What Do Registered Nurses Do? An RN explains.

Nurse in emergency department talking to young woman patient in bed.

If you’re considering a career in health care, you may wonder, “What does a registered nurse actually DO?”

What does your day look like as a nurse? Is it busy? Is it hard? Is it fun? Is is sad? Is it gross?

You may have seen nurses portrayed on TV and wonder if that’s what it’s REALLY like to be a nurse.

Nursing is demanding and rewarding and many nurses wouldn’t have it any other way.

Would you make a good nurse? Would you like the nursing field? Is an RN career for you?

Why would I want to be a nurse?

Year after year, for the last 17 years, nurses are ranked by the Gallup Honesty and Ethics Poll ethics survey as the most trusted profession in the United States. As healthcare professionals, nurses enjoy respect as kind, compassionate, smart, hard-working healthcare employees.

Nurses are well-paid and in demand. Nursing jobs are available in almost any town or city in the country. The U.S Bureau of Labor Statistics expects the demand for nurses to increase in the next decade.

Nursing is fast-paced and always changing and challenging.

If you like to help people and you work well with others, you might seek a job in the nursing profession.

What are the kinds of nurses?

Nurses can be Registered Nurses (RN) or Licensed Practical Nurses (LPN) or Licensed Vocational Nurses (LVN).

There are also several advanced practice areas of nursing, such as family nurse practitioner (FNP), certified nurse midwife (CNM) and certified registered nurse anesthetist (CRNA).

In this article, I’ll mostly be referring to a registered nurse with an ADN or BSN.

What kind of education do nurses have?

A nurse will have either an associate’s degree in nursing (ADN) or a bachelor of science in nursing (BSN). Nurses who complete an associate degree may decide to later complete a bachelor’s degree, either in person or online.

Read more about ADN vs RN vs BSN Nursing Degrees.

Nurses have to pass the NCLEX (National Council Licensure Examination) before they can be issued a nursing license.

Some nurses go on to complete a graduate degree or even a doctor of nursing practice (DNP). This all depends on the career path the nurse wishes to pursue. Many nursing specialties require specific training and orientation in that area, but not a specialized degree.

At a minimum, all nurses will be certified in BLS, Basic Life Support, in case their patient suffers a cardiac arrest and the nurse has to perform CPR.

Depending on what department a nurse works, the hospital may require other certifications such as ACLS (Advanced Cardiac Life Support), PALS (Pediatric Advanced Life Support), or TNCC (Trauma Nurse Core Course).

Some nurses have specialty certifications in their areas of specialty. This would be OCN for oncology nurses; CCRN for critical care (ICU) nurses; and CEN for emergency room nurses.

Nurses are lifelong learners. Nurses need to keep up on the latest nursing best practices. Nurses also need to learn the latest medications and medical technologies and techniques in their specialty areas.

Nurses push a hospital bed down a corridor.

Where do nurses work?

Nurses serve in diverse roles in healthcare in a variety of settings.

Most nurses (58%) work in hospitals, but nurses also work in other settings. This may include doctors’ offices, ambulatory care (outpatient) clinics, long-term care facilities, dialysis clinics, home health, schools, correctional facilities, the military, and other healthcare facilities. Nurses may also work in case management or for insurance companies or other healthcare organizations, doing quality review.

I will refer here mostly to the role of a bedside registered nurse in a hospital setting performing direct patient care. This is the most common nursing role and where most nurses start their careers. (Some nurses will work their entire careers at the bedside).

Within the hospital, nurses may work in specialized units such as critical care nurses in intensive care units (ICU) or emergency departments (ED). Labor and delivery nurses, neonatal nurses and pediatric nurses also receive specific training in their specialty areas.

Do nurses work for doctors?

In a private practice or clinic, a nurse might work for the doctor who owns the practice. In the hospital, nurses are employees of the hospital, not employees of the doctor. However, a lot of what nurses do requires orders from a doctor before the interventions can be implemented. Examples of this are giving medications, starting an IV, or drawing blood for lab tests.

What skills and qualities does a good nurse need?

Nurses need to be well-educated, patient, and compassionate. It sounds basic, but nurses need to care about their patients.

Nurses need to be organized, efficient and have diligent attention to detail. Nurses need to have good time management skills.

Good nurses are flexible team players with excellent critical thinking skills and technical skills. Patient situations can change rapidly, and the nurse must be able to adapt and respond quickly.

Nurses must be good communicators, both verbally and written.

Nurses need to be able to see a holistic picture of a patient.

Nurses care for a patient, not a diagnosis.

That “knee replacement in room 16” is a PERSON who had a knee replacement. A person who will respond to the procedure in their own way, with their own fears and concerns. A person who has a lot more to them than just the procedure they underwent today. It’s the nurse’s job to customize the patient’s care so that it works best for that person.

Is nursing stressful?

Nursing can be stressful. Nurses have an enormous amount of responsibility and their actions can mean life or death for their patients. Nurses pay a vital role assessing patient conditions and monitoring for changes.

Nurses are busy. There are multiple tasks for the nurse to complete during a shift and there never seems to be enough time to get everything done. And chart about it too, which is required.

It can be even more stressful when staffing ratios are too high. If there are not enough nurses and other staff to effectively and safely care for patients, it places great stress on the entire healthcare team.

Nursing is mentally, physically, and emotionally exhausting. Some days you’ll feel like you just can’t go on. But you must, because people are counting on you.

Burnout is a very real concern for nurses. It is important for nurses to practice self care and stress reduction.

Nurse in scrubs leans against wall in hospital, looking exhausted.

Is nursing depressing?

It can be sad to see people suffering, in pain, or upset.

It’s also painful to see the patient’s family who is scared that their loved one is suffering or may die.

But it is also satisfying to be able to ease someone’s pain and comfort them through their fears. And often the nurse gets to be there to see that same sick patient recover and be discharged home.

Sometimes patients die. This is a hard reality nurses face that doesn’t really get easier.

There is a certain honor in caring for a dying patient, helping them in any way you can so they die in peace and comfort, and with dignity.

Do nurses supervise others?

Nurses supervise nursing assistants or similar unlicensed personnel, delegating them to perform appropriate tasks. Registered nurses (RNs) can also supervise and delegate to licensed practical nurses (LPNs).                                                                                                                                      

There is no task the nursing assistant performs that the nurse shouldn’t be willing to perform herself. However, there are many tasks only the nurse is qualified to perform. The nurse often delegates tasks, as appropriate, such as taking blood sugars and feeding patients, to the CNA.  

Nurses work with nursing assistants or techs to bathe, dress, feed and exercise patients, depending on the patient’s individual current abilities and needs.

Charge nurses and nurse managers supervise the nurses on the floor or in their department.

Do nurses have to see blood?

Yes. Patients may have bleeding wounds or surgical incisions. Nurses may have to change blood stained dressings. Nurses perform venipuncture to start IVs. Nurses may also draw blood for labs via vein puncture or via central lines. And when administering blood transfusions, nurses hang a bag of blood and monitor the blood-filled IV tubing.

Some specialty nurses will see blood more often than others. For example, OR nurses who assist with surgery will see blood every day. Emergency department nurses also frequently observe blood and may witness patients with gruesome traumatic injuries.

There are some nursing roles (usually desk jobs) who never (or infrequently) deal with blood. However, these jobs are hard to come by without some nursing experience in direct patient care. And because nursing students receive general training, they are sure to encounter some blood just to get through nursing school clinicals.

Truthfully, most nurses who are sqeamish about blood or needles are able to get over it.

Healthcare worker in lab coat holding a vial of blood next to a rack of more vials.

Do nurses have to deal with body fluids?

Yes, sometimes nurses clean up pee and poop. It’s really not as bad as it sounds, and the nurse has to behave maturely to protect the patient’s dignity.

Nurses often monitor I&Os, the intake and output of patient fluids. They may have to measure (and record) everything the patient eats and drinks (intake) and everything that comes out (output). Output includes measuring urine, diarrhea, blood loss, drainage from tubes and surgical drains, or fluids lost when a patient throws up.

Yes, sometimes you have to clean up vomit too. I won’t sugar coat it. Nurses frequently encounter urine, stool, vomit, blood and other bodily fluids. It just comes with the job.

Are nurses in danger of catching diseases at work?

Nurses sometimes come into contact with patients with infectious diseases. Nurses are taught how to avoid contracting or spreading these diseases by the proper use of PPE (personal protective equipment) such as gloves, gowns, and masks.

This has become particularly relevant in the recent Covid-19 pandemic.

Nurses are careful to wear gloves when coming into contact with body fluids such as blood, which could contain microorganisms that cause diseases such as HIV or hepatitis C. Because it’s not visible that patients have such infections, nurses follow universal precautions and just assume everyone could have a disease.

Do nurses have sore feet and bad backs?

Sometimes, yes. Bedside hospital nurses spend most of the day on their feet. They are grateful when they can find the time to sit down to chart about their patients and review labs, test results and chart notes.

Nurses know that proper footwear is what saves their feet and backs. And some swear that wearing compression socks under their scrubs also helps immensely.

Nurses also have to lift or reposition patients when the patients are unable to do it themselves. Nurses have to be careful to use proper body mechanics to prevent injuring their backs.

Do nurses have to care for mean patients?

Nurses will meet all kinds of patients and families. Most people you encounter are kind and reasonable, even grateful, but there will always be some difficult individuals. Patients can be in pain, worried, confused, or just plain crabby. The nurse needs to not take it personally. Nurses learn how to best deal with these unpleasant interactions.

In rare instances, a patient may be abusive or violent. In these cases, nurses may have to call for assistance from hospital security to keep themselves safe. It’s an alarming but real concern than a patient could bite or hit the nurse.

Nurse standing in hospital corridor conferring with doctors and healthcare team.

Nurses work with other disciplines in the hospital.

A nurse is often the primary communicator between a patient and their physician. The bedside nurse also coordinates with others on the healthcare team such as pharmacy, lab, respiratory therapy, physical therapy, and care managers and social workers. The nurse keeps track of any procedures or tests the patient needs and helps coordinate all these activities taking place.

Nurses are teachers.

Nurses educate their patients (and patient families) about procedures and disease states as well as wellness and disease prevention. The nurse teaches the patient what to expect in various procedures. The nurse explains why particular medications are being given and potential side effects.

Long before discharge, the nurse begins teaching the patient what they can expect when they go home. Nurses also teach lifestyle modification such as specialized diets or smoking cessation.

Nurses admit and discharge patients.

As soon as one patient goes home, there is frequently another one to take their place. It’s not often that you’ll have an empty bed for long.

When a doctor admits a new patient to the floor (through the emergency department, directly from the doctor’s office, or after a scheduled surgery or procedure requiring an overnight stay) the nurse guides the patient through an admission process.

This admission may include a physical assessment, taking a health history, reviewing any medications the patient is taking, and recording the patient’s current symptoms and complaints.

The nurse will explain the treatment plan and the routines of the unit to the patient. The nurse will also answer questions patients have about their diagnosis, their plan of care and what will happen during their hospital stay.

When a patient is ready to go home, the doctor writes a discharge order. The discharging nurse assures that the patient has everything in place to thrive outside the hospital. The nurse reviews any discharge instructions with the patient and often their family.

This might include teaching the patient certain activities to aid in their recovery; follow up appointments; and any new prescriptions the doctor has written.

Male And Female Nurse Working At Nurses Station

Nurses report off to other nurses.

Nursing is a 24-hour job, and one of the nurse’s responsibilities is to obtain a thorough report about the patient from the off going nurse. The nurse also must give a thorough report to the nurse coming on the next shift.

Although everything about the patient and their care should be in the patient chart, shift reports give the nurses caring for the patient a chance to summarize the patient’s situation, discuss the plan of care, and ask each other questions.

Nurses also stay in touch with their charge nurse throughout the shift, letting them know if they need help or if patients have a change in status which would affect staffing or require a transfer to another unit in the hospital.

What does the nurse do all day?

No matter where you work as a nurse, you will do much more than hand out aspirin and mop your patient’s weary brow. Nursing has evolved over the years and today’s nurses have numerous skills and responsibilities.

What is a typical day like for a nurse? Well, frankly, there is no typical day. Nurses have an approximate routine to follow for the shift, but they have to be able to quickly re-prioritize when patient situations change.

Generally, your job as a bedside nurse is to monitor and care for your patients under the guidance of a physician, providing physical and emotional support. It’s a busy job with a lot of moving parts.

Nurses work with physicians to develop and implement a plan of care for each patient and their unique diagnosis and situation. Nurses implement doctor’s orders to provide appropriate therapeutic interventions. This may include administering medication and treatments and observing for side effects or expected beneficial outcomes.

Nurses monitor patients’ vital signs and assess patients throughout the day, charting the findings, and reporting noteworthy changes to the patient’s doctor as necessary. Although doctors visit the patient each day, it is the nurses who spend the entire day with the patients. In addition to formal physical assessments up to 3 times a day, nurses are vigilant in watching their patients for changes in physical or mental status.

Specific duties vary depending on the department or clinical setting where the nurse works.

Read about A Day in the Life of a Nurse.

Nurses do a lot of charting.

Nurses document the care of the patient in the patient chart throughout the day.

Nurses must chart all vital signs, assessment findings, medication administration, procedures performed, communication with physicians, personal care, I&Os if applicable.

It is also the responsibility of the nurse to ensure that any care has been documented that was performed by aides or techs they supervise. The patient charts are permanent legal medical records. Most charting is done in computer charting programs.

Nurses give (and keep track of) medications.

It is the responsibility of the nurse to ensure that all ordered medications are given in a safe and timely manner throughout the shift, and that all meds are recorded in the MAR (medication administration record).

The nurse works with the physician and pharmacist if any medication changes are needed.

Nurses need to understand what the medications they give are for, the desired effects, and what side effects they should look for.

Nurse handing pills to patient in hospital bed.

What kinds of tasks do nurses do? What are nurse job duties?

The list of nursing skills is extensive and may vary on a daily basis. It also depends on the department and nursing specialty.

Duties of a nurse may include:

Care for patients with a variety of health issues and medical conditions.

Chart in a computer EMR (electronic medical record).

Take, record and interpret vital signs such as temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation.

Administer medications, delivered by a variety of routes (by mouth, IV, topical, suppository, etc.)

Assess heart and lung sounds using a stethoscope.

Start IVs. Access central lines.

Apply and titrate (adjust) supplemental oxygen.

Administer and monitor IV infusions. Program IV pumps or calculate drip rates.

Collect samples for lab tests such as blood and urine.

Change wound dressings. Obtain cultures of wound drainage when needed.

Administer vaccine injections.

Perform enemas.

Set up and maintain traction for orthopedic patients.

Manage and monitor chest tubes.

Record patient medical histories and symptoms.

Maintain infection prevention precautions.

Insert, monitor, and remove urinary catheters.

Apply monitoring equipment such as heart monitors.

Interpret heart monitor rhythm strips and EKGs.

Administer and monitor blood transfusions.

A front view of nurse with IV drip and patient in bed in hospital room.

Update patients and family members about treatment plans.

Check blood sugars and administer insulin if needed.

Start and titrate IV insulin drips.

Implement and enforce isolation precautions for patient with infectious diseases.

Assess for fall risk and prevent falls.

Manage and monitor BIPAP, CPAP or ventilators.

Turn and reposition patients that can’t move themselves in bed.

Suction endotracheal tubes and tracheostomy tubes.

Help and encourage patients to do the exercises recommended by physical therapy.

Monitor output from drainage tubes.

Perform health screenings.

Set up and maintain a sterile field for a procedure.

Assist physicians and other medical staff in procedures and diagnostic tests.

Administer and monitor medications to sedate a patient for a procedure.

Assess, monitor and treat patient’s pain.

Obtain informed consent for invasive procedures.

Administer TPN (IV nutrition).

Teach and counsel new mothers about breastfeeding.

Monitor patients for alcohol withdrawal symptoms and medicate if needed.

Implement seizure precautions.

Apply and monitor restraints for patients who may harm themselves or others.

Nurse adjusts cardiac monitor in operating room.

Prepare patients for surgery or procedures.

Accompany patients to imaging for tests like x-rays, CT scans and MRIs.

Teach patients and their families about health conditions and illness prevention.

Deliver tube feedings by nasogastric tube or other feeding tube.

Monitor patients on suicide watch.

Program and operate patient-controlled IV or epidural pain pumps.

Operate specialized equipment such as dialysis machines and intra-arterial balloon pumps.

Perform post-mortem care when a patient dies.

Collaborate with healthcare providers to develop care plans for patients to provide the best care possible.

Conduct research to find ways to improve nursing care and patient outcomes.

Serve on department or facility-wide councils to make nursing policy decisions.

Orient and train nursing students and new employees.

What about unit-specific skills?

Nurses working in specialty areas will learn additional skills relevant to their areas of expertise.

For example, oncology (cancer) nurses will have additional training in administering chemotherapy to cancer patients. ICU nurses will have training in caring for patients on ventilators and managing those vents. Emergency department nurses will learn advanced trauma skills.

Operating room (OR) nurses learn about sterile fields and assisting physicians in surgery. Labor and delivery nurses learn specialized skills to assist mothers giving birth and care for newborn babies

Can a nurse change specialties?

The exciting thing about nursing as a career is that there are many areas you can specialize in without being required to go back to school. You will learn the skills you need for your specialty from the nurses in your department and training programs specific to the department.

There are many types of nurses that don’t require additional schooling beyond your nursing degree. School nurses and public health nurses usually have bachelor’s degrees in nursing.

Nurses and a doctor assessing a patient in a bed in the emergency department.
Emergency department staff assess a patient.

What do Advanced Practice nurses do?

There are some nursing specialties that require an advanced degree in a specialized area. These include advanced practice nurses such as nurse practitioner (NP), clinical nurse specialists (CNS), and certified registered nurse anesthetists (CRNA).

Nurse educators usually have a master’s or higher degree in nursing education to teach other nurses in their jobs or at colleges. Nurse practitioners require a doctoral degree and provide medical care in hospitals and clinics, and may have their own private practices.

Nurse Practitioners may work in hospitals or clinics and have greater responsibility than regular nurses. Nurse practitioners can assess and diagnose medical problems and prescribe medications. (Non-advanced practice nurses are not trained or legally permitted to prescribe medications).

Nurse practitioners provide medical care in a holistic, nursing-based model.

Certified registered nurse anesthetists (CRNAs) work independently or with an anesthesiologist to administer anesthesia for surgical procedures. CRNAs also insert epidural catheters and can intubate patients to protect their airway in an emergency or while under anesthesia.

A CNS (Clinical Nurse Specialist) has advanced nursing education in a specialty area and usually serves as a resource for other nurses.

Informatics nurses also usually hold master’s degrees and are experts in EMRs (electronic medical records), computer charting, and other patient care software.

Do nurses work 12-hour shifts?

Most bedside nurses in the hospital work three 12-hour shifts each week. This 36-hour workweek is considered full time. The long hours are grueling, but then you get 4 days off a week! In clinics or another work setting, a nurse may work 8 or 10 hour shifts.

Hospital nurses have to work some weekends and holidays. The hospital is open 24/7 and patients require nursing care around the clock.

Do nurses have to work night shifts?

Some hospital nurses work overnight shifts because there always has to be someone there to take care of the patients. Night shift nurses are usually paid a slightly higher wage (shift differential) for the inconvenience of working at night.

Some nurses enjoy night shift and the schedule may work well for their family. Often, new grad nurses work night shift for a few years while they gain experience and seniority.

Do nurses have to be on call?

Some areas of nursing (such as OR or cardiac catheterization lab) require nurses to take turns being on call. This means the nurse on call has to be available to come to work immediately if there is an emergency after regularly scheduled hours.

Do nurses make a lot of money? What is nurse salary?

Your income as a nurse will vary greatly depending on your level of clinical experience, the type of facility you work, and where you live.

According to the U.S. bureau of labor statistics the median RN salary in 2019 was about $73,000/year. This can vary greatly depending on where you live in the country, and how much experience you have.

If you’re interested in how much nurses make in you area, look at the U.S. Bureau of Labor Statistics website to find current local statistics.

Many hospitals also state the starting nurse hourly wage in their job postings.

The advanced specialties mentioned above make more than their ADN or BSN colleagues.

Is real life nursing like on TV?

In real life, nursing is not even a teensy bit like most of the medical dramas on TV, except that we use stethoscopes like on TV. But better ones.

How do you become a nurse?

To become a registered nurse, you’ll attend an approved nursing program, take a state board exam to get your license, and apply for your first job.

Student nurses may obtain an ADN (Associate’s Degree in Nursing) or BSN (Bachelor’s Degree in Nursing). Either degree offers classes about nursing theory and extensive clinical training.

Read more about nursing degrees here: ADN vs RN vs BSN

New grad nurses get a long orientation (3-6 months) to their departments before they can care for patients on their own.

The pathway to becoming a nurse can be simple, but it’s sure not easy. Nursing school is hard work, but a nursing career is lucrative and fulfilling.

Do you have more questions about what nurses do? Drop a comment below and I’d be happy to answer!

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