Registered nurse

A registered nurses (RN) is a nurse who has graduated from a nursing program and met the requirements outlined by a country or state licensing body in order to obtain a nursing license.^[1] An RN's scope of practice is determined by local legislation governing nurses, and usually regulated by a professional body or council.

Registered nurses are employed in a wide variety of professional settings, often specializing in their field of practice. They may be responsible for supervising care delivered by other healthcare workers including enrolled nurses, licensed practical nurses, unlicensed assistive personnel, nursing students, and less-experienced RNs.

Registered nurses must usually meet a minimum practice hours requirement and undertake continuing education in order to maintain their registration.^[2] Furthermore, there is often a requirement that an RN remain free from serious criminal convictions.^{[3][4] [5]}

History

The registration of nurses by nursing councils or boards began in the early twentieth century. New Zealand registered the first nurse in 1901 with the establishment of the Nurses Registration Act.^[6] Nurses were required to complete three years of training and pass a state-administered examination. Registration ensured a degree of consistency in the education of new nurses, and the title was usually protected by law. After 1905 in California, for example, it became a misdemeanour to claim to be an RN without a certificate of registration.^[7]

Registration acts allowed authorities a degree of control over who was admitted to the profession. Requirements varied by location, but often included a stipulation that the applicant must be "of good moral character"^[8] and must not have mental or physical conditions that rendered them unable to practice.^[9]

As nursing became more of an international profession, with RNs travelling to find work or improved working conditions and wages, some countries began implementing standardized language tests (notably the International English Language Testing System).^[10][11]

By nation

Australia

Nursing registration in Australia has been at a national level since 2010, since the inception of the Nursing and Midwifery Board of Australia (NMBA), which forms part of the Australian Health Practitioners Registration Authority (AHPRA). Prior to 2010, Nursing registration in Australia was administered individually by each state and territory.

The title 'Registered Nurses' (also known in the state of Victoria as a 'Division 1 Nurse') is granted to a Nurse who has successfully completed a board approved course in the field of nursing, as outlined by education and registration standards defined by the NMBA. Registered Nurses are also required to meet certain other standards in order to fulfil registration standards as outlined by the NMBA, and these can include continuing professional development, recency of practice, criminal history checks and English language competency.^[12]

Educational requirements for an entry level Registered Nurse are at the level of bachelor's degree in Australia, and can range in two to four years in length with three years being the national average. Some universities offer a two-year 'fast track' bachelor's degree, whereby a students study three years worth of coursework compressed in a two-year period. This is made possible by reducing summer and winter semester breaks and utilising three semesters per year compared to two.^[13] Some universities also offer combined degrees which allow the graduate to exit the program with a Masters in Nursing, e.g.: Bachelor of Science/Master of Nursing, and these are generally offered over a four-year period.^[14]

Postgraduate Nursing education is widespread in Australia and is encouraged by employing bodies such as state health services (e.g. New South Wales Health). There are many varying courses and scholarships available which provide a bachelor level Registered Nurse the opportunity to 'up-skill' and assume an extended scope of practice. Such courses are offered at all levels of the post graduate spectrum and range from Graduate Certificate to master's degree and provide a theoretical framework for a bachelor level Registered nurse to take up an advanced practice position such as Clinical Nurse Specialist (CNS), Clinical Nurse Consultant (CNC) and Nurse Practitioner (NP).

Canada

In all Canadian provinces except Quebec, new registered nurses are required to have a Bachelor of Science in Nursing.^[15] This is either achieved through a four-year university (or collaborative) program or through a bridging program for registered practical nurses or licensed practical nurses. Some universities also offer compressed programs for applicants already holding a bachelor's degree in another field.

United Kingdom

United States

There are approximately 3.1 million active registered nurses in the United States. There, a registered nurses is a clinician who has completed at least an associate degree in nursing or a hospital-based diploma program. The RN has successfully completed the NCLEX-RN examination for initial licensure. Associate degrees in nursing frequently take three years to complete because of the increased volume of undergraduate coursework related to the profession of nursing. Bachelor of Science in Nursing degrees include more thorough coursework in leadership and community health.

Specialty certification is available through organizations such as the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. After meeting the eligibility requirements and passing the appropriate specialty certification exam, the designation of Registered Nurse – Board Certified (RN-BC) credential is granted.

Economics

As of 2011, there are 2.24 million registered nurses in China.^[16] In 2008 the United States had approximately three million nurses ^[17] and Canada had just over 250,000. In the US and Canada this works out to approximately eight nurses per 1000 people. According to the Bureau of Labor Statistics, the job growth rate of registered nurses is 24%, well above the national average of 14%.^[18] The highest paid registered nurses in the United States are in California. California cities often comprise the top five highest paying metropolitan areas for registered nurses in the country.^[19]

See also

• Advanced practice nurse
• Nurse registry
• Nursing board certification
• Nursing education
• Nursing shortage
• Registered psychiatric nurse

References