Carol asks…
What different settings can i work at with a nursing degree?
could you name all or as many different settings as you can think of that a nurse with a nursing degree could work at. also the different names for different nurses, such as nurse practitioner , RN, physician assistant etc
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vti answers:
Ambulatory care nursing
Advanced practice nursing
Burn nursing
Camp nursing
Cardiac nursing
Cardiac catheter laboratory nursing
Medical case management
Community health nursing
Correctional nursing
Critical care nursing
Emergency and trauma nursing
Environmental health nursing
Faith community nursing
Flight nursing
Forensic nursing
Gastroenterology nursing
Genetics nursing
Geriatric nursing
Health visiting
Holistic nursing
Home health nursing
Hospice and palliative care nursing
Hyperbaric nursing
Immunology and allergy nursing
Intravenous therapy nursing
Infection control nursing
Infectious disease nursing
Legal nursing
Maternal-child nursing
Medical-surgical nursing
Mental health or psychiatric nursing
Midwifery
Military and uniformed services nursing
Neonatal nursing
Neurosurgical nursing
Nursing informatics
Nursing management
Nursing research
Obstetrical nursing
Occupational health nursing
Oncology nursing
Orthopaedic nursing
Ostomy nursing
Pediatric nursing
Perianesthesia nursing
Perioperative nursing
Private duty nursing
Psychiatric or mental health nursing
Public health nursing
Pulmonary nursing
Quality improvement
Radiology nursing
Rehabilitation nursing
Renal nursing
School nursing
Space nursing
Sub-acute nursing
Substance abuse nursing
Surgical nursing
Telenursing
Telephone triage nursing
Transplantation nursing
Travel nursing
Urology nursing
Utilization management
Wound care
Robert asks…
Should I become a physician Assistant or a nurse practionner ? Is there a better or worse option ?
Should I become a physician Assistant or a nurse practionner ? Is there a better or worse option ? Or are they just different. I do know that NP’s have to work as a nurse first and PA’s just need health expierence but otherwise I dont know which is better or which to pick !
vti answers:
There are differences in NPs and PAs, some are philosophical, and educational, some are practice related based on the state practice acts.
Lovesol has given you a correct answer, for her state, but not a full perspective. In some states, NPs and PAs must have a full collaborative agreement with a physician. In others PAs require a full elaborative agreement, but as NPs are licensed as independent practitioners they can work without a physician, but must have some ability to refer patient they feel exceed their scope of practice. Also, each state regulates it’s own presciptive privleges. Virtually all US states have prescriptive privleges for both NPs and PAs, in most the physicians name must appear on the PAs presciptions (this also applies to NPs in some states) in others NPs write their scipts without oversight. In many states NPs (and in some PAs) have DEA numbers and can write for narcotics, the amounts and levels vary by state.
All nurse practitioners currently educated in the US must be graduates of an MSN program. Most states require certification by the NPs national certifying board for licensure. NPs also have a BSN as a prerequisite and most programs require the RN to have some experience in the clinical setting before admission. This is the basis upon which the MSN is built. The NPs are trained to perform in specific areas, such as geriatrics, pediatrics, adult health, womens heatlh, neonatal care. The exception to this is the Family nurse practitioner, who is trained as a generalist, but the certifying board, is built from all the boards put together (except neonatal). There has been some discussion about changing the entry to NP to a doctoral program and increasing the length of the course of instruction. This has met with some resistance. NP programs are usually based on a holistic process, with the mindset of treating the whole patient, and not the current disease. Emphasis is on disease prevention and wellness, in addition to management of acute and chronic medical conditions.
PAs education process is less defined. They have an organization which sets the standards for certifyiong the programs, but there is no standard level of entry to practice, or standard prerequsite degree. There are PA programs in the US which award associates degrees, bachelors degrees, and masters degrees. There is a strong push among the leadership in the PA organizations to make the masters degree the standard, but there are reservations, by those who have previously attended associates and bachelors programs. The people entering PA programs usually are required to have some type of health care experience, but these are from various fields, a high number have been EMTs, some have been RNs from ADN programs who did not want to attend the RN to MSN program and found a bachelors PA program or BSNs who did not have NP programs available or desired to be a PA instead of an NP. There have also been noted to be many students in PA programs who majored in Pre-med as an undergraduate yet were unable or decided not to attend medical school. PA programs usually train using a traditional disease model, emphasizing treatment of the disease state. They are trained as generalist, and then often either learn on the job or take additional training in specialty areas.
The salaries for NPs and PAs in the same areas are similar, and NPs and PAs will frequently be seen working in the same clinic. In general, there is no direct competition between the two professions, and each has developed to respect the other. It is common for PA and NP conferences to invite preoviders from both diciplines to present and attend the conferences as the roles are very similar.
In general both PAs and NPs can perform approximately 85% of the functions of physicians, and both have excellent patient satisfaction and patient outcome statistics.
Now that you have seen my long winded statement of the basics, I will sya, that I chose to be a nurse, and then an NP because it allows more versatility. While PAs can perform, most of the same functions an NP can, they are not licensed to perform all the functions an RN can. NPs remains RNs and are NPs, and can work in almost any area of health care they choose. Some will say that PAs can be surgical first assistants, and NPs can’t. And it is true, that surgery is not a direct component of the NP educational programs, however, as I am an RN first assistant as well as an NP, that issue can be covered.
It is really up to you, what you want to do, and where you want to go.
Where ever you choose, you will be performing a great service as a health care provider.
EDIT: Just a couple of additions:
First, I apologize for all the typos in my answers, I have a med condition, and don’t feel the keyboard, it sometimes seems to type what it wants, I truely can, spell.
Second, I have never, been asked to work as a nurse, since completing my NP program, I do, however, stress, that I have known, NPs who also wanted, to work performing some tasks, which are generally under the auspices of the Nurse Practice Act of their state. It gave them versatility. Additionally, while, I did spend time learning the nursing information and skills during my undergraduate degree, at the time my goal was to be a nurse anesthetist, and not an NP, it was the ability of an RN to choose many fields, that allowed me to change, and go to the NP program.
Finally, I have found prescriptive privleges invaluable, as I often work in clinics, without physician oversight. As I have specialized and then subspecialized, I usually, work with patients, not seen by other health providers. In working with patients with severe pain issues I need the ability to write prescriptions and on occasion narcotics.
Sandra asks…
Difference in having a doctorate in nursing and being a doctor?
I might sound like an idiot right now but what is the difference in a nurse with a doctorate and just a doctor? Is that wat a doctor is? Or is there a separate major and everything to be a doctor?
vti answers:
The first answer was not exactly correct. First of all, there are two doctorate-level degrees in nursing, the PhD and the Doctorate of Nursing Practice (DNP). The PhD is a doctorate designed mostly for nurses who want to go into academics or research. It’s not a common degree for nurses who want to become a Nurse Practitioner (NP). Most NPs will hold the DNP degree, because that is an actual clinical practice degree.
Nurse Practitioners function very similarly to physicians in practice. NPs can prescribe – and contrary to the first answer, in many states they CAN prescribe narcotics. The nurse practice act in each state might vary, so there are a few states where NP practice is more limited and they cannot prescribed narcotics. In some states, NPs can practice completely independently of physicians and can open their own clinic / practice by themselves. In other states, NPs work rather independently but they must be employed / affiliated / partnered with a physician who essentially takes the legal responsibility for the clinic and practice (but the NP still functions independently and doesn’t “need permission” or seek out the MDs opinion when treating patients).
I also take issue with the previous answer who said they treat “simple” illnesses and cannot do surgery. NPs do not always handle simple cases. I will be working in a perinatal clinic with women who have high risk pregnancies, some of them have extremely rare conditions and will travel to our clinic from several states away to get treatment from our specialists. The NPs have a lot of responsibility and round on pts in the hospital, manage their care collaboratively with the MDs. While it is true that NPs cannot do surgery as primary surgeon, many NPs act in the capacity of First Assist and have their hands in the surgery with the physician. Often times, when the surgery is complete, the First Assist is the one who completes the surgery and finishes the suturing to close the incision. So the scope of practice can be very diverse for NPs, and they can do things that many people had no idea we are qualified to do.
Nurses are trained in the nursing model of caring for patients – meaning they treat holistically, the whole person, mind, body, spirit. It’s about achieving the highest level of functioning, preserving and restoring health and preventing illness and disease. Doctors are educated with the medical model of care, which focuses more on identifying specific illnesses and treating them, along with some focus on illness / disease prevention. There is less concern for holistic wellness of mind, body, spirit.
So, nurses go to nursing school. To become a DNP-NP it’s a graduate-level education, so we’re talking 8-10 years of education plus a few years of work experience thrown in the mix.
For a doctor, it’s a 4 year undergrad degree, 4 years of medical school and then 3-4 years of residency before you can practice independently as an MD. They are completely different education tracks.
Donald asks…
How to become an oncology nurse?
I live in Ontario, and the only University I know that has a program is McMaster.
But does anyone know how to become an oncology nurse? I looked on the website but it’s difficult to find. What do you do in university to become one? Oh, and is there other universities where you can become an oncology nurse?
Also, is it a rewarding job? Is it hard to do since you are dealing with sick people? And how many years of schooling do you need?
Thanks
vti answers:
You have to finish your degree and become a standard, general nurse, then you do it as a post grad stage. You can sometimes go to university and do a course, or otherwise, some hospitals allow you to do it within the hospital, as on the job training. You can’t do it as an undergraduate.
I found oncology nursing really rewarding. The patients are really grateful for all you do and it is about more than just rushing people in, curing their disease and throwing them back out again. It is a more holistic approach. It can be sad though, not everyone likes it because it can be quite emotionally demanding, especially for the terminal patients because you know that no matter what you do, they aren’t going to get better and death occurs on these wards more often than most others. I found it rewarding and interesting though and found comfort in the fact that i got to care for all aspects of a patient, could relieve their suffering and make their passing as dignified and pain-free as possible. Its an amazing feeling knowing that doing the simplest things like having a chat, providing hope for a peaceful progression or giving them some pain relief for someone can make such a huge positive impact on their life. The patients and their family members are always so grateful no matter what the prognosis or outcome is.
And when you get the ones who have hit rock bottom with their health status and then slowly get better and healthier and stronger or even cured whilst under your care, and then leave hospital and go on to live normal lives, that’s amazing and rewarding as well. Don’t rule it out, you might just love it.
Nancy asks…
How long do i have to go to school to become a nurse practitioner?
My mother is an LPN and she suggested that i should become a nurse practitioner. I was wondering how much do they make ? how long do i have to go to school to become one? and is that job really in demand nowadays?
vti answers:
How long it takes will depend on if you always attend school full-time, how long it takes to complete prerequisite courses, etc. But here is what it generally involves:
First, you must get your RN license. You can do that a few different ways, you can start out as an LPN (1 year program), then finish an Assoc. Degree in Nursing (ADN) in about another year. Or, you can skip the LPN and go straight for ADN RN, which in full is a two-year program, but there are prerequisite courses which usually take about a year, sometimes a bit more. Or, you can go straight into a BSN program, which is 4 years of full-time study. First two years are spent working on those prerequisite type courses and then you apply to the nursing major and the last two years are your nursing courses. If you get your ADN RN, you can complete the BSN in about 18-24 months, sometimes almost entirely online, offered by regular state/public colleges, not just those for-profit places like University of Phoenix.
At the end of whatever RN program you take first, you take the NCLEX-RN exam, the national RN license exam, so you can get your license in your state. It’s the same test whether you go the ADN or the BSN route. You do not have to take it again if you get the ADN and complete BSN later.
Then you’ll need some work experience, at least 1 year in whatever specialty setting you’re interested in, so if you want to be a Psychiatric NP, work in a mental health / behavioral health / chem dep unit somewhere, for example. After you have work experience, you can apply to MSN programs for NP certification in whatever your focus is (psych, women’s health, nurse midwife, geriatric, pediatric, neonatal, etc.). MSN programs are about 2-3 years in length of full-time work, and there are a lot of clinical hours required so it’s difficult to work more than part-time during this program. Also, there is a movement to change the minimum education for NP certification to a Doctorate of Nursing Practice, which is another 2-3 years beyond MSN, or, some schools are already transitioning and some offer a BSN to DNP bridge program where if you are eligible (high GPA) you can skip about a year’s worth of the MSN courses, to complete the program in about 4 years.
NPs are in demand, because the structure of how health care is being delivered is changing. There is higher recognition to the expertise of NPs and their ability to provide primary care services, functioning in similar capacity as physicians but with many unique qualities that bring about holistic care that MDs usually don’t focus on. With the changes in health care reimbursement, esp. If Obama’s health care plan is not struck down by the Supreme Court, more people will have medical insurance coverage than ever before, and more people will seek out primary care than before, when the uninsured typically would rely on hospital ERs as their safety net.
It is a process that takes a long time and a lot of dedication. Some people get their RN license and find a decent job and are happy to remain there and change their minds about going back to school, because they get burnt out on school. You can take a break. You can go back whenever you want. Either way, RN or NP, you will have a stable career. If you don’t mind hard work, if you have a passion for helping people (even sometimes difficult ones), want to feel some personal sense of satisfaction about the work you do, then it’s a great career choice. But then again I’m self-admittedly biased, being an NP student currently.
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