Registered nurse

A registered nurse (RN) is a nurse who has graduated from a nursing program and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license.[1] An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.

For the 1934 American Pre-Code film, see Registered Nurse (film).

Insignia of the United States Army Nurse Corps

Registered nurses are employed in a wide variety of professional settings, and often specialize in a field of practice. They may be responsible for supervising care delivered by other healthcare workers, including student nurses, licensed practical nurses (except in Canada), unlicensed assistive personnel, and less-experienced RNs.

Registered nurses must usually meet a minimum practice hours requirement and undertake continuing education to maintain their license.[2] Furthermore, there is often a requirement that an RN remain free from serious criminal convictions.[3][4][5]

History

The registration of nurses by nursing councils or boards began in the early twentieth century.[6] New Zealand registered the first nurse in 1901 with the establishment of the Nurses Registration Act.[7] Nurses were required to complete three years of training and pass a state-administered examination. Registration ensured a degree of consistency in the education of new nurses, and the title was usually protected by law. After 1905 in California, for example, it became a misdemeanour to claim to be an RN without a certificate of registration.[8] Now typical requirements for an RN licence in the United States include earning either an associate degree (community college) or a baccalaureate degree (college or university) in nursing and passing an examination.[9]

Registration acts allowed authorities a degree of control over who was admitted to the profession. Requirements varied by location, but often included a stipulation that the applicant must be "of good moral character"[10] and must not have mental or physical conditions that rendered them unable to practice.[11]

Before the 1870s, most people were cared for at home by family members. The view on nursing began to change as more medical advances were made during the end of the 19th century and leading into the beginning of the 20th century.[12]

As nursing became more of an international profession, with RNs traveling to find work or improved working conditions and wages, some countries began implementing standardized language tests (notably the International English Language Testing System).[13][14]

Benefits of nursing

When obtaining a nursing degree there are personal benefits that come with it. One personal benefit is that nursing is a highly respected position.[15] Another personal advantage is the availability of jobs; nurses are in high demand.[16] Nursing also provides many different possibilities of employment, because with a nursing degree, there are many positions that fall under this category.[16] Being able to explore multiple options gives someone the chance to find the most suitable job for themselves.[17]

Patients benefit from having a sufficient number of nurses to meet the clinic's or hospital's needs.[18] As the number of nurses increases, the quality of life for the patients increases as well.[19]

By nation

Australia

Nursing registration in Australia has been at a national level since 2010, since the inception of the Nursing and Midwifery Board of Australia (NMBA), which forms part of the Australian Health Practitioners Regulation Agency (AHPRA). Prior to 2010, Nursing registration in Australia was administered individually by each state and territory.

The title 'Registered Nurse' (also known in the state of Victoria as a 'Division 1 Nurse') is granted to a nurse who has successfully completed a board-approved course in the field of nursing, as outlined by education and registration standards defined by the NMBA. Registered Nurses are also required to meet certain other standards to fulfil registration standards as outlined by the NMBA, and these can include continuing professional development, recency of practice, criminal history checks and competency in the English language.[20]

Educational requirements for an entry-level Registered Nurse are at the level of bachelor's degree in Australia, and can range in two to four years in length with three years being the national average. Some universities offer a two-year 'fast track' bachelor's degree, whereby a students study three years worth of coursework compressed in a two-year period. This is made possible by reducing summer and winter semester breaks and utilising three semesters per year compared to two.[21] Some universities also offer combined degrees which allow the graduate to exit the program with a Masters in Nursing, e.g.: Bachelor of Science/Master of Nursing, and these are generally offered over a four-year period.[22]

Postgraduate nursing education is widespread in Australia and is encouraged by employing bodies such as state health services (e.g. New South Wales Health). There are many varying courses and scholarships available which provide a bachelor-level Registered Nurse the opportunity to 'up-skill' and assume an extended scope of practice. Such courses are offered at all levels of the post graduate spectrum and range from graduate certificate to master's degree and provide a theoretical framework for a bachelor level Registered nurse to take up an advanced practice position such as Clinical Nurse Specialist (CNS), Clinical Nurse Consultant (CNC) and Nurse Practitioner (NP).

Canada

In all Canadian provinces except Quebec, newly registered nurses are required to have a Bachelor of Science in Nursing.[23] This is either achieved through a four-year university (or collaborative) program or through a bridging program for registered practical nurses or licensed practical nurses. Some universities also offer compressed programs for applicants already holding a bachelor's degree in another field.

Prior to 2015, initial licensure as an RN required passing the Canadian Registered Nurse Examination (CRNE) offered by the Canadian Nurses Association. As of 2015, for initial licensure, Canadian RNs must pass the NCLEX-RN exam offered by the National Council of State Boards of Nursing. In Quebec, the 'Ordre des infirmières et infirmiers du Québec' (Quebec Order of Nurses) administers their own licensing exam for registration within the province.

In British Columbia, due to cuts to education funding made by the BC Liberal government, funding for foreign students in the clinical parts of nursing programs was eliminated, and as a consequence, all public institutions no longer admitted foreign students to their undergraduate nursing programs.

Denmark

In Denmark, nurses are certified by the Danish Ministry of Health. It is also the ministry that keeps track of violations and can retract individual authorization.

Hong Kong
Main article: Nursing in Hong Kong

In Hong Kong, applicants must complete a pre-registration nursing programme lasting not less than 3 years to enroll as registered nurses. Applicants trained outside Hong Kong must have a practising certificate recognised by the Nursing Council of Hong Kong and pass the Licensing Examination for Registration.[24]

India

In the Republic of India nursing is regulated by the Indian Nursing Council.[25]

Malaysia

In Malaysia, nursing is regulated by the Ministry of Health Malaysia Nursing Division.[26]

United Kingdom
Main article: Nursing in the United Kingdom

United States

In the US, a registered nurse is a professional clinician who has completed at least an associate degree in nursing or a hospital-based diploma program, followed by successfully completing the NCLEX-RN examination for initial licensure. Other requirements vary by state. More information about the NCLEX-RN examination and specific state nursing boards is provided by the National Council of State Boards of Nursing.[27]

Although Associate degree programs are often two years, Associate of Science in Nursing (ASN) degrees frequently take three years to complete because of the increased volume of undergraduate coursework related to the profession of nursing, sometimes as part of the program itself and sometimes as prerequisites for admission. Bachelor of Science in Nursing (BSN) degrees include more thorough coursework in leadership and community health, as well as more clinical hours, and can be completed as an extension of an Associate program or standalone. Accelerated versions of both exist, and are considered particularly challenging due to the increased course-load necessary to complete the program in a short time. Some employers, especially hospitals, may require a bachelor's degree even for entry-level positions, however it is also increasingly common for hospitals to hire ASN-licensed individuals for limited practice, under the condition that the individual complete a BSN within a designated time-frame, typically 2-3 years.

Specialty certification is available through organizations such as the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. After meeting the eligibility requirements and passing the appropriate specialty certification exam, the designation of Registered Nurse – Board Certified (RN-BC) credential is granted.

Registered Nurses can work in a variety of settings including hospitals, physicians' offices, nursing homes, and home health care services. The median pay for a registered nurse in 2016, according to the Bureau of Labor Statistics, was $68,450.00 per year with a bachelor's degree.[28]

In some states, the law allows nurses with higher-level degrees, such as Masters of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) to work with increased autonomy, permitting them to practice limited medicine including sometimes even the prescription of medication without the official supervision of a licensed physician (MD or DO). However, a number of advanced nursing degree programs are sufficiently specialized for work within a hospital setting (for example, Nurse Anesthetist) that it is uncommon for such nurses to run their own medical practice.

Nurses in the United States follow the Nurse Practice Act (NPA) which are laws that protect the public's health and welfare by outlining the safe practices of nursing. All states and territories in the U.S. have a nurse practice act. The rules and regulations may vary from state to state. It is important to know the current laws governing nursing practices in their state.[29]

Typical requirements to get into a nursing school: High School diploma, required GPA for school of choice, admissions application, personal essay, personal interview, teacher recommendations, volunteer experience (preferably in healthcare), application fee, test of English as a Foreign Language (TOEFL) if applicable, minimum SAT scores or TEAS.[30]

Economics

As of 2011, there are 2.24 million registered nurses in China.[31] In 2014, the United States had approximately 2,751,000 registered nurses[28] and Canada had just over 250,000. In the US and Canada this works out to approximately eight nurses per 1,000 people. According to the Bureau of Labor Statistics, registered nursing jobs are projected to grow by 15% between 2016 and 2026, which is much faster than the average overall rate. The growth rate in the United States is due to a number of reasons, including an increased interest in preventative care, an increase in chronic illnesses, and the demands of services required by the baby boom generation.[28] The highest-paid registered nurses in the United States are in California. California cities often comprise the top five highest-paying metropolitan areas for registered nurses in the country. [32] Most registered nurses start working with competitive salaries. The median annual salary for registered nurses was $80,000 per year as of June 2020, according to the Bureau of Labor Statistics (BLS.) The lowest 10 percent of RN's earned less than $70,000, and the highest 10 percent earned more than $101,360 for 2015.[33]

See also

References
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  2. "Registered Nurses". College of Registered Nurses of British Columbia. Retrieved 9 October 2014.
  3. "Criminal history registration standard" (PDF). Nursing and Midwifery Council of Australia. Retrieved 11 October 2014.
  4. "Requirements for registration as a registered nurse: Information for students" (PDF). Nursing Council of New Zealand. Retrieved 11 October 2014.
  5. "Registered Nurses". Institute of Health and Nursing Australia. Retrieved 9 October 2014.
  6. Cooter, Roger; Pickstone, John (2013). Companion Encyclopedia of Medicine in the Twentieth Century. Routledge. ISBN 978-1136794711.
  7. Kirkman, Allison. "Health practitioners – Nurses and midwives". Te Ara – the Encyclopedia of New Zealand. Retrieved 10 October 2014.
  8. "History of the Board". California Board of Registered Nursing. Archived from the original on 6 October 2014. Retrieved 10 October 2014.
  9. "Steps to Become a California Registered Nurse". California Board of Registered Nursing. Retrieved 24 October 2020.
  10. "License Requirements: RN & LPN". New York State Education Department. Retrieved 11 October 2014.
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  13. "International English Language Testing". Nursing and Midwifery Council (United Kingdom). Archived from the original on 17 October 2014. Retrieved 11 October 2014.
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  16. Purdue University Global (7 June 2018). "Should You Become a Nurse? 5 Things to Consider". Purdue Global. Purdue University Global.
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  19. Middaugh, Donna J., and Patricia E. Thompson (December 2007). "Nursing students benefit your facility". MedSurg Nursing, Gale OneFile: Health and Medicine. 16 (6): 408–10. PMID 18390263. Retrieved 24 November 2019.
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  25. "Indian Nursing Council New Delhi". National Institute of Management & Technology. Retrieved 8 September 2018.
  26. "Homepage - Official Nursing Division Portal Ministry of Health Malaysia". Retrieved 3 February 2019.
  27. National Council of State Boards of Nursing
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  33. "Registered Nurse Career Guide". Nurse.org.
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