Guide To Becoming A Nurse

If you're considering a career in nursing, you're in good company. Nurses make up the largest health care profession in the US with over 2.9 million RNs nationwide. Nurses are involved in all types of health care, acute and chronic.

Nurses are trained to:

• Assess the needs of patients

• Determine desired outcomes of patient care

• Develop a plan of care specific to the patient

• Intervene on the patient's behalf and perform care

• Evaluate the effectiveness of the care and change the plan of care accordingly

• Advocate for the patient

While most nurses (56%) work in hospitals, you will also find them in nursing homes, ambulatory care, home health care, community health clinics, schools, and in nursing education.

There are advanced nursing careers available, too. An Advanced Practice Registered Nurse (APRN), globally, has a masters degree and has met clinical practice requirements in their specialty.

Nurse Practioner (NP) - NPs are able to deliver primary care, preventive health, and women's health care services, prescribe medication, and diagnose and treat common minor illnesses and injuries.

Certified Nurse Midwife (CNM) - Provide well-woman gynecological care and low-risk obstetrical care.

Clinical Nurse Specialist (CNS) - Specialize in treating various physical and mental health problems, and also work in consultation, research, education, and administration

Certified Registered Nurse Anesthetist (CRNA) - Provide anesthesia in 65% of surgical procedures performed in this country every year.

Congratulations on choosing a nursing career. Now you need to find a nursing school that fits into your plan and your lifestyle. Nursing schools can be found at universities, community colleges, and even online.

Your first decision will be what type of degree you want or can afford to obtain, ASN or BSN. The associate degree will be the quickest one to get and has fewer prerequisites than a bachelor degree. Any college degree will have general courses associated with it. Basic courses usually required are English and English Composition, Humanities, Anatomy and Physiology, Microbiology, Social Sciences, Mathematics, and some electives. My recommendation is to obtain all your prerequisite credits before entering the Nursing program. Many nursing programs have long waiting lists, so start applying a couple of semesters before you finish up your prerequisites. Don't get discouraged if you get turned down a couple of times as students further along will probably get chosen over you.

Are you staying local or going to go away to school? Does the school only offer daytime classes or can you go to classes after you finish working? If you need to continue working while you go to school, a local community college or university makes more sense. If you can afford to take time off from your current job, your choices are increased. Do your homework about nursing programs. Some programs require a heavier course load than others. Community colleges tend to offer lower credit hour fees.

If you don't like the stricter structure of classroom learning, online universities may be your answer.

With the nursing shortage you would think you would have an easy time getting into a nursing school. That's not necessarily the case. The nursing shortage also means a shortage of nursing instructors. This leads to long waiting lists. So what do you need to do to make yourself look more desirable to nursing school? Here's an example of what schools are looking for in their prospective students.

Good Grades are always a positive. The better your grades are, the higher you will climb on the list. Nursing schools have many candidates to choose from and those with mediocre grades won't get considered. Keeping your grade point average above 3.4 is desirable. Some colleges are asking nursing candidates to write an essay or a statement of purpose for entrance to their programs. Why do you want to be a nurse? Answering this question honestly is the best way to respond. Don't try to write what you "think" they want to hear.

Are you already working in a health care related job? This is always a plus. Becoming a CNA (certified nursing assistant) shows your strong desire to pursue a nursing career. Ask some of your co-workers, preferably nurses, to write a letter of recommendation emphasizing your work ethic. Even if you're not working in health care, these letters demonstrate how you work and interact with people.

Congratulations, you've been accepted into a nursing program. Now what? What does learning to be a nurse involve. No matter where you go to school, the basics are pretty much the same. Nursing evolves around the nursing process: assessment, diagnosis, outcomes/planning, interventions, and evaluation. These skills will be taught and honed during the clinical phase of your education. Clinicals create stress for a lot of nursing students. It's natural to fear doing something that may harm a patient. Using common sense can help avoid these situations. If you're not sure about a procedure, ask questions. Your instructors and preceptors will think better of you for this than just charging in and doing it wrong.

Here are some of the basic skills you will learn referred to as the Nursing Process:

Assessment is the first step in patient care. It involves the collection of data and analyzing that data to prepare to care for the patient. Pain assessment is common. The nurse not only collects data about the location, characteristics, and severity of the client's pain, but also how the pain affects the person's ability to perform activities of daily living. They ask how the patient tries to alleviate the pain and if those measures have been effective.

Diagnosis for nurses differs from a physician's diagnosis. Nursing diagnosis provides a holistic approach to determining how factors affect the patient and other areas like nutrition, activities, and psychosocial reactions. The nursing diagnosis is the basis of the nursing care plan.

Outcomes and planning are short-term and long-term goals that are measurable to determine the effectiveness of the care plan. They are observable and measurable like the patient tolerating sitting in the chair three times a day for meals or achieving effective pain control with medications by the patient rating pain at 2 out of 10. These goals are written into the care plan so all other care providers can read them and measure their results accordingly.

Interventions are the actual performance of nursing care. Care is performed with achieving the goals at its core.

Evaluation of the patient's progress is ongoing and new goals are established and implemented as old goals are met. Discharging a well patient is the ultimate goal.

There are many specialties of nursing. This can be a good thing or a bad thing. What sort of patients do you want to treat? Here are a few specialties and a brief definition for each.

Pediatrics - caring for children 18 years old and younger. Caring for children can be one of the most difficult areas of nursing. We don't like to see sick children and caring for them can take its toll on you emotionally more than physically.

Adult nursing - involves all types of nursing from medical to OR nursing. This area will give you a broad base of experience in your career. Skills learned in this type of nursing can be carried to other specialties.

Critical Care - Areas like the ER and ICU are considered critical care. If you like excitement, this is the specialty for you. The patient load is lighter (1-2 patients), but the patients are more acutely ill.

Psychiatric Nursing - Caring for the mentally ill either in an outpatient or inpatient setting.

Labor and Delivery/Maternal Health - a good specialty for nurses interested in women's health.

Community Health - This specialty promotes wellness and health education in their communities.

Hurray, you've graduated! The newest rules say you can't work as a graduate nurse any longer. So you need to take and pass the NCLEX exam as quickly as possible. You'll need to review as some of your classroom and clinical education was learned 2 or more years ago. Your instructors have referred to the NCLEX throughout your schooling. Most schools pattern their quizzes and tests after the NCLEX, so you should be used to this type of questioning. There are many good review books available to help you review and refresh.

The most important thing is not to panic. The average pass rate for the NCLEX is 83%. That's pretty good. If your grades have been that good or better you shouldn't have any trouble. Take as many practice exams as you can. Review areas that you miss questions about. You already know the other stuff so you don't need to concentrate on those areas.

The questions on the NCLEX are worded to make you use critical thinking skills and determine priorities in the situation. Don't rush through the exam. Take your time and read each question carefully. Think about what the question is asking. There are usually 2 answers that are easy to throw out. The remaining 2 answers will be close to each other, but one is just a little bit better answer than the other. Relax and you'll do fine.

Your first job as a nurse is an important one. It builds your confidence in your skills as a nurse. An important question to ask the manager of the unit you want to work is how long do new nurses stay here? If the unit has a high turnover rate, it may not be new nurse friendly. The concept of teamwork is important in nursing. Support from your coworkers is essential. Who will be there to help you when your first patient dies? Debriefing for you must occur the day this happens, not a week or two down the road. Will this happen? What processes do they have in place? Find out about preceptors on the unit. Are they helpful or are they on the verge of burnout? A preceptor can make or break a new nurse.

Whatever you do, don't take a job, just to have a job. Being happy with your job is essential to your success.

Getting a job in nursing is easy with the nursing shortage. Is it the right job for you? Do some homework. Check out what jobs are available in your area. If you are looking for a specific job, check out where those jobs are. Will you be willing to relocate? Do these jobs offer relocation assistance? In today's economy, that could be an important factor. Nursing recruiters are paid to hire nurses. They'll offer many little perks to entice you to come to work at their facility. Don't be blinded by the dazzle. Have questions prepared to ask to make sure they offer what you want in a job. Interview the interviewer. You want to be happy with the job. They just want to fill the position.

Ask them if you would be allowed to shadow a nurse. This affords you the opportunity to see what is expected of nurses on the unit and see if you think you would fit in.

Now you are a nurse. Okay, you say, but I'm a new nurse. Surviving the first year is a crucial step in any nurses career. First, don't expect too much from yourself. You are new, you don't know all there is to know. Nursing is one of the most dynamic professions there is. New procedures and equipment are being introduced almost daily. You have a lot to learn and even experienced nurses are still learning. Ask questions. Ask for help. Ask to observe new procedures or to assist with procedures you haven't done. Nursing is a career that gives equally to what it gets.

Welcome to our profession. We're glad to have you here.