Certified Nursing Assistant Training Laramie WY
Full-Time In-State Tuition Costs : $2820
Full-Time Non-Resident Tuition Costs : $10230
Type of Institution : University
Institutional Designation : Public—State
Full-Time In-State Tuition Costs : $1560
Full-Time Non-Resident Tuition Costs : $4680
Type of Institution : Two-Year college
Institutional Designation : Public—District
# of Undergrads
Rock Springs, WY
Full-Time In-State Tuition Costs : $1916
Full-Time Non-Resident Tuition Costs : $5040
Type of Institution : Two-Year college
Institutional Designation : Public—State and Local
Types of Nurses
The International Council of Nurses defines the nursing career as encompassing "autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles."
Types of nurses include registered Nurses (RN), who are college educated, with one of the following: a 4-year Bachelor of Science in Nursing (BSN); an "accelerated" one to two year second baccalaureate degree (BSN); or a 2-year Associate Degree in Nursing (ADN). Sometimes BSNs are called "Registered Professional Nurses" and ADNs are called "Registered Technical Nurses." Today, nurses are increasingly prepared with collegiate bachelors, masters, and doctoral degrees. National statistics show that ADNs, though they make up about half of all nurses in the U.S., rarely advance their education and rarely hold positions above staff level. Therefore, a BSN is considered the best basic nursing preparation upon which to build a rewarding career.
Advanced Practice Nurses (APN) include several types: nurse practitioners (NP), a BSN with a master's degree; certified Nurse midwives (CNM), a BSN with a master's degree; certified Nurse Anesthetists (CRNA), a BSN with a master's degree; Clinical Nurse Specialists (CNS), a BSN with a master's degree; Clinical Nurse Leader (CNL), a BSN with a master's degree. In 2004, the number of RNs prepared to practice in at least one advanced practice role was estimated to be 240,461, or 8.3 percent of the total RN population. 51 percent are NPs, 24 percent are CNSs, 13 percent are CRNAs, 4 percent are CNMs, and 8 percent are combinations of two or more specialties.
Hospital Nursing Specialties
Many hospital specialties are available for RNs and advanced practice nurses. Typical hospital work may also occur at other sites, usually in community or long-term care. Advanced practice nurses providing hospital care include clinical nurse specialists, acute care NPs, and nurse anesthetists. Critical care nurses provide critical/intensive care in hospitals; patients most often have cardiovascular, respiratory, or pulmonary failure. Emergency/trauma nurses provide emergency care for life-threatening conditions due to accidents, heart attacks and strokes. Emergency nurses most often work in hospitals, in the military, or in emergency transit, such as flight nurses. Medical-surgical nurses are the most numerous; they care for a variety of patients in hospitals, clinics, home care, and nursing homes. Nurse anesthetists are advanced practice nurses who manage anesthesia for patients undergoing surgery. Perianesthesia nurses work during surgery to care for patients under anesthesia. Perioperative nurses work inside operating rooms to assist surgeons in a variety of surgical specialties. Psychiatric nurses work with patients in hospitals and community settings who have personality and mood disorders. Radiologic nurses care for patients undergoing ultrasounds, magnetic resonance imaging, and other radiologic procedures. Rehabilitation nurses take care of patients with disabilities due to a variety of events, such as hip replacement surgery, stroke and traumatic brain injury. Transplant nurses provide care for patients receiving transplants and their living donors. Nurse administrators are employed by health care facilities to supervise and manage nursing staff, maintain employee work schedules and budgets, and oversee supply inventories.
Addictions nurses care for people with alcohol, drug and tobacco addictions. Developmental disabilities nurses work with disabled people challenged by ongoing physical, mental or behavioral disabilities. Nurses may help with activities of daily living, including feeding, elimination and mobility. Diabetes management nurses work with diabetic people to teaching self-care, including nutrition, exercise, blood sugar testing, and medication and insulin administration. HIV/AIDS nurses take care of patients with HIV and AIDS. Oncology nurses work with patients and families facing many varieties of cancer and the associated radiation and chemotherapies. Wound, ostomy and continence nurses care for patients with wounds from injury, disease or surgery; care for people with surgical openings for elimination of bodily wastes; and care for patients disabled by bowel and bladder incontinence.
Community and public health care
Home health care nurses provide real or virtual visits to patients at home and support family caregivers. Patients who have insurance reimbursement for home care RN visits are most usually recovering from surgery, accidents and childbirth. Medicare reimburses home care for a period of time after a hospitalization for severe medical illness, such as congestive heart failure. Positions in home health care are predicted to rise due to the growing numbers of elderly and infirm persons with Medicare coverage. Because of the independent nature of this work, and the growing number of complex procedures performed in the home, RNs are usually required to have a year or two of work experience in a general medical-surgical floor of a hospital before employment in home health care by Visiting Nurses Services. Home health care nurses will work most usually for a nonprofit agency that provides home care subsequent to a physician's order. Public health nurses work in publicly-funded city or county health departments to provide health screening, patient education, and infectious disease control. For example, public health nurses may be in charge of screening for tuberculosis or sexually transmitted diseases and providing treatment and patient education as needed.
Positions in outpatient practice (such as private offices and public clinics) are available for RNs and for advanced practice nurses. RNs most usually work with a physician or NP to initiate care when a patient comes in to the office to triage or determine the need for immediate care, and to provide patient education. Some RNs provide patient support by telephone rather than face to face. This is especially common in pediatric offices and in some health maintenance organizations where patients are encouraged to phone for advice that may prevent or delay the need for face-to-face care. Nurses in outpatient practice, self-employed or employed by physicians, may specialize in many areas, as follows. Cardiac and vascular nurses care for patients with heart disease and heart surgery. They may be involved with postoperative rehabilitation which commonly involves blood pressure, activity, and diet monitoring. Dermatology nurses focus on patients with skin diseases and skin cancer. Gastroenterology nurses care for people with diseases of the stomach and intestines, such as gastro-esophageal reflux and inflammatory bowel syndrome. Nurses may become skilled in a variety of endoscopic procedures to examine the inside of the gastrointestinal tract with special equipment. Gynecology nurses care for women with reproductive system problems, such as cancer and sexually transmitted diseases. Nurse midwives are advanced practice nurses who care for childbearing women during the pre-conception, prenatal, intrapartum and postpartum periods. Nephrology nurses focus on patients with kidney disease. Neuroscience nurses work with patients with nervous system problems, such as seizures and spinal cord injuries. Ophthalmic nurses care for patients with eye disorders and eye surgery. Orthopedic nurses focus on patients with muscular and skeletal problems, including sports injuries and fractures, arthritis, and joint replacement. Ear-nose-throat nurses provide care for patients with ear, nose and throat problems, including allergies, infections, and congenital defects. Respiratory nurses work with patients who have respiratory problems such as asthma, chronic obstructive pulmonary disease (related to smoking), and cystic fibrosis. Urology nurses focus on patients with kidney and urinary tract problems, as well as problems with male reproductive organs. Genetics nurses work with patients and families to educate them as to available screening for genetic disease and to treat people with genetic disorders, including sickle cell disease and cystic fibrosis.
Nurse practitioners work as primary and specialty care providers in outpatient settings such as private offices and public clinics. NPs provide health promotion and disease prevention services, and care for people with acute and chronic diseases. NPs may provide periodic examinations and lab work to screen for common illnesses, such as hypertension and diabetes, and may manage the care for these common chronic illnesses. Many NPs work with vulnerable populations in nonprofit or publicly-funded clinics in medically underserved areas. There is a great need for bilingual NPs in many areas of the U.S. NPs may specialize in family practice, adult practice, women's health, pediatrics, acute care (adult, pediatric and neonatal), gerontology, mental health and many other sub-specialties. NPs can prescribe medications in all 50 states.
Nursing homes and extended care specialties
RNs in nursing homes and extended care often are the most knowledgeable professionals on site; they supervise aides and LPNs providing direct care. They may be the top administrator in charge of the facility. Positions for RNs in nursing homes and extended care are expected to grow quite rapidly due to increasing numbers of elderly in the U.S. who are no longer able to live in their own homes. In addition, nursing homes provide rehabilitation many times for patients discharged after a brief hospital stay for hip replacement surgery and the like. Furthermore, specialized rehabilitation in nursing homes for stroke and head injury, as well as Alzheimer's and dementia patients, is expected to increase. Assisted living facilities are becoming more prevalent; many of these are adjacent to a nursing home where patients may move when their independence declines. Many times, RNs and NPs play a large role in health promotion and assessment on site.
Nurses with advanced degrees teach at college and university levels. Some nurse educators teach continuing education or orientation within hospitals. They may teach topics in general or specialty nursing. In addition, those in universities usually are expected to publish articles and develop research projects with funding from government or private foundations. Nursing faculty positions vary according to the resources of the institution. Because some universities are associated with large health science centers, clinical teaching opportunities are on campus. However, many nursing schools are in universities without a medical school or health science center. In these schools, the clinical teaching may be widespread about the community hospitals and health care system.
In general, nursing education is very demanding due to relatively low salaries and large responsibilities in classroom and clinical teaching as well as university and professional service and the expectation to bring in funding for research. These realities have led to a growing shortage of nursing faculty across the country. Nurses who enjoy teaching and who appreciate the self-determined schedule of academia may thrive in the role.
Nurses work in other settings, including schools, industry, informatics, and a variety of businesses related to health care. School nurses work to ensure that students have required immunizations and health screenings. They may also provide first aid and administer daily medications to students. NPs may manage school-based clinics in many districts. These clinics often provide routine care to students and their families.
Occupational health nurses work inside businesses to treat job-related injuries and illnesses. They work within the Human Resources department at the worksite. They also work to prevent accidents by detecting workplace hazards and ensuring health and safety standards. Many occupational health nurses provide health education and health promotion to employees. Similarly, nurses may work in related facilities, such as correctional institutions, summer camps and the military.
Holistic nurses care for people who desire alternative care, such as acupuncture, massage and aroma therapy, and biofeedback. Holistic care is meant to encompass mental, spiritual and physical health. It is usually provided in office settings.
Case managers are nurses who are employed in a variety of sites, inside or outside hospitals to work with patients and their care givers to coordinate care from various sources. Case managers may work within the hospital to facilitate discharge planning and follow up care. Or, they may work in specialty areas, such as HIV or substance abuse care in the community health center. Forensics nurses work in the community bring nursing skills to law enforcement in order to both treat and investigate victims of sexual assault, child abuse, or accidental death. They may work within an emergency room or in a law enforcement agency. Infection control nurses are employed by healthcare facilities to investigate and prevent infectious outbreaks and to prepare to respond to biological terrorism. Most large hospitals now have infection control nurses.
Legal nurse consultants may be self-employed or employed by lawyers to gather evidence from patients, witnesses, and medical and billing records for medical cases. Nurse informaticists are employed by healthcare facilities or information technology companies to arrange for the collection, and analysis of healthcare data. More and more hospitals and ambulatory offices are looking for skilled nurse informaticists to facilitate the documentation of care to examine its quality and to contain costs. RNs also may be employed by a wide variety of agencies to work as private consultants, public policy advisors, pharmaceutical researchers and salespersons, and medical writers and editors.
Some nurses manage health care businesses in ambulatory, acute, home-based and chronic care. RNs and advanced practice nurses are in demand by employers in hospitals, insurance and pharmaceutical companies. RNs working in these business arenas may have responsibilities in many areas, including planning, marketing, policy development, quality assurance, and research. For example, an experienced RN may be hired by a pharmaceutical company to manage a research study regarding safety and effectiveness of a new drug. Or, an RN with several years' experience may work with a health insurance company or hospital to study "best practices" in health care and to train others to implement them to improve the quality of care provided.