And you thought this is all there was in nursing...

Nursing career roles refer to specific employment opportunities in nursing. Many career opportunities currently are available to nurses with the growth of the U. S. health care system. In addition to the usual focus on the management of acute and chronic illnesses of individuals across the age span in inpatient settings, there is an increased emphasis on health promotion and illness prevention as goals of health care, particularly in a variety of community settings. In the past, the only role of nurses was to provide care and comfort as they carried out specific nursing tasks prescribed by others. Now, nurse clinicians function in the interrelated roles of caregiver, decision-maker, comforter, rehabilitator, client advocate, communicator, and teacher. Thus, expanded or advanced practice roles contemporary nurses have been developed in many areas, with a parallel increase in nursing educational opportunities.

With the growth of the profession, nursing career roles include administrator, educator, researcher, and advanced practice nurse (comprised of several kinds such as clinical specialist, nurse practitioner, certified nurse midwife, and anesthetist) These roles are described below. Additional non-clinical career roles are not described here, including case manager, risk manager, quality assurance nurse, and product consultant; nurse entrepreneurs are increasing in number as well.

Nurse Administrator
This nurse manages patient care and the delivery of specific nursing services within a health care agency. This nurse may hold an upper level management position such as assistant or associate director or director of [sometimes, in large medical centers, Vice President for] nursing services. This administrator may also hold a middle management position, such as nurse manager, head nurse, or supervisor.

Nurse Educator
This nurse works primarily in three areas: Schools of nursing, staff development department of a health care agency, or a patient/client education department. A nurse educator in a staff development department of a health care institution provides educational programs for nurses within that setting. The programs include orientation of new personnel, instruction on new equipment or procedures, or special updates as needed, such as critical care nursing courses. A nurse educator in an agency's client education department functions to teach ill or disabled clients and their families how to provide care in the home. In most smaller agencies, however, this role may be assigned to staff nurses as part of their patient care plans.

Thirdly, a faculty member in a school of nursing teaches students at the undergraduate level to function as nurses in an effective, efficient, ethical, and collaborative manner in any health care setting. At the graduate level, this faculty member prepares students to be leaders [local, state, regional, national, international, administrators, educators, researchers, and advanced practice nurses. A minimum educational requirement for this nurse is an advanced degree in nursing.

Nurse Researcher
This nurse focuses on investigating problems to improve nursing care, and to further define and expand the scope of nursing practice. The minimum educational requirement for this nurse is an advanced degree in nursing, especially if functioning as principal investigator. The nurse researcher may be employed in an academic setting, a large medical institution, a private foundation or company, in an independent professional or community agency, or at the federal level, at the National Institutes of Health.

Clinical Nurse Specialist (CNS)
The CNS has a graduate degree in nursing and expertise in a specialized area of practice such as critical care, acute care, trauma, long-term care, and practice in a community health care agency. The CNS also may specialize in the management of specific illnesses such as diabetes, cancer, cardiovascular, or pulmonary disease; or in a specific field such as pediatrics or gerontology. The CNS functions as clinician, educator, manager, consultant, and researcher within the area of practice --the overall goal being, to plan and deliver, as well as continuously improve the quality of, nursing care to the client and family.

Nurse Practitioner (NP)
Currently, the minimum educational requirement for a NP is a graduate degree in nursing. Historically and initially, this nurse provided health care to patients/clients in an outpatient, ambulatory care, or community-based setting; this role still is active currently. Such a NP may work with clients in a specific age group, or with clients of all ages -- examples include family, adult, pediatric, obstetrics-gynecology, or gerontology nurse practitioner. This type of NP has the knowledge and skills necessary to detect and manage self-limited acute and chronic-stable conditions, and works in collaboration with a primary physician. Other types of NPs have been developed currently, to include inpatient work settings. Furthermore, there is a current movement to try to merge the roles of CNS and NP.

Certified Nurse Midwife (CNM)
This nurse is educated in nursing and midwifery, and is certified by the American College of Nurse-Midwives. The CN functions include providing independent care for women during pregnancy, labor, and delivery, and newborn care. Some gynecological services may be provided also, including routine Pap smears and family planning. A CNM practices in conjunction with a health care agency that provides medical consultation, collaborative management, and referral services to clients.

Nurse Anesthetist
This nurse is an RN with advanced training in an accredited program in anesthesiology, and certification. In major surgeries, this nurse provides surgical anesthesia under the guidance and supervision of an anesthesiologist [a physician with advanced knowledge in surgical anesthesia. Nurse anesthetists frequently administer anesthetics to patients undergoing minor surgery.

Contributed by Phoebe Dauz-Williams, Ph.D., RN, FAAN

[previous] [table of contents] [next]