Roles in Nursing

Roles in Nursing

There are many different kinds of nurses, working in many different roles and settings. Registered Nurses are the most numerous type of licensed nurse, and about half of the RNs in this country and in WA work in hospitals. The other half work in long-term care, home health, public health, schools, research projects, and many other settings.

Certified Nursing Assistant (CNA

What they do: Provide care such as helping with meals, bathing, exercises, taking and recording vital signs, weights, and other observations. Prepare patients for office visits. Ensure that physicians, nurse practitioners, physician assistants, and nurses have the help they need during treatments or examinations. Work under the direction of an MD, RN, ARNP, or PA. (Sometimes called NAC - nursing assistant certified.)

Where they work: Hospital, long-term care, home care, or out-patient (ambulatory) care setting.

Preparation: Complete a CNA program; these are offered by some high schools, voc-ed centers, community colleges. Pass the written exam. CNAs are licensed by the State.

Licensed Practical Nurse (LPN)

What they do: Provide direct care to patients, collect data for assessment. Participate in planning, delivering and evaluating care, administer medications, and perform treatments. Work under the supervision of an MD, RN, ARNP or PA. (In some states they are called LVNs - licensed vocational nurses.)

Where they work: Hospital, long-term care, home care, or out-patient setting.

Preparation: Complete an approved Licensed Practical Nurse program (12-18 months). Pass the LPN-NCLEX exam.

Registered Nurse (RN)

What they do: Promote health and wellness; provide direct care to patients, manage complex patient care, oversee and supervise other caregivers, provide education to patients and families, collaborate with other professionals in planning, delivering and evaluating care, lead teams of care professionals.

Where they work: Hospital, long-term care, home care, ambulatory care, public/community health, schools, case management, teaching, research, and many other systems and care settings.

Preparation: Complete either an Associate or Baccalaureate degree nursing education program. Pass the RN-NCLEX exam.

Public Health Nurse

What they do: Focus on populations and community nursing practice, provide care for vulnerable populations and high-risk groups, evaluate health trends and risk factors of populations and help determine priorities for targeted populations, manage disease surveillance and data analysis.

Where they work: In Washington State, there is a local public health department for each county. 

Preparation: Usually Baccalaureate degree in nursing, although requirements vary by position. 

More Information:
Overview of Public Health Nursing in WA 

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Advanced Registered Nurse Practitioner (ARNP)

What they do: Provide high-quality healthcare services similar to those of a doctor, diagnose and treat a wide range of health problems. Besides clinical care, ARNPs focus on health promotion, disease prevention, health education and counseling. ARNPs may be primary care providers, Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, or Certified Nurse Midwives.

Where they work: Ambulatory care and urgent care clinics, physician or independent ARNP group practices, hospitals, emergency rooms, and long-term care.

Preparation: RN with a Master’s or Doctoral degree. Usually certified in specialty area by national specialty organization. Licensed by the State.

More information:
American Association of Nurse Practitioners

National Organization of Nurse Practitioner Faculties

Clinical Nurse Leader (CNL)

What they do: Coordinate care for distinct groups of patients, work with staff who care for those patients, directly provide care, and evaluate care outcomes.

Where they work: In hospitals.

Preparation: Usually RN with a Master’s degree.

Clinical Nurse Specialist (CNS)

What they do: Provide education to staff and patients/families; may consult or oversee care for groups of patients with specific clinical needs. 

Where they work: Hospitals, ambulatory care, home health, and other settings.

Preparation: RN with Master’s degree in a specific clinical area; specialty certification.

National Association of Clinical Nurse Specialists

Nurse Anesthetist (Certified Registered Nurse Anesthetist, CRNA)

What they do: Manage patients’ anesthesia needs before, during and after surgery or the delivery of a baby. 

Where they work: Hospitals, ambulatory care and ambulatory surgery centers, pain clinics, physician’s offices.

Preparation: RN with a Master’s degree from a Nurse Anesthetist program; specialty certification. 

American Association of Nurse Anesthetists

Nurse Midwife (Certified Nurse Midwife, CNM)

What they do: Provide primary health care to women, including prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. 

Where they work: Hospitals, birthing centers, ambulatory care, clients’ homes. 

Preparation: RN with a Master’s degree in Midwifery or DNP specialty program; certification by the American Midwifery Certification Board.

American College of Nurse-Midwives

Chief Nurse Executive or Chief Nursing Officer (CNE/CNO)

What they do: Participate in creating policy, strategic plans, implementation plans, evaluation of care, and general operations as a member of an organization’s senior leadership team. Are accountable for the quality of care delivered to patients, staff recruitment and retention, financial performance, professional development, and often, community relationships on behalf of the organization.

Where they work: All healthcare organizations. 

Preparation: RN with at least a Master’s degree, with emphasis on leadership in healthcare (required preparation and education varies with role and institution).

Nurse Educator

What they do: In nursing schools, provide both classroom and clinical education. Design curriculum, teach and advise and evaluate students, evaluate effectiveness of nursing program. In clinical settings, provide education to staff, develop resources and clinical policies.

Where they work: Community and technical colleges, universities, clinical agencies. 

Preparation: RN with a Master’s or Doctoral degree (education required varies with the level of educational program and setting).

Be a Nurse Educator (PDF brochure)
National League for Nursing
American Association of Colleges of Nursing
Professional Nurse Educators Group

Nurse Manager

What they do: Lead staff in caring for patients in a department, clinical service, or facility. Accountable for quality of care, service, financial performance, and staff development and retention.

Where they work: All settings where nurses work with patients and families.

Preparation: RNs with clinical experience and usually advanced education (preparation and education required vary with role and institution).