Wakefield 1

Michael Wakefield

A. Minks

Introduction to Healthcare

6/30/08

Career Project

Career: Nursing, Registered Nurse

Overall Description:

Provide care for patients as directed by physicians. Care focuses on the mental,
emotional, and physical needs of the patient.

Job Roles and responsibilities:

Registered nurse (RNs)

• Work under the direction of physicians
• Provide total care to patients
• Observe patients
• Assess patients’ needs
• Report to other health care personnel
• Administer prescribed medications and treatments
• Teach healthcare
• Supervise other nursing personnel

RNs are not limited to employment as bedside nurses. Registered nurses are employed
by physicians, attorneys, insurance companies, private industry, school districts, ambulatory
surgery centers and fire departments, among others. Some registered nurses are independent
consultants who work for themselves, while others work for large manufacturers or chemical
companies. Research Nurses conduct or assist in research or evaluation in many areas such as
biology, psychology, human development, and health care systems.

Occupational Requirements and Recommendations:

Requirements:

Education
• 2-3-year diploma program in hospital school of nursing, or associate’s or
bachelor’s degree. Master’s or doctor’s degree for some
administrative/educational positions and for some advanced practice nursing
positions.
Licensure
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• Licensure is in the state of practice. The scope of practice of registered nurses

is the extent to which an RN can practice and the limits of that practice. In the
United States, these limits are determined by a set of laws known as the Nurse
Practice Act of the state or territory in which an RN is licensed (Wikipedia,
2007).

Recommendations:

• Personal Skills and Qualities:

i. Intelligence, compassion, leadership, flexibility, empathy, the ability to
stay calm in a crisis.

Educational Requirements:

Educational Path:

• 2-3-year diploma program in hospital school of nursing, or associate’s or

bachelor’s degree. Master’s or doctor’s degree for some
administrative/educational positions and for some advanced practice nursing
positions.

Education Obtained:

• Education is obtained from an accredited college, university, hospital school of

nursing institution. There are also annual continuing education requirements
depending on state of licensure.

Governing Agencies:

State:

• Each state has its own laws, rules, and regulations governing nursing care.
Usually the making of the rules and regulations is delegated to a state board of
nursing, which performs the day-to-day administration of these rules, qualifies
candidates for licensure, licenses nurses and makes decisions on nursing
issues.

Professional:

• These depend on your primary specialty as a nurse, as there are different

professional organizations that you can join depending on your specialty. Most
nurses are members of the American Nurses Association.
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Licensure, Certification, Registration:

Completion of any one of any of the educational routes described previously allows a
graduate nurse to take the National Council Licensure EXamination-Registered Nurse
(NCLEX-RN), the test for licensure as a registered nurse, and is accepted by every state as
adequate preparation so long as the graduate attended an NLNAC-accredited school.
Professional nursing organizations, through their certification boards, have voluntary
certification exams to demonstrate clinical competency in their particular specialty.
Completion of the prerequisite work experience allows an RN to register for an examination,
and passage gives an RN permission to use a professional designation after their name. For
example, passage of the American Association of Critical-care Nurses specialty exam allows
a nurse to use the initials 'CCRN' after his or her name. Other organizations and societies
have similar procedures.
The American Nurses Credentialing Center, the credentialing arm of the American
Nurses Association, is the largest nursing credentialing organization and administers more
than 30 specialty examinations (Wikipedia, 2007).

Description of Job Outlook and Job Growth Predictions:

The job outlook is promising. There are currently more job opportunities than there
are nurses to fill their positions. This shortage allows nurses to be more selective in choosing
their practice settings. In 1996, 1,971,000 RNs were employed in the United States. By the
year 2006 there was a 21% increase (2,382,000) in jobs for RNs. 72% of BSN students and
94% of MSN students had awaiting jobs prior to the completion of their degrees. The
unemployment rate for RNs is less than 2% (Good et. all, 2007).

Career Path:

Entry level RNs start out as ADN (Associate Degree – RN) or BSN (Bachelor Degree
– RN). They then have the opportunity to pursue a Master of Science in Nursing (MSN)
degree which is for BSN-prepared nurses intending to pursue further studies. MSN programs
vary from 12-18 months of full-time study.

Examples of advanced nursing practice include:

Clinical Nurse Specialist (CNS)
Nurse Practitioner (NP)
Certified Registered Nurse Anesthetist (CRNA)
Certified Nurse-Midwife (CNM)

Doctoral degrees for nursing include the doctor of philosophy in nursing (PhD),
nursing doctorate (ND or DN), and doctor of science in nursing (DSN). The overall goals of
doctoral education are to broaden nursing’s scientific knowledge base through research and
other scholarly activities and to prepare nurses to serve in a capacity of leadership roles or as
educators (Good et. all, 2007).
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Pay Levels:

Financial earnings for nurses vary according to the type of nursing, geographic
location, years of experience, and level of education. Beginning salaries for entry-level staff
nurses range from $30,000 to $45,000. $60,300-$108,900 with advanced specialties.
Here are some examples of nurse specialty salaries:
• $51,089 average annual - Clinical Nurse Specialist
• $55,014 average annual - Nurse Practitioner/Midwife
• $86,310 average annual - Certified Registered Nurse Anesthetist

Additional Items:

Job Opening Announcements:

1. Swedish Medical Center Job Title: STAFF REG NURSE, Shift: Evenings, FTE: 1.00,
Location: First Hill Campus, Reference: 009285

Position Specifications
STAFF REGISTERED NURSE – INPATIENT PACU - First Hill.

This is a regular, hourly, 8 hour, Evening shift position, 1.0 FTE, 40 hours per
week. This position is eligible for full benefits.

SALARY: Placement within the scale is dependent upon years of work

experience. The salary scale is reviewed on an annual basis for market comparison and
may change with the market.

SCHEDULE: Shift starts at 1pm. Schedule may vary according to business

needs. Call required on a rotational basis.
Responsibilities
The Registered Nurse is responsible for providing nursing care adapted to
individual patient needs based on the nursing process, which includes assessment,
planning, implementation, and evaluation. He or she is also responsible for delegation
and supervision of personnel, as states above, that participate in the provision of care to
ensure that patient needs and expected outcomes are met.

The PACU (/Post Anesthesia Care Unit) Registered Nurse (RN) assumes
leadership, responsibility and accountability for designated patients in the Pre-operative,
post-operative, and other assigned locations in the peri-operative continuum. The work
area consists of separate units in relatively close proximity to each other. This is a
combined staff with nurses working between Day Surgery, Pre-Surgical Center,
Fiberoptics, PACU, and Medical Treatment Center. Day Surgery provides ambulatory
care for the patient undergoing surgical, non-surgical and diagnostic procedures. The Pre-
Surgical Center nurse interviews patients a few days before the procedure, assessing and
obtaining history and lab work. Day Surgery provides ambulatory care for the patient
undergoing surgical, non-surgical, and diagnostic procedures. The pre-anesthetic phase
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focuses on preparing patients physically and emotionally for their experience through
interview, physical assessment, and education. The Post Anesthesia Phase II, also done in
Day Surgery, focuses on preparing patients to care for themselves. PACU RN is
responsible for providing triage assessment, nursing diagnosis and evaluating all aspects
of nursing care in the PACU, and focuses on providing a transition from a totally
anesthetized state to one requiring a less acute intervention. The Fiberoptic nurse admits
and discharges patients through Day Surgery. The Fiberoptic nurse assesses and monitors
the patient, and assists the physician during endoscopic procedures. The Medical
Treatment Center nurse cares for out-patients receiving Chemotherapy and other
procedures. Nurses in these clinical departments are cross-trained to work in all areas as
needed.
Qualifications
The minimum qualifications listed below are representative of the knowledge,
skill and abilities needed to perform this job successfully. Reasonable accommodations
may be made to enable individuals with disabilities to perform the essential functions of
this job.

Education: Graduate of an accredited Registered Nurse Program.

Licensures/Certifications: Current license to practice as a Registered Nurse in the

State of Washington. Current BLS Certification and ACLS certification. Completion of
EKG interpretation and Critical Care course or Critical Care Course equivalent.

Experience and Skills: Experience acquired from Accredited Registered School of

Nursing. Minimum of 1 year of PACU experience or 2 years of Critical Care or
Emergency experience required, including cardiac and hemo-dynamic monitoring.
Nurses with acute care setting experience need to complete a critical care course prior to
employment in the PACU or completion of an approved training course preferred. Ability
to operate, or learn to operate, unit-specific equipment as outlined in defined
competencies. Working knowledge of ventilators, cardiac monitors, defibrillators, chest-
tubes and other related medical devices. Adequate knowledge to perform assessments,
plan patient care, provide direct care, and educate and orient families and staff. Skilled to
work with a wide range of staff as part of an interdisciplinary team including physicians,
nurses, and ancillary staff. Ability to read, write, understand and communicate in
English. Ability to complete mathematical calculation (addition, subtraction,
multiplication, division, equivalencies). Must have knowledge of human growth and
development to modify services to the age and development stage of the patient.
Closing Statement
As per the 1199NW/SEIU Contract employees in this position are required to
become a union member in good standing and successfully complete a 90-day
probationary period.

Swedish Medical Center has a non-discrimination policy and is an equal

opportunity employer.

2. Part Time LPN and Full Time School Nurse (RN with BSN)

Highline School District is in need of a part time LPN and a full time School Nurse
(RN with BSN). Come join a group of caring professional nurses providing quality care in
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the school setting. Enjoy the peer support and excellent orientation. If you are a School
Nurse ( RN) candidate you will need to obtain a temporary ESA certificate.

The information about that certificate is available at our Health Services office. 206-
433-2413, FAX 206-433-2110 or denverat@hsd401.org. Call or send a resume today.
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Personal Interview:

David Bork is an RN at Puget Sound VA Hospital on Beacon Hill in Seattle, WA.

David has worked for the VA for over 18 years. 12 years at American Lake VA Hospital in

Tacoma, WA and almost 6 years at Puget Sound VA Hospital in Seattle.

A typical day for David starts at 9:30am when he starts his shift at the Same Day Unit

on the 2nd Floor of Building 100. The SDU is the outpatient surgery clinic at the VA Hospital

in Seattle. David performs Diagnostics: this includes blood draws, EKG’s, urine samples. He

also completes a Valuables Inventory. This is an inventory of patients’ valuables that are kept

under lock and key until the patient is discharged.

After these tasks are completed, David helps out in the OEC office. This is the

Outpatient Education Clinic. This is where patient education about upcoming outpatient

surgery is completed. These are typically for either scheduled patient admissions or patient

admissions for surgery that day (unscheduled outpatient surgery overflow on space available

basis). Any patient medications are also inventoried at this time and then delivered to the

Pharmacy in Building 1. Chain of Custody for Schedule Drugs must be maintained as well.

Schedule drugs are highly addictive drugs that a patient might be prescribed. Other duties

might include: Patient teaching (scrub body parts for surgery, stop taking meds, fasting, bowl

prep, what time to be here etc.) is discussed. Lodging and a ride home is also squared away at

this time. Then, patient charts are broken down. All paper is destroyed by a shredding

company and transferred to microfilche or computer records for electronic retrieval.

At the end of the day (around 4pm or so), David might float to Recovery depending

on the census and number of nurses available. Secondary recovery (vital signs taken 3 times

at 15 minute intervals) is done here after surgery. A wait for x-rays, or setting up slings for

orthopedic surgeries, if applicable. They might have to wait for a patient to urinate unless

they had GI surgery. Also, follow-up appointments and discharge appointments with doctors
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are scheduled during this time as well. Discharge orders are also reviewed with the patient.

David typically ends his day around 6pm and closes up the unit along with the rest of

the nurses that remain in SDU. This includes general cleanup and sanitation of rooms.
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Bibliography

Good, Holly, Meghan McGonigal, Casandra Moyer, Jill Muller, and Pernell Peppers. "What

is Nursing?" University of Iowa. May 2000. University of Iowa. 28 Nov. 2007

<http://www.nursing.uiowa.edu/sites/users/hgood/>.

"Registered Nurse." Wikipedia, the Free Encyclopedia. 28 Nov. 2007. Wikimedia Project. 28

Nov. 2007 < http://en.wikipedia.org/wiki/Registered_nurse>.

"Registered Nurses." Occupational Outlook Handbook. 4 Aug. 2006. U.S. Department of

Labor. 28 Nov. 2007 <http://stats.bls.gov/oco/ocos083.htm>.

Simmers, Louise. Health Science Career Exploration. Clifton Park: Thompson Delmar

Learning, 2007. 94-98.