What Do Nurses Do?
Discover the Most Common Nursing Duties and Responsibilities
The role of the nurse occupies a beloved spot in our collective human psyche. From the famous historical figures of Florence Nightingale and Clara Barton to popular TV nurses such Margaret Houlihan on M.A.S.H. or Abby Lockhart on ER, nursing is a high-profile profession.
But beyond taking vitals or interacting with patients and doctors, most of us don’t know what an average workday looks like for a registered nurse. What are the main facets of the job? How about some common specific duties?
This article should give you a good idea of the daily world of being a nurse. If you’re considering making a move into this respected and in-demand career, read on and see what’s involved. We’ll get into some basics of the registered nurse (RN) role, and then we’ll break down 10 specific typical duties.
What is the Role of a Registered Nurse?
Often considered to be the backbone of the nursing system, registered nurses can work in all sorts of healthcare settings. They can work in any specialty. As a key component of the healthcare system, RNs work with physicians and other healthcare team members to provide the best patient care. They provide direct care and help educate patients and family members about the patient’s situation and prognosis.
According to the Bureau of Labor Statistics, about one-third of RNs work in hospital settings. Another 15 percent work in outpatient care centers. Just over 11 percent work in-home health care.
How Much Do Registered Nurses Make?
As with any career, where you work and any specialization involved affects your compensation. Still, the BLS cited the average annual wage for a registered nurse in May 2021 at about $83,000, with the top 10 percent of earners making over $120,000.
What is a Typical Schedule Like for an RN?
The schedule for a registered nurse varies depending upon the specialty and the healthcare setting. In hospitals and care facilities, RNs typically work in shifts. This provides round-the-clock care on all days of the year. Shifts are usually 10 to 12 hours, as this minimizes the turnover for each patient throughout the day and night. RNs in these settings will usually work three or four shifts per week.
Nurses who work in schools or offices tend to work regular business hours with some on-call availability. Home care settings vary with the patient’s needs.
What Sorts of Specialties and Units Can RNs Choose?
There is a wide range of options when choosing an area to specialize in as a registered nurse. This creates great flexibility to allow you to align with a specialty or unit that fits your interests and personality.
The following are examples of possible specialization or unit choices:
- Emergency room
- Operating room
- Labor and delivery
- Neonatal intensive care (NICU)
- Ambulatory care
- Developmental disability
- Pain management
- Infection control
- Psychiatric nurse
What Are Some of the Typical Daily Tasks of Being a Registered Nurse?
With specialization options come diverse working situations and a customizable career as a registered nurse. Still, no matter where you’re an RN, and no matter what your specialization, these are some daily tasks you’ll likely be doing:
- Preparing patients for exams and treatments
- Assessing, observing, and speaking with patients
- Drawing blood, urine samples, and other fluids for lab testing
- Recording symptoms and other health details of the patient’s medical history
- Administering medications and treatments
- Monitoring patients for side effects and reactions
- Developing or assisting with unique patient care plans
- Operating and monitoring medical equipment
- Performing wound care
- Educating and interacting with patients and family members about diagnoses, treatment and care plans, and progress
- Supervising licensed practical and vocational nurses, nursing assistants, and nursing students
10 Duties Performed by RNs and Advanced Practice Registered Nurses
The daily duties of an RN or APRN are diverse, and we detailed some of the common aspects of the job above. Now let’s get into 10 specific duties. In future blog articles, we’ll break each of these down in more detail.
When patients cannot empty their bladder on their own, urine can build up, leading to pressure in the kidneys. This pressure, if left unchecked, can lead to kidney failure. Urinary catheterization may also be used to measure the residual amount of urine in a patient’s bladder or obtain a sterile urine specimen from a woman. Catheterization is often done before surgery to ensure the patient’s bladder is completely empty.
Nurses place and remove catheters. It is considered one of the fundamentals of nursing and an especially important skill in nursing homes or geriatric care settings.
What is Catheterization?
There are three types of catheters:
- Indwelling catheters sit in the bladder. The RN inserts the indwelling catheter into the bladder through the urethra. In some cases, the catheter may be inserted into the bladder through a small hole in the abdomen. Once in place, a tiny balloon at the end of the catheter is inflated with water to prevent the tube from sliding out of the body.
- External catheters, or condom catheters, are placed outside the body. These are typically used with men who don’t have urinary retention problems but have functional or mental disabilities.
- Short-term catheters, as the name implies, are only used for a short period after surgery until the bladder empties.
Click here to learn How to Perform Catheterization
If a patient loses blood during surgery or from an injury, a blood transfusion replaces the missing blood with donated blood. A blood transfusion can also be necessary when a patient has an illness preventing their body from producing blood or the blood produced is inadequate.
Nurses perform blood transfusions.
How is a Blood Transfusion Done?
In some cases, patients donate blood for themselves prior to having elective surgery, but in most cases, the blood used comes from blood bank donations. The first step is for the nurse to align your blood type with the proper donated blood type. Most transfusions involve red blood cells and other materials. “Whole blood” transfusions are rare.
Next, an intravenous (IV) line is attached to a needle, and the nurse inserts the needle into one of the patient’s blood vessels. The blood is contained in a 0.5- to 0.7-liter bag, and gravity moves it into the blood vessel. Throughout the process, which takes between one and four hours, the nurse monitors the patient’s blood pressure, temperature, and heart rate.
Click here to learn How to Perform Blood Transfusions
When a patient’s airway is blocked or the passage space is reduced (such as in a crushed trachea), a nurse will insert a tube into a hole created in the front of the neck to provide air to bypass the blocked airway. The placement of the tube is known as a tracheostomy. The creation of the hole is known as a tracheostomy.
Tracheostomy may be necessary when a medical condition will require the patient to be on a ventilator for an extended period. Other conditions, such as vocal cord paralysis, could call for this treatment. It can be used prior to major head or neck surgery in preparation for breathing during recovery. Or it can be an emergency situation following trauma.
What Role Does the Nurse Play in Tracheostomy?
Although a surgeon usually performs the surgical hole and the insertion of the breathing tube, it’s the nurse’s job to provide follow-up care. The nurse will initially ensure the tracheostomy tube remains clean, as infection can become more likely because the upper airways are not filtering the air entering the lungs. Initially, the nurse may need to suction and clean the tube every one to two hours. Once the initial inflammatory response runs its course, the tube will need cleaning once or twice a day.
For patients needing long-term breathing tube assistance, the nurse will teach the patient the proper method for cleaning and changing the tracheostomy tube.
Click here to learn How to Perform Tracheostomies
Patient counseling is a part of virtually all nursing roles in all specialties. Nurses play a multifaceted role as educators, boosters, coaches, and supporters of the patient. Patients need to know what’s going on with their health, whether there is an acute problem or a more general or chronic condition. Education and support are necessary for patients to create the changes in their lifestyle or behaviors to improve their health moving forward. In acute situations, the nurse relationship is critical in boosting patient morale, which can directly impact healing during recovery.
What Role Does the Nurse Play in Patient Counseling?
While it’s obvious to understand the nurse’s role in patient education during recovery, the nurse plays a much larger part in patient communication throughout just about any healthcare delivery. This is because the nurse typically has the most amount of contact with the patient. Through patient counseling, nurses alleviate patient anxiety about upcoming procedures. They guide the recovery plan. This information helps patients avoid the need to be readmitted to the hospital, and it helps the patient learn to become self-sufficient.
These are some instructions RNs will provide for patients:
- Self-care steps they need to take and why these are necessary
- What warning signs to watch for during recovery
- What to do if problems occur
- Who to contact in case of problems
Click here to learn How to Perform Patient Counseling Tasks
Wound care is an essential part of being a registered nurse, but it can also be a specialization. Keeping wounds clean and free from infection is a critical part of any procedure, whether after trauma or surgery. It’s the nurse’s job to assess, treat, and care for patient wounds. Cleaning wounds, changing bandages, and watching for any signs of infection are vital for patient success.
Wound care nurses often work with patients with diabetes, ostomies, or pressure ulcers, as wounds are common. Here nurses play a crucial role in preventing infection and educating patients on proper wound management at home.
What is Involved with Wound Care for a Nurse?
Avoiding incidence of infection and smooth healing is the overall goal of all wound care. These are the duties that a nurse will use when dealing with patient wounds:
- Assess and monitor wounds
- Debride, clean, and bandage (and rebandage) wounds
- Work with the rest of the medical team to ascertain the need for antibiotics and other options
- Educate patients, family, and caregivers about wound care and infection prevention
- Provide documentation of the wound progress as necessary
A nurse anesthetist or advanced practice registered nurse (APRN) typically handles intubation — the insertion of a tube through either the mouth or nose and into the airway. This is necessary to bypass a blockage, aid in breathing, or deliver anesthesia or medications.
Intubation is known as endotracheal intubation when the tube is inserted into the mouth. It is known as nasogastric intubation when the tube is fed through a nostril.
How is Intubation Done?
Due to gag reflexes and other issues, patients are either fully sedated or partially sedated prior to being intubated. With endotracheal intubation, the patient is laid on their back, and the APRN or nurse anesthetist is above the person’s head. The mouth is opened, and the tube is inserted into the mouth. A lighted instrument helps to keep the tongue out of the way, and the tube is gently guided into the throat and advanced downward into the airway. When the tube is at the proper depth in the throat, a small balloon at the tube’s end is inflated; this keeps the tube in place and helps keep air from escaping.
For nasogastric intubation, the process is similar to the tube being inserted through the nostril. Decongestant spray is used to prevent nosebleeds, along with a topical anesthetic to reduce pain. As with endotracheal intubation, a muscle relaxant is used to numb the gag reflex. With nasogastric intubation, a laryngoscope is used to help guide the tube between the vocal cords and into the windpipe.
Click here to learn How to Perform Intubation
There is some variability by state as to whether a registered nurse can place stitches. Generally, suturing a wound closed is considered to be a “minor surgical procedure.” As such, it is not within the purview of most nurses. But advanced practice nurses and emergency room RNs can sometimes place stitches. This is because both have received additional training and have qualified to perform more complex procedures, such as suturing patient wounds.
However, the policy varies widely between the various state nursing boards.
How are Stitches Done?
Conversely, nurses can remove stitches when the time is right. This is a part of the standard training RNs receive. Again, however, the option of an RN being able to remove a patient’s stitches varies by state.
Click here to learn How to Place Sutures
Earwax, also known as cerumen, is one of the body’s many protection mechanisms. Glands produce earwax in the ear canal. It acts as a natural barrier that prevents dirt and bacteria from entering the innermost parts of the ear. Earwax also acts as a moisturizer and protective coating for the ear canal. It even works as an insect repellant.
But some of us produce more earwax than can be sloughed off naturally, which builds up. It can build up to the degree where it impacts hearing. Now it’s time for ear irrigation, and this is performed by a nurse.
Ear irrigation is used to remove excess earwax or to remove a foreign object from a patient’s ear canal.
How is Ear Irrigation Done?
Doctors can perform this procedure, but it is more often the nurse who does so. The doctor will usually use an otoscope to see into the ear and decide if the wax buildup is the problem. From there, the nurse will usually take over. Here’s the easy process:
- A syringe is filled with a saline solution.
- A collection cup is placed beneath the ear to catch the saltwater and earwax.
- Next, the nurse places the syringe into the outer ear, inserting it up and toward the back of the ear.
- The nurse gently depresses the syringe plunger to allow a stream of saline solution to enter the ear. This is known as irrigation.
- The water then drains out of the ear into the cup with pieces of earwax.
- This process is repeated a few times to remove the necessary wax buildup.
Click here to learn How to Perform Ear Irrigations
Splints and Casts
When a patient fractures a bone, a cast or splint is used to immobilize the bone completely. Because it can’t be moved, the bone fibers stitch back together in the body’s healing process, repairing the fracture. Beyond fractured bones, casts and splints are also used in cases of ligament damage or surgery, as immobilization is necessary to let the injured or repaired ligament heal.
What’s the difference? Casts are custom-made from plaster or fiberglass and are wrapped all the way around the injured area. A splint is only hard on one side and uses elastic bands or wraps to hold it in place. Because of this, splints can be adjusted while casts cannot.
Nurses typically do not place a cast or splint but can remove them. As with suturing, this can vary by state. Some states allow advanced practice nurses to set bones and place casts.
How Does a Nurse Remove a Cast?
Unlike a splint, which is easily removed, casts can only be removed with a cast saw. This specialized saw has a flat, rounded metal blade that vibrates. This allows it to cut through the cast without injuring the skin underneath. When removing the cast, the doctor or nurse will cut the cast in several places, usually along both sides. The cast is then peeled open and lifted away. Scissors are then used to cut any protective padding and the stockinette beneath.
Click here to learn How to Apply Splints and Casts
Our blood holds essential information about our health. It’s sent to a lab for testing, which can then reveal how well our organs, such as our kidneys, liver, heart, and thyroid, are working. The blood can also point to signs of coronary heart disease, diabetes, and even cancer.
Getting a sample of blood is one of the most common nursing procedures. Clinically known as venipuncture or phlebotomy, you know it more commonly as having blood drawn. While all nurses learn this procedure, it takes experience to become an expert at finding the correct vein, using the right angle of entry, and such. Some people have veins that are not as easy to access. Other people may be a little dehydrated, making successful venipuncture more difficult.
How Does a Nurse Draw Blood?
Patients really appreciate a nurse who is an expert at venipuncture. A single needle insertion with a fast accumulation of the requisite blood is a welcome thing. Here’s the basic process:
- The patient usually sits in a chair with a special armrest.
- The nurse asks the patient to make a fist with the hand of the target arm.
- The nurse then examines the available veins, searching for the best option.
- Next, the nurse will tie a piece of rubber tubing (a tourniquet) around the patient’s upper arm. This makes the veins pop out a little more.
- The vein is chosen.
- The needle is inserted into the vein. It is attached to a small tube that allows the patient blood to flow into the test tube or sometimes into a small bag.
- If more tests are needed, the nurse will fill one tube, remove it, attach a second and fill it. This may be repeated.
- When the necessary blood has been obtained, the needle is removed, and the tourniquet is released.
- A small cotton ball is placed over the insertion site and held in place with some medical tape.
Click here to learn How to Draw Blood
Ready to Become a Registered Nurse?
Now you have a feel for what it’s like to be a registered nurse. It’s a rewarding career where you’re helping people every day. Plus, it’s a career that is in high demand, with a shortage of nurses projected for the foreseeable future. The Bureau of Labor Statistics projects the job market for registered nurses to grow by 9 percent between now and 2030.
At Brookline College, we offer three nursing programs in Arizona and New Mexico. Our Bachelor of Science in Nursing (BSN) and our Second Degree in Nursing program create a great pathway to becoming a registered nurse.
Click the “Get Started” button at the top of this page and get more information on your options and what you need to do next to make the move to becoming a registered nurse.