About Different Types of Nurses

Since the licensing of the first U.S. nurses in the early 1900s, nursing has grown to encompass a wide range of licensing options that include License Practical Nurses (LPN), Registered Nurses (RN) and Nurse Practitioners (NP).

The Facts

• Nurses are health care professionals who treat the ill, support patient recovery, provide instruction for maintaining and achieving health, perform research and educate the public. Education requirements and job duties of nurses vary worldwide. Nurses currently practice in every field of medicine and function as educators, managers and clinicians employed in government, hospitals, private practice, academia, clinics and private industry. In the U.S., nursing license and education requirements are governed by individual states.

Misconceptions

• A common misconception is that nurses report to and are managed by physicians. Although nurses may be employed by physicians, they collaborate in patient care with physicians, answering to their own code of ethics and regulating boards and maintaining separate malpractice liability. Most states recognize the autonomy of the nursing profession and continue to define it as independent of a physician's care.

Type

• LPNs have the smallest scope of practice and shortest education requirements--18 months and 2 years of post-high school education. LPNs must pass the National Council Licensure Examination-PN and are supervised in practice by RNs or physicians. The largest group of nurses in the U.S., RNs, graduate from 2- to 5-year state-approved nursing schools and must pass the NCLEX-RN. Several forms of advanced degree nurses exist in the U.S., including Advanced Practical Nurses (APN), Nurse Anesthetists (CRNA), Nurse Practitioners (NP) and Ph.D. nurses (DPN).

History of

• Florence Nightingale is credited for establishing the field of nursing as we know it today. Prior to Nightingale's founding of the Nightingale Training School in 1860, nurses were unpaid nuns or underpaid domestic help. In the U.S., North Carolina was the first state to license nurses in 1903. By 1955 every state eventually followed North Carolina's lead.

Evolution

• The nursing field evolved out of the traditions of wet nurses and nuns. Wet nurses sometimes served as midwives, a practice that eventually evolved into greater patient care. Nuns, charged with care of the ill and indigent as a public service, were often the only caretakers for the poor. Beginning in the mid-1800s, nursing became established as a profession. In 1965, the field of nurse practitioner was introduced and has expanded so that RNs today have a range of career choices.

Function

• The various nursing licenses translate into differing functions in patient care. For example, LPNs must be supervised by an RN or a doctor and administer various medications, take vital signs, monitor patient condition, collect samples and document patient information. RNs perform all the duties of LPNs and may also triage patients, perform procedures, execute pain management and manage other staff. NPs, APNs and DPNs have the highest level of independence, including diagnosing and treating patients.

Significance

• The U.S. Department of Labor reported in 2005 that nurses are the largest group of health care workers. Nurses are central players in the health care system with diverse duties that include every field of medicine. They provide care for individuals of all races, origins and ages from birth to death. Nursing duties extend far beyond basic health care, providing continuity of care, patient and community education, research, comfort and support in times of crisis.