Nursing Specialties Working Out of the Hospital Setting

With 3.1 million jobs held, registered nurses (RNs) make up the largest healthcare occupation. There are 2.6 million licensed RNs or 84.8 percent employed while there are almost 500,000 licensed nurses who are not working in the nursing field but potentially could do so. According to the Bureau of Labor Statistics (BLS) ^[1], U.S. Department of Labor, the employment of Registered Nurses is expected to grow 22 percent from 2008 to 2018, much faster than the average for all occupations.

Of the total number of licensed nurses working almost 60 percent works in the hospital, while 21 percent work in other settings that includes offices of physicians, home health care services, nursing facilities and employment services. The rest works in government agencies, social assistance agencies, and educational services. Some of the licensed nurses are finding their way towards alternative employment including public health, and other care settings like assisted living facilities, hospices, businesses, schools, and many more.

Table of Employment ^[1]

Regardless of their specialty or work setting, registered nurses have common job descriptions and responsibilities which are to treat patients, educate patients, the family as well as the public about the different medical conditions, and are there to explain to the patients’ families the situation, teach patients and the families how to manage the illness or injuries, offer advices and provide emotional support for the family. One misconception is that registered nurses are one and the same. While it’s quite true, the specific work responsibilities will differ from one RN to another based on their specialties as well as work settings or patient population served.

Although majority of licensed nurses works in the hospitals, more and more are going into alternative career or specialties. There are those who find they want to add more excitement to their already exciting career and take a different path than the usual. Nurses are fanning out into a multitude of jobs, ranging from nurse-run community clinics to long-term care facilities to corporations. The market is now shifting and this giving way to alternative careers or specialties. Businesses are now focusing on preventive care and wellness in the workplace and have become a big source of jobs. Long-term facilities or nursing care facilities are growing bigger with the increase number of elderly people. More and more people want to be taken care of at home or in hospices rather than the hospitals and would-be nurses should also look beyond the hospitals to alternate care settings.

Below are some of the few specialties that do not necessarily work in the hospital settings or may not work with patients. Some of these specialties may require additional certifications whose qualifications may or may not need number of years of clinical experience or relevant work experience and/or number of hours of continuing education. Primarily, one needs to have a current and active RN license before one can take a certification with American Nurses Credentialing Center (ANCC) or American Nurses Association (ANA) or the corporation tasked for specific certifications or credentials.

Forensic Nurse – The TV series Bones and CSI have certainly made forensic really popular. Unfortunately, many assume that those in forensics are all medical doctors. There are also forensic nurses who are actually registered nurses who provide care to the victims of violence. They assist police investigations by collecting evidences and thus serve unique and critical roles to the health care and judicial systems with at least eight (8) specialty areas or career paths including Forensic Clinical Nurse Specialist, Forensic Nurse Investigator, Forensic Psychiatric Nurse, Nurse Coroner, Sexual Assault Nurse, Legal Nurse Consultant, Forensic Gerontology Specialist and Correctional Nursing Specialist. These specialty areas allow these forensic nurses to work in different settings including schools, corrections, pediatrics, and the crime labs. They can certainly travel to different crime scenes, morgues, prisons, police departments and yes, hospitals.

Occupational Health Nurse – These are the registered nurses who work in different industries such as manufacturing, construction, mining and environments including offices, schools, factories, and hospitals to observe the working conditions and hazards in these workplaces. This is one very diverse specialty as OHNs can work as clinicians, independent consultants, educators and corporate directors. Some of their jobs include making sure that companies/industries comply with government regulations for workplace safety, designing disease-prevention programs, training and mentoring co-workers, and advising employees on health and wellness in the workplace, to name a few.

Home Health Nurse – This is one of the fastest growing areas of nursing and according to BLS it is expected to grow by 33percent from 2008 to 2018. This is because more and more patients would rather receive care in their homes rather than in the much expensive hospitals. Also, technology has made it easier to provide complex treatments in the home and so there is an increasing need for highly skilled health care specialist in the home setting. They have a variety of patients from the elderly to the disabled who prefers to be treated at home to those who are recovering from accidents or who suffer from a serious and/or terminal illness. They may work with an individual patient on a full-time basis or multiple patients every day. Usually though they work independently with the patient’s family as the working team from administering medications at the right time and with the proper dosage, wound care, monitoring of patients health and needs and many more.

Public Health Nurse – Public health nurses cares not for an individual but rather provides healthcare services for the whole community to prevent diseases and improve overall health. Health screenings, preventive care, and health education are just some the services that public health nurses provide to the community especially to those without healthcare. The PHNs may work in public health departments, home health agencies, and ambulatory care clinics. They may be assigned in a specific geographical area and they may travel to schools, community shelters, patient’s homes and other healthcare facilities within the specified area.

Legal Nurse Consultant – One of the specialty nurses of forensic nursing is legal nurse consultants who are highly experienced registered nurses who provide their services to businesses, attorneys, prosecutors, insurance companies, healthcare facilities, private corporations and government agencies. They use their nursing knowledge and qualifications to fill in the gaps in medical knowledge in the legal profession such as in reviewing medical records to verify if medical malpractice occurred, helping lawyers prepare for a deposition, and can sometimes be used as expert witnesses in court cases.

Genetic Clinical Nurse – A genetic nurse is a licensed registered nurse with special education and training in genetics. Many common diseases including cancer, heart disease, diabetes, and Alzheimers are now known to have genetic component. Genetic nurses provide help to people that are at risk or are affected by these diseases with genetic component by performing risk assessment and analyzing the genetic contribution to the disease risk. They also discuss these and the impact of the risk on healthcare management to the patients and the families. They may work with patients but genetic nurses work in other settings that include specialty clinics where gene-based diagnoses and therapies are offered, prenatal and reproductive technology centers, cancer centers, primary health care settings, pediatric clinics, industrial health, school health, research centers, biotech and insurance industries.

Correctional Nurse/Prison Nurse – Another specialty under forensic nursing is correctional nursing wherein the specialists provide quality health care to individuals detained by courts including those in jails, prisons, and other correctional facilities and institutions. Experienced nurses can work as correctional/prisons nurses after having been certified. The ability of the nurse to assess medical issues is critical especially since they are required to determine if there is a need to relocate the patients for additional treatment options.

School Nurse – By the name itself we know that school nurses are licensed professional nurses who work in schools and are responsible for providing health care to those attending the schools or colleges. They are not just there to intervene when students are in need of medical help but they are important to the daily operation of a school since there are emergency and non-emergency situations that they need to take care of. They assess and monitor immunization status of the students, collaborate with the faculty, parents and students on health and safety awareness programs and as a whole ensure that there is a healthy school environment. This specialty should work best for those who want to work on predictable and regular working hours and in a specific community.

Travel Nurse – Indulge your love for travel and nursing at the same time by becoming a travel nurse. These licensed registered nurse travel in different states on a short term assignment to lessen staff shortages due to nurse staff on vacation, maternity leave, on training, or urgent shortage due to epidemics or pandemics. The assignment could last up to a year but majority of the assignments usually last 3 to 4 months. The allure of travel and high salary, with bonuses and stipends such as housing, relocation, travel allowance and insurance reimbursement to name a few, as well as the opportunity of gaining knowledge and expertise in the different fields of healthcare wherever you go is certainly a dream come true for some people.

Nurse Informatics Specialist – Nursing has certainly evolved over time and just like all the other industries and sectors, it has also crossed over the lines of technology in nursing informatics. No longer limited to providing care to patients in need nurses, like the nurse informatics specialists, also use technology to provide improved delivery of healthcare services. In nurse informatics the science of nursing is merged with information science and computer technology to ensure improved communication and documentation and totally making nurse practices even better. For those who love nursing and technology, nurse informatics may just be the thing to go into.

Ambulatory Care Nurse – For those registered nurses who thrive in unpredictability, this may be the specialty for you. Ambulatory care nurses provide preventive care and pain management for widely diverse illnesses and injuries with patients who are on outpatient or episodic basis. They usually come in contact with the patient for less than 24 hours and they may not have prior knowledge of the patients’ medical history and background. These specialized nurses requires specialized skills such as including IV therapy, teaching, phlebotomy, interpersonal communication, triage, ECG, and autonomy.

Telephone Triage Nurse – Triage services are not health advice lines that offer answers to general healthcare questions. Triage services, where telephone triage nurses work, are offered by healthcare facilities in association with a physician’s office. They take calls when patients try to contact their physicians or other health care providers after office hours. They do not diagnose patients over the phone but is there to assess the severity of the caller’s complaints or the patient’s symptoms and directs the caller to the appropriate emergency services if necessary. For telephone triage nurse it is important to have impeccable listening skills because they will just be listening to the complaints and assessing the health concerns without face-to-face interaction or the advantage of visual inspection.

Nurse Researchers – Considered one of the highest paying specialties, nurse researchers are scientists who design and implement scientific studies in order to look for ways to improve healthcare services and outcomes, improve quality of life of chronically ill patients, better ways to provide care and comfort to patients at the end of life and many more. They study the different aspects of health, illness, and healthcare and may work in diverse healthcare settings such as universities, laboratories, research organizations or may be hired by private companies and non-profit organizations that focus on healthcare issues. Nurse researchers already get high salaries but those with advanced degrees can supplement their income by teaching, consultancy and writing books and professional speaking engagements.

Military Nurse – Serving the country and still be a nurse can be done in military nursing. All one has to do is choose which branch of the military service – army, navy, air force. These nurses provide nursing care and practice both in peace and war-time settings. Since these registered nurses enter active duty as an officer, they are often given broader range of responsibility and scope of practice than civilian practice nurses are. Also, because the US military can be found nationally as well as internationally, it is expected that registered nurses in active duty may be placed in a wide variety of work environments around the world including field hospitals, military hospitals overseas, on a ship or vessel. It may also happen that as part of the military program as a nurse you will be called to provide help to other communities in need around the world.

Flight / Transport Nurse – These are licensed professional nurses who give medical and emergency care to patients as well as injured individuals at scenes of accidents and who play a role in transporting these patients via ambulance, helicopter or airplane to the nearest medical facility. They may also transport via commercial airplanes those less critical patients. They evaluate the in-flight needs for medications, supplies and equipment as well as serve as liaisons between support personal, flight paramedics, aircrew members, and medical personnel. In case of an absence of a doctor, they may also provide emergency treatment during a flight. Being able to think and act fast under pressure is important because there are times this is what the job will demand.

Camp Nurse – A camp nurse provides medical and healthcare services to camps and retreat attendants of all ages. It can be a summer camp or groups of terminally ill patients on a retreat. The expertise needed for camp nurses is highly skilled since they have variety of patients from healthy to ill patients of all ages, young and old.

These specialties work in a wide variety of settings but clinical experience has always been a basis in being successful in these exciting specialties. Take a look at these specialties and take courses and work on towards your goal.

http://www.bls.gov/oco/pdf/ocos083.pdf

http://www.bls.gov/oes/current/oes291111.htm

http://www.nursingschools.net/profiles/

http://www.nursingschoolguys.com/careers/

http://www.learn4good.com/nursing/career_choices_nurse_education.htm

http://www.free-4u.com/nursing/Careers-and-Salaries.html

http://www.allnursingschools.com/nursing-careers/career

http://www.registerednursern.com/nursing/different-types-of-nursing-specialities/

Nursing Specialty Certification/Credentialing

American Nurses Credentialing Center http://www.nursecredentialing.org/Certification.aspx

AboutNursing.com http://www.aboutnursing.com/certifications/

NurseZone http://www.nursezone.com/Edu-Prof-Development/certification.aspx

The National Certification Corporation http://www.nccwebsite.org/Certification

The Genetic Nursing Credentialing Commission http://www.geneticnurse.org/

American Forensic Nurses http://www.amrn.com/

International Association of Forensic Nurses http://www.iafn.org/

American Association of Occupational Health Nurses https://www.aaohn.org/

Home Health Nurses Association http://www.hhna.org/

American Public Health Associatio http://www.apha.org/

American Association of Legal Nurse Consultants http://www.aalnc.org/

International & American Association for Legal Nurse Consultants http://www.iaalni.org/

International http://www.isong.org/

American Correctional Health Services Association http://www.achsa.org/

National Association of School Nurses http://www.nasn.org/

American Travel Health Nurses Association http://www.athna.org/

ANIA-CARING - Nursing Informatics Organization http://www.ania-caring.org/

American Academy of Ambulatory Care Nursing http://www.aaacn.org/