 Specialty
Areas
RNs can specialize in
one or more patient care specialties. The most common specialties can be
divided into roughly four categories -- by work setting or type of
treatment; disease, ailment, or condition; organ or body system type; or
population. RNs may combine specialties from more than one area -- for
example, pediatric oncology or cardiac emergency -- depending on personal
interest and employer needs.
RNs may specialize by work
setting or by type of care provided. For example, ambulatory care nurses
treat patients with a variety of illnesses and injuries on an outpatient
basis, either in physicians' offices or in clinics. Some ambulatory care
nurses are involved in telehealth, providing care and advice through
electronic communications media such as videoconferencing or the
Internet. Critical care nurses work in critical or intensive care
hospital units and provide care to patients with cardiovascular,
respiratory, or pulmonary failure.
 Emergency,
or trauma, nurses work in hospital emergency departments and treat
patients with life-threatening conditions caused by accidents, heart
attacks, and strokes. Some emergency nurses are flight nurses, who
provide medical care to patients who must be flown by helicopter to the
nearest medical facility. Holistic nurses provide care such as
acupuncture, massage and aroma therapy, and biofeedback, which are meant
to treat patients' mental and spiritual health in addition to their
physical health. Home health care nurses provide at-home care for
patients who are recovering from surgery, accidents, and childbirth.
 Hospice
and palliative care nurses provide care for, and help ease the pain of,
terminally ill patients outside of hospitals. Infusion nurses administer
medications, fluids, and blood to patients through injections into
patients' veins. Long- term care nurses provide medical services on a
recurring basis to patients with chronic physical or mental disorders.
Medical-surgical nurses provide basic medical care to a variety of
patients in all health settings. Occupational health nurses provide
treatment for job-related injuries and illnesses and help employers to
detect workplace hazards and implement health and safety standards.
Perianesthesia nurses provide preoperative and postoperative care to
patients undergoing anesthesia during surgery. Perioperative nurses
assist surgeons by selecting and handling instruments, controlling
bleeding, and suturing incisions. Some of these nurses also can
specialize in plastic and reconstructive surgery. Psychiatric nurses
treat patients with personality and mood disorders. Radiologic nurses
provide care to patients undergoing diagnostic radiation procedures such
as ultrasounds and magnetic resonance imaging. Rehabilitation nurses
care for patients with temporary and permanent disabilities. Transplant
nurses care for both transplant recipients and living donors and monitor
signs of organ rejection.
 RNs
specializing in a particular disease, ailment, or condition are employed
in virtually all work settings, including physicians' offices,
outpatient treatment facilities, home health care agencies, and
hospitals. For instance, addictions nurses treat patients seeking help
with alcohol, drug, and tobacco addictions. Developmental disabilities
nurses provide care for patients with physical, mental, or behavioral
disabilities; care may include help with feeding, controlling bodily
functions, and sitting or standing independently. Diabetes management
nurses help diabetics to manage their disease by teaching them proper
nutrition and showing them how to test blood sugar levels and administer
insulin injections. Genetics nurses provide early detection screenings
and treatment of patients with genetic disorders, including cystic
fibrosis and Huntington's disease. HIV/AIDS nurses care for patients
diagnosed with HIV and AIDS. Oncology nurses care for patients with
various types of cancer and may administer radiation and chemotherapies.
Finally, wound, ostomy, and continence nurses treat patients with wounds
caused by traumatic injury, ulcers, or arterial disease; provide
postoperative care for patients with openings that allow for alternative
methods of bodily waste elimination; and treat patients with urinary and
fecal incontinence.
 RNs
specializing in treatment of a particular organ or body system usually
are employed in specialty physicians' offices or outpatient care
facilities, although some are employed in hospital specialty or critical
care units. For example, cardiac and vascular nurses treat patients with
coronary heart disease and those who have had heart surgery, providing
services such as postoperative rehabilitation. Dermatology nurses treat
patients with disorders of the skin, such as skin cancer and psoriasis.
Gastroenterology nurses treat patients with digestive and intestinal
disorders, including ulcers, acid reflux disease, and abdominal
bleeding. Some nurses in this field also specialize in endoscopic
procedures, which look inside the gastrointestinal tract using a tube
equipped with a light and a camera that can capture images of diseased
tissue. Gynecology nurses provide care to women with disorders of the
reproductive system, including endometriosis, cancer, and sexually
transmitted diseases. Nephrology nurses care for patients with kidney
disease caused by diabetes, hypertension, or substance abuse.
Neuroscience nurses care for patients with dysfunctions of the nervous
system, including brain and spinal cord injuries and seizures.
 Ophthalmic
nurses provide care to patients with disorders of the eyes, including
blindness and glaucoma, and to patients undergoing eye surgery.
Orthopedic nurses care for patients with muscular and skeletal problems,
including arthritis, bone fractures, and muscular dystrophy.
Otorhinolaryngology nurses care for patients with ear, nose, and throat
disorders, such as cleft palates, allergies, and sinus disorders.
Respiratory nurses provide care to patients with respiratory disorders
such as asthma, tuberculosis, and cystic fibrosis. Urology nurses care
for patients with disorders of the kidneys, urinary tract, and male
reproductive organs, including infections, kidney and bladder stones,
and cancers.
Finally, RNs may
specialize by providing preventive and acute care in all health care
settings to various segments of the population, including newborns
(neonatology), children and adolescents (pediatrics), adults, and the
elderly (gerontology or geriatrics). RNs also may provide basic health
care to patients outside of health care settings in such venues as
including correctional facilities, schools, summer camps, and the
military. Some RNs travel around the United States and abroad providing
care to patients in areas with shortages of medical professionals.
 Most
RNs work as staff nurses, providing critical health care services along
with physicians, surgeons, and other health care practitioners. However,
some RNs choose to become advanced practice nurses, who often are
considered primary health care practitioners and work independently or
in collaboration with physicians. For example, clinical nurse
specialists provide direct patient care and expert consultations in one
of many of the nursing specialties listed above. Nurse anesthetists
administer anesthesia, monitor patient's vital signs during surgery, and
provide post-anesthesia care. Nurse midwives provide primary care to
women, including gynecological exams, family planning advice, prenatal
care, assistance in labor and delivery, and neonatal care. Nurse
practitioners provide basic preventive health care to patients, and
increasingly serve as primary and specialty care providers in mainly
medically underserved areas. The most common areas of specialty for
nurse practitioners are family practice, adult practice, women's health,
pediatrics, acute care, and gerontology; however, there are many other
specialties. In most States, advanced practice nurses can prescribe
medications.
 Some
nurses have jobs that require little or no direct patient contact. Most
of these positions still require an active RN license. Case managers
ensure that all of the medical needs of patients with severe injuries
and illnesses are met, including the type, location, and duration of
treatment. Forensics nurses combine nursing with law enforcement by
treating and investigating victims of sexual assault, child abuse, or
accidental death. Infection control nurses identify, track, and control
infectious outbreaks in health care facilities; develop methods of
outbreak prevention and biological terrorism responses; and staff
immunization clinics.
Legal
nurse consultants assist lawyers in medical cases by interviewing
patients and witnesses, organizing medical records, determining damages
and costs, locating evidence, and educating lawyers about medical
issues.
 Nurse administrators supervise nursing staff, establish work
schedules and budgets, and maintain medical supply inventories. Nurse
educators teach student nurses and also provide continuing education for
RNs. Nurse informaticists collect, store, and analyze nursing data in
order to improve efficiency, reduce risk, and improve patient care. RNs
also may work as health care consultants, public policy advisors,
pharmaceutical and medical supply researchers and salespersons, and
medical writers and editors.
Note: Some resources in this section are provided by the US Department
of Labor, Bureau of Labor Statistics.
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