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1 Nurses work to restore health and wellness, prevent diseases, and help patients and families cope with illness. They are a critical resource in patient care because they consider the emotional and mental, as well as the physical, needs of patients. Nurses perform both lifesaving and routine duties, all of which are extremely challenging and rewarding. There is currently a shortage of nursing professionals, which means that this career offers lots of opportunities for those entering the field. Individuals will find many career paths, all with different education, training, and certification requirements.

2 These health care workers assist in the care for the ill or injured by providing basic nursing skills and personal care. They perform patient care under the supervision of registered nurses and licensed vocational nurses. They have a broad range of duties including bathing, walking, and feeding patients, making beds, assisting patients in and out of bed and dressing and shaving patients. They may provide skin care to patients. Aides also play an important role in observing patient s physical, mental and emotional well-being. Nurse s aides may work in long-term care facilities where they provide most of the care for patients. They may also work in hospitals, doctors offices, health departments and home health care agencies. Some duties may be unpleasant such as emptying bedpans and changing soiled linens. Nurse s aides also come in contact with patients who may also be uncooperative or disoriented. This training can be conducted in a high school, medical or long-term facility, or at a community college. The nurse s aide programs can be 2 to 15 weeks in length. Successful completion of an approved program in nursing assisting prepares the student to take the Texas Nurses Aide Registry skills and written exam, a certification exam. To work in a licensed nursing home in Texas, a nurse s aide is required to have this certification. Most hospitals and other facilities also require certification. In addition, the CNA is eligible for certification as a home health aide with additional training in home health care. Alvin Community College C Angelina College C Central Texas College C DCCCD El Centro College C El Paso Community College C NHMCCD Cy-Fair College C Kingwood College C Montgomery College C North Harris College C Tomball College C Odessa College C South Texas College C Tarrant County Community College South Campus C Texas State Technical College Harlingen C Trinity Valley Community College C Victoria College C Wharton County Junior College C 69

3 A certified nurse-midwife (CNM) is a registered nurse with advanced education and clinical training, usually at the master s level in midwifery. A certified nurse-midwife s focus is on the women s wellness and consumer choice. Safe, sensitive, confidential personal care is the hallmark of the CNMs unique attention to the special primary care and reproductive needs of women. CNMs are often the initial contact for providing health care to women. The care provided by CNMs encompasses all of the essential factors of primary health care, such as evaluation, assessment, treatment and referral when required. There are a variety of career options from which a CNM might choose. Certified nurse-midwives practice in hospitals, birth centers, private practice, health maintenance organizations (HMOs), clinics, universities, homes, group physician practices and group CNM practices. Completion of registered nurse training is a prerequisite for entering a master s level nurse-midwife program. The master s program requires 16 to 24 months of study, and some require an additional year of clinical experience. The basic curriculum for accredited American College of Nurse-Midwives (ACNM) programs consists of theory and clinical experience based on core competencies developed by the College. The core competencies are the fundamental knowledge, skill, and behaviors that enable a new graduate to practice midwifery in the United States. Courses include well woman gynecology, family planning, pre- and postpartum management, newborn care, professional issues, pharmacology, and health assessment. Applicants for Texas state certification must have an active RN license. To become a certified nurse-midwife, you must complete a nurse-midwifery program accredited by the American College of Nurse- Midwives/ Division of Accreditation and pass the certifying exam within 12 months of completing the program. Parkland School of Nurse Midwifery UT Southwestern M American College of Nurse-Midwives (ACNM) 70

4 Anesthesia is a safe and effective method of alleviating pain during a medical procedure. Certified registered nurse anesthetists (CRNAs) administer spinal (in the spine), intravenous (in the vein), and other anesthetics to patients during surgical procedures, childbirth, and special medical treatments. They are responsible for patient care before, during and after procedures, monitoring every critical function of the patient s body to ensure that blood pressure, pulse, respiration, pupils, and skin color return to pre-operative levels. They communicate these vital statistics to the physician during and after the procedure. Baylor College of Medicine M Texas Wesleyan University M University of Texas Health Sciences Center Houston M American Association of Nurse Anesthetists Texas Association of Nurse Anesthetists, Inc. A CRNA may sub specialize in pediatrics, obstetrics, cardiovascular, plastic surgery, dental or neurosurgical anesthesia. Others also hold credentials in fields such as critical care nursing and respiratory care. CRNAs provide anesthetics to patients in collaboration with surgeons, anesthesiologists, dentists, podiatrists and other qualified health care professionals. They can work in a variety of settings where anesthesia is used, including hospitals, birthing centers, dental centers, plastic surgery centers, ambulatory surgical centers, health care educational institutions and military health care facilities. Applicants for this advanced training must hold a bachelor s degree in nursing or the equivalent, be licensed as a registered nurse and have at least one year of critical-care nursing experience. Nurse anesthesia education programs consist of 25 to 36 months of graduate work including both classroom and clinical experiences. The primary clinical component provides experience with a variety of anesthesia techniques and procedures for all types of surgery and obstetrics. CRNA s are advanced practice nurses registered by the Texas State Board of Nurse Examiners. Certification as a nurse anesthetist is granted through the American Association of Nurse Anesthetists (AANA) Council on Certification. CRNAs must complete a continuing education and recertification program every two years. 71

5 The role of the clinical nurse specialist (CNS) involves advanced expertise in a particular practice area of nursing. As the title implies, a CNS has a clinical specialty such as perinatal or adult health nursing. The role evolved in response to changes in health care technology that required nurses with highly specialized knowledge and skills. These nursing professionals deliver direct patient care, teach staff and patients, consult with other professionals, and provide supervision in the workplace. Depending on the specialty they choose, CNSs may have an extended scope of practice authority. A clinical nurse specialist (CNS) may specialize in any of the following areas: addiction disorders, critical care, adult health, child health, community health, emergency care, gerontological care, high-risk maternity care, maternal-child health, medical-surgical, neonatal, oncology, pediatric, perioperative, psychiatric/mental health and women s health. The program of study must be at least one academic year in length and may include a formal preceptorship. Most CNSs work in hospital settings. They may work in medical-surgical, pediatric, perinatal, geriatric, psychiatric, rehabilitation, critical-care and emergency/trauma units. CNSs may also work in public health clinics, home health agencies and school systems. As with other advanced practice nurses, CNSs require education beyond the basic nursing curriculum. A CNS must be a registered nurse with a Bachelor s degree and a Master s of Science. All clinical nurse specialists are registered nurses who hold a master s degree in nursing with a focus on a particular specialty. Each specialty has its own method of credentialing, which is typically a combination of a specified number of hours of practice and a board certification process. Angelo State University M Texas A&M Corpus Christi M Texas Christian University M Texas Tech University Health Sciences Center M Texas Woman s University M University of Texas at Arlington M University of Texas at Austin M University of Texas at El Paso M University of Texas at Pan American M University of Texas Health Science Center at Houston M University of the Incarnate Word M West Texas A&M University M National Association of Clinical Nurse Specialists 72

6 A home health aide or personal care aide cares for the elderly, patients recovering from illness or persons with disabilities in their homes. They perform an integral service that allows patients to enjoy a level of independence within their homes. Home health aides carry out medical instructions, perform various household chores such as changing bed linens, washing laundry, and preparing and serving meals. The health aide helps the patient with personal hygiene, transfers the patient to and from their beds or wheelchair, and accompanies the patient to doctor s appointments. Home health aides should be reliable, patient and compassionate. They should also be able to work independently with a variety of people. Most home health aides work with a variety of patients. Although some may choose to work with clients who have specific conditions such as Parkinson s Disease. Home health aides work for state or county welfare agencies, private home health agencies or on their own. A home health aide provides services primarily in private homes. The job can be physically challenging. Aides are usually expected to provide their own transportation and often spend time driving from one place to another. Night and weekend work are sometimes required. Some community colleges offer educational training programs. Most agencies provide a two to three week training for home health aides if they have no previous experience. Training focuses on maintaining a clean, safe environment; basic nutrition; taking and recording vital signs; infection control; recognition of emergencies; communication skills; personal hygiene; and range of motion. Passing the National Association for Home Care exam can nationally certify home health aides. This certification is voluntary. El Paso Community College C Odessa College C San Antonio College C Victoria College C Texas Association for Home Care, Inc. 73

7 Licensed vocational nurses (LVNs) help care for ill or injured people under the direction of physicians, dentists and registered nurses. Most LVNs provide basic bedside care to patients such as taking vital signs, applying dressings, helping patients with bathing and personal hygiene, and administering prescribed medications. LVNs observe and report patients symptoms, reactions to treatment and medication, and progress. Licensed vocational nurses can work in hospitals, long-term care facilities, schools, doctors offices, private homes, businesses and health departments. They generally work 40-hour weeks, including weekends, nights and holidays. The work demands that they be on their feet most of the time and requires bending, stooping, lifting and walking. They work as part of the health care team caring for the patient. Vocational nursing training programs usually require one year of study and are offered in community colleges, technical and vocational centers, and hospitals. Supervised clinical experience is provided in hospitals and other settings. LVNs may advance to registered nurse with additional training. Graduates of vocational nursing programs approved by the Texas State Board of Nursing must pass the NQEX-PN comprehensive examination administered by the National Council of State Boards of Nursing and approved by the Board of Vocational Nurse Examiners. Del Mar College C El Centro College C El Paso County Community College C Frank Phillips College C Galveston College C Grayson County College C Hill College C Houston Community College System C Howard College C Kilgore College C Lamar State College (Orange) C Lamar State College (Port Arthur) C Laredo Community College C Lee College C McLennan Community College C Midland College C Navarro College C NHMCCD Cy-Fair College C Kingwood College C Montgomery College C North Harris College C Tomball College C North Central Community College C Odessa College C Panola College C Paris Junior College C Ranger Junior College C San Jacinto Community College C South Plains College C South Texas Community College C Southwest Texas Junior College C Sul Ross State University C Temple College C Texarkana College C Texas Southmost College C Texas State Technical College Sweetwater C Trinity Valley Community College C Tyler Junior College C Vernon Regional Junior College C Victoria College C Weatherford College C Western Texas College C Wharton County Junior College C ACCD St. Phillips College C Alvin Community College C Amarillo College C Angelina College C Austin Community College C Blinn College C Brazosport Community College C Central Texas College District C Cisco Junior College C Clarendon College C Coastal Bend College C DCCCD El Centro College C Licensed Vocational Nurses Association of Texas (LVNAT) (512) National Association for Practical Nurse Education and Service (301) National Federation of Licensed Vocational Nurses, Inc. (NFLVN) 74

8 A nurse practitioner (NP) is an advanced practice nurse. They obtain medical histories; perform physical examinations; diagnose patients with chronic diseases; treat and monitor acute and chronic illnesses; order and interpret lab tests and x-rays; provide health education and disease prevention information to patients and discuss disease prevention strategies with the public. Nurse practitioners also provide prenatal care and family planning. They prescribe medications and medical treatments. Collaborating with physicians and other health care professionals, nurse practitioners help provide comprehensive health care for the patient. While they refer patients to physicians when necessary, nurse practitioners may practice independently through a written protocol or document established with their collaborative physician. Nurse practitioners are also educators and researchers. They work under the rules and regulations of the Nurse Practice Act of the State of Texas. Nurse Practitioners can specialize in a number of areas, including adult health, family health, geriatric/elder health, pediatrics/child health, psychiatric/mental health, school/college health, emergency care, women s health, including perinatal care and neonatal/newborn infants health. In Texas, a nurse practitioner may practice and prescribe medication without the oversight of a physician, provided the appropriate protocols are in place. Nurse Practitioners can work in diverse settings including hospitals (inpatient and outpatient units), health maintenance organizations, freestanding nurse-run primary care clinics, private practice offices, extended-care facilities, home health organizations and schools. Abilene Christian University M Baylor University M Houston Baptist University M Howard Payne University M Midwestern State University M Prairie View A&M University M Texas A&M International M Texas A&M University - Corpus Christi M Texas Tech University Health Sciences Center M Texas Woman s University M University of Texas at Arlington M University of Texas at Austin M University of Texas at El Paso M University of Texas Health Science Center at Houston M University of Texas Health Science Center at San Antonio M University of Texas Pan American M University of Texas Medical Branch at Galveston M University of Texas Southwestern Medical Center at Dallas M University of Texas at Tyler West Texas A&M University M West Texas A&M University M American Academy of Nurse Practitioners National Association for Nurse Practitioners in Women s Health Texas Nurse Practitioners Applicants must have completed a BSN and MSN as well as hold a RN license prior to applying to a nurse practitioner program. They must pass a certification exam conducted by an appropriate specialty board. 75

9 Registered Nurses (RNs) observe patients to assess symptoms, reactions to treatment, and progress. They administer medications, perform therapeutic procedures, and instruct patients and their families in proper health care practices. RNs supervise licensed vocational nurses, nursing assistants, patient care assistants, and home health aides. Working in collaboration with physicians and other members of the health care team, RNs develop and implement a plan of care to help the patient achieve optimal health. Registered nurses are qualified for specialty practice at two levels: basic and advanced. These levels are differentiated by education. RNs with an associate degree (ADN) or a bachelor s degree (Bachelor of Science in Nursing or BSN) practice at the basic level. Advanced practice nursing requires additional education at the master s level. There are many specialty practices in the nursing profession. Some nurses work with patients in a particular age group, such as children or older adults. Other nurses specialize in specific illnesses such as neurological disease, heart problems, pregnancy, diabetes, and emotional disorders. Still other RNs become consultants, educators, administrators and researchers. Prospective nurses may choose an associate degree in nursing (ADN), the bachelor s of nursing degree (BSN), or a master s degree in nursing (MSN). ADN programs are offered by community colleges and take two to three years to complete. BSN programs are offered by universities and take four years to complete. MSN programs are offered at universities and take at least two years to complete past the BSN. 76

10 To be licensed, graduates of approved registered nursing programs must pass the NCLEX-RN comprehensive examination developed by the National Council of State Boards of Nursing. The test is administered by the Texas Board of Nurse Examiners. The term registered nurse may be used only by those graduates who have successfully passed this licensing examination. The American Nurses Credentialing Center of the American Nurses Association certifies registered nurses based on predetermined standards, including a written subject examination and the amount of practice time in a specified area. Although certification is voluntary, it provides tangible recognition of professional achievement in a defined area of nursing. ACCD St. Philips College A San Antonio College A Abilene Intercollegiate School of Nursing B Alvin Community College A Amarillo College A Angelina College A Angelo State University A, B, M Austin Community College A Baylor University B Blinn College A Brazosport College A Central Texas College A Cisco Junior College A College of the Mainland A Collin County Community College District A Covenant School of Nursing D DCCCD Brookhaven College A El Centro College A Del Mar College A East Texas Baptist University B El Paso County Community College A Galveston College A Grayson County College A Howard College at Big Spring A Kilgore College A Lamar State College (Orange) A Lamar State College (Port Arthur) A Lamar University A, B Laredo Community College A Lee College A McLennan Community College A Midland College A Midwestern State University B, M Navarro College A North Central Texas Community College District A NHMCCD Kingwood College A Montgomery College A North Harris College A Tomball College A Northeast Texas Community College A Odessa College A Panola College A Paris Junior College A Prairie View A&M University B, M San Jacinto Community College District A South Plains College A South Texas Community College A Stephen F. Austin State University B Tarleton State University B Tarrant County College (South Campus) A Temple College A Texarkana College A Texas A&M International University B Texas A&M University - Corpus Christi B Texas Christian University B Texas Southmost College A Texas Tech University Health Sciences Center B, M, D Texas Woman s University B, M, D Trinity Valley Community College A Tyler Junior College A University of the Incarnate Word B, M University of Mary Hardin-Baylor B University of Texas at Arlington B, M University of Texas at Austin B, M, D University of Texas at Brownsville B University of Texas at El Paso B, M University of Texas at Tyler B, M University of Texas Health Science Center at Houston B, M, D University of Texas Health Science Center at San Antonio B, M, D University of Texas Medical Branch B, M, D University of Texas-Pan American B University of Texas of the Permian Basin B, M, D Vernon College A Victoria College A West Texas A&M University B Wharton County Junior College A American Academy of Nursing American Association of Colleges of Nursing American Nurses Association National League for Nursing Texas Board of Nurse Examiners Texas Nurses Association 77

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