Exploring Nursing Career Paths: From CNA to ARNP

Particular Function: To notify my audience about the various levels of nursing readily available to be able to operate in the healthcare field, what their task description for each level requires, and identifying do they really have what it takes to become an excellent nurse. INTRODUCTION

Attention Getter: To begin with let me state "I Love My Task". I understood from a youth age that I wished to be a nurse. There is absolutely nothing much better than the fantastic sensation that comes by you knowing you are able to comfort, motivate and advise a complete stranger in their time of need; Understanding that you have actually touched their lives, or a member of the family life, in such a way that they will always remember.

Audience inspiration: A lot of people become or think they want to end up being a nurse due to the fact that of the pay scale. They believe it is an "easy" method to earn a living.

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I am here to inform you of the other side of nursing; you understand the one nobody lets you in on up until the first day on the job. Reliability: I have actually always been a nurturer by nature, even in youth with good friends, siblings and at times feeling as if I was the parent and protector of my mother. I find excellent interest in particular health problems, their causes and their remedies, having the ability to offer useful details to clients, their member of the family, and the basic public, and to bring awareness of concerns, remedies and treatments to the leading edge.

Purpose: I am going to place this question in your thoughts; “Am I considering a career in nursing due to the prospect of an easy salary, or do I truly have the heart and personality that is required to be a success in this field.” Preview: Today I am going to outline the multiple levels of nursing certificates, licenses and degrees available. I will discuss the job description and care you will be expected to provide to the patient at each level. Finally I will discuss the bottom line; you know the one factor that influences over half of all individuals to become a nurse. [Transition]: Let us begin with touching on the levels available to work in while employed in the nursing arena of healthcare. BODY

I. The field of nursing offers many opportunities for individuals who are considering this as a career move. Keeping in mind no matter what level you choose in nursing it will be a very demanding and rewarding career to participate in. A. There are different levels of nursing starting at the beginning with a CNA, PCT, LPN, RN, and eventually ending with ARNP. Certified Nursing Assistant- referred to a CNA. Working in hospitals, long term facilities, assisted living centers, adult day care centers, home health agencies and other medical, community and residential settings. A Certified Nursing Assistant is authorized to perform specific duties to assist nurses. CNAs work closely with patients to help provide care for their basic physical and emotional needs, and may also perform vital signs and administer medications “if” licensed to do so. BODY (Continued)

Licensed Practical Nurse- referred to as an LPN. helps physicians and registered nurses (RNs) care for patients. They have the teaching and knowledge to perform routine nursing duties. LPNs also schedule appointments, maintain patient records, and perform clerical style duties. Available positions can be found in hospitals, nursing homes, and multiple health care institutions, and private homes. Registered Nurse- referred to as an RN. You treat patients and help in their rehabilitation, provide advice and emotional support to patients’ families. Many registered nurses are general duty nurses who focus on the overall care of the patents. In addition to patient care they are placed in positions of supervising LPNs and CNAs, nursing aides and orderlies. They hold responsibility for scheduling of nurse staffing and patient assignments to other nursing based on that nurse’s experience and abilities. Advanced Registered Nurse Practitioner- referred to ARNP practice advanced nursing in one of four specialized areas, including Certified Nurse Anesthetists, Certified Nurse Midwives, Certified Nurse Practitioners and Clinical Nurse Specialists.

Nurse Practitioners are licensed to practice independently without direct supervision. Nurse Practitioners work in a variety of settings to include private practice, hospitals, ambulatory care centers, public health departments, school based health clinics and other settings. B. There are multiple work shifts available to all levels of nursing, which makes this field appealing to many people. Eight hour shifts are generally available within the office settings of private practice facilities. This shift generally runs 08:00 am to 5:00 pm. Twelve hour shifts are the general guideline that majority of hospitals schedule by in today’s time. These shifts normally run between 07:00 am until 7:00 pm, or 7:00 pm until 07:00 am. Transition: Now let’s move on to actual descriptions of their individual positions. II. Each level of certificate or degree contains different responsibilities and requirements from job to job, but we will primarily speak of the general standards. CNA- Vital signs assist with or totally perform personal care of each patient, documenting in chart graphs the patient intake and output for a particular time frame, and in some instances performing non-evasive procedures such as Foley catheter insertion, and dressing changes. As a CNA you are more than likely the first point of contact with a patient during your shift, you will spend majority of your time somewhat catering to the patient.

You will be supervised by most often an RN and occasionally an LPN depending on the setting. LPN- includes a lot of the above mentioned duties along with medication administration, starting and discontinuing intravenous access, charting full assessments on your patient during beginning of each shift and periodically throughout the shift depending on the status of your patient. Preparing patient for scheduled procedures including ensuring that all proper consent forms are signed and witnessed, administering any type of prep that may have been ordered by the physician. Ensuring that the patient medical record is kept up to date and assisting the physician with any questions or needs he may have in reference to you patient. You will be supervised by an RN. RN- as mentioned in the other two categories you will be responsible for all of the above duties and additional duties. These may include: Mentoring other nurses new to the field or just to your area of specialty, scheduling of your shift staff, assigning specific patients to specific nurses depending on their level of skill, managing Code situations in crises and administering certain medication that are governed and cannot be administered by the above mentioned positions. Answering to physicians throughout your shift in reference to patient care, record keeping and scheduling of orders, tests or procedures their patient is in need of. BODY (Continued)

ARNP- in this position you are eligible to work independently as well as alongside a physician on a daily basis. You are allowed to write specific orders for tests, medication and procedures for patient with the understanding that a physician will follow behind and co-sign these orders. ARNP’s can and do manage and run independent medical offices while a physician maybe working at the hospital, in the OR, at another clinic. ARNP’s often cover call periods for the physician they work for taking calls throughout the day and night from patients in need. Transition: Keeping in mind that all of the above positions are critical in the overall picture of the healthcare system from a nursing perspective. We have covered the levels of certificates and degrees in nursing now let’s address the bottom line topic. III. This is a topic that causes a lot of individuals to make a decision to become a nurse without truly investigating the duties and responsibilities of someone in the nursing field.

It also is a topic that blinds a lot of individuals from assessing their own personality, patience and ability to perform these tasks. CNA- pay scale for the CNA varies depending on the type of facility of which you are employed. Base starting pay is around $8.92 and up to $11.87 according to research posted by www.payscale.com. LPN- pay scale for an LPN varies depending on the type of facility of which you are employed. Base starting pay is $14.09 and up to $20.90 according to research posted by www.payscale.com. RN- pay scale for the RN varies depending on the type of facility of which you are employed. Base starting pay is $20.98 and up to $29.55 according to research posted by www.payscale.com. ARNP- pay scale for the ARNP is based on an annual salary rather than an hourly rate, and again it depends on the type of facility and specialty you practice in. Base starting pay is $65,924 and up to $93,341. CONCLUSION

Summary: Taking into account the information I have covered here today, and considering the salaries I have quoted are all beginning salaries fresh out of school, do you think you have what it takes to make a “Good” nurse. When I say “Good” nurse I am speaking of a person who performs their job putting all of the skills they have learned to use, working from their heart and honestly loving their job and the people they care for. An “OK” nurse is one who is there for the dollar, they are disturbed by the patient complaints, the repetitiveness of their duties and the strenuous demands placed on nursing on a day to day basis. If you are an “OK” nurse you will be subjected to the term “BURN OUT” quicker than you will ever begin to enjoy the career path you have invested in. Refocus: In making your decision to become a nurse take into consideration all of the factors that have been presented here today. Truly make this decision based on a life time goal and long range plan. It is a demanding, a giving and rewarding profession and there is a need for what we call truly “Good” nurses.

References:

Salary Snapshot for Certified Nursing Assistants, update Sept 12, 2010 www.payscale.com/Research/US/Job=Certified_Nurse_Assistant_(CNA)/Hourly_RateSalary Snapshot for Licensed Practical Nurse, updated Sept 19, 2010 www.payscale.com/Research/US/Job=Licensed_Practical_Nurse_(LPN)/Hourly_RateSalary Snapshot for Registered Nurse, updated Sept 15, 2010 www.payscale.com/Research/US/Job=Registered_Nurse_(RN)/Hourly_RateSalary Snapshot for Advanced Registered Nurse Practitioner, updated Sept 14, 2010 www.payscale.com/Research/US/Degree=ARNP/Salary“Financial Considerations.” Advance For LPNS (November 2010) Vol. 11