Who Is the Nurse?

Registered Nurses (RNs) complete basic training in a 4-year baccalaureate program, a 3-year diploma program, or a 2-year associate degree program. All graduates must pass a state licensing exam to be licensed as a RN. RNs are the largest group of health care providers and work across all health care settings providing hands-on care. Basic RN functions include patient assessment, administering therapeutic therapies, patient education, integrating complex care delivery, providing emotional support, and supervising support staff such as licensed practical nurses and direct care workers. RNs work to promote health, prevent disease, and help patients cope with illness. They are advocates and health educators for patients, families, and communities. Within patient care, nurses can move into a nursing specialty such as clinical nurse specialist, nurse practitioner, certified nurse midwife, or certified registered nurse anesthetist. These positions require about 2 years of graduate education leading to a master’s degree.

Licensed Practical Nurses (LPNs) complete basic training in a 12-18 month program emphasizing technical skills. Graduates must pass a state licensing exam to practice as a LPN. LPNs primarily provide direct patient care under the direction of a physician or RN including basic bedside care, taking vital signs such as temperature, blood pressure, pulse, and respiration, preparing and giving injections and enemas, monitoring catheters, applying dressings, treating bedsores, and assisting with personal care. In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Experienced LPNs may supervise direct care workers.

Direct Care Workers (DCWs), or paraprofessionals, include nursing assistants, home health care aides, and personal attendants. DCWs have only minimal basic training, for example federal law mandates only 75 hours of training for nursing assistants working in nursing homes. DCWs perform routine tasks under the supervision of nursing and medical staff. They answer patients’ call lights, deliver messages, serve meals, make beds, and help patients eat, dress, and bathe. Aides also may provide skin care to patients; take their temperatures, pulse rate, respiration rate, and blood pressure; and help patients get in and out of bed and walk. They escort patients to operating and examining rooms, keep patients’ rooms neat, set up equipment, store and move supplies, or assist with some procedures. Aides observe patients’ physical, mental, and emotional conditions and report any change to the nursing or medical staff.

Source: US Department of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook, 2004-2005.