As is the case within most industries, there are various areas of specialism within the nursing sector. As a registered nurse (RN,) a nursing practitioner (NP) or any other area of focus, you will need to be empathetic, compassionate, organized and committed to ongoing learning and development in line with medical science advances.
If you are thinking of changing the current area you work within the sector, or you are a nurse-in-training looking for inspiration regarding which route to go, then researching the industry will be helpful in aiding your decisions. Primarily, you will have two critical choices to make; where do you want to work, and who do you want to work with? When you have settled on this then you can decide on how you will get there.
It is common to believe that a nurses’ place is in a hospital. This is somewhat stereotypical and most definitely inaccurate. Nurses are indeed required within a hospital setting, of course, but other facilities include care homes, schools, clinics, nursing homes, community health care centers and also in patients’ homes.
Having an understanding of the environment you would like to find yourself in can be a helpful tool in determining which training you may require.
Inpatient vs. Outpatient
Inpatient care is care provided when a patient is admitted to hospital. Generally, hospital admissions only occur when a condition is severe enough to deem it necessary. Therefore, there is likely to be an opportunity to spend extended time with the same patients, provide them with comfort and support, coordinate their care, perform analytical duties and reports and administer appropriate treatments. It is likely to require night and weekend working. You will work with other nurses, doctors, surgeons, and medical practitioners, so you will need to have excellent communication skills and attention to detail and be able to exercise patience with your patients.
Outpatient care occurs within an ‘in and out’ environment, such as clinics, accident and emergency departments, schools; essentially any environment in which an extended stay is not required. The number of patients you see will be significantly higher than that of an inpatient nurse, and the conditions you experience may be diverse. You could be involved in pre-surgery preparation, supporting surgeons during clinics, conducting medical history reports, taking blood tests and ECG’s, etc. The hours may be more favorable for family life too and is less likely to require evening and weekend working.
Acute and Secondary vs. Primary Care
This is similar to the above comparison regarding environments. Nurses trained in acute care are likely to work in an inpatient setting, whereas primary care is predominantly undertaken in an outpatient environment. The key difference here is regarding the level of care required.
Care falls under three categories: Primary, Secondary and Tertiary. Acute care is a subcategory of secondary care which is provided to those suffering from more severe health conditions. This may be post-surgery care, oncology, and any other severe (and sometimes sudden) infections, diseases or injuries requiring specialist assistance. Although secondary care is largely conducted within a hospital environment, acute care can also be required in an outpatient setting, such as accident and emergency services where a condition can be both sudden and extreme.
Primary care, meanwhile, is more centered around day to day healthcare and preventative strategies. It is the care received from your general practitioner, health clinics, midwives, community nurses, dentists, and opticians, etc. As a primary care nurse, you will be involved in ‘first point of call’ duties; this may be those who require basic treatment or tests, guidance on preventative measures and healthy living, signposting, general health checks, screenings or vaccinations. The role of a primary care provider is basic level care and assessment, referring patients to the necessary secondary care professionals when the need for further, and more extensive, treatment or investigation is identified.
Nursing classifications and specialisms
This list is not exhaustive; however there are likely to be some primary areas or specialisms that you are looking at pursuing, whether you are newly entering into nursing or are already an RN looking to transition into new areas. You may be considering a career as:
RN – Registered Nurse
A registered nurse requires a minimum of an Associate’s Degree. Generally working to inform the patient and family on their health and recovery process. Monitoring and recording vitals, conducting physical assessments, blood test and ECG’s and administering basic care.
OCN – Oncology Clinical Nurse
Oncology is the treatment and study of tumors, namely an oncologist deals with cancer treatment and works with patients undergoing treatment for cancer at various degrees of progression. This can be highly rewarding but can also be challenging, as this sometimes-aggressive condition can mean you are dealing with patients who are undergoing treatment to prolong life or are experiencing palliative care. You will require specific training in working with cancer patients, and most will aim to have achieved a Bachelors level Degree.
CNS – Clinical Nurse Specialist
A CNS will have competence in a specific area. This may be obstetrics, oncological or cardiological treatment, or intensive care for example. A CNS will require a Master’s Degree and will have to have focused on clinical nursing.
NP – Nurse Practitioner
The term ‘practitioner’ literally means the active involvement or ‘practice’ of a chosen field, primarily medicine. Becoming a practitioner allows for greater autonomy than an RN and enables the NP to be more hands-on in the determination and administration of treatments, prescribing medicines and tests, and ongoing care. This has subcategories its own in various specialisms, as seen below.
WHNP – Women’s Health Nurse Practitioner
A WHNP, as you may have already guessed, is a nurse who specializes in the treatment and health care of women and the conditions and circumstances that they may experience over the course of their life. This can include gynecological conditions, pregnancy and childbirth, post-natal complications, menopause, and other gender-specific health issues. It will involve examination and treatment administration, and you will need a recognized qualification at a Master’s Degree level in order to become a WHNP.
AGNP – Adult-Gerontology Nurse Practitioner
Gerontology is the study of old age, the aging process, and the health conditions associated with it. Whether an acute or primary care provider, in this area, your primary focus will be on adults and the elderly. Common conditions facing the elderly include diabetes, arthritis, skeletal and muscular complications, dementia, kidney and bladder problems and hearing and eyesight deterioration among others. As an AGNP, (both AG-PCNP and AG-ACNP) you will be educated to Master’s Degree level and may undergo further training specific to geriatric conditions.
PNP – Pediatric Nurse Practitioner
Pediatrics is the study and treatment of children and childhood conditions. Issues you may face as a PNP include, childhood obesity, the effects of bullying, chronic conditions such as asthma and substance abuse to name a few. The role of a PNP can present an array of challenges, such as educating parents, the prospect of having to inflict discomfort during treatments, detecting unreported or psychological issues and dealing with relevant authorities when required and the overall duty of care. If you choose to specialize in an area such as pediatric oncology, you may experience distressing or upsetting scenarios, and it is wise to be aware of this and understand your own capabilities when looking to pursue a career in health care that involves working with children. A Master Degree level qualification will be required, and you will have a direct responsibility in implementing care and treatment to your patients as a pediatric practitioner.
FNP – Family Nurse Practitioner
An FNP offers the broadest range of experiences and is an excellent career choice for those who thrive in a diverse environment and enjoy working with a broad spectrum of ages, genders and health conditions. As a Family Practitioner you will work with patients from all areas, backgrounds, cultures, and stages of development. You will be fundamental in initiating their treatment and recovery, promoting health and educating on preventative measures to reduce the risk of disease and complications. You will require a Master’s level qualification, and this can even be obtained online, allowing you to continue working within the sector while you study. Further details surrounding qualifications is available below.
Training and Education
In order to get into nursing, you will obviously need to obtain the required qualifications. At a basic level, in order to become an RN, you will require an Associates Degree in Nursing (ADN.)
ADN – This is typically a 2-year degree and qualifies you as an RN and validates you to take the NCLEX-RN in order to further your career and education prospects, such as training for a Bachelor’s Degree (BSN).
BSN – This is typically another 2 years once you have secured your ADN or up to 4 years as a stand-alone degree; both allow you to sit your NCLEX and allow you to operate as an RN. However, obtaining your BSN not only includes advanced subjects not covered at an ADN level but also offers employment advantages, such as promotional opportunities, higher pay grades as well as access to and contribution in committees. You will often be more appealing to employers too, some of which will only hire those who hold a BSN. Your BSN will also open up graduate opportunities if you wish to further your career and education.
MASTERS – Achieving a Master’s level qualification allows you to move from RN into NP territory. It is now possible to achieve this through online learning. If you want to move from BSN to FNP, then the online program can provide accredited, supported training to get you there, typically, in under 3 years.
Entering into nursing is also an unwritten commitment to ongoing learning throughout your career. Modern medicine and treatment options are changing and advancing, and as medical professionals, it is necessary to keep up with these.
Improving your employability as a newly qualified nurse
There are other things you can do to stand out among other applicants when you come to seek out employment or apply for further training in addition to securing qualifications. Some medical schools operate graduate programs in partnership with health care providers to assist newly qualified professionals to get into work.
There are usually placement elements to your training, which means that most newly qualified nurses will have a degree of experience within a practical nursing environment. For some, this can result in an offer of employment upon completion. Taking on additional hours when they are offered, showing genuine interest in your learning and seeking out further opportunities within the placement (in other departments or shadowing staff for example) can all add favor to an application. Volunteering in the health care industry and with local community activities can also demonstrate a level of dedication and commitment that will be favorable to employers and education providers. Show willingness and passion for your career development.
Demonstrate a sincere dedication to the role that you are applying for, perhaps there are personal reasons why you have pursued a career in nursing, and this can demonstrate an extra sense of compassion and empathy, both of which are crucial skills for any nurse when dealing with patients and sometimes highly sensitive issues. Be sure to sell yourself in your application and your resume.
A career in nursing can be fulfilling, rewarding, and diverse. You can experience a variety of conditions, and meet a variety of people; especially as an FNP, for example, where your patients will come from all walks of life. The options available are vast and deciding on your career path will require you to evaluate what you want to get from your career, where you would like to work and who you would like to work with. Whether you want to develop a niche or have the freedom to cover a wider spectrum of ailments.
Nursing is a career that offers an endless opportunity for learning and growth and many chances to further your qualifications and climb up the professional ladder. It is never too late to change direction and seek training in other fields, so you won’t need to feel under pressure. Not only is it necessary to commit to your patients and strive to ensure they receive the best care and treatment, but you must also commit to yourself. Continue to seek out training, information and keep abreast of changes and developments within the sector. It will ensure that your career in nursing remains exciting, engaging, educating and can secure your career satisfaction.