1. What is a nurse’s job description?
To present the information in a correct way, let’s look over the “official” definitions for the nursing profession:
The concept of nursing is an important part of the individual’s healthcare system. It includes three important elements: health promotion, disease prevention and care for sick people of all ages in all sanitary units and community settlements.
Virginia Henderson, one of the most well-known medical nurses in history has defined the medical assistant as follows: “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death)that he would perform unaided if he had the necessary strength, will or knowledge.”
The same Virginia Henderson formulated several principles underlying the nurse’s job: “The nurse is temporarily the consciousness of the unconscious, the love of life of the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the newborn, knowledge and confidence for the young mother, a voice for those too weak to speak.”
The American Nurses Association (ANA) defines the nursing role as: “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences”.
The World Health Organization (WHO) defines the medical assistant as: “a person who, being formally admitted to a nursing educational program recognized by the Member State in which he/she has successfully completed his/her nursing studies and obtained the required qualifications to be registered and/or obtained a nursing practice license.”
Besides these, the International Nursing Board (ICN) mentions that a nurse may perform those procedures and functions that health requires in any situation, but not to make a procedure for which they are not qualified.
2. What are the different levels of nursing?
In the United States there are several levels of nurses, each with similar, but different credentials depending on their field. Discover what nurses do below:
Certified nursing assistants (CNA) help registered nurses (RN) note vital signs, dispensing medications and they take care of patient’s personal needs. The licensed practical nurse (LPN) has extra qualifications, like administering injections, performing therapeutic massages, preparing patients for surgery, keeping medical records, changing bandages, managing intravenous dips and conveying the patient’s message to the medical staff.
The registered nurse (RN) is the main professional level found in clinics and hospitals. They assist the physician in conducting clinical investigations and supervise the work of both CNAs and LPNs. They help program patients. They make sure to sterilize instruments and materials for general hygiene and they ensure the necessary conditions for unfolding treatments.
Once qualified, RNs can choose to undertake specialization courses in radiology and medical imaging, laboratory, nutrition and dietetics, balneo-physio-kinetotherapy, hygiene and public health. The advanced registered nurse practitioner (ARNP) includes midwives, nurse practitioners, clinical nurse specialists and nurse anesthetists.
Pharmacy nurse specialist
Collaborates with the licensed pharmacist, performing tasks such as tablet numbering, drug labeling, cashier tasks, stock inventory, drug distribution, checking for correct prescription information, to name a few. The pharmacy assistant can work in pharmacies, laboratories and in private hospitals and clinics, galenical laboratories, drug factories, drug stores, or drug delivery centers.
Balneo-physio-kinetotherapy and recovery nurse
Performs thermotherapy, electrotherapy, recovery massage, reflexology, physiotherapy procedures, assesses the articular and muscular balance of the patients, all while respecting the prescriptions made by the physician on the treatment files. Recovery nurses can work in clinics and hospitals with a spa profile, in recovery centers, SPAs, beauty centers and body remodeling.
Radiology medical assistant
Plans everything from the patient to the materials needed before a specialist’s investigation, helping in radiology examinations. They also provide hygiene conditions in the cabinet/department.
Laboratory assistants or technicians
Collects and analyzes patient samples, provides protection against contamination, uses laboratory equipment, stocks the laboratory with the necessary materials and substances, schedules patients for investigations. The difference between assistants and technicians is that the latter has more experience and responsibilities.
3. The qualities and abilities of a nurse
Most of the time, choosing to become a nurse has emotional reasons, like the desire to help someone in difficulty. Some people want to become a nurse due to the fit between personality traits required by the job and their own abilities. Whatever qualification you have, there are some key skills a nurse needs.
- A nurse is not afraid and doesn’t get wobbly feet if they see blood or wounds.
- He or she is passionate about anatomy. Studying every part of the human body requires patience and curiosity.
- A nurse has good response speed. A patient’s life depends on a few seconds of attention or a proactive attitude.
- A caregiver’s job is empathetic. A nurse understands the patient’s suffering. They put themselves in his shoes while giving moral support.
- A nurse has excellent listening skills and patience. He or she has to listen to the patient’s worries and have an open communication for a positive interaction. At the same time, if they need more information, patients complain of pain or they are irritable and don’t understand medical procedures, the assistant has to treat them with respect and patience.
- A specialist has integrity and is responsible. The two qualities complement each other. A nurse will report to their superior when she or he a mistake.
- Nurses have to be well organized. They have to concentrate on more patients with different needs. This means that they have to divide their time depending on the gravity of the cases. They also have to be by the doctors’ side and migrate fast from one case to another. For example: from administering treatment to mounting an IV.
- An attendant has to have resistance to stress. Nursing is demanding because of the high number of patients, but also because of the level of stress. What’s more, in sub-domains such as intensive care, the operator block can be exhausting. It is important that the nurse knows some relaxation techniques, like deep breathing, relaxing muscles, becoming aware of the critical moment and taking a break, so that the interaction with the patients is not marked by frustration or other inappropriate reactions.
- A nurse complies with rules, regulations, and instructions. No matter how much experience the nurse has, she or he has to follow the doctor’s instructions for each patient. The caregiver will also abide by internal regulations of each institution in which they work to maintain a pleasant workplace atmosphere.
- Caregivers don’t discriminate, especially in the public system, where social categories are very different. Nurses have to show non-discriminatory behavior. For example, if the patient drove under the influence of alcohol and has serious injuries, the nurse will provide him with the same care as he or she would for the victim of the traffic accident.
- A medical professional has to have computer skills. This skill is necessary to keep track of patient’s treatment, to update their observation charts in an electronic record system, or to report to the Insurance House. Any assistant wishing to evolve needs to know the basic of the Microsoft Office package
4. How to become a nurse in America
If you’re interested in a nurse’s job, it’s time to start looking for a nursing school. All those who want this career have options for attending nursing classes, it depends on what type of nurse you want to become.
First, opt for programs which The Accreditation Commission for Education in Nursing and The Commission on Collegiate Nursing Education have accredited. You can still take the final exams no matter the program, but hospitals usually hire nurses that have taken an accredited one.
The main prerequisites for admission at a special nursing program are a high school diploma or the equal, but admission to a nursing university depends on each college. Some need only grades, while others need exams, a letter or an interview. The difference between a vocational-technical school and a college or university degree is that the latter type of education offers in depth studies which come with a higher income.
The main programs are associate degree, which takes 2 years, and bachelor’s degree, which needs 4 years of studying. Some type of nurses need only one year before they can practice, while the full program to become an advanced registered nurse practitioner can lead up to 8 years or more as you can see below. Nurses have to keep up with their studies each year or every 2-3 years.
The most important nursing programs are:
Admission: high school diploma or GED, entrance exams, references, personal essay, C.V.
Admission: high school diploma or GED, entrance exams, references, personal essay, C.V.
Duration: 1 year at most colleges or vocational-technical schools, you can take it part-time or full-time.
Program: basic patient care nursing – first aid, introduction to pharmacology, geriatric care and psychological care
Certification: pass the national licensing exam of the state you’re in or NCLEX
- Bronx Community College in Bronx, NY
- Indian River State College in Fort Pierce, FL
- Lewis-Clark State College in Lewiston, ID
ADN (The Associate Degree in Nursing) Programs:
Admission: SAT or ACT exam, GPA between 2.0 or 3.25, 3 years of math (geometry, algebra), 3 years of science (biology, chemistry), 4 years of English, 2 years of a foreign language
Duration: 1-2 years at community colleges or 4 years at universities
Program: nursing basic classes – anatomy, physiology, microbiology, pharmacology, nutrition and clinical work
Certification: pass the NCLEX
- State College of Florida-Manatee-Sarasota in Bradenton, FL
- Southeast Community College in Lincoln, NE
- Mississippi University for Women in Columbus, MS
BSN (The Bachelor of Science in Nursing) Programs:
Admission: cumulative GPA or ADN grade of 2.75 or higher, essay, references, C.V., volunteer experience, prior classes in anatomy, biology, chemistry, organic chemistry, microbiology, and physiology
Duration: 4 years, but if you already have an ADN or an RN license you can take a 2-year RN/ADN-to-BSN course, and if you have a bachelor’s degree in another field you can apply for a 2-year accelerated BSN program
Program: anatomy and physiology, statistics, nutrition and diet, nursing theory and research, general education, advanced clinical work in hospitals, nursing homes or psychiatric facilities
Certification: same steps – 1. Apply for the RN license and 2. Take the NCLEX exam.
- Excelsior College in Albany, NY
- George Mason University in Fairfax, Virginia
- Northeastern University in Boston, Massachusetts
MSN (The Master of Science in Nursing) Programs:
Admission: you need a BSN to continue your studies, the RN license, minimum GPA and GRE scores, clinical experience, recommendations, and essay
Duration: some universities offer online classes and they usually take about 2 years
Program: classroom study, research and clinical experience, it depends on what you want to specialize in – nurse practitioners, certified nurse anesthetist, clinical nurse specialists, certified nurse midwife
Certification: the special exam for each certification/license
- Towson University in Towson, Maryland
- University of Central Florida in Orlando
- University of Delaware in Newark
To be a certified nurse you have to pass the National Council Licensure Examination (NCLEX) or the state licensure required, each comes with its own rules. RNs who want to specialize in a particular domain like AIDS, oncology, pediatric have to apply for an extra specialty certification.
For the NCLEX you have to apply for a nursing license and then take the exam which covers four categories: Safe and Effective Care Environment; Health Promotion and Maintenance; Psychosocial Integrity, and Physiological Integrity. This is a multiple choice exam of about 85 questions. Find everything you need to know here.
What you need to do to continue your nursing education
Once you complete a program, you have to continue your medical education throughout your professional life. Each state has its own rules and each hospital its own regulations. The medical field is evolving, important discoveries occur every year, so you have to be up to date.
You’re required to accumulate points each year, or every 2-3 years. These attest you’re updating your professional knowledge, improving the level of competency, acquiring new skills and abilities necessary to practice your job.
On the east coast the requirements for RNs and LPSs are:
New Hampshire – 30 contact hours every 2 years and 400 practice hours every 4 years
Massachusetts – 15 contact hours every 2 years
Rhode Island – 10 contact hours every 2 years including 2 hours of substance abuse CE
New York – 3 contact hours infection control every 4 years; 2 contact hours child abuse (one time requirement for initial license)
New Jersey – 30 contact hours every 2 years
Delaware – 30 contact hours every 2 years
Virginia – 15 contact hours every 2 years
North Carolina – One of the following every two years: 15 contact hours and 640 hours of active practice, OR National certification or re-certification, OR 30 contact hours, OR completion of refresher course. Completion 2 semester hours of post-licensure academic education, OR 15 contact hours plus various other nursing-related activities. See website for further details
South Carolina – 30 contact hours every 2 years. May also show proof of competence by maintenance of certification by a national certifying body, completion of an academic program, or employer certification
Georgia – every 2 years, 5 different options – See State Board website
Florida – 24 contact hours of every 2 years: including 2 hours for medical errors, and 2 hours for FL Laws and Rules, 1 hour HIV/AIDS training (first renewal only), 2 additional hours of domestic violence CE every third renewal for a total of 26 hours
Besides these, it’s also important for a nurse to have extra key competencies, like work planning and scheduling, communicating, mentoring, problem identification, and team work. Some can take extra classes as a hobby to learn to speak with a partner or with a whole team, others learn public speaking to have a better flow with their patients and some even take up a new language to have an extra skill at work.
5. Where can you work as a nurse in America?
Once you get your NCLEX-RN license, you can start looking for your first job! You have two options: either look for a job in the public health system or in the private sector. Some of the most popular nursing jobs in the US are:
- Hospital nurses
- Office nurses which take care of patience at a doctor’s office or an outpatient clinic
- Public health nurse which works with individuals to improve health in a community
- Long-term care nurses who look after residents in assisted living facilities or nursing homes
How do you get a job in the public health system?
You can get a job within a public medical institution through a college or university. You can get teacher’s recommendations if you study a nurse program and you also specialize in public health, public policy, or health administration.
If not, you can look online for different jobs at public hospitals, clinics, schools or even NGOs, to name a few. You should also keep up with the American Public Health Association.
In the public health system you can work in a public hospital, but also a small clinic. There are benefits at a bigger hospital, more hours means more experience, but also more stress. At a clinic you have a slow raise, but you can have equilibrium between the professional and the personal. It all depends what you’re looking for.
How do you get a job in the private sector?
Private employment is a bit different from public health. The jobs come with perks, more benefits, but also more responsibilities, more hours put in and more anxiety. Of course, here also depends if you work at a hospital or a private clinic owned by one or a few doctors.
Most of the time, clinics, hospitals, or private offices display their available jobs on their website and wait for candidates to sign up with a resume. Available posts are also displayed on platforms with job advertisements. Among them, MEDIjobs centralizes available jobs for nurses in the country.
How do nurses work?
Nurses have different schedules available: full time jobs, part time schedules and can even work “per diem”:
- Full time nursing jobs offer stability once you have acquired experience. This means you work around or even over 40h/week in about 3 shifts of 12h each. You can grow in a position like this, but it takes a while. You are offered some bonus or payment for extra work, but it’s usually a fix salary type of job.
- Part time nursing jobs are great if you are also focusing on your personal life or if you want to continue your studies. It offers liberty to work in more than one place at a time for extra revenue. You can work at a hospital and then freelance the rest of your time – e.g. teaching, home care, volunteering.
- Last, but definitely not least, comes the “per diem” or “as needed” nursing shifts. In this type of job you don’t always have benefits as you are usually used as a substitute – e.g. sick calls or vacations, but you do get a higher paycheck. Your schedule varies from week to week, this one you can work full time, but the next ones you don’t work at all. It’s great if you don’t have a primary job or if you need more experience in a field while you study.
6. Responsibilities of a nurse
If you haven’t decided on what nursing subdomain to study, below are some of the most popular ones, each with a set of minim responsibilities to help you make up your mind. Nurses can practice in several medical subdomains, they’re not constrained like physicians, for example, that must complete their residency before work.
- Help the dentist prepare materials and make dental fillings.
- Prepare dental instruments, make them available to the dentist and sterilize medical instruments, prepare local anesthesia injections before extraction.
- Prepare materials for teeth and pass fingerprints, radiographs, to name a few, to the dental technician.
- Answer the phone, make client appointments and give advice on dental hygiene.
- Keep patients’ medical records and make sure the waiting room is clean.
- Organize the work space: specific activities necessary for medicine distribution, sanitary and pharmaceutical materials and supplies, cover the reception.
- Sell medicine, galenical products, and sanitary materials according to prescriptions and check medicines and pharmaceuticals’ end date.
- Verify that the release documents are properly filled with the physician’s signature and stamp.
- Recommend way to administer medicine as prescribed by the doctor and provide information on the side effects of the drug.
- Respect the current regulations on prevention, control and combat nosocomial infections, and participate in health education programs.
- Use and keep in good condition the pharmacy’s equipment.
- Respect the nurses’ code of ethics and deontology.
- Use the computer for official documents.
- Inform the patient about the radiology investigation, the risk of irradiation and the benefits of the examination.
- Do the radiological procedures only at the doctor’s advice and comply with the radiological safety rules.
- Check the state of the radiology service, the connection system, the status of the radiological cassettes, and the automatic washing machine for developing radiological films according to the rules.
- Supervise and maintain the patient’s position according to the radiologist’s indications. Operate the radiological device and take radiographs as prescribed by the doctor.
- Administer contrast agents if the radiological procedure requires it, making sure you know the patient’s reactions to different substances (e.g. allergies), possibly testing the substance before.
- Tell the radiologist any change in the patient’s evolution while at the lab.
- Wear protective equipment against radiation that will be changed whenever necessary and comply with hygiene rules. Tell the radiologist any irregularity in the equipment you are handling as soon as you see it.
- Schedule patients in correlation with the ophthalmologist’s schedule.
- Assist and give support for smooth medical services and update or archive medical documents (physically and electronically).
- Take part in the medical act with your doctor.
- Recommend patients eyewear frames and lenses according to the physician’s prescription.
- Prepare and sterilize medical instruments before you make them available to the doctor.
- Evacuate patients in critical situations (e.g. platforms, ships, road accidents) and lead them to the hospital.
- Get first aid and manage trauma.
- Stabilize medical and surgical emergencies, including cardiovascular and trauma.
- Update, along with the specialist doctor, reports for each patient.
- Assure the necessary medical equipment.
- Draw up lists of drugs and supplies you’ll need.
- Availability for helicopter flights.
- Availability for work 24h/7days a week.
- Take care of patients’ medical documents and make them available to the doctor in order of appointment or arrival taking into account urgent cases.
- Participate in consultations and treatment.
- Offer medical services in a non-discriminatory manner and with confidentiality.
- Preserve and sterilize medical instruments you work with.
- Keep and store properly biological materials.
- Comply with the cabinet’s internal rules.
- Carry out your work responsibly according to the professional regulations and job requirements.
- Meet and take care of the newly hospitalized patient and his or hers companion.
- Give first aid in emergencies and call the doctor.
- Take the patient for examination to the specialist and inform him about his condition from admission and throughout hospitalization.
- Observe the patient’s symptoms and condition, record them and inform the doctor.
- Prepare the patient and help the doctor perform investigation and treatment techniques.
- Prepare the patient for specific techniques, organize the patient’s transport and, if necessary, supervise his condition during transportation.
- Harvest biological products for laboratory examinations according to the doctor’s prescriptions and for B.K. in tuberculosis harvest patient’s sputum closely supervised.
- Administer medication personally; perform treatments, immunizations, biological tests, to name a few, as prescribed by the doctor, including strictly supervised treatment of tuberculosis.
- Prepare the patient for discharge.
- Use and maintain the equipment, supervise the collection of disposable materials and tools used and ensure that they are stored properly for destruction.
- Respect the current regulations on the prevention, control and fight against nosocomial infections.
- Investigate the type of infection and the pathogen together with the treating physician.
- Supervise and coordinate the activities of the subordinate staff.
- Use existing medical informatics applications in the department where you work.
Diabetes, nutrition and metabolic diseases nurse
- Help and assist the doctor when conducting medical consultations.
- Take into consideration patient’s medical records for personalized consultations; respect the confidentiality of the recorded data.
- Give first aid in case of emergency.
- Respond to customers promptly and inform the doctor about any request that relates to the medical care of the sick.
- Run food logs.
- Provide support to the specialist doctor in conducting their other activities.
Surgery is a complex specialization. There are two areas of activity regarding the work of a nurse:
- Welcome the patient in the operating block and identify the next procedures.
- Prepare the patient physically and mentally for surgery.
- Position the patient on the operating table (depending on the type of surgery and the surgeon’s instructions).
- Hand out sterile equipment.
- Assist the surgeon during the operation.
- Provide the doctor with the necessary tools during the wound intervention.
- Prepare the operating room and the instrument table.
- Help the surgeon to dress with sterile equipment.
- Assure the necessary materials during the intervention.
- Respect the rules for sterilization and the steps for preparing the tools to be washed.
- Follow the aseptic and antisepsis rules.
- Manage patient records.
- Fill in the documents and the registers.
- Enter information in the database.
- Apply medical treatments under the guidance of the doctor.
- Perform harvesting at the doctor’s indication, label the containers correctly, and check the referral ticket.
- Do ultrasounds.
- Take part in the consultation (e.g. first check-up, follow-up, sick people included in health programs).
- Complete the check-up documents (e.g. consultation sheet, medical checklist, medical recipe, special referral ticket).
- Add monthly reports to the statistical dossier.
- Define sterilization procedures for each item you use.
- Prepare soft material (e.g. pads, compresses) for sterilization.
- Pour the materials and instruments for sterilization.
- Prepare equipment, instruments and sterile material for interventions.
- Store consumables and tools in compliance with the rules.
- Lead the patient to the dialysis section.
- Prepare the patient physically and psychologically for dialysis.
- Take the patient’s hematological samples.
- Prepare the dialysis machine and mount the system to deplete the serum.
- Give the medication the doctor asked for to the patient.
- Weigh the patient before and after dialysis.
- Stabilize the dialysis catheter before and the fistula after the treatment.
- Supervise the patient by monitoring regularly heart rate during dialysis.
- Make sure the dialysis gets completed and the equipment is sterilized after each use.
- Prepare patients for doctor’s daily visits (consultation of hospitalized children).
- Monitor children’s health – fever and blood pressure.
- Take blood samples.
- Test antibiotics.
- Administer treatment.
- Join children at various other specialist consultations inside the clinic.
- Join and attend a physician with the radiology service.
Intensive therapy nurse
- Help and organize the pre-anesthetic consultation.
- Pre-anesthesia preparation of patients in the room: administer the medication at the advice of the anesthetist at the pre-anesthetic consultation.
- Harvest urine and blood for compatibility testing.
- Prepare the anesthesia machine: mount the tubing to the appliance, check the evaporator and the circuit.
- Prepare aspiration, check probe intubation, suction, laryngoscope, face masks, blood pressure meter, monitors, mandrel and bacterial filters.
- Prepare the anesthesia and perfusions.
- Mount the flex to a peripheral vein and dissolve the substances.
- Perform blood orders and derivatives; prepare the materials required for vascular catheterization and check for emergency medication.
- Participate in any anesthetic technique and other monitoring: mount the electrodes, the strain gauge, and the O2 sensor.
- Monitor blood pressure, pulse and saturation of O2 (5 minutes or more).
- Inject the substances for induction and assist your doctor in tracheal intubation.
- Ensure continuity of infusions; watch pupils, skin coloration, the amplitude of the respiratory movements, the diuresis.
- Administer blood transfusion and follow the post-transfusion reaction, reporting the occurrence of post-transfusion events immediately.
- Prepare substances to awaken the patient and take part in de-tubing maneuvers, carry the patient to intensive care or in the postoperative room following vital functions.
- Take into account the medication used for anesthesia and record the anesthetized patients.
- Prepare the materials and assist the physician in performing loco regional anesthesia techniques.
- Prepare laryngoscope and probes for emergencies.
- Receive interned and ambulatory patients, accommodate and inform them about the obligation to comply with the rules.
- Evaluate patients and, depending on the physiotherapeutic procedures prescribed by the physician, establish a recovery schedule.
- Monitor patients’ condition during physiotherapy and recovery procedures.
- Keep an eye on and record the patient’s status and inform the doctor of any changes.
- Inform and instruct the patient about the treatment they are taking, the therapeutic effects and the adverse effects that may occur.
- Apply special physical procedures for medical recovery, as prescribed by the doctor, and respond to the technical parameters of each procedure.
- Follow prescriptions made by the physician as the recovery program indicated.
- Record the procedures performed by the patient on the treatment files.
- Assure the maintenance and use of the equipment.
- Apply first aid in emergencies.
- Apply and respect the norms for prevention and control of nosocomial infections.
- Respect confidentiality and the ethics’ code of a medical physiotherapist.
- Respect work protocols and various instructions in the activity sector (e.g. treatment, dressing rooms, medical practices, sterilization).
- Ensure the application of hygiene rules and anti-epidemic measures to identify and neutralize diseases in sectors like cleaning, disinfection, protective equipment, hand hygiene and even food.
- Participate in epidemiological investigations in the event of an outbreak of nosocomial infections.
- You are part of the team in charge with cleaning bed linen and making sure cleaning materials are used properly.
- Check daily the cleanliness of sick rooms and sanitary facilities, storage areas and food corners.
Pathological anatomy nurse
- Take the materials from the hospital areas; check that the data on the analysis bulletins and on the container are correct.
- Verify the fixation of the histopathological parts you received.
- Prepare the instrument and the necessary materials to take the samples.
- Participate in the sampling of histopathological parts from patients and from other necropsies.
- Make sure the sampled pieces are dehydrated.
- Add paraffin to the parts; make the microtome section of the resulting blocks, as well as the coloring and mounting of the obtained sections.
- Prepare the necessary reagents and dyes, constantly checking their condition and changing them when they lose their chemical properties.
- Register, prepare, and archive the histopathological bulletin.
- Join the doctor and the autopsy specialist in the necropsy room.
- Clean, check and keep the equipment in good condition.
- Inform the coordinating assistant about any technical problems with the equipment.
- Respect safe work rules and regulations regarding prevention and control of nosocomial
Family medicine nurse
- Perform treatments under the doctor’s supervision at the clinic or at the patient’s home (e.g. intramuscular, intravenous, child and adult vaccination, patch wounds).
- Measure blood pressure and arterial pulse.
- Complete medical forms at the doctor’s indications.
- Participate in the preparation of monthly medical reports.
- Participate in the direct transmission of the reports to the authorities.
- Keep monthly records of sanitary materials and drugs used.
- Update patients’ medical records.
- Sterilize medical instruments under the supervision of the physician.
- Give first aid in case of emergency.
- Inform patients about the doctor’s schedule, how to conduct consultations, offer moral support to sick patients, create a pleasant atmosphere for them while waiting to be checked.
General medicine nurse
- Respect the hospital’s internal regulations.
- Welcome the patient and his attendant to the room.
- Inform the patient about hospital procedures and the obligation to keep up with internal rules.
- Give first aid in emergencies.
- Participate in ensuring an optimal and safe living environment.
- Identify issues and evaluate the results obtained during hospitalization.
- Evaluate patients with the doctor, record the symptoms and conditions.
- Prepare the patient, equipment and materials to help the doctor perform investigations or to offer treatment.
- Prepare the patient for special investigations and consultations, and when these take place outside the department, organize the transport and, if necessary, monitor the condition of the patient during transport.
- Take biological products to the laboratory for examination according to the physician’s prescription.
- Take care of the patients’ hygiene and supervise the nurse looking after patients’ care, like changing the bed linen and towels. In addition, meet patients’ physiological needs or change the position of the patient in bed.
- Observe the patient’s appetite and monitor the distribution of food according to the recommended diet.
- Perform treatments or tests according to medical prescriptions.
- Prepare tools and materials for sterilization.
- Respect the rules of handling and discharging of drugs.
- Prepare the patient for discharge.
- In case of death, do an inventory of the patient’s belongings, identify the body and secure his or her transport to the hospital’s morgue.
- Monitor the collection of materials and tools used.
- Protect the equipment provided.
- Respect the rules of prevention, control and fight against nosocomial infections.
- Assure hygiene, sanitary and safe conditions at work.
- Check and calibrate the devices at the beginning of the program and whenever it is needed, signal the dysfunctions occurring to the superior.
- Sterilize the material required for investigations.
- Prepare dyes and certain reagents for laboratory techniques. For bacteriological examinations inseminate according to the analyzed product and the type of bacteriological analysis. Prepare samples in a sterile environment, choose the instrument (e.g. pipette), and set the incubation parameters.
- Collect disposable materials and tools for destruction.
- Take charge of biological products for tests.
- Choose the specific harvesting tools.
- Identify the necessary data (e.g. patient’s personal data on the container with the physician’s prescription data, the product analyzed and the type of analysis).
- Prepare the patient physically and mentally for harvesting.
- Draw up biological products in hygienic and safe conditions for both you and the patient.
- Check the harvested product (e.g. everything is in order: technique, harvest time, storage temperature and transport).
- Prepare the biologically harvested product for analysis (e.g. centrifugation, homogenization, separation, dilution).
- Monitor analyzers.
- Record patient data, analysis requests, and draft bulletins.
- Store laboratory data on the computer.
- Perform laboratory techniques specific to the activity sectors. Observe the rules for storing and preserving laboratory reagents.
- Respond to the quality of the medical act and its effectiveness.
- Respect the current regulations on prevention and control of nosocomial infections.
Medical education nurse
- Take care of medical triage daily.
- Prepare reports.
- Prepare the harvesting tools; check the equipment needed for the investigation.
- Take biological samples and perform various medical procedures (e.g. EKG, audiometry) within the cabinet.
- Conduct doctor’s recommendation regarding treatment.
- Provide support in order to ensure good performance and avoid delays.
- Participate along the doctor in medical education classes.
ENT (ear, nose, throat) nurse
A medical assistant working in the ENT department may conduct several types of investigations, all of which are performed under the supervision of the specialist:
- Harvest it prior to the administration of antibiotics or sulfonamides.
- Wash hands, disinfects with alcohol and put a protective mask on.
- Open the tube with the pharyngeal swab, flame the neck of the tube and close it with a sterile plug.
- Ask the patient to open the mouth, then press the patient’s tongue with the spatula and inspect the back of the throat.
- With the instrument swab pharynx and tonsils, unclip a portion of fake membranes (when applicable).
- Flap the mouth of the tube and insert the pharyngeal swab into the tube that closes with a flapped plug.
- Put the product obtained on glass for analysis or on culture media in two tubes.
- Wash your hands with soap and water.
Prepare Product For Laboratory
- Transport the product to the laboratory avoiding contamination.
- If sowing at the patient’s bed is not possible, moist the pad with serum or 15% glycerol.
Nasal Secretion Analysis
- Analysis should be done in the morning.
- The patient is seated with his head back in forced extension.
- Inject an isotonic solution of sterile NaCl into the nasal passages with a 2-4 cm syringe. Proceed with the lavage one nostril at a time.
- The patient bends his head forward and lets the liquid drain into a sterile petri dish.
- Pass the liquid into tubes and send them to the lab.
- If the lab is late, place the product on ice.
Eyes Secretion Analysis
- The harvesting is done with a swab with the help of an otoscope from the external auditory canal.
- Give the patient a glass of water to rinse his mouth.
- Give the patient the collection vessel, depending on the required exam.
- Ask the patient to spit after coughing.
- Collect the morning spit or gathered from 24h.
Faringian And Laringian Mucus Analysis
- Wet the cotton swab with sterile distilled water.
- Press the tongue with the spatula, insert the swab into the pharynx and ask the patient to cough.
- Rub the spatula on a cotton swab and insert it immediately into a sterile tube.
- The analysis is done by the doctor with the swab under a laryngoscope.
Mucus Analysis Through Bronchial Wash
- It is used in patients with tuberculosis who can’t spit.
- Bacilli are encapsulated in the submucosa, which do not usually appear in the sputum.
- Place 5ml of physiological saline, or 4ml of 3% theophylline solution, with 1ml of strychnine solution 1/1000 in the aerosol container.
- The patient inhales several times through deep, repeated inspirations, followed by brief exhalations.
- Take a short pause of 4 or 5 seconds and repeat until the entire amount of liquid has gone.
- After the aspiration, the patient begins to cough even if he couldn’t.
- Sputum, spit or mucus is harvested in a sterile bowl, harvesting is repeated every 4 days, in separate dishes.
- Wash hands and put on sterile gloves.
- Check the temperature of the wash liquid and load the Guyon syringe.
- Ask the patient to open the mouth for easier extraction, pull the ear flap up and back with your left hand, inject the liquid to the bedside upper wall with the right hand and wait for the evacuation. The operation is repeated as needed.
- Get the external auditory line.
- The doctor checks the result of the wash by otoscope.
- Insert a cotton swab into the duct and place the patient in the dorsal decubitus for 30 or 60 minutes.
- To record the EKG motionless you have to place the electrodes, lubricate with gel and add them to the skin: on limbs the red goes on the right hand; the yellow on the left hand; the green on the left leg; the black – on the right leg.
- In the procedural area, you place:
- V1 – called parasternal right point located in IV intercostal space, on the right edge of the sternum
- V2 – the left parasternal point, located in IV intercostal space, on the left edge of the sternum
- V3 – located between points V2 and V4
- V4 – located in V intercostal space on the left medial clavicle
- V5 – located at the horizontal intersection of the V4 and the left anterior axillary line
- V6 – located at the intersection between the horizontal V4 and the middle axillary line.
- Record the EKG and take notes of the doctor’s interpretation.
- Record the EKG while exercising and inform the patient how the test is performed
Follow the procedures:
- Mount the electrodes
- Make a simple electrocardiogram
- Monitor the patient while he or she uses an ergonomic bicycle or walks fast on a carpet for 20-30 minutes
- during the effort, record the EKG and blood pressure
- Monitor the patient for any manifestation during the exam (e.g. pain, palpitations, respiratory distress)
School, College, University nurse
- Perform the annual medical examination of each student, indicating to the doctor what you found. Note down height, weight, thoracic perimeter, blood pressure, heart rate, manual muscle strength, pulmonary vital capacity.
- Data is interpreted on the basis of national standards; write the record of the results in the students’ charts.
- Help apply prescribed treatments by the family doctor to children with special issues.
- Write in their charts what treatment they have taken and the reason for medical absence or for school physical education classes’ dismissal.
- Complete, under the supervision of the physician, a monthly and an annual form with statistics on the activity of medical practices in the school.
- Offer family planning consultations, sexually transmitted disease prevention classes and take part in community’s health surveys.
- Register pupils and/or students undergoing vaccinations.
- Perform under the supervision of the physician the planned prophylactic immunizations, according to the National Immunization Program.
- Register vaccinations.
- Perform epidemiological triage for all pupils after each vacation.
- Take action to combat diseases in schools or higher education institutions.
- Control individual hygiene; work with the teaching staff to remedy deficiencies.
- Participate along the doctor to prepare food menus in compliance with nutrition rules.
- Keep records of the staff’s medical examinations.
- Perform, under the guidance of the doctor, health education classes for students, families and teachers, including first aid lessons and demonstrations.
- Accompany teams to competitions and offer emergency help.
- Take the newborn from the delivery room, give first aid in emergencies, and clean him or her following the rules.
- Easily maneuver all devices, help ensure optimum and safe newborn conditions.
- Identify newborn care issues, set priorities, develop and implement a care plan, and evaluate the results achieved throughout the process.
- Assess vitals like temperature, respiration, pulse, diuresis, nappies or vomiting.
- Harvest biological and pathological tests.
- Collect blood by puncture for biochemistry, hematology, serology, immunology, pharyngeal exudate, nasal exudate, ocular secretions, skin secretions, eyes secretions, urine summary.
- Administer medication according to the medical prescription.
- Administer blood infusions and transfusions according to medical prescriptions.
- Respond to newborn baby care in the room.
- Respond to newborn diet, supervise nursing, or offer formula.
- Monitor newborns in intensive care.
- Prepare the newborn examinations, organize transport and, if necessary, monitor condition during transport.
- Register in the procedure sheet all the techniques performed during your service.
- Prepare newborn for discharge. In case of death, identify the body according to the protocol and organize the transport to the place established by the hospital management.
- Participate along the physician at check-ups, note recommendations in the evolution sheet and hand it over to the next shift.
- Respect the work schedule and the nurses’ ethics code.
7. The hazards of being a nurse
A nurse’s job is a noble profession. They listen with patience and calm. They talk to angry patients, inspire trust and understand that all the actions they take are for the other’s benefit. Most of the time, it’s about teamwork, courage, dedication, and smiles. But there are also many challenges a nurse has to face and you can find some of them below.
In almost any section, nurses get exposed to dangerous infectious diseases like HIV, hepatitis B and C, tuberculosis, MRSA or other contagious infectious diseases, like a seasonal flu. For example, in the radiology and imaging sections, nurses get in contact with ionizing radiation, which predisposes them to the appearance of genetic mutations that can cause the evolution of several types of cancer, such as blood, breasts, thyroid gland or skin.
In laboratory and pathological anatomy sections, nurses come in contact with certain powders, reagents, aerosols or other dangerous substances. They can get chronic obstructive bronchopneumonia, professional bronchial asthma or other respiratory diseases. Of course, a nurse can avoid these risks if she or he uses the necessary protective equipment and takes all the safety measures recommended, like vaccination.
When a person needs medical care, they aren’t feeling good and are not polite. Most patients need a high level of empathy and simple communication. Patients want to make sure that the medical staff does their best to improve their condition or that of somebody they care about.
The caregiver’s mission is to be transparent and to inform patients and their families about all interventions which will take place. Also, the nurse has the role of providing a safety and judgment-free environment.
There are a lot of patients and not enough staff. This puts a lot of stress on nurses as they always have to give more to the clinic or the hospital. Each caregiver usually takes on more responsibilities than they should.
A medical staff member usually has to deal with a lot of sharp objects. Stress, anxiety to move fast and tiredness makes them prone to accidents. It is important to remember that occupational accidents can happen at any job, but you can avoid it with protective materials and by handling utensils in a correct way.
In conclusion, there are a lot of challenges in the nursing profession, but for each one there are also many solutions. Being a human-centered profession it’s important to communicate and report to others.
If you are a high school student or if you are thinking about making a career change and considering the nurse’s job, this information is for you. The article defines what is nursing, how to become a nurse, types of nurses, what nurses do and things every nurse should know before jumping in.
Take your time making a decision and analyze everything that this job entails, it is the most trusted profession for a reason. Whenever you want to give a career in nursing a shot, the health system needs dedicated and passionate people who want to maintain the well-being of the community. All the luck in the world making a difference!