Registered Nurses

Career summary

#No alternate titles CJ

Most registered nurses (RNs) work as part of a team that includes doctors and therapists. Registered nurses work in a variety of settings.

Hospital nurses

Hospital nurses observe patients and carry out medical treatments. They use computerized equipment to monitor patients' vital signs and record observations and other medical data in patients' charts. Nurses may write and manage patient care plans. They explain to patients how to continue treatment after they go home.

Office nurses

Office nurses prepare patients for exams and check vital signs. They assist doctors with exams when requested. They draw blood and give injections. Office nurses may also perform routine lab tests and office work.

Public health nurses

Public health nurses work in community settings to provide health care and first aid. They give shots and screenings such as blood pressure tests. Public health nurses develop and provide health education programs on topics such as nutrition and child care. In addition, they refer patients to community agencies and other health care providers

Nursing care facility nurses

Nursing care facility nurses manage the health care of residents. They write care plans and supervise licensed practical nurses (LPNs).

Home health nurses

Home health nurses provide prescribed nursing care to patients in their own homes. They also instruct patients and their families how to perform necessary procedures.

Additional specialties

Registered nurses can also specialize in:

• Addiction nursing
• Cardiovascular nursing
• Critical care nursing
• Neonatology
• Rehabilitation
• Genetics
• School nursing

With additional education, registered nurses can also work as nurse anesthetists, nurse practitioners, and nurse midwives.

Related careers

This career is part of the Health Science cluster of careers.

Related careers include:

• Cardiovascular Technologists and Technicians
• Emergency Medical Technicians
• Licensed Practical Nurses
• Medical Assistants
• Medical Sonographers
• Nurse Anesthetists
• Nurse Midwives
• Nurse Practitioners
• Nursing Assistants
• Physician Assistants
• Psychiatric Technicians

Military careers

• Registered Nurses

Job duties

Task list

The following list of tasks is specific to registered nurses.

• Maintain accurate reports and records.
• Observe patients. Monitor vital signs using computerized equipment.
• Record patients' medical information, vital signs, and progress.
• Write and manage care plans for patients.
• Discuss cases with doctors and other medical staff.
• Monitor patient's reaction to anesthesia.
• Deliver infants and provide prenatal care under doctor's supervision.
• Evaluate tests to assess patient's condition.
• Monitor patient care.
• Supervise licensed practical nurses and aides.
• Prepare patients and assist with exams.
• Observe nurses and visit patients. Make sure proper nursing care is provided.
• Give patients treatments and medications.
• Provide health care, first aid, and shots in schools, clinics, and community agencies.
• Visit patients' home and work to identify health or safety problems.
• Develop health programs. Teach the public about topics such as health education, disease prevention, child care, and nutrition.
• Perform routine laboratory and office work.
• Examine patients on the way to the hospital or at disaster sites.
• Prepare rooms, sterile instruments, equipment, and supplies. Hand items to surgeons.
• Prescribe or recommend medications and treatments.

Common work activities

Registered nurses perform the following tasks. These tasks are common to many careers.

• Assist and care for others
• Document and record information
• Get information needed to do the job
• Make decisions and solve problems
• Update and use job-related knowledge
• Organize, plan, and prioritize work
• Communicate with supervisors, peers, or subordinates
• Identify objects, actions, and events
• Perform for or work with the public
• Monitor events, materials, and surroundings
• Evaluate information against standards
• Use computers
• Explain the meaning of information to others
• Establish and maintain relationships
• Teach others
• Process information
• Inspect equipment, structures, or materials
• Judge the value of objects, services, or people
• Develop and build teams
• Coordinate the work and activities of others
• Communicate with people outside the organization
• Coach others
• Resolve conflicts and negotiate with others
• Perform administrative tasks
• Think creatively
• Guide, direct, and motivate others
• Analyze data or information
• Perform activities that use the whole body
• Provide advice and consultation to others
• Estimate sizes, quantities, time, cost, or materials needed
• Develop goals and strategies
• Handle and move objects

Work requirements

Working conditions

In a typical work setting, registered nurses:

Interpersonal relationships

• Have a high level of social contact. They work closely with patients.
• Often deal with angry or unpleasant patients.
• Are responsible for the health and safety of patients.
• Are often placed in conflict situations.
• May be responsible for the work outcomes of practical nurses and aides.
• Communicate with coworkers and patients daily by telephone or in person.
• Work in a group or as part of a team.
• Communicate with coworkers and patients by e-mail or letters on a weekly basis.

Physical work conditions

• Are exposed to diseases or infections on a daily basis. Always wear masks or rubber gloves to protect themselves and their patients from disease.
• Usually work indoors.
• Work very near patients and doctors. They come into physical contact with patients throughout the day.
• Usually wear a uniform or lab jacket.

Work performance

• Must be very exact in their work. Errors could seriously endanger the health and safety of patients.
• Repeat the same tasks over and over, such as recording patients' medical information.
• Make decisions on a daily basis that strongly impact patients. They rarely consult doctors before making a decision.
• Are usually able to set their tasks for the day without consulting with a doctor.
• Must meet strict deadlines on a daily basis.

Hours/travel

• Generally have a set schedule each week.
• May work part time or full time, but most work 40 hours a week.
• May work nights, weekends, and holidays, especially in hospitals or nursing homes.
• May be on-call to work on short notice.

Physical demands

Registered nurses frequently:

• Stand for long periods of time.
• Use their hands to handle, control, or feel objects, tools, or controls.
• Walk or run for long periods of time.
• Bend or twist their body.

It is important for registered nurses to be able to:

• Understand the speech of another person.
• Speak clearly so listeners can understand.
• See details of objects that are less than a few feet away.
• Use stomach and lower back muscles to support the body for long periods without getting tired.
• See details of objects that are more than a few feet away.
• Be physically active for long periods without getting tired or out of breath.
• Hold the arm and hand in one position or hold the hand steady while moving the arm.
• Use one or two hands to grasp, move, or assemble objects.
• Use fingers to grasp, move, or assemble very small objects.

It is not as important, but still necessary, for registered nurses to be able to:

• See differences between colors, shades, and brightness.
• Focus on one source of sound and ignore others.
• Use muscles to lift, push, pull, or carry heavy objects.
• Bend, stretch, twist, or reach out.
• Move two or more limbs together (for example, two arms, two legs, or one leg and one arm) while remaining in place.
• Hear sounds and recognize the difference between them.
• Make quick, precise adjustments to machine controls.
• Choose quickly and correctly among various movements when responding to different signals.
• Coordinate movement of several parts of the body, such as arms and legs, while the body is moving.
• Determine the distance between objects.
• React quickly using hands, fingers, or feet.
• Move arms and legs quickly.
• Use muscles for extended periods without getting tired.

Skills and abilities

Registered nurses need to:

Communicate

• Speak clearly so listeners can understand.
• Understand spoken information.
• Listen to others and ask questions.
• Understand written information.
• Read and understand work-related materials.
• Write clearly so other people can understand.

Reason and problem solve

• Notice when something is wrong or is likely to go wrong.
• Use reasoning to discover answers to problems.
• Combine several pieces of information and draw conclusions.
• Analyze ideas and use logic to determine their strengths and weaknesses.
• Follow guidelines to arrange objects or actions in a certain order.
• Judge the costs and benefits of a possible action.
• Recognize the nature of a problem.
• Understand new information or materials by studying and working with them.
• Develop rules that group items in various ways.
• Concentrate and not be distracted while performing a task.
• Remember information such as words, numbers, pictures, and procedures.
• Think of new ideas about a topic.

Manage oneself, people, time, and things

• Check how well one is learning or doing something.
• Manage the time of self and others.
• Go back and forth between two or more activities or sources of information without becoming confused.

Work with people

• Be aware of others' reactions and understand the possible causes.
• Look for ways to help people.
• Change behavior in relation to others' actions.
• Teach others how to do something.
• Use several methods to learn or teach new things.
• Persuade others to approach things differently.

Perceive and visualize

• Identify a pattern (a figure, object, word, or sound) that is hidden in distracting material.
• Quickly and accurately compare letters, numbers, objects, pictures, or patterns.

Education and training

Educational programs

The programs of study listed below will help you prepare for the occupation or career cluster you are exploring.

Programs of study directly related to this occupation

• Advanced Nursing
• Registered Nursing

Other programs of study to consider

• Anatomy
• Emergency Medical Care
• Gerontology
• Midwifery
• Nurse Anesthetist
• Nurse Midwifery
• Nurse Practitioner
• Nursing Education
• Pre-Nursing

Training

To work as a registered nurse, you typically need to:

• have a high school diploma or equivalent;
• graduate from a nursing program;
• complete supervised clinical work experience; and
• have a license.

Education after high school

There are three training options for registered nurses. One, you can earn an associate degree in nursing (AND). Community and two-year colleges offer these two-year programs. Two, you can earn a bachelor's of science degree in nursing (BSN). Colleges and universities offer these four-year programs. Three, you can earn a diploma. Hospitals offer these two to three year programs.

In general, graduates of any of the three types of programs qualify for entry-level positions. However, you must also pass national and state exams. Nurses who have a bachelor's degree have more options for jobs.

As a nursing student, you study anatomy, physiology, and chemistry. Near the end of training you complete a supervised work experience in a hospital. During your clinical work experience you work in several hospital departments, such as surgery, emergency, and pediatrics.

Work experience

You can volunteer in a nursing home or other medical setting to get experience.

On-the-job training

New registered nurses generally receive some training on the job. Training varies by employer, but often lasts up to six months.

Military training

Some branches of the military offer training in nursing specialties to people who are already licensed as a registered nurse. Training lasts 14 to 27 weeks, depending on your specialty. Additional training occurs on the job.

Helpful high school courses

In high school, take classes that prepare you for college. A college preparatory curriculum may be different from your state's graduation requirements.

You should also consider taking some advanced courses in high school. This includes Advanced Placement (AP) and International Baccalaureate (IB) courses if they are available in your school. If you do well in these courses, you may receive college credit for them. Advanced courses can also strengthen your college application.

Helpful electives to take in high school that prepare you for this career include:

• Anatomy and Physiology
• Computer Applications
• Health Education
• Introduction to Health Care
• Nursing
• Safety and First Aid

The courses listed above are meant to help you create your high school plan. If you have not already done so, talk to a school counselor or parent about the courses you are considering taking.

You should also check with a teacher or counselor to see if work-based learning opportunities are available in your school and community. These might include field trips, job shadowing, internships, and actual work experience. The goal of these activities is to help you connect your school experiences with real-life work.

Join some groups, try some hobbies, or volunteer with an organization that interests you. By participating in activities you can have fun, make new friends, and learn about yourself. Maybe one of them will help direct you to a future career. Here are examples of activities and groups that may be available in your high school or community.

Things to know

Employers may prefer to hire registered nurses who have a BSN degree. Nursing supervisors are nearly always required to have a BSN degree.

Some employers will hire registered nurses who do not have any work experience. Other employers prefer to hire registered nurses who have one or two years of related work experience.

Employers prefer to hire registered nurses who have a strong desire to help others and a genuine concern for patients' welfare. Because work with the sick and injured can be stressful, employers look for nurses who are emotionally stable.

Some hospitals may require registered nurses to have Advanced Cardiac Life Support (ALCS) or Pediatric Advanced Life Support (PALS) training. Employers also look for applicants who have good communication and critical thinking skills.

Tips

Obtaining a degree in a specialty area is helpful. Professionals in the field of nursing advise students to work vacations and holidays in health care facilities. Applicants with such experience often have an easier time obtaining work. Volunteer in a health care facility and observe a registered nurse at work to see what the job entails to see if you like this kind of work.

Costs to workers

Many registered nurses join professional associations, which have annual dues. Many must pay for their own malpractice insurance. Other costs vary depending on one's personal preference, including comfortable walking shoes and several uniforms. Additional expenses include continuing education classes to keep up to date with changes in the nursing profession and as a licensing renewal requirement.

#updated 11/24/15 lh

Licensing/certification

Registered nurses must be licensed by the Washington State Nursing Care Quality Assurance Commission. Requirements include:

• completion of an approved school of nursing program;
• passing a national exam;
• answering personal data questions;
• completion of a one-time six-hour training in suicide assessment, treatment, and management;
• enrollment in Nursys national nursing database and completion of related surveys;
• seven-clock hours of HIV/AIDS education;
• payment of application and renewal fees.

Registered nurses must renew their license each year and complete 531 practice hours and 45 continuing education hours every three years. If licensed registered nurses have not yet enrolled in and completed the survey for the Nursys national database, they must do so when they renew their license.

For more information, contact:

Washington State Department of Health
Nursing Care Quality Assurance Commission 
PO Box 47864
Olympia, WA 98504
360.236.4700

Nurses who work in schools must also have an Educational Staff Associate Certificate from the State. For more information on certification, contact:

Washington State Office of Superintendent of Public Instruction 
Old Capitol Building
PO Box 47200
Olympia, WA 98504-7200
360.725.6400

#Added requirement of enrollment in Nursys 11/29/17 as is new requirement starting 1/1/18 cj. Added suicide training, rest same as before, 3/18/19 cj.

Job listings

Listed below are links to job categories from the National Labor Exchange that relate to this career. Once you get a list of jobs, you can view information about individual jobs and find out how to apply. If your job search finds too many openings, or if you wish to search for jobs outside of Washington, you will need to refine your search.

• Registered Nurses 

To get a listing of current jobs from the WorkSource system, go to the WorkSource website .

Wages

Registered nurses working for public schools throughout the state have an average base salary of $48,941 per year.

#Updated OSPI wage from 2013/14 School District Personnel Summary report, 3/25/15 cj; updated 08.16 sd, OSPI 4/11/16 lh & 4/13/17, 3/18/19 cj. 

Wages vary by employer. For example, hospital nurses tend to earn more than nurses in doctors' offices.

Full-time registered nurses generally receive benefits. Typical benefits include paid vacation, sick leave, and health insurance. Many employers also offer child care, education benefits, and bonuses.

Employment and outlook

Washington employment

According to licensing information from the State of Washington Department of Health at the time this career was updated, there were about 91,036 registered nurses licensed by the State. Some may live out of state.

#email from pdc@doh.gov 3/23/12 lh. Requested licensing data 5/16 & again 8/7/13 cj. Rec'd new data from Thomas Bolender (Thomas.Bolender@DOH.WA.GOV) 8/7/13 cj. Nursing commission 3/10/14 lh. Received licensing data from Thomas 3/25/15 cj. Sent email to nursing@doh.wa.gov for new data 3/6/17 cj; sent again 4/5/17 & rec'd data same day.

Washington outlook

#Between 2014 and 2024, it is estimated that there will be 1,061 openings annually due to new positions and 1,407 openings annually from workers leaving this career.

#Updated outlook 06.16 sd

In Washington, many factors affect the outlook for this occupation including changes in the health care system; the financial health of hospitals and other medical facilities; the demand for nursing services; geographic location; the supply of nursing school graduates and faculty; and the retirement of existing workers. A growing and aging population, which is likely to need more nursing care, has increased the demand for registered nurses with geriatric specialization.

The table below provides information about the number of workers in this career in various regions. It also provides information about the expected growth rate and future job openings.

National employment

Three out of five nurses work in hospitals.

Major employers:

• Hospitals
• Doctors' offices
• Home health care services
• Nursing homes and other personal care facilities

National outlook

Demand for nurses will be very strong. The aging population contributes to some of this demand. New federal health care laws also means that more people will have access to health care. Patients are released from hospitals to rehabilitation centers and nursing homes. As a result, rapid growth is expected in home health care and nursing homes. At nursing homes, job growth is expected in units that provide specialized care such as long-term rehabilitation for stroke and head injury patients or treat Alzheimer’s patients.

Many procedures which once were performed only in hospitals are being performed in doctors' offices and in outpatient care centers. Employment is expected to grow faster than average in these places as health care in general expands.

Job prospects are best for those with a bachelor's degree in nursing. Job openings will occur as people retire from this occupation.

Other resources

Academy of Medical-Surgical Nurses 
East Holly Avenue
Box 56
Pitman, NJ 08071-0056
866.877.2676

American Nurses Association 
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910
800.274.4262
301.628.5000

Clinical Nurse Leader Association 

Explore Health Careers: Registered Nurse (RN) 

Health Occupation Students of America 
548 Silicon Drive, Suite 101
Southlake, TX 76092
800.321.HOSA

Hospice and Palliative Nurses Association 

National Association for Home Care & Hospice 
228 Seventh Street SE
Washington, DC 20003
202.547.7424

National League for Nursing 
The Watergate, 2600 Virginia Avenue NW
Eighth Floor
Washington, DC 20037
800.669.1656

National Student Nurses' Association 
45 Main Street, Suite 606
Brooklyn, NY 11201
718.210.0705

Northwest Organization of Nurse Executives 
4000 Kruse Way Place, Suite 2-100
Lake Oswego, OR 97035
503.479.5834

Nursing 
From Johnson & Johnson

Service Employees International Union 
1800 Massachusetts Avenue NW
Washington, DC 20036
800.424.8592

Society of Trauma Nurses 
446 East High Street, Suite 10 446 East High Street, Suite 10
Lexington, KY 40507

Washington Center for Nursing 
1101 Andover Park West, Suite 105
Tukwila, WA 98188
206.787.1200

Washington State Nurses Association 
575 Andover Park West
Suite 101
Tukwila, WA 98188
206.575.7979
800.231.8482

Your Nursing Career: A look at the facts 

References

Career cluster

• Health Science

Career path

• Social

O*Net  occupation

• Registered Nurses (29-1141.00) 

O*Net job zone 

• Job Zone 3 - Medium preparation needed. Previous work-related skill, knowledge, or experience is required for these occupations.

DOT occupations

• Nurse Anesthetist (075.371-010) 
• Nurse Practitioner (075.264-010) 
• Nurse, Consultant (075.127-014) 
• Nurse, General Duty (075.364-010) 
• Nurse, Head (075.137-014) 
• Nurse, Infection Control (075.127-034) 
• Nurse, Office (075.374-014) 
• Nurse, Private Duty (075.374-018) 
• Nurse, School (075.124-010) 
• Nurse, Staff, Community Health (075.124-014) 
• Nurse, Staff, Occupational Health Nursing (075.374-022) 
• Nurse, Supervisor (075.167-010) 
• Nurse, Supervisor, Community-health Nursing (075.127-026) 
• Nurse, Supervisor, Evening-or-night (075.127-030) 
• Nurse, Supervisor, Occupational Health Nursing (075.137-010) 
• Nurse-midwife (075.264-014) 

Strong Interest Inventory

• Registered Nurse

Holland occupational cluster

• Social/Investigative/Conventional

COPSystem

• Service Professional