Emerging Opportunities The traditional hospital setting shows the levels of nursing hierarchy are established.

The hierarch is shown below:

Director of nursing (anagers )taff *urses But since the mid-198 !s" this trend changed" there are fewer managers and additional clinical bedside nurse. Certification #t is the process by which a nongovernmental agency of association certifies that an individual licensed to practice a profession has met certain predetermined standards specified by that profession for practice. Fields of Specialization Critical care nurses are responsible for giving one-on-one care to critically ill patients and their families. Their wor$ life tends to be comple% and intense" re&uiring a high level of vigilance and advocacy. Cardiac nurses help patients who have heart problems. They have advanced $nowledge about how the heart wor$s and how speciali'ed treatment is given to a client" such as transplantation" heart pumps" and mechanical-assist devices. Medical/surgical nurses stay at the cutting edge of comple% care and treatment for patients who have a serious illness and aid them in the transitions from surgery to recovery to full health. Oncology nurses help patients who have or are at ris$ for cancer. They administer health care" and educate and counsel people about screening" prevention" and detection. Orthopedic nurses speciali'e in treating musculos$eletal issues in patients. They wor$ in a wide variety of settings and help with education" treatment" and rehabilitation. Primary care nurses provide the first line of contact for patients with the medical system. They typically administer routine care for common health problems on an outpatient basis.

Rehabilitation nurses assist patients recovering from an illness to full health through the process of rehabilitation. They provide healthcare" prevent complications" advocate" manage cases" counsel" and educate. Addiction nurses wor$ with patients suffering from addictions li$e alcoholism or drug abuse. They help with deto%ification" therapy" monitoring" and assessment. They help patients improve their mental health" behavior" and relationships. Perioperati e nurses help patients before" during" and after they undergo surgery. They assist doctors during surgery and advocate for the patient throughout the surgery process. Correctional nurses provide treatment for inmates in +ails and prisons. They serve as primary clinical care providers" but have speciali'ed $nowledge of how to deal with dangerous patients or those suffering from issues related to prison life. Emergency nurses &uic$ly assess and treat severely ill patients in a stressful emergency room setting where every second counts. They have a broad range of $nowledge and can thin$,act &uic$ly on their feet. !eriatric nurses provide medical assistance for the elderly. They speciali'e in issues of aging and end-of-life" and serve as advocates for elderly people and their families. This is currently a high-demand specialty area" as much of the -.). population is aging. Occupational health nurses help treat and prevent +ob-related illnesses and in+uries. They help businesses and other places of employment maintain satisfactory levels of health and safety in the wor$place. "ospice nurses focus on end-of-life care for terminally ill patients" usually in a home environment. They help the dying and their families come to terms with the illness" treat symptoms" and provide the best medical treatment possible for a specific individual. #ephrology nurses treat people with $idney problems" particularly $idney disease stemming from hypertension" substance abuse" or diabetes. They are educated in the diagnosis" treatment" and education of these issues. #eonatal nurses wor$ with mothers and their newborn babies from the time they are born up until .8 days of age. They have speciali'ed $nowledge about how to care for new mothers and newborn infants. Pediatric nurses speciali'e in providing medical treatment to children and adolescents. They understand how to tal$ with" relate to" and help this age group" and deal with the health problems and illnesses related to them. Respiratory nurses help people with breathing problems li$e asthma" cystic fibrosis" or tuberculosis. They are trained in how to diagnose problems" provide palliative treatment" and reduce pain and breathing difficulties. School nurses help students learn by promoting health and safety in the school and home environments. They provide health services" coordinate school health programs" treat students" and educate school populations about wellness issues.

E$panded Roles of #urses

/The functions of a nurse that are not specified in the traditional limits of nursing practice legislation.0 1.1dvanced practice nurses /1dvanced practice nurses must be master!s or doctorally prepared. 2ritical reflective thin$ing" self-directed learning" and leadership s$ills are mandated e%pectations for health-care providers in the .1st century.0-1merican 1ssociation of 2olleges of *ursing %ound& Ostomy& Continence #urse Specialist: 2ertification: 3nterostomal therapy nursing education program 43T*356 changed to be a bachelor!s degree with a ma+or in nursing 1side from ostomies" the nurses could include s$in care" management of draining wounds and fistulas" pressure sores" and incontinence. Flight #ursing' nurses who are riding in helicopters and other air transportation which is called an air ambulance. 2ertification: 5ediatric advanced life support 4517)6" 1dvanced cardiac life support 4127)6" neonatal resuscitation program 4*586" strong 3mergency 8oom bac$ground There is the need for technical s$ills to practice flight nursing" such as patient intubation" 39: interpretation" intravenous and chest tube insertion" medication administration" etc. Certified Registered #urse Anesthetist' #t is an advanced practice nurse specialty re&uiring the graduate to obtain a master!s degree. 2ertification: Bachelor!s of science in nursing and at least 1 year of acute care nursing The 28*1 needs to ta$e care of the patient!s anesthesia needs before" during and after surgery or other procedures alone or in con+unction with other health care professionals. Certified #urse'Mid(ife 2ertification: there are more than ; basic nurse-midwifery educational programs" most offering master!s degree while some with a certificate They are allowed to practice in a variety of settings including" hospitals" homes and birthing centers providing care for women throughout the childbearing cycle as well as postpartum. Clinical #urse Specialist' 3ducators first developed the 2*) role because of their concern for improving nursing care. 2ertification: 8egistered nurses with advanced nursing degrees" master!s degree or doctorate" who are e%perts in a speciali'ed area of clinical practice. They are primarily hospital based" practicing in secondary and tertiary care inpatient settings and serving as a consultant in addressing issues in patient care and health care systems. 3ssential 2*) competencies: <

 developing an in-depth $nowledge base demonstrating clinical e%pertise in a selected area of clinical practice serving as a role model serving as a practitioner,teacher" consultant" teacher #urse Practioner -an advanced practice nurse who has education beyond the bachelor!s degree in clinical specialty area strongly focused on primary care" though some subspecialties are hospital based. 2ertification: They have received speciali'ed training 4most often at the master!s level6 in diagnosing and treating illnesses and providing health care maintenance. They have been legally and financially dependent on physicians for their +obs but some wor$ independently. ..*urse 3ducator 5rofessional 8oles of *urse 3ducator 3ducation 2linical )upervision 8ole model and mentor 2ontinuing education 8esearch <.*urse 8esearcher The nurse researcher investigates problems to improve nursing and further define and e%pand the cope of nursing practice. The nurse researcher may be employed in an academic setting" hospital or an independent professional or community service agency. The nurse researcher assists with collecting data in the field of health and medical care. The nurse may review the data and provide information on the results. The researcher plays a significant role in helping doctors and scientists understand the complications of medical conditions. ;.*urse 1uthors Their goals are to: 5romote literary e%cellence in nursing= 3ncourage authorship and writing for" by and about nurses and nursing e%periences= 3ducate patients and nurses through fiction and nonfiction= and )upport and encourage other nurse authors and those who want to write

)A*A#C+#! PERSO#A* A#, PROFESS+O#A* #EE,S >ealth is a comple% and dynamic state of being. 1 healthy person must balance various aspects in life to achieve and maintain good health. ?hen one area of life is affected" general health" is also affected. >ealth has been divided into the following elements: physical health" intellectual health" emotional health" professional health" social ;

health and spiritual health. Physical "ealth *utrition (aintaining good nutrition is often a difficult tas$. @inding the time and motivation to eat a nutritious diet in our fast-paced world is not easy" but it is when we eat properly" then we will feel better and perform tas$s at a higher level. Benefits of 3%ercise @ollowing nutritional guidelines is not enough to maintain physical health. Daily e%ercise is another essential ingredient for healthy living. 3%ercise provides many benefits such as improving cardiovascular function by lowering cholesterol and blood pressure and strengthening heart muscle. #t can boost the immune response to disease. )leep #t is not uncommon for nurses to sleep less than eight hours per night. *urses who wor$ nights may find it especially difficult to sleep for an uninterrupted bloc$ of time. *urses who are constantly changing shifts are more susceptible to sleep deprivation. 5hysicians" family members and critically ill patients place heavy demands on nurses. +ntellectual "ealth #ntellectual 1cuity #t is important to find some activity outside nursing that is of interest. 7i$e shopping" reading" painting" photography" and so on. Developing a new hobby to $eep your mind sharp by staying abreast of developments within your interest area. 5ersonal @inancial 5lanning #dentify your annual salary then identify how many percent of your salary you want to save for the future. )aving up for a home" your children!s education and even retirement 4)ocial security" 3mployee retirement funds" etc.6

Emotional "ealth Aur emotions e%press how we are feeling about an event. Aur challenge as a human being is to ac$nowledge the emotion and then respond appropriately. #t is important to have balance between our thought processes and the emotion we are feeling. 2ontrolling our anger and learn to laugh is a way for us to have a good emotional health. B

Social "ealth 8elationships give meaning to our lives. The essence of social health is interacting with other people. ?e strive toward harmony in all relationships. #t is human nature to see$ out others and grow in relationships. Spiritual "ealth )piritual health is to find strength within. The strength results from a connection with a higher being or power. #t is through our spirituality that we find meaning in life. %ays to Maintain Professional "ealth )ee$ out others within the health care field. @ind a more e%perienced nurse you can relate to or who can act as a mentor" who can provide guidance and support when problems arise. 9eep in touch with other nurses because you can learn things from them. 8ead as often as possible because learning is unending.

Occupational "azards Common among #urses The ma+or infectious agents are >#C" herpes" tuberculosis and hepatitis. *eedlestic$ in+uries account for about 8 -9 D of the transmission of infectious diseases among health care wor$ers. The importance of a good environment for the wor$place is vital because it can lead to health problems if there is a failure of having a healthy environment.