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Nurses are indispensable when it comes to protecting public health and giving care to people who are sick or injured.
There are various specialties in the nursing field, from working in the NICU with the tiniest of newborn patients, to geriatrics and palliative nursing for those at the end of their lives. Regardless of the specialty, nurses strive to offer their patients respect, kindness, dignity, and compassion.
Nurses strive to achieve the best possible quality of care for individuals, families, and communities, regardless of disease or disability.
Nurses that work in a hospital setting follow a certain protocol when caring for patients and when working with doctors and other staff members. Some responsibilities include administering medication, helping prepare patients for surgeries and treatments, and assisting doctors and surgeons during procedures.
Educating patients is another important aspect of nursing. Sharing knowledge about health, and ways to stay healthy, can have a very positive effect on a patient's life. Many nurses agree that learning doesn't end with graduating, and indeed, they continue to learn throughout their careers so as to become better caregivers.
Nurses are found in a variety of roles and practice settings:
Licensed Practical Nurse
A licensed practical nurse works under the supervision of doctors and registered nurses to perform basic healthcare and assistance for patients that are sick and injured.
In states where a wide scope of practice is allowed, a licensed practical nurse can perform most of the same skills as a registered nurse. In states where a narrower scope of practice is in place, these nurses are quite limited in their duties. These types of nurses are most appropriately suited to patients with less complex needs, and patients with stable and predictable conditions.
A licensed practical nurse needs to complete a two year college program leading to a diploma in practical nursing.
Registered Nurse
A registered nurse is part of a support system, and has a variety of tasks they take care of on a daily basis. They administer medication, keep records, monitor patients, consult with other care providers, and educate individuals and their families on healthcare.
They provide direct care to their patients, as well as supervise orderlies, nursing assistants, and licensed practical nurses. A registered nurse can care for patients in unpredictable situations, and with more complex needs.
A registered nurse needs to complete a collaborative college-university nursing program or a four-year university nursing program — both leading to a Bachelor of Science in Nursing degree (BScN) or Bachelor of Nursing degree (BN).
Clinical Nurse Specialist
Clinical nurse specialists (CNSs) work to improve patient outcomes by using theory and research to further the success of nursing systems. This career is categorized as an advanced practice registered nurse (APRN) role.
Clinical nurse specialists provide care to patients in one of many specialties, such as geriatrics, pediatrics, oncology, and emergency care, to name a few. They may also work as consultants by helping other health professionals to improve patient care and can play a leading role in developing guidelines and protocols, providing support and consultation, facilitating system change, and promoting the use of evidence.
Clinical nurse specialists are registered nurses who typically hold a master’s degree along with national certification. They spend two to three more years in school beyond the requirements for registered nurse licensure. Certification indicates advanced knowledge and clinical skills specific to a specific patient population or specialized area of nursing.
Nurse Practitioner
Nurse practitioners are able to prescribe medications, perform in-office procedures, communicate diagnoses, and order and interpret diagnostic tests. They also have hospital admitting, discharge, and hospital rounding privileges.
There is a great deal of collaboration between a nurse practitioner and the physician and vice versa. Because the nurse practitioner can practice independently from the physician, the physician is freed up to leave the office and focus on surgical cases, do rounds at the hospital, or tend to an emergency.
There are four nurse practitioner specialty areas: primary health care, adult, pediatric care, and anesthesia. After obtaining a bachelor’s degree, candidates must complete an additional two to six years of study to earn a Master’s Degree in Nursing, or Doctorate of Nursing Practice (many graduate schools require nurse practitioner candidates to also have a few years of experience as a registered nurse).
Acute Care Nurse Practitioner
An acute care nurse practitioner (ACNP) provides advanced nursing care to patients suffering brief but severe illnesses, typically in an emergency department, ambulatory care clinic, or other short term stay facility.
They can care for patients suffering from heart attacks, respiratory distress syndrome, or shock. They also care for pre- and post-operative patients, perform advanced invasive, diagnostic, and therapeutic procedures, prescribe special medications, perform screenings exams, provide x-rays, and assign patients to rehabilitation programs.
Acute care nurse practitioners need to get a Master's of Science in Nursing (MSN) degree that includes specialized ACNP coursework, and become certified by their State Board of Nursing, or receive a national certification from an agency such as the American Nurses Credentialing Center, or the American Academy of Nurse Practitioners.
Nurse Anesthetist
A nurse anesthetist (or a certified registered nurse anesthetist (CRNA)), is capable of administering anesthesia under the oversight of an anesthesiologist , surgeon, dentist, podiatrist, or other qualified healthcare professional.
Nurse anesthetists are independently licensed health professionals, and are often the sole providers of anesthesia services that offer surgical, obstetrical, and trauma stabilization services in rural hospitals and areas where it would otherwise not be possible.
Outside of the operating room, a nurse anesthetist can provide services in other areas, such as lithotripsy units, MRI units, and cardiac catheterization labs. Some nurse anesthetists hold credentials in fields such as respiratory care or critical care nursing, and some choose to specialize in obstetric, neurosurgical, pediatric, dental, or cardiovascular anesthesia services.
To become a certified registered nurse anesthetist, one must first become a licensed registered nurse and work for a minimum of one year in an acute care setting. At that point, one can enter an anesthetist program and earn an MSN (Master of Science in Nursing) in Nurse Anesthesia.
Note: The profession’s educational requirements are transitioning from the master’s level to the doctoral level. In 2025, all CRNAs will need a Doctoral Degree in Nurse Anesthesia to enter the field.
Informatics Nurse Specialist
Nursing informatics is a well-established specialty within nursing. The American Nurses Association defines the position as "overseeing the integration of data, information, and knowledge to support decision-making by patients and their healthcare providers."
Technology is now at the point-of-care in hospitals and nursing homes — from electronic medical records and barcoded medication administration, to physiologic monitoring and 'smart' IV pumps and beds.
Informatics nurse specialists are able to choose an appropriate system; provide systems preparation, development, optimization, and maintenance; write policies; train and provide support to systems users; perform quality control; and even sales. They are also involved in educating other nurses and promoting professional development. Many informatics nurse specialists are registered nurses, which is key in understanding the workflow as well as the working environment of the various care settings.
Many employers prefer registered nurses for health informatics positions, because nurses already have knowledge of the medical profession. Some employers may also prefer job applicants who have earned a Master’s Degree in Health Informatics, Healthcare Management, or Quality Management.
Nurse Educator
Most nurse educators work as registered nurses for a period of time before dedicating their careers to educating future nurses. They therefore have the ability to play a major role in supporting the nursing workforce.
These nurses have a good grasp and in-depth knowledge of nursing theories, which they can easily explain. They are also skilled at basic and advanced nursing practices and are able to teach and demonstrate them to their students. Nurse educators work both in the classroom and the practice setting.
Nurse educators evaluate educational programs, develop lesson plans, teach courses, and oversee students’ clinical practice. They may also choose to focus on areas of specialization, such as nursing informatics, geriatric nursing, or pediatric nursing.
Most employers require nurse educators to have a minimum of a master’s degree, but mandatory Doctoral Degrees in Nursing are becoming more common, especially for those seeking tenure.
Areas Of Specialization:
Cardiovascular Nursing
Community Health Nursing
Critical Care Nursing
Critical Care Pediatric Nursing
Emergency Nursing
Enterostomal Therapy Nursing
Gastroenterology Nursing
Gerontological Nursing
Hospice Palliative Care Nursing
Medical-Surgical Nursing
Nephrology Nursing
Neuroscience Nursing
Occupational Health Nursing
Oncology Nursing
Orthopaedic Nursing
PeriAnesthesia Nursing
Perinatal Nursing
Perioperative Nursing
Psychiatric and Mental Health Nursing
Rehabilitation Nursing

Nurses have distinct personalities . They tend to be investigative individuals, which means they’re intellectual, introspective, and inquisitive. They are curious, methodical, rational, analytical, and logical. Some of them are also social, meaning they’re kind, generous, cooperative, patient, caring, helpful, empathetic, tactful, and friendly.


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This is a career for people who are patient, kind, motivated, enjoy a structured environment, and have a high energy level. Some nurses work with a great deal of autonomy, while others work with very close supervision. This is something to keep in mind when considering different nursing careers.
Most people would immediately think of a hospital when thinking of where a nurse would work, and that is indeed a common place of employment. However, there are many other places of employment, such as private practices, clinics, retirement centres, nursing homes, and in-home healthcare. Schools and universities, cruise ships, airports, and sports teams are some of the more unusual places for a nurse to find employment, but these and countless more opportunities exist.
Nurses work long hours, often on their feet, and evenings and weekends are almost a given. Frequently, 12-hour or split shifts are necessary as well, and since hospitals and nursing homes require 24-hour coverage, frequently the less desirable "overnight" hours are assigned to nurses with less seniority. Nurses that work in a general practice, or in a doctor's office, might find the hours and workload to be more palatable, however the salary might reflect this convenience.
A licensed practical nurse can perform simple and occasionally more complex procedures, but is under the supervision of a registered nurse or a physician. They keep records, administer basic care, are able to administer most medications, and can perform CPR. They have approximately two years of training and are licensed.
A registered nurse usually has a Bachelor's Degree in Nursing , along with many hours of clinical experience. They must also pass examinations before earning the registered nurse title. They provide direct care to their patients, as well as supervise orderlies, nursing assistants and licensed practical nurses.
Nursing can be very demanding in all areas - physical, mental and emotional. You'll typically be on your feet all day, and heavy lifting is often required. There are days that are so busy that there is no time to eat or to even go to the bathroom. Decisions you make can have huge consequences, both positive and negative. You'll be forever assessing and re-assessing, constantly using your critical thinking skills. You'll have to admit that you can't save everyone, and will have to watch people die while providing understanding and support to their loved ones.
It can be the best and most rewarding job, and can be the most thankless and challenging job at the same time. Most nurses will tell you that when you can make a difference in someone's life, it often makes the difficulties worth it.
An excellent nurse is able to be both compassionate and competent. Trust and understanding between the patient and the nurse is the result of the nurse being sympathetic to the patient's (and the family's) misfortune and being able to convey complete understanding and knowledge of what they are experiencing. The nurse needs to confidently convey that she is skilled, knowledgeable, and trusted to do the right thing. These qualities result in the ultimate bond between a patient and the nurse.

Amanda Bucceri Androus, RN, BSN | Updated/Verified: Aug 29, 2022
Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.
Latest posts by Amanda Bucceri Androus, RN, BSN ( see all )
Home / Nursing Articles / What Happens When a Nurse Has a Substance Abuse Problem?
Substance abuse can affect any socioeconomic class, gender, race, and profession. Nursing is certainly not immune to the pitfalls of this terrible disease. Nurses are entrusted to protect the patients in their care from harm at all times. This protection includes the ability to perform at a high level of critical thinking. Caring for patients while under the duress of substance abuse puts the entire nursing process in harm’s way.
Prior to the 1980s, before substance abuse was recognized as a disease, nurses were relieved of duty and/or had their nursing license revoked with little recourse or treatment options when found to have a substance abuse disorder. Since that time, many states have enacted non-disciplinary rehabilitation programs to assist nurses with recovery. These intensive programs allow the nurse to gradually return to the working environment once it can be established and confirmed that the nurse is safe to practice in a clinical setting.
Although alcohol has been a main source for substance abuse disorders, there are more mind-altering and dangerous options for those with an addiction disease. Chemical changes occur in the brain of an addict, making it more and more challenging to recover and rehabilitate from the abuse. The earlier the disease and abuse is recognized and treated, the better the outcome for recovery for the nurse and the option to return to the work environment.
A unique challenge to the nursing profession and substance abuse is the access to narcotic medications. Diversion of these drugs for self-use is not only harmful to the nurse, but is also unethical in the failure to protect the patient from harm by diverting the drugs from the patient. Furthermore, the impairment of the nurse may endanger the life of the patient in their care.
Identifying nurses who have a substance abuse disorder and assisting them to find appropriate treatment programs can save lives. Signs of impairment can include extended absence, frequent trips to the restroom, arriving late and leaving early, excessive medication errors, isolation from colleagues, inappropriate emotional outbursts, or diminished alertness.
Once a substance abuse disorder is suspected, the nurse is typically placed on leave until an investigation can be conducted. The nursing leadership team and human resource leaders are required to, in most states, report the abuse to the Board of Nursing (BON) and the local police authority. Each BON has a process for investigation and varying levels of programs to assist nurses through recovery. The Nurse Practice Act for each state will define the process for programs in the state to assist the nurse with returning to work once they are safe to practice.
Many states offer a graduated program of returning to work where there is oversight of the nurse with strict restrictions on the work environment. These restrictions can include a weekly check-in with a nursing leader, a weekly or monthly report to the BON, restrictions on shift assignments such as no night shift work, or complete removal of the nurse from clinical practice such as an advice nurse or case-manager role.
The National Council of State Boards o
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