Operating with the highest level of autonomy, nurse practitioners are lifelines for many patients.
This week’s designation as National Nurse Practitioner Week (November 10-16) is an excellent time to examine the roles nurse practitioners (NPs) play in the nation’s healthcare system.
The American Association of Nurse Practitioners is a leading professional organization for NPs and also leads advocacy for issues relating to NPs. A nurse practitioner has achieved an educational path that brings them to Advanced Practice Registered Nurse (ARPN) designation. That gives them essential nursing knowledge and combines it with the ability to use it in a more comprehensive manner than a registered nurse (the first step to becoming an NP).
One of the biggest challenges facing NPs today is achieving full-practice authority (FPA) in all states. Because NPs have wide-ranging responsibilities that include examining and treating patients, diagnosing illness, and prescribing medications, they often work at the level of a physician. In some states, a nurse practitioner is not mandated to work under the supervision of a physician or required to have a physician sign off on some of their treatments. In states that don’t recognize the full practice authority of an NP, that additional layer of physician sign-off is required.
A nurse practitioner is able to “hang a shingle” and operate as a solo practice in any location. Many NPs choose to do so in remote areas where practicing physicians are hard to find or in urban areas where transportation to a medical office is a barrier to care. They are a vital cog in the healthcare wheel. They often assume many of the responsibilities of a primary care physician, developing relationships and providing preventive and long-term care. They see and treat patients with chronic diseases like asthma or diabetes and work in conjunction with a specialized care team as well.
If upping your career to a nurse practitioner level interests you, there are steps to get started. NPs require a master’s in nursing (with a focus on the population you intend to serve) and achieving a PhD in nursing is desirable for this role. After becoming a registered nurse, completing the BSN and MSN, you’ll need to earn your state-level advanced practice nursing license.
While NP authority is determined on the state level, there is progress toward achieving a national model. For now, some states participate in the APRN Contract, which allows a nurse holding an APRN license to essentially have authority to practice in several states. Not all states are part of the ARPN, so you’ll need to check to see where your own practice location, or intended location, fits in.
Career outlooks for NPs are stable. As the number of family practice physicians decline and the population increases, NPs are there to help patients on a high level. They are also able to work with communities that may not have had reliable medical care in years. The freedom to develop deep and lasting multigenerational relationships with patients and families is a routinely cited reason for working in this busy role.
If you’re an NP, National Nurse Practitioner Week is a good reminder to let people know of the training and skill set required of nurses in this area of nursing. And it’s a good time to give yourself a pat on the back for all you do.
Urology nurses are the nurses who care for patients with a range of conditions and diseases that impact the urologic system.
This week highlights the care these nurses give with Urology Nurses and Associates Week running from November 1-7. Sponsored by the Society of Urologic Nurses and Associates (SUNA), the week offers a time to recognize this particular area of nursing while also calling attention to urologic conditions.
According to the American Medical Association, urology covers conditions of the urinary tract, the reproductive tract of males, urinary tract infections, cancer, incontinence, reconstructive urology, urogynecology, stones in the urinary tract, and some aspects of male and female infertility.
Urology nurses may treat adult or pediatric cases and may see cases from the routine to the exceedingly complex. They are called on to help men and women who present with sexual dysfunction or to help those with congenital conditions. They may assist with surgical procedures or with continual care of chronic conditions.
As a urology nurse, education is an important job responsibility. Nurses are a patient’s first resource for managing, coping with, and treating a condition. Patients turn to nurses to find out how to prevent a urinary tract infection, how to manage a catheter, or what kind of recovery they face after urologic surgery.
Within this role of educator, nurses can help patients manage expectation of healing, understand any prescriptions, or activity restrictions, and understand what is happening to their bodies. Urology nurses can help patients’ families learn how to help with the care and healing process as well. Minority nurses in the field are especially important as the more they understand the culture of a patient, including dietary traditions, the better they can help them heal.
Urology nurses are also the best ambassadors for this area of nursing. The Urology Nurses and Associates Week is a good time to celebrate with colleagues, and it’s also an opportunity to learn more and help educate others about what you do. You can send a photo of your team to the local paper with a short explanation of your success or how you care for people.
You can also take your voice public. Think of ways you can work in your community or on a wider platform to promote better policies to protect nurses and patients. Become a member of a professional nursing organization in your specialty, like SUNA, and volunteer your time to make an impact in whatever way you can.
Any nurse is committed to lifelong learning, so seek out ways to learn more. Become certified in urology nursing if you have not already. Take courses or sign up for webinars with your healthcare organization to refresh your knowledge on any area of nursing. Decide to become the go-to person in your unit on treating a specific condition and learn all you can to make that a reality. Take on leadership roles within your local nursing association chapter so you can develop agendas that keep urology nursing at the forefront of healthcare priorities.
And be sure to take a moment and think of how your hard work changes the lives of the patients in your care. Urologic issues often hold a certain level of embarrassment for some patients, so the compassionate and empathetic care urology nurses give is meaningful and will be remembered.
Each year the Academy of Medical-Surgical Nurses (AMSN) celebrates med-surg nurses with Medical-Surgical Nurses Week.
This year, Medical-Surgical Nurses Week runs from November 1-7 and helps bring attention to this broad and complex nursing specialty.
According to AMSN, medical surgical nurses are a vital part of a healthcare team, juggling many different duties with top-notch patient care, including the following:
- Being advocates and activists for their patients and patient care protocols
- Using evidence-based practices to inform the patient care they give
- Educating the public, patients, and families on healthcare and the nursing profession
- Researching for healthcare improvements
- Supporting others in the nursing profession and acting as mentors and proponents within the med-surg specialty
- Working for the best patient care practices by encouraging and promoting certification and high standards in nursing
Med-surg nurses work primarily in a hospital setting and care for patients who have been admitted for illness, are recovering from surgery, or are receiving treatment for ongoing chronic conditions that require hospital care. Med-surg nurses are registered nurses, and they work with adult, not pediatric, patients.
Nurses in this specialty are trained to recognize, diagnose, treat, and manage a variety of conditions as the patient population and their health conditions are diverse. Nurses in this role are treating many patients at once, helping their team coordinate and provide the proper care, monitoring medications, and watching for changes that could indicate an improvement or decline.
These nurses also work with families of the patient to help them understand what’s going on, the treatment plans, what will happen after the patient goes home, and what they can do to help.
These nurses also help patients who do not have strong support systems, so they are able to receive necessary care when they go home using various community, government, and local resources to pull together a plan of care.
Because they do not focus on one specialty, med-surg nurses have vast knowledge about what could present for a patient. One patient who arrives with sepsis from a wound could progress to pneumonia. Or a patient who comes in complaining of a sore shoulder could be having heart troubles. Med-surge nurses are alert to these changes and watch for red flags for all their patients.
Med-surg nursing is the largest nursing specialty in the nation, with the AMSN estimating approximately 650,000 med-surg nurses in the United States. Most nursing students will complete at least one med-surg clinical as it offers a broad application of all the skills nursing students are learning.
If students choose to move into a med-surg career, they will want to obtain certification, which can be as a Certified Medical-Surgical Registered Nurse (CMSRN®) or as an RN-BC.
Medical-surgical nurses are the engine of many healthcare and hospital settings. Celebrating the hard work they do is a welcome recognition for their efforts.
According to a recently released report, nursing salaries has remained fairly steady, but the wider averages in pay depend on where the nurse works.
The Medscape RN/LPN Compensation Report, 2019, collected information from the 7,145 nurses (5,143 RNs and 2,002 LPNs) who responded to the online survey over an 11-week period this summer. The nurses were asked questions about their earnings, workplaces, and general hours (about 75 percent worked full-time as opposed to part-time or per diem) for 2018.
The compensation report found that RN earnings averaged $80,000 (down from $81,000 in 2017) while LPN earnings rose from $46,000 to $48,000 over the same period. Employees who are paid with an annual nurse’s salary earn more than those who are paid an hourly rate. Salaried RNs report earnings that average $83,000 vs. hourly RNs who make $78,000. A salaried LPN reports an average annual pay of $53,000 compared to the hourly earnings of $47,000.
Without specific explanation, the report says it’s difficult to determine the root cause of the nearly flat earnings, especially for RNs over the past three years of surveys. Because the results are the average, meaning some nurses make more and some make less, the flat levels could reflect higher paid experienced nurses retiring or it could be a result of stagnant wages for nurses.
Despite all those fluctuations in nursing salaries, it is the type of workplace that drives the higher wages. Traditionally, the report states, RNs in hospital settings earn the largest salaries ($83,000) and nurses who work in non-profits or in school settings earn the lowest salaries ($65,000).
On the higher end of the earning spectrum are nurses in industry settings (insurance or health plans), an occupational health setting, a hospital-based outpatient clinic, a home health or visiting nurse position, or an academic faculty role all earn an average of at least $80,000.
RNs in hospice or palliative care, in non-hospital medical or urgent care, in a skilled nursing facility, or in a public health setting earn somewhere between $72-80,000. For LPNs, working in a skilled nursing facility brought in an average full-time nurse’s salary of $51,000 as compared to the lower earnings of an LPN in a school or college setting who earned an average of $36,000.
One finding that repeats yearly is the distinct gender pay gap that persists in nursing salaries. Male RNs report earning an average of $3,000 more than their female counterparts while a male LPN reports earning an average of $4,000 more than female LPNs. The report points to variations in how men and women work—with more men reporting working overtime, working on inpatient units, working high differential shifts, and working paid weekend or evening hours—that could account for the higher earnings.
As expected, the greater the education level, the higher the earnings with nurses with a doctoral degree reporting average earnings of $94,000 vs. $75,000 for an associate’s degree level. And, as with many industries, workers with more years of experience, with professional certification, and in higher-paying regions will earn more.
The Medscape report, like Minority Nurse’s annual salary reports, offers points for nurses to think about when choosing a location to live, when considering getting additional education, or when thinking about what type of facility matches their interests and can support their cost of living.
This week’s observance of National Orthopaedic Nurses Week from October 28 through November 1 calls attention to the work of nurses who care for patients with problems related to their muscles and joints.
Sponsored by the National Association of Orthopaedic Nurses (NAON), the week salutes nurses who work in this field and change the lives of their patients every day. Orthopaedic nurses specialize in treating patients with musculoskeletal problems and all the associated tasks with their treatment.
Because of the wide range of issues that come with musculoskeletal development and use, these nurses may work with patients of all ages.
Orthopaedic nurses may treat patients with any of the following conditions:
- Sports injuries
- Pediatric disorders such as osteogenesis imperfecta
- Broken or fractured bones
- Carpal tunnel syndrome
- Back pain and injury
- Strain and resulting inflammation around tendons and joints
Nurses may diagnose and treat patients with immediate injuries in hospital or emergency department settings. They might also work with a rehabilitation or physical therapy facility to help patients regain their strength, flexibility, and full range of motion. They may work with patients who need various castings to keep bones in place and will help them manage getting around or coping with the casting restrictions.
Every nurse is an essential source of information and for someone who has a mobility-limiting injury or condition, the education provided by nurses can be a true lifesaver. Patients will learn from their nurses about how to control and manage any pain, how to prevent further injury, and what to expect during different stages of healing. If a patient has had any surgery, for example a hip replacement, they will help with plans for how to care for themselves during the healing process and progress through a faster recovery. They will even learn about how to cope with an itchy cast or gain real-life tips for soothing arthritis flare-ups.
As with virtually any nursing specialty, professionals in this nursing path are encouraged to obtain certification through the Orthopaedic Nurses Certification Board. Certification keeps your knowledge and skills current so you’re able to take your experiences, combine it with the latest evidence-based practices, and give your patients the best possible care. Nurses may also continue their quest for lifelong learning with recertification, so even nurses who have obtained this credential can continue to learn more.
Seeing direct patient progress is one of the best parts of being an orthopaedic nurse. It’s especially gratifying to see a patient progress from a badly broken bone to a strong recovery. Helping a patient with a condition that causes painful joints, tendons, and muscles find exercises and treatments that can reduce pain is extremely rewarding.
If you’re an orthopaedic nurse, celebrate with your colleagues this week. Spread the word about what you do so people understand the broad scope of this nursing path—this kind of visibility helps elevate the nursing profession. If you are a nurse leader in your team, continue to offer mentorship to new nurses or those wondering if this career path would match their career goals.