Best Careers 2009: Registered Nurse

US News

Overview. There's great unmet demand for nurses, and you'll have lots of options. If you want to work directly with patients, you can specialize in everything from neonatology to hospice care. You can work in a hospital, a doctor's office, or a patient's home. Outside of patient care, options range from nurse informatics (helping nurses get access to computerized information) to legal nurse consulting (helping lawyers assess a claim's validity.)

On the downside, many registered nurses must work nights and weekends, and burnout is a factor, especially in medical/surgical wards, and in critical-care specialties such as surgery, oncology, and emergency medicine. There are potential hazards, too: exposure to people with communicable diseases and back injuries from moving patients.

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Something to think about: Studies report large numbers of errors by healthcare providers that endanger or kill patients. This is a career for people who are both caring and extremely attentive to detail -- even when stressed.

A Day in the Life. You report to the nurses' station in Ward 3, a general medical/surgical ward. You are a generalist at a community hospital, so you'll see a wide range of patients, although you have specialist nurses and physicians to call on if you're not sure what to do.

Your first patient is having a lot of pain. Following the orders on the doctor's chart, you alter the medication, carefully noting the change on the bedside records. Your next patient needs to go on a dialysis machine. You assiduously follow the required procedures, carefully, to avoid mistakes. At the same time, you make sure to give the patient some TLC.

Next, a patient is wheeled up from surgery. You check her vital signs and other indicators, which reveal that she's doing OK. So, you hook her up to the appropriate monitors and insert an IV, double-checking that the medication is correct.

Your next patient had surgery two days ago and now needs to have his dressing changed and tubes drained. It's uncomfortable for him, but you're both fast and gentle, with a reassuring manner that makes the process easier.

After a couple of hours of routine monitoring of your eight patients, you meet with a patient who is about to be discharged. You teach him how to self-administer medications and you highlight problems to watch out for, handing him emergency phone numbers just in case.

Smart Specialties

Nurse practitioner. Like a physician's assistant, you'll typically provide most of the direct patient care normally handled by a physician. Training is shorter than for physicians, there's less paperwork, and you're likely to work with healthier patients -- which means a high success rate.

Nurse anesthetist. With anesthesiologists often earning $300,000 a year, healthcare providers are increasingly looking to nurse anesthetists to lower costs. You're usually the last person to see a patient before surgery and help ensure a pain-free surgery and after-surgery experience. The job can be stressful, but the high demand (especially in rural and inner-city hospitals ), high pay (average is well over $100,000), and high psychological reward make this a smart specialty indeed.

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Salary Data

Median (with eight years in the field): $60,200

25th to 75th percentile (with eight or more years of experience): $54,500-$76,100

(Data provided by PayScale.com)

Training

A two-year hospital or community college-based program will earn an R.N., but a bachelor's degree in nursing opens many more doors. A master's in nursing prepares you for broader careers such as nurse practitioner, nurse anesthetist, nurse midwife, and nurse supervisor. The American Association of Colleges of Nursing publishes a list of bachelor's and graduate R.N. training programs. For two-year associate of science degree programs, see your local community colleges. Discovernursing.com issues a list of nursing programs without a waiting list.

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