctor of Nursing Science (DNSc, DNS or DSN); and
Doctor of Philosophy (PhD) in Nursing. Typically the PhD
and DNS degrees are considered reach-oriented degrees,
while the DNP is a practice-oriented or clinical doctorate.
Programs typically take 4 to 6 years to complete. (See
the All Nursing Schools and
the BestNursingDegree websites.)
See the American Association of Colleges of
Nursing for more
information on nursing education programs, including
undergraduate programs, programs for RNs, Master’s
Degree Programs, Doctoral Programs, and Accelerated
Programs.
This
article was originally published in the Summer 2007 issue
of
Winds of Change. This page was
updated 2010. (The cover artist is Bunky Echo-Hawk,
Yakama/Pawnee.)