Nursing Trends

When a person decides to become a nurse the initial problem is school. School means money and time. I came to nursing late in life, complete with two children that I supported basically on my own. I really worried about how to pay my bills while I was learning how to be a nurse, and I am sure that some of you out there will also have these same worries. So, the first thing you have to do is get your house in order and make applications to schools based on what you need and what will be best for you and yours.

The next problem will be getting accepted into nursing school. I know that doesn't sound much like a problem, but believe me it will be. I know, I know. We have a terrible nursing shortage and so it should be no problem getting in, right? Not necessarily so. First, there are only so many nursing programs around and the number of openings is predetermined by the number of students each professor can take. Unfortunately, there is a shortage of nursing professors just like there is a shortage of staff nurses.

After you look around for nursing programs you would like to be accepted into, then you start the applications process. Each school will have its own standards and prerequisites. You will need to complete this step even before you find out if they will accept you into their program.

So, now you have a plan and a program to follow. Are you a nurse yet? Not by a long shot! Keep reading and I will help you through this maze of challenges. Here is a link to a site you might find interesting while you are making your plans:

Before we get too much farther along, let me help clarify some of the questions you may have about "What is a nurse?"

Within this profession there is much diversity. You can get to nursing through numerous pathways. So, here, let's explore those pathways.

First, you may decide to start as a LVN or LPN so you can get out of school fast and get working soonest. Good plan, but if you are like most of us, if you take this pathway, you may never do any more. You may stay an LVN or LPN for your entire career. There is nothing wrong with this choice! You will be a nurse, but the state board specifies strict limits to what you can and cannot do on the job.

It has been my experience that life will always intervene in your plans, so you may get sidetracked here if you choose this route. No shame, no problem. You just need to look at your life circumstances realistically before you make a decision.

If you decide that you want to be an RN, there are different pathways here, too.
You can go to school for two years and get an associate degree in nursing. When you graduate, you will be able to take the state boards for the RN license. You will be a fully functioning nurse when you get a job.

Another pathway would be to go to the University near you and get your Bachelor's of Science in Nursing. This is a longer process, and will cost you more money, but you will be a fully functioning nurse upon graduation and be eligible to sit the state board exam. I chose this option because I already had an associate's degree and didn't want to get another. Each of us has to decide what is best for our circumstances. BSN RN's are really no better or worse than ADN RN's. They usually start out at a higher salary and they are better equipped to move into management positions. Not always, though.

Then, if you already have a Bachelor's Degree you could become a nurse by taking a fast-track Master of Science in Nursing. Or, maybe you might want to get into a Nurse Practioner's program.

Any way you go, you can get to be a nurse. It's really up to you and how much time and effort and money you want to invest in yourself and your future.

So, now you are about to start nursing school. There are a few things you need to know from the start.

First, this will be like no other school you have ever attended. The profession of nursing is one that demands the ability to take high levels of stress and to make competent judgments on the fly. You will need to be both flexible and assertive. You need to be able to work well with others, but be able to set good personal boundaries for yourself. You need to know your stuff or if facing a new situation, you need to know where and how to find out what you need to know. You cannot be bashful or timid. You are your patient's advocate in the red tape that has become healthcare.

With all of this in mind, you need to understand that nursing school will be designed to give you a taste of what it will be like in the working world as a nurse. You will be stressed, you will have to make decisions on the fly, you will be held accountable for everything you say and do, you will be expected to be there and to give 100% effort. If you cannot stand it in nursing school, how will you ever stand it at work? Do not take anything personal. The instructors are doing you a favor if they make it hard and stressful. You need to know that you can stand up to the demands of this profession before you get into it.

Another thing to learn right away is how to study for and how to take nursing tests.
These are not the same tests you took in high school. These tests are designed to confuse you and make you unsure of your knowledge. Most nursing tests will be multiple choice. You will need to look for the MOST correct answer, not necessarily the right one.

To be able to pass these tests, you may want to go here and check out this resource: Learn the in's and out's of taking nursing tests. Don't let test anxiety sink your dreams!

Controversy continues to rage over nursing as a graduate entry profession, but this move is a necessity to deliver healthcare in the 21st century, says Sue Bernhauser

The demands on the nursing profession in the 21st century are far more complex than those of the past. Historically, nursing has sometimes been viewed as a low status profession, but this must change if we are to embrace the challenges ahead (see this week's In depth article).

Over the next 15 years and even beyond, nurses will meet challenges relating to changes in demography, disease patterns, lifestyle, public expectations and information technology. We will see the greatest demands in healthcare met by nursing or other therapy care. There will also be a growing need for healthcare professionals with advanced practice skills and they will need to develop these from a graduate knowledge base.

The announcement that nursing would become an all degree profession by 2013 was greeted with concern by those whose image of nursing rests in the past rather than in the future. Nursing is not - and should never be - simply the carrying out of uncomplicated tasks under the direction of others. Nor is it a vocation for which short term technical training will suffice. It is a profession that requires highly knowledgeable and competent individuals....read more

Sue Bernhauser is dean of the School of Human and Health Sciences, University of Huddersfield

Source:
Bernhauser, S (2010) Degrees will equip nurses to meet future challenges in healthcare. Nursing Times; 106: 21, 8.

It is not uncommon for a brand-new graduate to step into his or her first role as a registered nurse, only to state shortly thereafter, "What have I gotten myself into?"

Clinicals are over. Orientation is over. Those seven patients on that medical-surgical ward are yours, all yours. Also yours is the responsibility to give meds within one hour of the assigned time (after knowing the purpose of each drug and potential side effects, of course), to make sure each patient receives abundant personal care, to follow physicians' orders to the tee, to make sure each patient is prepped for surgery, radiology, or lab work, to give your charting exquisite attention to detail, just in case a lawyer will eventually read it, to make sure foley bags are emptied regularly and urine totals are kept up-to-date, to record vital signs every four hours and report significant changes to the physician, to replace outdated IV lines, to replace outdated IV tubing, to answer a multitude of family members' questions with intelligence and grace, and to provide tender loving care with a smile. The funny thing is that I have seen medical-surgical nurses do this day after day for twenty years in an effort that appears to be flawless. How on earth do they do it? Why am I not good at this? You see, when I was a medical-surgical nurse, I was anything but flawless%u2026

During nursing school and throughout my nursing career I discovered that I exhibit the very definition of the word klutz. I am the type who will go into a patient's room, trip over the IV pole, grab for something to ease my fall, and yank the oxygen and the call light cord out of the wall. In the meantime, I have pulled the IV cannula out of the patient's arm with accompanying blood everywhere, and have strangled myself with the oxygen tubing and have gracefully landed on top of the patient in their bed! Since the call light has been pulled out of the wall, the emergency light is on and the entire floor comes to see what the problem is. Try explaining that.

(Okay, now don't you pretend this has never happened to you...)

The multitasking ability and managerial expertise that is required for a medical-surgical nurse just was not in my skill set. How could I multitask when I was concentrating on putting one foot in front of the other and not injuring someone? Did I make a mistake by going into nursing in the first place? Was there a better "fit" out there for me?

Ahh, but this is the beauty of nursing! There is a place for everyone, even the more klutzy among us!

After my stint in medical-surgical nursing (casualty free, thank God), I ventured into the area of critical care. This was a little bit better fit, but it was not for me either. I am a very slow methodical thinker, and I found that in critical care you need to be a little quicker in the old noggin. My next move was to home health. Again, this was an even better fit. I loved the independence of setting my own schedule, writing my own care plans, and spending individual time with each patient (although I cringed when I walked into the home of an elderly lady that was filled with a multitude of tiny, fragile glass knick-knacks that were just daring me to do one of my klutzy pirouettes that would send them crashing to the ground). However, as good as a fit this seemed to be, it just wasn't for me.

What on earth in the field of nursing WAS for me?

The answer came during a flashback from nursing school. I remembered studying nursing theorist Virginia Henderson, and I recalled her saying that an effective nurse was a combination of heart (caring), head (intellect), and hands (clinical skill). It seemed to me that not every nurse was going to be equally blessed in all three areas. Wouldn't every nurse be a little more skilled in one area over the others? Was one area necessarily better or more essential than the others?

This became the key for me in finding my niche in nursing.

I began to examine my nursing practice in light of Virginia's theory. My greatest skill was obviously not my hands (see embarrassing revelations above). I was definitely strong in the area of caring, but I found through close examination that my greatest strength lay in my head, my intellect. I remembered the enjoyment of trying to figure out complex medical issues on a medical-surgical ward where there just was no time for that. I recalled loving to orient new nurses and to teach them the finer points of nursing practice. Especially, I loved sitting at the computer and devising comprehensive care plans for my home health patients. Maybe my place, my greatest contribution to nursing as a whole, was not at the bedside, but at the computer.

Thus began my journey into the realm of nursing education. It started with continuing education and a BSN and an MSN degree. This was followed by a several-year stint teaching clinical rotations at our local community college (the very one where I graduated). Finally, my dream came true when Kaplan University took a chance on me and gave me a fulltime, online teaching position as a member of their wonderful faculty.

At this writing, I have worked with hundreds of online students and now work to orient and train new faculty members at Kaplan. I can still be involved in nursing practice because I am working with nursing faculty who, in turn, train their students to become better nurses! Indirectly, I work with hundreds of patients each day throughout the country without the risk of my hurting anybody! (When I went into nursing education, I just knew that I heard the nationwide patient population give a collective sigh of relief.)

Take heart, my nursing colleagues. If your current position is not a good fit for you, just know that there is something out there that will be, no matter if your greatest strength lies in your heart, your head, or your hands. When in doubt, just remember that Virginia knew best.

Nurses, please leave a comment below sharing your thoughts on this article!

About the Author: Susan Kieffer, RN, MSN/Ed., is a fulltime faculty member with the Kaplan University School of Nursing online. Her current position involves orienting and training new faculty members in their transition to online education. She is a busy pastor's wife, worship leader, a mother of two, a grandmother of six, and pet owner of a Great Dane, Pomeranian, a Himalayan cat, a snake, and other multiple critters. She is currently pursuing her Ph.D. in E-Commerce.

Last Updated Feb 2010
List of Nursing Specialties

* Ambulatory care nursing
* Advanced practice nursing
* Behavioral health nursing
* Burn nursing
* Camp nursing
* Cardiac nursing
* Cardiac catheter laboratory nursing
* Case management
* Clinical nurse specialist
* Clinical research nurse
* Community health nursing
* Correctional nursing
* Critical care nursing
* Developmental disabilities nursing
* District nursing
* Emergency nursing
* Environmental Health nursing
* Flight nursing
* Forensic nursing
* Gastroenterology nursing
* Genetics nursing
* Geriatric nursing
* Health visiting
* Hematology oncology nursing
* HIV/AIDS nursing
* Home health nursing
* Hospice nursing
* Hyperbaric Oxygen Therapy Nursing
* Intavenous therapy nursing
* Infectious disease nursing
* Legal nursing
* Legal Nurse Investigator
* Maternal-child nursing
* Matron
* Medical-surgical nursing
* Military and uniformed services nursing
* Neonatal nursing
* Neuro-surgical nursing
* Nurse anesthetist
* Nurse-midwife
* Nurse practitioner
* Nursing educator
* Nursing informatics
* Nursing management
* Obstetrics gynecology nursing
* Occupational health nursing
* Oncology nursing
* Operating room nursing
* Orthopaedic nursing
* Ostomy nursing
* Pain management and palliative care nursing
* Pediatric nursing
* Perianesthesia nursing
* Perioperative nursing
* Plastic and reconstructive surgical nursing
* Private duty nursing
* Psychiatric or mental health nursing
* Public health
* Pulmonary nursing
* Quality improvement
* Radiology nursing
* Rehabilitation nursing
* Renal dialysis nursing
* Renal nursing
* Research
* School nursing
* Sub-acute nursing
* Substance abuse nursing
* Surgical Nursing
* Telenursing
* Telemetry nursing
* Telephone triage nursing
* Transplantation nursing
* Travel nursing
* Urology nursing
* Utilization management
* Wound care

Source: Wikipedia www.wikipedia.com

What is Forensic Nursing

Forensic Nursing is one of the newest specialty areas recognized by the American Nurses Association. It involves working with law enforcement officials to aid in the investigation of crimes such as abuse, accidental death and assault.

They also collect evidence from the survivors of the violent crime as well as the suspect so a case can be can be made and justice can be served.

Since crimes happen almost everyday even when the suspect is already in prison, forensic nursing requires a lot of manpower. Just to give you an idea, there is a Correctional Nursing Specialist, Forensic Clinical Nurse Specialist, Forensic Gerontology Specialist, Forensic Nurse Investigator, Forensic Psychiatric Nurse, Legal Nurse Consultant, Nurse Coroner/Death Investigator and Sexual Assault Nurse Examiner.

The largest subspecialty of forensic nursing is sexual assault, closely followed by death investigation, forensic psychiatric nursing and medical-legal consulting.

When sexual assault or rape occurs, it is the job of the forensic nurse to collect evidence and take pictures so whoever is responsible can be caught. This is done by cross referencing the DNA sample into the criminal database system assuming that the one who did it has a criminal record. If the victim knows who did it, a DNA sample can be collected from the suspect and if it is match, then an arrest is made.

In terms of death investigation, the forensic nurse assists the pathologist in determining the cause of death of a victim. In some areas, this person is already the coroner.

Forensic psychiatric nursing is all about giving a convict or a suspect a psychiatric evaluation. This will determine if he or she is fit for trial. Inmates who have been released who have been pardoned and released from prison may also have to do the same test so they can find work.

In order for you to become a forensic nurse, you have to enroll in a program offered by a university which focuses on the criminal justice system, forensic mental health, interpersonal violence, perpetrator theory and victimology.

You will also need practice experience under the auspices of a trained forensic doctor or nurse. Since there are improvements in forensic science, you must also enroll in continuing education courses. If you want to move forward in your career, take a formal graduate study program so you have a master's degree.

Once you have your degree, you can already apply for work without having the need to get a certificate which is required in other nursing professions.

Can you shift to forensic nursing after working for some time as a registered nurse? The answer is yes. You should just pass the exam that is given by the International Association of Forensic Nurses.

Aside from helping law enforcement officials solve a crime or help a victim, forensic nursing is also useful in other fields. These include tissue and organ donation, pediatrics and in a correctional institution.

In tissue and organ donation, the forensic nurse will talk to the family of the potential donor. When they agree, he or she will fill up the legal paperwork so everything is properly documented.

In pediatrics, forensic nurses are present to assist and give comfort who have been victims of abuse and neglect.

Sep 24, 2009 08:09 PM - The RN specializing in Perioperative Nursing practice performs nursing activities in the preoperative, intraoperative, and postoperative phases of the patients' surgical experience. Based on the Standards and Recommended Practices for Perioperative Nursing--A.O.R.N., the operating room nurse provides a continuity of care throughout the perioperative period, using scientific and behavioral practices with the eventual goal of meeting the individual needs of the patient undergoing surgical intervention. This process is dynamic and continuous, and requires constant reevaluation of individual nursing practice in the operating room.

I have been an Operating Room Nurse since 1995. Previously, I worked in the Operating Room as a LPN/Surgical Technician from 1980-1994. I love working there. I do tire of hearing comments from other nurses that OR nurses don't really do nursing duties. I'm here to set the record straight. I am as much a RN as the next nurse and I do patient care. Operating Room Nurses assess, diagnose, plan, intervene, and evaluate their patients just like every other nurse. Let me tell you how.

Assessment

The patient enters the preoperative area and is assessed by the preoperative RN. The perioperative RN (Circulating Nurse), then interviews the patient with particular emphasis on ensuring the patient has informed consent, has been NPO for at least 6 hrs. prior to surgery, and current medical history to determine any special needs for the care plan. The perioperative nurse explains to the patient what will happen during the operative phase and tries to alleviate any anxieties the patient and their family may have. The nurse develops a rapport with the patient that enhances the operative experience for the patient by building trust and assuring the patient and the family of the best care possible.

The assessment includes, but is not limited to:

* Skin color, temperature, and integrity
* Respiratory status
* History of conditions that could affect surgical outcomes (i.e. diabetes)
* Knowledge base related to the planned surgery and complications that could arise
* NPO status
* What medications were taken the morning of surgery and the time taken
* Allergies and what reactions the patient experiences
* Placement of any metal implants, especially AICD's and pacemakers
* Time of last chemotherapy or radiation therapies
* Verification of patient's name and date of birth
* Checking to verify all medical record numbers match the patient's name band and paperwork

This information is then used to develop the perioperative nursing care plan.

Diagnosis

The nursing diagnosis is written in a manner that helps determine outcomes. Some nursing diagnoses for surgical patients are:

* Impaired gas exchange related to anesthesia, pain, and surgical procedure
* Potential for infection related to indwelling catheter and surgical procedure
* Activity intolerance related to pain
* Anxiety related to anesthesia, pain, disease, surgical procedure
* Alteration in nutrition less than body requirements related to NPO status.

Planning

Planning the patient's care in the operating room is focused on patient safety. The nurse gathers supplies needed for the procedure according to the surgeon's preference card, positioning equipment, and any special supplies needed as determined by the nurse's assessment and the patient's history. Preparation assures that the nurse will be able to remain in the surgical suite as much as possible to provide care for the patient. The nurse leaving the room is avoided as much as possible, but unforeseen circumstances may require the nurse to leave to obtain equipment or supplies. When the patient is brought to the operating room and transferred to operating table, patient comfort and safety are the priority. The nurse provides warmed blankets for the patient and applies the safety strap across the patient. The surgeon is called to the OR suite and the "time out" is performed with the patient participating. Items verified in the time out are the patient's name, date of birth, allergies, procedure to be performed, correctness of consent, site marking, if applicable, and any antibiotics to be given within one hour prior to incision. The patient is instructed to take deep breaths before and after anesthesia to maintain oxygen saturation above 95%. Strict aseptic and sterile technique are maintained throughout the surgical procedure to reduce the risk for postoperative infection. The nurse remains at the bedside during the induction phase and holds the patient's hand to help reduce anxiety. The patient is reassured as needed.

Nursing Intervention

The circulating nurse and the scrub nurse/technician work as a team to protect the sterility of the operative field by maintaining constant surveillance. Any breaks in sterile technique, such as a tear in the surgeon's glove, are remedied immediately.

The nurse provides for patient comfort by placing warm blankets, remaining at the patient's side until anesthesia has been successfully induced and the anesthesia provider releases the care of the patient to the surgical team. At this time a foley catheter will be placed, if indicated, using aseptic technique. The patient will be positioned and all pressure points will be padded to prevent altered skin integrity. The surgical skin prep is then performed aseptically and allowed to dry before placement of the surgical drapes. Fumes from a wet surgical prep can form pockets of gas that have the potential to be ignited by a spark from the electrocautery used in surgery.
Prior to the surgical incision, the anesthesia provider initiates the infusion of the antibiotic ordered by the surgeon. A preincision verification performed by the circulating nurse rechecks the patient's name, the surgical procedure, the site/side of the procedure, the antibiotic infusion has started, and the prep is dry.

Evaluation

The circulating nurse monitors the patient vigilantly during the course of the perioperative phase which includes preoperative, operative, and postoperative stages of surgery. He/she is responsible for the smooth transition for the patient between these phases. Evaluation of the patient's response to the surgical intervention is ongoing and continuous. Have the surgical outcomes been met? If not, reassessment takes place to plan further.

Conclusion

The patient under anesthesia is totally dependent on the surgical team for their well-being. The perioperative nurse advocates for the patient. He/she is their voice during the surgical intervention.
Whether scrubbing, circulating, or supervising other team members, the perioperative nurse is always aware of the total environment, as well as the patient's reaction to the environment and the care given during all three phases of surgical intervention. The perioperative nurse is knowledgeable about aseptic technique, patient safety, legal aspects of nursing, and management of nursing activities associated with the specific surgical procedure being performed. OR nursing is unique: it provides a specialty service during the perioperative period that stresses the need for continuity of care and respect for the individuality of the patient's needs.

Beth, RN, CNOR
ASN Degree with Honors from St. Petersburg College, St. Petersburg, FL
Staff RN

________________________________________________________________

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Runaway, Exploited Girls Reap Strong Benefits from Nurse Interventions
Posted on: 08/26/2009

A nurse intervention program that helps sexually exploited runaway girls re-connect to family, school and healthcare reduces trauma and restores healthy behaviors, according to a new study led by University of British Columbia researcher Elizabeth Saewyc and Children's Hospitals and Clinics of Minnesota nurse practitioner Laurel Edinburgh.

The study, published online this month in the Journal of Adolescent Health, and due out in print later this year, examined the effects of the Runaway Intervention Program (RIP) at Children's Hospital in St. Paul, Minnesota. Girls and their families reported significant improvements in family and school relationships, self-esteem and grades after participating in RIP. The researchers also found significant reductions in emotional distress, substance use, suicide attempts, and risky sexual behaviors.

"Runaways often become isolated from supportive family and school relationships, which are important for healthy development," says Saewyc, a professor in UBC's School of Nursing who also holds a Canadian Institutes of Health Research (CIHR) Public Health Chair in Youth Health. "When they are also sexually assaulted or exploited, where can they turn for help in coping with the trauma? RIP was designed to reintroduce protective relationships back into young girls' lives and help them heal."

Through the intervention program, nurses worked beyond the clinic to support girls and their families with home and school visits. In addition to providing health exams and health education, they used creative problem-solving strategies to improve communication between family members, help girls stay in school, and find the support they need to be healthy.

"Remarkably, by six and 12 months into the program, the girls had improved so much that in most areas they were indistinguishable from girls in school who had never been abused," says Saewyc, who is also a scientist at the Child & Family Research Institute at BC Children's Hospital.

Edinburgh attributes the program's success to the individualized approach to health care, which may include interfacing with law enforcement and community services.

"Every runaway girl has a unique set of circumstances, issues and needs and therefore require individualized intervention in order to restore a supportive environment that would help them heal," says Edinburgh. "These could range widely from working with the school's police officer to make the school a safe environment, free from threats of gang members to helping find free piano lessons as a reward for ongoing school attendance.

"A vital element of the program is utilizing the specialized training of nurses to bring well-rounded healthcare to these girls, identifying their unique issues and working with each girl - and their support networks, including family, school and the community - to address them head on."

"CIHR understands the importance of helping sexually exploited runaway girls reconnect with family members and return to school to ensure positive and healthy development," says Dr. Joy Johnson, scientific director of CIHR's Institute of Gender and Health, which helped fund the study. "Abuse has a devastating effect on people's lives, so it is essential to invest in programs that give victims an equal chance of success and hope for the future."

Click hereto read the original article and see follow-up articles on this topic.

Nursing jobs in the intensive care unit, emergency room and pediatrics will always be staples of the profession, but changes to the evolving health care system will also determine which nursing specialties will grow at an accelerated pace.

Health care reform, technological advances and our nation's aging population all have an impact on the nursing profession and the direction it will take in the future. With President Obama's overhaul of the health care system on the horizon, nurses trained in health information and technology and other highly specialized segments will be needed and in high demand.

Judy Ozbolt, RN, Ph.D., FAAN, FACMI, FAIMBE, program director for the University of Maryland's Nursing Informatics program, said that nurses specializing in informatics, which combines nursing science with computer and health sciences to integrate systems and help health care providers document care and record evidence of their practice, will be in greater demand as technology and health care become more integrated.

"Nursing informatics is a field that is certainly in growing demand," Ozbolt said. "The Recovery and Rehabilitation Act covers $1 billion a year for projects that will help acquire and implement electronic health records. There will be an acute need for nurse informatics once this is implemented."

Graduates of nurse informatics programs most often go on to work in health care organizations to help maintain and develop systems that support everything from patient information to care documentation. Nurse informatics graduates also work at companies that develop these systems as well as branches of the federal government.

"Health care reform is going to depend very heavily on electronic tools to improve the safety and quality of care," Ozbolt said. "People trained in nursing informatics will be needed to help get good, useful systems in place. Because nurses are at the heart of the information flow in health care, they really have excellent insights into which kind of information systems will work well."

Nursing specialties focusing on technology, geriatrics and the acute-care patient population are all expected to expand in the near future, according to Mary Jean Schumann, RN, MSN, MBA, CPNA and chief programs officer for the American Nurses Association.

"I think critical care will always be an area that will be in demand because of the complexity of the patient population-that's where the sickest patients are," Schumann said. "Another area that is typically in demand is the ER, because it requires not only a specialized skill set, but a mindset as well. NICU is also in demand because more and more people are giving birth to premature babies with problems."

Specialties centered upon more complex clinical cases are also expected to grow in demand as patients become sicker with chronic illness and disease. "Due to the economy, we are going to see more of these kinds of patients with complex needs because they are waiting to see the doctor and receive care."

As the baby boomer generation continues to age, we will also see an uptick in the need for geriatric, home health and hospice nurses, Schumann explained.

"Geriatrics is a growing need because there aren't enough of them (nurses)," she noted. "We are going to see an increased need for home care and hospice care."

Genetics nursing has also seen an increase in interest, as various colleges and nursing schools are now offering programs dedicated to the specialty. Advances in science and technology have contributed to the increased awareness of this specialty.

"I think genetics could be an interesting area," Schumann said. "As we acquire more and more knowledge about how genetics will impact care, we will need more nurses."

The University of Iowa College of Nursing offers a Master of Science in Nursing program focusing on genetics nursing. The school also offers other programs in up and coming specialties, including nursing informatics and gerontological nursing.

Many advanced practice degrees and specialty certifications can now be completed online, giving nurses the opportunity to continue working full-time while pursuing higher education and more specialized clinical knowledge.

Related Links

Read more about Informatics nursing Read more about Genetics nursing Read more about Geriatric care managers

© 2009. AMN Healthcare, Inc. All Rights Reserved. To read the original article>>click here

By Andrew M. Seder aseder@timesleader.com
Times Leader Staff Writer

EDWARDSVILLE - Times have changed since registered nurse Susan Wehrer began her career in 1968. But she said her occupational duties are the same as they were when she first started in 1968. Employed with the Visiting Nurse Association, Wehrer makes house calls and sees an average of six patients a day.

"We're caregivers," said the 63-year-old, married mother of one.

She started her nursing duties as a candy striper at Bloomsburg Hospital while a freshman at Bloomsburg High School. She graduated and enrolled in the Nesbitt Memorial Hospital School of Nursing in Kingston, where she said an education was much different from the one nurses get today.

"Much more hands-on," she said. "You were immersed in patient care." For $550, nursing students spent three years working in all divisions of health care, from surgical rounds to mental health rotations in state hospitals, maternity wards to emergency rooms.

The hospital rooms were their classrooms and at the end of her three years she received a diploma, not a degree. And she believes the way they did it back then was the better method.

With diploma in hand she went to Yale University Hospital in New Haven, Conn. She worked there for a year before heading to her birthplace, Danville, where she worked at Geisinger Hospital until 1980. She then moved to the Wyoming Valley to work at Nesbitt Memorial for a dozen years before she noticed a change in the industry on which she wasn't keen.

She said there was more stress, fewer nurses on staff and less face time with patients.

"As you get older, it's very physical work. It's physical and mental and it takes a toll on you," Wehrer said.

"I just decided no more hospitals," she said. She took a job with the Visiting Nurse Association 16 years ago and said the care she gives is the type she gave when she got into the field four decades ago.

"It takes a special person to do home care," said June Hannon, the acting administrator at the VNA based at the Thomas P. Saxton Medical Pavilion in Edwardsville.

Visiting nurses care for patients who are well enough not to be hospitalized but still in need of medical care, such as those who have just been discharged from a hospital. She said she sees an average of six patients a day and spends up to 90 minutes with each.

She said she gets to know the patients because it's one-on-one care, unlike at a hospital where you may get pulled in several directions by dozens of patients and doctors.

"When you're in the home you don't have the interruptions %u2026 you can focus on their problems," Wehrer said.

Hannon, of Shavertown, has worked with Wehrer for two years and called her "a very hardworking advocate for all of her patients." She added that Wehrer "has an impeccable work ethic."

Wehrer, who said she believes nursing was her calling, said that there were times in her career when she questioned what she was doing and considered another profession, but each time she decided to stick it out.

"I think in a lot of ways, nurses are taken for granted," she said.

Wehrer said she hopes to retire in two years, but like many nurses, she won't stop working. She'll look to keep her license and work part-time, but also be able to spend more time with her husband, David, and their son, Kevin.

What do nephrology nurses in a hemodialysis center do?

Nurses are caring individuals. After all, that's what they do: provide care. Registered nurses (RNs) who care for patients who have kidney disease are called nephrology nurses. The word nephrology means, "relating to the kidneys." Nephrology nurses are specially trained and educated to care for patients with kidney disease.
RNs working in a hemodialysis center plan and manage the care patients receive. The nurses responsibilities include:

* checking the patients' vital signs and talking with them to assess their condition
* teaching patients about their disease and its treatment and answering any questions
* overseeing the dialysis treatment from start to finish
* making sure patients are given the correct medications ordered by their doctors
* evaluating patients' reaction to the dialysis treatment and medications
* reviewing the patients' lab work, home medications and activities and letting the doctors know about changes in their patients' conditions
* helping patients follow-up with their transplant center
* supporting the entire care team in delivering quality care in a considerate, respectful manner

What do PD nurses and home hemodialysis nurses do?

Some dialysis patients don't get hemodialysis in a center but perform peritoneal dialysis (PD) at home or hemodialysis at home. These patients also rely on nephrology nurses to plan, coordinate and oversee their care. While many of the responsibilities of the peritoneal dialysis (PD) and home hemodialysis nurse are the same as in-center hemodialysis nurses, there are some differences.
The main duties of the home hemodialysis and PD nurses are to:

* assess the patients' condition
* teach patients how to do peritoneal dialysis or hemodialysis in the home setting
* consider the patients' learning needs and provide education about their treatment
* make a training plan for each patient
* give the patients the medications ordered by their doctors
* evaluate the patients' ability to perform their dialysis treatments and take all doctor-prescribed medications
* help patients follow-up with their transplant center
* review the patients' lab work, home medications and activities and let the doctors know about changes in their patients' conditions

PD and home hemodialysis nurses have excellent teaching skills. They teach their patients how to perform their own treatments at home and give them the knowledge to know what to do if any complications occur during their treatment.

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