Registered Nurse Careers

Name: Kim McAllister
Job Title: Registered Nurse – Staff Emergency
Where: San Francisco Bay Area
Employer: Medium-sized community hospital
Years of Experience: 29
Education: Associate’s Degree in Nursing, Currently in school for my BSN
Salary: According to the PayScale Research Center, the median registered nurse salary (for those who work in emergency rooms) can range from $54,968 to $69,352 in major cities.

Registered Nurse Careers

With a shortage of nurses in the U.S. and baby boomers getting older, the outlook on jobs for registered nurses is stronger than ever. In a previous Salary Story we interviewed a traveling registered nurse and learned about traveling registered nurse careers. This time around, we interviewed a registered nurse who works in an emergency room. Kim McAllister spoke to us about registered nurse careers, different jobs for registered nurses, interview questions for registered nurse candidates and factors that affect a registered nurse salary.

She also told us about the job description of a registered nurse and the educational requirements to become a registered nurse. Kim explained that registered nurse careers involve more than just treating illness. Speaking from the experience of her own registered nurse career, Kim said that nurses "promote wellness through educating patients on healthy behaviors and working with them to help them stay well." For readers who want to learn more about registered nurse careers, the typical registered nurse salary and jobs for registered nurses, this chat is good medicine!

Registered Nurse Job Description:

A registered nurse provides care for patients/clients across the life span. We do this by using the “Nursing Process”: assessment, planning, intervention and evaluation.

In assessing, we look at the entire patient – physical and emotional – and identify problems or challenges the patient is facing. We then “plan” our nursing care around helping the patient work through those problems/challenges to the best of their ability. Intervention is the actual application of what is decided during the planning stage. Finally, in evaluation, we look at how the patient responded to the interventions and modify them as necessary to help the patient reach their optimum wellness level.

Nursing is not the same as medicine; while medicine looks at the disease process, nursing looks at how the disease process affects the whole being – physical, emotional, functional – and personal relationships. Nursing is not just caring for the sick, nursing promotes wellness through educating patients/clients on healthy behaviors and working with them to help them stay well.

My daily duties consist of interviewing new patients as they come into the ER (or “triage” – a french word that means “to sort”), and assessing how sick they are. For example, someone with chest pain or trouble breathing will be seen before someone who has sprained their ankle, because having a heart attack or breathing trouble is more serious.

Eventually, all patients are seen and my job, after the initial triage, is to facilitate the medical care plan by drawing blood, taking and evaluating EKGs, obtaining urine samples and medicating the patients with whatever is ordered for their condition. It can seem sort of task-oriented to the casual observer. But, the entire time, the nurse is watching (assessing) the patient to see how they are responding to treatment and modifying it as needed.

Nurses and doctors who work together in the ER function as a team, and they are constantly giving feedback to each other on how the patient is doing. The doctor may have as many as 12 or more patients at the same time. It is up to the nurse to keep them aware of how the patients are responding to treatments.

What are the requirements to become a registered nurse?

My career steps were slightly different than what you see today.

I knew I wanted to be a nurse, so in high school I stayed on a college-prep path that was heavy in the sciences and math. My first year out of high school I went to a junior college where I took every non-nursing course required for the diploma: anatomy and physiology, sociology, psychology, American history and microbiology.

The next year I was accepted into the nursing program itself and spent the next two years attending part-time, taking actual nursing courses and completing clinical rotations in medical/surgical, obstetrics and gynecology, psychology and pediatrics.

These days, having those prerequisites completed prior to applying to the nursing program is required. It’s not unusual to spend three or four years obtaining an AA degree; rarely are nursing students accepted right out of high school.

What drew you to a registered nurse career?

On my 9th birthday in 1966, my great-grandmother gave me “Cherry Ames, Student Nurse” as a gift. As I sat on the porch that summer day and read the book, I decided to become a nurse by the time I was into the fourth chapter. I never deviated from it.

I have a sister, a brother-in-law and a niece who are nurses. I was the first to enter the nursing profession in my family. I have no other family in nursing or medicine, but I have dozens of friends in both professions.

What advice would you give to those interested in registered nurse careers?

Get started!!! Even if all you can do is one prerequisite at a time, just do it! If you are in high school, take every science course you can get your hands on and stay in math – don’t just coast through on easy electives.

Research the nursing programs in your area and find out the requirements of each. If you can volunteer in a hospital or clinic, so much the better. You will be able to see if you really want to enter the profession. Talk to nurses. They will tell you the good and the bad. Some may even say “don’t.” Do not listen. It’s a great profession with great opportunities. It isn’t easy. Nothing worth doing ever is!

What are the typical job interview questions for registered nurse candidates?

A nurse is likely to be questioned about how they feel about public relations, working in collegial relationships with other members of the health care team, how they view nursing, what is their background, what are their strengths and what are their weaknesses.

Remember – a nurse is not a doctor and so the questions would relate to nursing practice as opposed to medical practice, although often the two overlap.

What is the outlook on jobs for registered nurses these days?

The outlook on jobs for registered nurses is fantastic. As we baby-boomers enter our sixties, more and more of us will require health care and that means more nurses! There is already a shortage and it is expected to increase unless more people step up and join our ranks. The average age of an RN as of today is 49 years old!

The big issue is finding the space and the instructors to educate the next generation of nurses. There aren’t enough spaces in nursing programs; this leads to waiting lists and lottery-style entry routines. Nurses are obtaining advanced degrees to help alleviate this problem.

What factors affect the average registered nurse salary?

A registered nurse salary varies depending on whether you work in a hospital or a private clinic (hospitals pay higher), the area of the country (New York and the San Francisco Bay Area are the highest, I believe), sometimes the level of education (ADN vs. BSN) and whether or not you are represented by a union (union nurses earn larger salaries).

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