The Professional Nursing Career

Nursing is a profession focused on assisting individuals, families and communities in attaining, re-attaining and maintaining optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life.

In pre-modern times, nuns and the military often provided nursing services. The religious and military roots of modern nursing remain in evidence today. For example, in Britain, senior female nurses are known as "Sisters". In recent times in the US and Canada many nurses are flowing back into working in a "religious" field through "Parish Nursing". These nurses work within a church community to perform health education, counseling, provide referrals to community support agencies, and connect volunteers from the church community with those in need of assistance.

Nurses acknowledge that the nursing profession is an essential part of the society from which it has grown. The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. The practice of nursing involves altruistic behavior, is guided by nursing research and is governed by a code of ethics.

Nursing continues to develop a wide body of knowledge and associated skills. There are a number of educational paths to becoming a professional nurse but all involve extensive study of nursing theory and practice and training in clinical skills.

In almost all countries, nursing practice is defined and governed by law and entrance to the profession is regulated by national, state, or territorial boards of nursing.

The American Nurses' Association (1980) has defined nursing as "the diagnosis and treatment of human responses to actual or potential health problems." Just as medical diagnoses help in the planning, implementing, and evaluation of medical care, Nursing diagnoses help in the planning, implementing, and evaluation of nursing care.

Like other maturing disciplines, nursing has developed different theories that are aligned with diverging philosophical beliefs and paradigms or worldviews. Nursing theories help nurses to direct their activities in order to accomplish specific goals with people. Nursing is a knowledge based discipline committed to the betterment of humankind. Nursing has not only developed into a profession, but an art as well.

Nursing is the most diverse of all healthcare professions. It is a universal role appearing in some form in every culture.

Nursing may be divided into different specialties or classifications. In the U.S., there are a large number of specialties within nursing. Professional organizations or certifying boards issue voluntary certification in many of these areas.

These specialties encompass care throughout the human lifespan based upon patient needs. Many nurses who choose a specialty become certified in that area, signifying that they possess expert knowledge of the specialty. There are over 200 nursing specialties and sub-specialties. Certified nurses often earn a salary differential over their non-certified colleagues, and studies from the Institute of Medicine have demonstrated that specialty certified nurses have higher rates of patient satisfaction, as well as lower rates of work-related errors in patient care.

Nurses practice in a wide range of settings from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies. Nurses work in occupational health settings (also called industrial health settings), free-standing clinics and physician offices, nurse-run clinics, long-term care facilities, and camps. Nurses work on cruise ships and in military service. They act as advisors and consultants to the healthcare and insurance industries. Some nurses are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was provided and testifying in court. In many cities, nurses can even enter their names in a "registry" and work a wide variety of temporary jobs.

In the modern world, there are a large number of specialities within nursing:

- Ambulatory care nursing
- Advanced practice nursing

- Behavioral health 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
- Medical-surgical nursing
- Military and uniformed services nursing, including Public Health Service

- 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

- Tele-medicine nursing
- Telemetry nursing
- Telephone triage nursing
- Transplantation nursing
- Travel nursing

- Urology nursing
- Utilization management

- Wound care

Professional organizations or certifying boards issue voluntary certification in many of these specialties.

Nursing assistant skills are the set of learned tasks used in helping residents or patients with activities of daily living (ADLs) and providing bedside care--including basic nursing procedures--under the supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN).

In today's hospitals and extended care facillities a nurse assistant is an important part of a healthcare team that includes many personnel outside of nurses. In the quest to make a profit from providing care many hospitals in the United States have reduced their nurse to patient ratios, requiring one nurse to take care of as many as twelve or fourteen patients at a time. In order for good care to be provided to those patients a nurse assistant is needed to provide the routine care so that the nurse can focus on tasks only he/she can do, such as care plans, nursing assessments, administering medication, and assist in surgery room preparation. The nurse assistant must not only be very skilled in the actual procedures being performed but must also be able to make quick observations of a patient's condition and report that information back to the nurse. Since the nurse cannot spend large amounts of time in the room with the patient, the nurse assistant is known as the nurse's "eyes and ears".

A nurse assistant must also have a strong grasp of emergency procedures and be able to stay calm in stressful situations. They must be able to initiate a Code Blue and be well-drilled in CPR.