To set a few facts straight: nurses are autonomous providers of care in many ways. For example, nurses independently assess and monitor patients.
They use the information from their assessment to decide what patients need to attain and/or preserve their health. Then, depending the setting in which they work, nurses provide that care, or communicate with other health care providers to obtain that care for the patient.
And nurses work in hospitals, yes, and many nurses find hospital work fulfilling and exciting. But one of the most amazing things about a nursing degree is how many different things can be done with it. In a recent advertisement for an informational seminar about career options for nurses, more than 60 different choices were listed. RNs work in outpatient settings, in free clinics, in schools, in factories, in pharmaceutical companies, in long-term care facilities, in homeless shelters, in nurse-managed clinics, in parishes, in insurance companies, on cruise ships, and at the zoo. Many nurses have started their own businesses; others maintain websites; and still others hold political office at the local, state, and federal levels.
And don't worry about looking unfashionable - in general, nurses do not wear caps anymore.
You wouldn't know this from watching television or going to the movies, because most of the healthcare jobs you see doctors doing on both the small and big screens is actually work nurses do. Doctors rarely have time to have extensive talks with families or to hold the patient's hand at the bedside. And while it's the doctor's job to diagnosis and treat disease (although there are specialized and specially trained nurses called nurse practitioners who do diagnose and treat) it is the nurse who spends the most time with the patients, and it very often the nurse who notices if something is going wrong.
What else do nurses do? Other responsibilities (which might vary from job to job) include:
- Being a patient advocate, i.e., to helping to protect the interests of the patient, especially when the patient cannot do this because they are ill or because they don't have adequate health care knowledge. Patients, especially those who are thrust into a hospital situation where they are unfamiliar with the culture - may have difficulty making their wants and needs heard in the din of the hospital environment. A good nurse helps them communicate these wants and desires, and - if appropriate - a great nurses teaches them how to effectively self advocate.
- Educating patients. Most nursing jobs have some patient education responsibilities. For example, hospital nurses are often responsible for explaining procedures and treatments. Home health nurses might teach families how to change a patient's dressing or teach a patient how to take their medications or monitor their blood sugar. Nurses guide patients towards healthy behavior, trying to take into consideration all the outside factors that might influence a person's choices.
- Discharge planning. Although traditionally associated with hospital nursing, discharge planning is done by nurses in many different work environments. For example, a nurse at an outpatient methadone clinic might work together with other providers to assess the possibility of tapering off the methadone use for a motivated client.
- Preventing illness. Many nurses working in community settings work to prevent illness by educating the public and providing services that help decrease illness and death through transmittable (i.e., contagious) illnesses, violence, substance abuse and tobacco use. Lilian Wald, a nurse who worked in New York the early part of the 1900s was credited with drastically improving the health of the recently immigrated tenement population by introducing shafts for fresh air, and insisting that the city provide clean water and garbage clean up.
- Researching. Not all nurses are involved in research, but many highly trained nurses (those with master's and Ph.D degrees) are, and at vary high levels. They might work in academia as scholars or educators, on research studies as primary investigators, or help develop public policy.