Nursing is a profession practiced in many different ways across the US, depending on what state, as the requirements for becoming a nurse are set differently than at the federal level. Nurses are a limited resource, and numerous factors contribute to the nursing shortage in America. There are plenty of variances regarding how nurses practice across America.
Each state has its unique set of laws governing the profession, from whether to pay hourly instead of an annual salary, down to where you can legally administer medication. These vary depending on your specialty as well as your level of certification. Some states only allow registered nurses to use syringes and controlled substances at specific levels.
Other states allow RNs of all levels to do so with proper documentation. In addition, different states have different requirements for continuing education.
Who are nurses?
Nurses are the people who provide care to those in need. They have a wide range of experience, from scrubbing in to assisting surgeons with life-or-death operations. We also have those who spend their days quietly providing patients with the balm of human contact.
They are not just rescuers and healers but educators and advocates as well. They often use their specialized training in physiology and psychology to help patients understand what is happening to them and get past the suffering.
Nurses are vital to the healthcare system in many ways. In addition to providing direct patient care, nurses provide crucial support for doctors and other caregivers. Nurses also help shape healthcare policy and participate in research.
The role of nurses
Nurses oversee providing safety, attending to patients and caring for them. They conduct basic assessments, diagnose medical conditions, and provide life-saving care.
They are a staple of the healthcare system, serving an essential role in caring for our nation’s most vulnerable patients with compassion and empathy. Here we look at some of their primary roles.
Administering medications and treatments
Nurses are responsible for giving medications to patients and monitoring their reactions. They also may have to administer treatments such as IVs or blood transfusions.
Diagnosing and treating illnesses
Nurses often must make medical decisions, such as whether a patient needs a blood transfusion or surgical intervention. It is up to nurses to decide how much information patients need and when decisions are outside the patient’s control.
Educating patients about their healthcare
Nurses often educate patients about their healthcare and the procedure’s results. They also answer the questions or concerns of family members.
Collecting data
Nurses collect and process patient data, such as vitals and lab reports, to help doctors identify emergencies. Nurses may also need to take notes at the doctor’s request.
Medical research is any study conducted to answer questions, solve problems or improve human health. The overall goal of medical research is to help people live longer, healthier and happier lives. Research is done by collecting data from nurses from different states.
Assisting in surgery
Nurses assist surgeons in operating on patients to repair defects, such as burns, broken bones or skin problems. They may also have to help post-operative patients learn how to care for their bandages and wounds.
Providing emotional and psychological support
Emotional support is essential, especially when patients undergo complex physical procedures. Nurses must provide care and comfort to all their patients.
Following proper sanitary procedures
Nurses also must make sure that they follow proper protocol when sterilizing equipment or changing bandages. It includes changing gloves or washing hands with sanitizer before treating a new area of the body.
Taking patients’ vital signs
A nurse must know how to determine patients’ blood pressure, pulse, temperature, and respiratory rate. They often use specialized tools that record these measurements for future reference.
Giving medication and treatments
Nurses often must give medications, such as painkillers, vitamins or antibiotics. They also may have to administer treatments to minimize procedures’ potential side effects or complications.
Following up with patients
Nurses should be able to determine how well patients are recovering and whether any complications have occurred. They help assess the risk of hospital readmission and overall treatment outcomes such as mortality and length of stay.
What is the nursing process?
All nurses use the same nursing process, but they may differ in how they carry it out. The nursing process is a guide that defines who nurses are and what their role in healthcare is. It also describes nursing tasks, including assessing, diagnosing, planning, implementing, evaluating and re-evaluating patients’ needs.
Assessing
Nurses help assess the patients before they can go home. The process nurses do depend on what type of care the patient needs.
Assessments for other types of care are also critical. For example, before patients have surgery, nurses will assess them and ensure everything’s for their procedure. Nurses oversee evaluating anything from their mental state to whether their surgery wounds will heal properly and without infection.
Diagnosis
Nurses help in diagnosing and treating problems in people’s health and wellbeing. The nursing process helps maintain a good quality of life for patients by preventing illness or chronic issues from developing into sickness or death. It also helps restore body functions to normal after any disaster that might have caused damage to one’s body or mind.
Planning
Nurses help plan and deliver care to sick or injured patients. The nursing care process composes a team of nurses and physicians who work with the patient’s primary healthcare provider to identify and manage the treatment plan.
Implementation
Nurses help implement the nursing process to promote health, prevent harm and achieve a quality of life. The process contains indications and interventions.
Indications are criteria that indicate the need for nursing intervention, such as pain or shortness of breath. Once the nurse identifies these indications, they evaluate several factors, including vital signs, medical history, physical observations and a view from different angles.
Evaluating
Nurses help in evaluating patients. To do this, nurses use clinical judgment and observation and record their observations in the nursing process, so they have a written record of what happens when a patient is at their most vulnerable point in the healthcare process.
Nurses document everything from changes seen on the physical exam to reactions to treatment and even notes on conversations with other staff. These are all part of a consistent pattern during a patient’s journey through nursing care that helps nurses understand what is going well for them and where potential problems may need attention.
How nursing differs across different US states
Here are some of the ways in which nursing differs across different states:
Supported retirement
Some states require nurses to stop working at a certain age or number of years on the job, and some have no retirement age. It is a defined benefit state and will give the same pension amount to an individual regardless of how long they worked.
In contrast, defined contribution states have different retirement benefits depending on their work years.
Licenses
States have different policies when it comes to licenses. Some states require advanced practice nurses to have a license to perform specific tasks, such as prescribing medications, while others do not.
States are also different about who can get a license. In some states, only those with degrees in nursing can get licensed. In others, only registered nurses can get licensed, and other health professionals, such as physicians and pharmacists, can prescribe medication without a nursing degree.
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Rights
Rights differ from state to state when it comes to the medical field. States have different requirements for nurses, including how long they must wait to graduate before becoming licensed nurses and the requirements for becoming a registered nurse.
They also differ regarding how much experience one must have before working as an advanced practice registered nurse (APRN).
Some states provide more rights to nursing staff than others. For example, some nurses have rights to health professional liability for injury under certain conditions. Also, some states make it easier for nurses to file grievances and disciplinary actions through arbitration.
Staffing levels
The number of jobs available in the nursing profession varies across different states, while the job market is less fluctuant than in other fields. It is still essential to understand where the demand for new workers is the highest. Providing a higher starting salary may be a strategy to attract more nurses into that region.
Payment format
Some states pay per hour, while others have a lump sum payment at the end of the contract. Some states have laws that require them to pay overtime, and others do not. Knowing how much you make an hour, let alone your weekly or monthly wage, can be challenging.
Education offering
The level of education required to enter the nursing profession varies depending on the state you want to work in and the type of job you want. Some states require a bachelor’s degree, while others only require an associate degree.
The highest-paying nursing positions are typically offered to registered nurses who have completed a nursing program and earned a bachelor’s degree. Different states have different educational requirements for nurses.
Some nurses must complete an approved bachelor’s level nursing program at an accredited college. In contrast, California requires just two years of college for state licensure as a registered nurse (RN).
Scholarship and loan options
If you plan on getting an advanced degree in nursing, ensure that your state offers any scholarship or loan option to help you pay for school. For example, some states provide nurse scholarships or grants for RN students — however, few offer student loans or financial aid.
Those who want to study nursing as a hobby may look into getting scholarships that the school they are attending offers. Although most states offer an associate degree in nursing, some do not provide any degree for nursing students.
Those who want to work as a nurse after getting an associate degree in nursing should ensure that the state they live in has professional licensure, for roles such as a registered or licensed nurse, and they enroll in one of the programs the state’s school offers.
Moving around the country
Most states offer RN licenses to graduates who have completed the necessary coursework and passed a state-specific exam. However, some states allow nurse practitioners who have completed an extra year of programming at a school not accredited by the AMA to receive licensure without passing the state’s licensing board exam.
Teacher training colleges and schools that award certification as certified nursing assistant or certified nurse aide may also be able to provide some limited credentialing in other states.
Technology and tools
The use of technology varies significantly among states. Some states allow nurses to use cell phones on the job, while others ban them. Others only allow nurses to use smartphones if they use them as voice-to-text devices.
LinkedIn is available to all employees in most states. Some states do not allow employers to search their employees’ social media accounts like Facebook. However, most states do not allow employers to ask their employees invasive questions or take personal information without permission.
Work hours
Work hours differ from state to state. In California, nurses are only required to work eight hours. Working conditions also vary. Nurses in California are more likely than nurses in New York to have overtime pay because they often have higher premium pay rates than their non-nurse counterparts.
Insurance
Most states allow nurses to become insured under a group health plan. It covers the cost of essential benefits and maternity leave, short-term disability and long-term disability insurance. Some states require nurses to purchase prescription drug coverage — however, many states do not require employers to provide employees with health insurance.
Professional organizations
Almost all states have an association representing nurses in their respective states. Some states have multiple nursing associations — each association charges different prices and offers various services and benefits to members.
For example, California has three major nurse associations: the California Nurses Association (CNA), the California Association of Nurse Anesthetists (CANA), and the California Association for Licensed Midwives (CALM).
CNA provides member discounts on cell phones and legal services from their law firm. CANA offers a quarterly magazine specific to nurses by nurses, and CALM provides newsletters for its members in multiple languages.
Specialization
Although many states offer LPN programs, only a small number offer an RN to BSN program. Most states that offer LPN programs require students to attain their LPN degree before they are eligible to apply. Other states do not restrict the number of applications they can accept per year.
For example, in some states, applicants can apply for a license anytime during the school year if they meet all application requirements. For nurses who want to pursue a master’s degree (MSN) or PhD program in nursing, most states require that their nurses pass all the necessary exams.
Contracts
Some states allow nursing staff to have their services performed under permanent full-time or part-time contracts. Permanent full-time contracts are often beneficial to nurses planning to retire and looking for a pension.
Still, they could be better for those who want flexibility and more stability in their schedule. On the other hand, part-time contracts do not offer healthcare benefits or retirement allowances.
Healthcare benefits
Healthcare benefits differ slightly across the United States. For example, in most states, health insurance is not mandated. Compared to other developed countries, healthcare in the US is more expensive and less effective due to this lack of mandated benefits and universal healthcare coverage.
It can significantly affect people’s lives — if they have access to care but do not have insurance. They could end up with excessive debt paid off by working a low-paid service industry job while they are ill or recovering. These differences can also affect careers and nursing education in different parts of the country.
Final thoughts
There is much to say about how nursing as a career differs across different US states. The variations are vast, and it is difficult to see the differences created by these varying laws and rules.
However, for those that want to consider going into nursing in the future, it would be difficult not to look out for these variables when weighing their options. As for the things that nurses can remain focused on regardless of what their state allows or disallows them from doing, this comes down to providing quality care.
In this way, the differences in nursing across different US states are like badges of honor. They can serve as a sign that you are an outstanding nurse or that you have earned a particular license or degree by being exceptional.