IntroWhy become a nurse? Perhaps, like our CODE BLUE nursing slogan, you want to make the world feel good again by caring for its people. Or, are you interested because nursing offers you the power to make a difference in the lives of others? You may be considering nursing because you want a career that combines both art and science – the art of caring and the science of healthcare. Also, you may be excited about the numerous nursing fields available, the variety of work settings, the job security nursing offers, and the profession’s excellent salaries and benefits. Nursing offers all of the above and much more. Nursing is a great career choice for both men and women in the 21st century.

Currently, there is a high demand for registered nurses who have completed the BSN degree in nursing. Many hospitals will require that nurses who have earned associate degrees in nursing agree to complete a bachelor of science in nursing program within an agreed number of years to continue employment.

Many hospitals, including Cone Health and High Point Regional Health usually do not hire LPNs (licensed practical nurses). LPNs usually work in long-term care facilities or physician practices.


RN (Registered Nurse)  
LPN (Licensed Practical Nurse)  
CRNA (Nurse Anesthetist)  



Patience and compassion are primary traits required to be a nurse. People are generally not at their best when they are ill, so the nurse must be understanding and supportive while providing care and bringing hope and encouragement to the patient. Thus, they must truly care about people and be able to express that concern.

Nursing also is a highly technical scientific field. An aptitude for and proficiency in mathematics, biology, chemistry, computer science, and the behavioral and social science are essential for a nursing career. Nurses should have a solid healthcare educational background. They also need to be able to plan, organize, and educate patients and their families. Nurses should have a solid healthcare educational background. They must be able to accept responsibility, direct or supervise others, follow orders precisely, determine when consultation is required, and be able to handle emergency situations.


Nurses are on the front line of defense in their patients’ battle for good health. They are among the most important professionals in the fight to promote health, prevent disease, and help patients cope with illnesses. Their focus generally is not on a particular health problem. Instead, nurses focus on the whole patient and his or her response to the treatment plan being implemented.

No matter in what setting a nurse works, the nursing process involves six basic areas:

Assessment: collecting and analyzing the patient’s physical, psychological, and socio-cultural data

Diagnosis: utilizing critical thinking skills to arrive at a judgment on the cause, condition, and path of the illnesses

Planning: relying on in-depth healthcare knowledge and assessment of the patient to create a care plan which sets specific treatment goals

Implementation: accepting responsibility for the plan either by carrying out the actual treatment or supervising it

Evaluation: continuous assessment of the plan

Education: instructing patients and their families on proper care and steps to take to improve and maintain their health. First and foremost, nurses are patient advocates and health educators for patients, families, and communities. Because nurses generally spend more time with the patient than any other member of the healthcare team, they are ideal for the position of patient advocate.

Nurses are directly involved in patient care. They assist physicians during treatments and examinations; they administer medications; and, they assist in convalescence and rehabilitation. Nurses regard both the patient and his or her family as members of the healthcare team and believe it is critical for patients to be informed and involved in their care and understand their treatments.

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RN (Registered Nurse)


  1. Assessing the patient's physical and mental health including the patient's reaction to illnesses and treatment regimens
  2. Recording and reporting the results of the nursing assessment
  3. Planning, initiating, delivering, and evaluating appropriate nursing acts
  4. Teaching, assigning, delegating to or supervising other personnel in implementing the treatment regimen
  5. Collaborating with other health care providers in determining the appropriate health care for a patient but, subject to the provisions of G.S. 90-18.2, not prescribing a medical treatment regimen or making a medical diagnosis, except under supervision of a licensed physician
  6. Implementing the treatment and pharmaceutical regimen prescribed by any person authorized by State law to prescribe the regimen
  7. Providing teaching and counseling about the patient's health
  8. Reporting and recording the plan for care, nursing care given, and the patient's response to that care
  9. Supervising, teaching, and evaluating those who perform or are preparing to perform nursing functions and administering nursing programs and nursing services
  10. Providing for the maintenance of safe and effective nursing care, whether rendered directly or indirectly.
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LPN (Licensed Practical Nurse)


  1. Participating in the assessment of the patient’s physical and mental health, including the patient’s reaction to illnesses and treatment regimens
  2. Recording and reporting the results of the nursing assessment
  3. Participating in implementing the health care plan developed by the registered nurse and/or prescribed by any person authorized by State law to prescribe such a plan, by performing tasks assigned or delegated by and performed under the supervision or under orders or directions of a registered nurse, physician licensed to practice medicine, dentist, or other person authorized by State law to provide the supervision
  4. Assigning or delegating nursing interventions to other qualified personnel under the supervision of the registered nurse
  5. Participating in the teaching and counseling of patients as assigned by a registered nurse, physician, or other qualified professional licensed to practice in North Carolina
  6. Reporting and recording the nursing care rendered and the patient’s response to that care
  7. Maintaining safe and effective nursing care, whether rendered directly or indirectly

A licensed practical nurse, (LPN or LVN), provides nursing care under the supervision of physicians or registered nurses (RNs). Their duties include basic bedside care such as taking temperatures, blood pressure, pulse and respiration; treating bedsores; preparing and giving injections and enemas; applying dressings, ice packs, and hot water bottles; giving alcohol rubs and massages; and monitoring catheters. LPNs assist patients with personal hygiene, provide emotional support, care for infants, perform routine laboratory tests, observe patients, and report adverse reactions to medications.

In nursing homes, LPNs provide routine bedside care, help evaluate needs, and develop treatment plans. Experienced LPNs often supervise nursing aides. LPNs also work in doctors’ offices and clinics as well as in homes where they may prepare meals and educate family members to perform simple nursing tasks.

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Clinical Nurses Specialists are advanced practice nurses who have completed a master’s degree
(or higher) to gain expertise in a specific area of nursing practice. For example:

  1. A population group such as pediatrics, geriatrics, or women’s health
  2. A nursing work setting such as critical care, emergency room, or cardiology
  3. A disease or medical subspecialty such as cancer, diabetes, or heart disease
  4. A specific type of care such as rehabilitation
  5. A specific type of problem such as stress or pain
Clinical nurse specialists work in a variety of practice settings (see Specialty Areas segment of this section) but are more commonly found in the hospital setting. They provide direct care for patients, teach staff and patients about their specialty area, consult with other professionals, and provide leadership and supervision in the healthcare setting. They are responsible for implementing improvement in healthcare delivery systems and procedures. They are particularly involved in assisting patients in the prevention or resolution of illnesses.

The use of clinical nurse specialists has proven very effective for medical facilities. Research results for facilities employing clinical nurse specialists show reduced hospitals costs and length of stay for patients, reduced frequency of emergency room visits by patients, improved pain management practices, increased patient satisfaction with care, and reduced complications for hospitalized patients.

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Nurse Anesthetists (CRNAs) are advanced practice nurses who have additional classroom and clinical training, at the master’s degree level, in anesthesia and have passed a national certification examination.

CRNAs provide quality anesthesia care to more than 65% of all patients undergoing simple or complex surgical or other medical interventions necessitating the services of an anesthetist. They are the sole anesthesia providers in two-thirds of rural hospitals in the United States. In addition to hospitals, CRNAs work in ambulatory surgical centers and in the offices of dentists, podiatrists, and plastic surgeons.

CRNAs practice with a high level of autonomy and according to their expertise, state statutes or regulations, and institutional policy. The full scope of their function and practice parameters can be found in American Associations of Nurse Anesthetists’ (AANA) “Scope and Standards for Nurse Anesthesia Practice.” (See the Lending Library and Other Resources section of this notebook for the AANA website.)

While men represent 5% of registered nurses, they account for 45% of the nation’s 30,000 CRNAs. This area is one of the highest paying nursing specialties. In 2001, the median annual income for a CRNA was approximately $113,000, based on a national AANA membership survey.

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Nurse practitioners are registered nurses who have completed a master’s level nursing degree and post-master’s specialty training. They provide basic primary medical and preventive healthcare to individuals and families in collaboration with a physician. State licensing regulations can vary but, generally, nurse practitioners diagnose and treat common and acute illnesses and injuries and can prescribe medications. Where state laws permit, nurse practitioners may establish their own offices for independent practice.

Nurse practitioners may concentrate in specific areas – the two most common being the family nurse practitioner and the nurse midwife.

The family nurse practitioner course of study provides training for practicing advanced primary healthcare in rural settings. These professionals perform duties similar to those of a family doctor, are often on-call, and work hours that exceed a normal eight-hour day. Family practitioners assess patients, perform physical examinations, monitor and assess patients with chronic diseases, order and interpret laboratory tests and x-rays as needed, and serve as healthcare educators.

Nurse practitioners work in a variety of settings including family practices, student health services, occupational health clinics, home health services, rural clinics, and hospitals.

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The nurse midwife manages the healthcare of women through pregnancy and childbirth. While some nurse midwives are affiliated with obstetric practices or hospitals, others work independently, especially in rural areas. In addition to pregnancies and childbirth, some midwives also perform gynecological examinations and pap smears and are involved in birth control, hormone replacement therapy and infertility problems. Midwives use time-honored techniques including soft lights and massage. Often they include herbs, homeopathic products, chiropractic, acupuncture, and allopathic medications. Their special touch brings proven positive results: hospitals with nurse midwife services have an approximate 13% lower than average cesarean section rate than other hospitals.

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Certified nurse assistants (CNAs), sometimes known as nurse’s aides or nurse techs, perform basic patient care duties such as taking vital signs including blood pressure, temperature and pulse. They work under the supervision of registered nurses and licensed practical nurses. They perform such duties as bathing, walking, and feeding patients; making beds; and assisting patients in a variety of tasks like getting in and out of bed and personal needs like shaving or getting dressed.

Nursing assistant certification is the first step to a nursing career. Most registered nurse educational programs require applicants to have successfully completed CNA training.

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