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Nursing - Paramedical

Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death.

Nurses work in a large variety of specialties where they work independently and as part of a team to assess, plan, implement and evaluate care. Nursing Science is a field of knowledge based on the contributions of nursing scientist through peer reviewed scholarly journals and evidenced-based practice.

Nursing as a profession:

The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at national or state level.

The aim of the nursing community worldwide is for its professionals to ensure quality care for all, while maintaining their credentials, code of ethics, standards, and competencies, and continuing their education. There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and practice and training in clinical skills.

Nurses care for individuals of all ages and cultural backgrounds who are healthy and ill in a holistic manner based on the individual's physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for those individuals.

In order to work in the nursing profession, all nurses hold one or more credentials depending on their scope of practice and education. A Licensed practical nurse (LPN) (also referred to as a Licensed vocational nurse, registered practical nurse, Enrolled nurse, and State enrolled nurse) works independently or with a Registered nurse. The most significant differentiation between an LPN and RN is found in the requirements for entry to practice, which determines entitlement for their scope of practice.

Practice settings:

Nurses practice in a wide range of settings, from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies. Nurses work in occupational health settings (also called industrial health settings), free-standing clinics and physician offices, nurse-led clinics, long-term care facilities and camps. They also work on cruise ships and in military service. Nurses act as advisers and consultants to the health care and insurance industries. Many nurses also work in the health advocacy and patient advocacy fields at companies such as Health Advocate, Inc. helping in a variety of clinical and administrative issues. Some are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contact in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing. Nurses work as researchers in laboratories, universities, and research institutions.

Throughout the world nurses are known to be caring individuals that people look for as someone to advocate for the sick and provide empathy towards the needy.

Bachelor of Science in Nursing (B.Sc Nursing):

The Bachelor of Science in Nursing (BSN) is a four year academic degree in the science and principles of nursing, granted by a tertiary education university or similarly accredited school. Though one is eligible to sit for the NCLEX-RN licensing examination to become a registered nurse after graduating from either a two year program with an Associate's Degree (ADN) or from a four-year program with an Bachelor's Degree (BSN), the BSN prepares nurses for a professional role away from the bedside with coursework in nursing science, research, leadership, and nursing informatics.

Master of Science in Nursing (M.Sc Nursing):

A Master of Science in Nursing (MSN) is an advanced-level postgraduate degree for registered nurses and is considered an entry-level degree for nurse educators and managers. The degree also may prepare a nurse to seek a career as a nurse administrator, health policy expert, or clinical nurse leader. The MSN may be used as a prerequisite for doctorate-level nursing education, and previously was required to become an advanced practice nurse such as a nurse practitioner, clinical nurse specialist, nurse anesthetist, or nurse midwife. The master's level advanced practice nurse programs have already, or are in the process of, transitioning to the requirements of the Doctor of Nursing Practice.

This graduate-level degree may focus in one or more of many different advanced nursing specialties such as acute care, adult, family, geriatrics, neonatal, palliative care, pediatric, psychiatric, obstetrics and gynecological nursing, etc.

Sub specialties:
Obstetrics and Gynecological Nursing:

Obstetrical nursing, also called perinatal nursing, is a nursing specialty that works with patients who are attempting to become pregnant, are currently pregnant, or are recently delivered. Obstetrical nurses help provide prenatal care and testing, care of patients experiencing pregnancy complications, care during labor and delivery, and care of patients following delivery. Obstetrical nurses work closely with obstetricians, midwives, and nurse practitioners. They also provide supervision of patient care technicians and surgical technologists.

Obstetrical nurses perform postoperative care on a surgical unit, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments. Obstetrical nurses must possess specialized skills including electronic fetal monitoring, nonstress tests, and medication administration by continuous intravenous drip.

Obstetrical nurses work in many different environments, including, medical offices, prenatal clinics, labor & delivery units, antepartum units, postpartum units, operating theatres, and clinical research.

Pediatric Nursing / Child Health Nursing:

Child health nursing or pediatric nursing is an area of nursing and medical practice with a focus on providing holistic care to infants, children and adolescents. It differs from pediatrics, in that the emphasis in pediatrics is ill-health and the alleviation of symptoms or disease. There are different places Pediatric nurses can work, one is they can work in a pediatric ward at a hospital, and others choose to work in a pediatric doctors office.

One of the major principles of pediatric nursing is the concept of family centered care. Pediatric nurses function to support the family by providing nursing care that the family cannot perform, educating and supporting them to maintain their normal caring activities and actively viewing the parents as partners in the care process.

Psychiatric nursing / mental health nursing:

Psychiatric nursing or mental health nursing is the specialty of nursing that cares for people of all ages with mental illness or mental distress, such as schizophrenia, bipolar disorder, psychosis, depression or dementia. Nurses in this area receive more training in psychological therapies, building a therapeutic alliance, dealing with challenging behavior, and the administration of psychiatric medication.

Medical-surgical nursing:

Medical-surgical nursing is a nursing specialty area concerned with the care of adult patients in a broad range of settings. The Academy of Medical-Surgical Nurses (AMSN) is a specialty nursing organization dedicated to nurturing medical-surgical nurses as they advance their careers. Traditionally, medical-surgical nursing was an entry-level position that most nurses viewed as a stepping stone to specialty areas. Medical-surgical nursing is the largest group of professionals in the field of nursing. Advances in medicine and nursing have resulted in medical-surgical nursing evolving into its own specialty.

Many years ago a majority of hospital nurses worked on wards, and everyone was a medical-surgical nurse. Today licensed medical-surgical nurses work in a variety of positions, inpatient clinics, emergency departments, HMO’s, administration, outpatient surgical centers, home health care, humanitarian relief work, ambulatory surgical care, and skilled nursing homes. Some military medical-surgical nurses serve on battlefields.

Cardiac nursing:

Cardiac nursing is a nursing specialty that works with patients who suffer from various conditions of the cardiovascular system. Cardiac nurses help treat conditions such as unstable angina, cardiomyopathy, coronary artery disease, congestive heart failure, myocardial infarction and cardiac dysrhythmia under the direction of a cardiologist.

Cardiac nurses perform postoperative care on a surgical unit, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments. Cardiac nurses must have Basic Life Support and Advanced Cardiac Life Support certification. In addition, cardiac nurses must possess specialized skills including electrocardiogram monitoring, defibrillation, and medication administration by continuous intravenous drip.

Cardiac nurses work in many different environments, including coronary care units (CCU), cardiac catheterization, intensive care units (ICU), operating theatres, cardiac rehabilitation centers, clinical research, cardiac surgery wards, cardiovascular intensive care units (CVICU), and cardiac medical wards.

Critical care nursing:

Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients. Critical care nurses can be found working in a wide variety of environments and specialties, such as emergency departments and the intensive care units.

Employment areas:

Critical care nurses work in a variety of different areas, with a diverse patient population. There are many critical care nurses working in hospitals in intensive care units, post-operative care and high dependency units. They also work on medical evacuation and transport teams.

Subspecialties of Critical Care Nursing:

Subspecialties of critical care nursing include such areas as Neonatal Intensive Care (also called Nursery ICU), Pediatric Intensive Care (or PICU), and Adult Intensive Care (or ICU). The patient population of these units is generally based on the age of the patient.

The Neonatal ICU has a patient population that primarily consists of newborn and premature infants. The NICU will care for patients up to about one month old, based on gestational age, at which point care will generally be assumed by the Pediatric Intensive Care unit.

The Pediatric Intensive Care unit will generally care for patients of about one month to eighteen years. After eighteen years, most patients will be admitted to an Adult Intensive Care Unit.

Emergency & Disaster Nursing:

Emergency Nursing is a nursing specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.

While this is common to many nursing specialties, the key difference is that an emergency nurse is skilled at dealing with people in the phase when a diagnosis has not yet been made and the cause of the problem is not known.

Neonatal nursing:

Neonatal nursing is the provision of nursing care for newborn infants up to 28 days after birth. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team.

Qualifications and requirements:

Healthcare institutions have varying entry-level requirements for neonatal nurses. Neonatal nurses are Registered Nurses (RNs), and therefore must have an Associate of Science in Nursing (ASN) or Bachelor of Science in Nursing (BSN) degree. Some countries or institutions may also require a midwifery qualification. Some institutions may accept newly-graduated RNs who have passed the NCLEX exam; others may require additional experience working in adult-health or medical/surgical nursing.

Some countries offer postgraduate degrees in neonatal nursing, such as the Master of Science in Nursing (MSN) and various doctorates. A nurse practitioner may be required to hold a postgraduate degree. The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes.

As with any registered nurse, local licensing or certifying bodies as well as employers may set requirements for continuing education.

Oncology nursing:

An oncology nurse is a specialized nurse who cares for cancer patients.

Operation room nursing / Perioperative nursing:

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, nurse anesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in operating theatres, stress test evaluations, cardiac monitoring, vascular monitoring, and health assessments. Perioperative nurses typically have Basic Life Support and Advanced Cardiac Life Support certification.

Orthopaedic nursing:

Orthopaedic nursing (or orthopedic nursing) is a nursing specialty focused on the prevention and treatment of musculoskeletal disorders. Orthopaedic issues range from acute problems such as fractures or hospitalization for joint replacement to chronic systemic disorders such as loss of bone density or lupus erythematosus.

Orthopaedic nurses have specialized skills such as neurovascular status monitoring, traction, continuous passive motion therapy, casting, and care of patients with external fixation.