A career in nursing can be challenging but being a frontline nurse is one of the most rewarding and satisfying jobs out there. By using your medical knowledge and skills to deliver essential care to patients, you can be confident that every day of your working life will be spent helping people.
Currently, there are around 3.8 million registered nurses in the USA and over 84% of them are in employment. However, this number is expected to grow in the future. In fact, the Bureau of Labor Statistics estimates that the number of registered nurses (RNs) in the U.S. will grow by 200,000 each year until at least 2026.
In terms of employment opportunities and job security, the healthcare industry is a great choice for graduates and postgraduates. People will always require healthcare services and the recent Affordable Care Act has made medical care more accessible to the wider population.
While many more people are now able to access medical services, the changes in fees and funding have resulted in more demand for nurse-led services. This means that nurses will continue to be in high demand in upcoming years, which is good news for recent graduates.
However, nursing is a varied profession and there are numerous roles to consider. Being a frontline nurse ensures you'll interact directly with patients and provide a high level of care, but the exact nature of your job will depend on the type of nurse you choose to be. To get an idea of the options available to you, take a look at these four essential frontline nursing roles worth considering:
1. Certified Nursing Assistant (CNA)
As a Certified Nursing Assistant, you'll provide support to Registered Nurses or Licensed Practical Nurses and will often work under their direction. CNAs can perform a limited number of procedures, providing they are instructed and supervised by other medical staff. Common procedures and duties carried out by Certified Nursing Assistants include:
Responding to patient calls
Assisting with procedures
Gathering supplies and preparing rooms
Cleaning bed linens and rooms
Taking patients' vital signs as per protocol
Repositioning or turning patients
Documenting information
Bathing patients
Assisting patients with elimination
Feeding patients
Measuring patients' food and liquid intake
Assistant patients with combing their hair, shaving, brushing their teeth, and nailcare
As you can see, Certified Nursing Assistants undertake a wide range of duties. However, the exact role of a CNA depends on their place of employment and the state in which they work. Some states allow Certified Nursing Assistants to undertake more procedures than others, for example.
Certified Nursing Assistants commonly work in long-term care facilities, but they are also employed in hospitals, adult daycare centers, rehabilitation centers, and, more rarely, in Doctor's offices.
To become a CNA, you'll need to complete a state-approved training program. Generally, these programs run for 4-12 weeks and are available at community colleges, local hospitals, technical colleges, and vocation schools, as well as online.
2. Licensed Practical Nurse (LPN)
Known as Licensed Vocational Nurses (LVNs) in California and Texas and Licensed Practical Nurses (LPNs) in all other states, these nurses undertake a wide range of duties. As well as performing the same tasks as Certified Nursing Assistants, LPNs are permitted to undertake additional duties, such as:
Monitoring and administering medication
Maintaining patient records
Administering injections
Prepare patients for surgical procedures
Assisting with procedures and tests
Perform therapeutic massage
Change dressings and bandages
Manage intravenous drips
Updating other medical professionals on patients' statuses
Licensed Practical Nurses are always working under the direction of other medical professionals. Often, Registered Nurses and/or Advanced Registered Nurse Practitioners will supervise Licensed Practical Nurses. In some instances, an LPN may oversee the work of CNAs.
LPNs may have additional duties, depending on their working environment. An LPN working in a maternity ward may coach women through childbirth, assist midwives, and feed infants in addition to their other duties, for example.
If an LPN chooses to, they can specialize in a specific field of patient care. Although this isn't compulsory, many Licensed Practical Nurses do take the opportunity to enhance their skills in a particular area. Generally, LPNs can choose to qualify in one area, such as:
Long-term care
Pharmacology
IV health
Correctional health
You don't need to attend college in order to become a Licensed Practical Nurse, but you do need to graduate from an accredited program. The Accreditation Commission for Education in Nursing (ACEN) accredits LPN programs, but you may find that courses are also approved by your state.
In most regions, you'll find that LPN programs are available at community colleges and vocational schools. Some hospitals may also run programs that enable you to qualify as an LPN. Generally, LPN programs run for approx. 12 months, although it is possible to find accredited LPN courses that can be completed in as little as seven months. Common topics covered during an LPN program include:
General anatomy and physiology
Nursing fundamentals
Medical-surgical nursing
Nursing math
Pediatric nursing
Geriatric nursing
Nutrition
After completing an accredited LPN program, students will also need to obtain a nursing license and pass the NCLEX examination. This test encompasses four main areas and ensures that all qualified LPNs can deliver safe patient care in accordance with the relevant protocols. The areas covered by the NCLEX are:
Health promotion and maintenance
Safe, effective care environment
Psychosocial integrity
Physiological integrity
Once you have completed this aspect of your training and successfully passed the NCLEX exam, you are ready to begin working as a Licensed Practical Nurse. The vast majority of LPNs work in residential care facilities and nursing homes, although many are also employed in hospitals. Additionally, LPNs sometimes work at doctor's offices and government facilities. Furthermore, some LPNs deliver home care services to patients who wish to be cared for in their own environment.
Qualifying as an LPN can be a great route into a career as a nurse. For LPNs who want to take on more responsibility, there are dedicated programs that enable you to use your existing experience and build upon it to qualify as a Registered Nurse. Alternatively, you may find that the varied duties and rewarding working life as an LPN fulfills your career ambitions.
3. Registered Nurse
Registered Nurses (RNs) account for the majority of nurses in the U.S. and are a critical part of the healthcare infrastructure. While RNs are permitted to carry out all of the same activities as CNAs and LPNs, they are also qualified to undertake more enhanced duties. As a Registered Nurse, you may also be responsible for:
Diagnosing patients
Performing diagnostic tests
Conducting patient evaluations
Recording patients' medical histories
Communicating treatment plans with patients
Counseling patients and members of their family
Interpreting patient data and making treatment decisions, when appropriate to do so
Consulting with other medical professions regarding patient treatments
Administering medication
Undertaking research to enhance patient outcomes
Supervising other nursing staff (e.g. CNAs and LPNs)
The majority of Registered Nurses work in hospital environments but the role does offer other employment options. Some RNs work doctor's offices or nursing homes, for example, whereas others deliver care in a patient's home, in schools, or at community centers.
Traditionally, students could qualify as an RN by completing either a Bachelor of Science in Nursing degree (BSN), an Associate Degree in Nursing, or a Nursing Diploma from an approved and accredited nursing school. However, the vast majority of employers now only hire Registered Nurses who have a (BSN) due to the extensive learning opportunities the degree program provides. Due to this, students should strongly consider obtaining a Bachelor of Science in Nursing if they plan on becoming an RN.
In addition to this, all Registered Nurses must pass the NCLEX exam before they are eligible to practice. The specific exam which must be taken by up and coming Registered Nurses is the NCLEX-RN, although this is subject to change depending on the National Council of State Boards of Nursing (NCSB).
However, this isn't the only examination RNs must successfully complete in order to start practicing. RNs must also obtain state licensure before they are permitted to work. This varies from state to state, so it's important to confirm exactly what the requirements are in your state before you begin climbing the career ladder.
4. Nurse Practitioner
The role of a Nurse Practitioner (NP) depends on a number of factors, including their specific job role, their field of specialism, and the state in which they work. Sometimes known as Advanced Practice Registered Nurses, NPs have a large amount of responsibility and undertake numerous duties. In addition to being qualified to carry out the same tasks as RNs, Nurse Practitioners can also:
Diagnose acute and chronic conditions
Prescribe medication
Devise treatment plans
Perform diagnostic tests
Order more advanced tests
Interpret test results
Coordinate patient care
Educate patients about disease management and health promotion
Refer patients to other medical professionals
Nurse Practitioners typically carry out other duties too, but these are dependent on their specific role and specialism. NPs can specialize in a number of areas, including:
Family health
Acute care
Gerontology
Pediatrics
Geriatric
Psychiatric
Being a Family Nurse Practitioner (FNP) is by far the most popular specialism, partly because of the varied working life FNPs enjoy. As an FNP, you'll treat patients of all ages, from infants right through to seniors. Furthermore, you'll diagnose and treat various medical problems, from acute conditions to chronic, long-term health problems. Take a look at this blog post to find out more about becoming a family nurse practitioner.
Many Nurse Practitioners begin their careers by obtaining a Bachelor of Science in Nursing and gaining practical experience as an RN. From there, they enroll in an RN-to-MSN program in order to obtain a Master of Science in Nursing. Alternatively, you can enter the graduate Master of Science in Nursing program directly, providing you meet the eligibility criteria. Alternatively, you can become a Nurse Practitioner after successfully completing the four-year Doctor of Nursing Practice program.
As you might expect, Nursing Practitioners must also complete the NCLEX and obtain state licensure before they can begin working as an NP. The role of an NP varies quite considerably from state-to-state, so you'll want to check the licensing requirements in your state before you progress any further.
Generally, states are categorized into three classifications depending on how much autonomy they give to Nurse Practitioners. These are:
Full practice states
Reduced practice states
Restricted practice states
As the classifications suggest, NPs operating in full practice states are given more autonomy than in reduced or restricted practice states. However, NPs in these states still operate with more responsibility than RNs, LPNs, or CNAs, although they are supervised more closely by other medical professionals.
Is a Career in Nursing Right for You?
If you thrive under pressure, you enjoy operating in a medical environment, and you're committed to helping your community, a career in nursing could be exactly what you're looking for. Although life as a nurse can be physically demanding and take an emotional toll, it's also highly rewarding.
People who are well-suited to working as a frontline nurse typically possess the following qualities and skills:
Empathy
Time management
Communication
Loves to learn
Critical thinking
Versatility
Responds to high-pressure situations
Assertive
Responsible
Flexible
Discreet
Reliable
Organized
Ethical
Moral
If you're eager to pursue a career in nursing but you're concerned about the emotional impact it may have on you, it can be advantageous to talk to current nurses, nursing teachers, and other healthcare professionals. While nursing can be emotionally draining, medical professionals do receive training in how to deal with the emotional impact of their role. Although emotional stability is at the core of nursing, it's important to remember that it's a caring and compassionate nature that compels most people to join the nursing profession.
Whether you dream of working in a hospital, you want to deliver care in a residential facility or you're keen to explore at-home nursing roles, there is plenty of scope for career progression. As nurses continue to be in high demand, you can be confident that a career in nursing will be filled with opportunities.
