. "3 Nurses Caring for Patients: Who They Are, Where They Work, and What They Do." Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington, DC: The National Academies Press, 2004.
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Keeping Patients Safe: Transforming the Work Environment of Nurses
nurses (RNs), licensed practical nurses/licensed vocational nurses (LPNs/ LVNs), or nursing assistants (NAs). In this report, we refer collectively to all three of these groups of personnel as nursing staff.
There are over 5 million nursing staff in the United States. Of these, 2.2 million are actively employed as RNs2 and 683,800 as LPNs/LVNs. RNs and LPNs/LVNs are licensed by the state in which they provide nursing care. Another 2.3 million unlicensed health care workers (Bureau of Labor Statistics, undated) supplement the work of licensed nurses by performing basic patient care activities under the supervision of an RN or LPN/LVN. These unlicensed health care personnel hold a variety of job titles, including nurse assistants, nurse aides, home health aides, personal care aides, ancillary nursing personnel, unlicensed nursing personnel, unlicensed assistive personnel, nurse extenders, and nursing support personnel. In this report, we refer collectively to these workers as NAs. Jobs for NAs are expected to be among the most rapidly expanding in the workforce as the overall U.S. population ages, and the need for postacute and chronic care increases. Indeed, the number of employed NAs increased by 40 percent between 1980 and 1990, more than twice the growth rate of the overall U.S. workforce. The greatest growth was in aides working in home care, whose numbers more than doubled from 1988 to 1998. From 1998 to 2008, a 36 percent increase in NA jobs is predicted, compared with a 14 percent increase in all workforce jobs (GAO, 2001b).
Variations in Education and in Experience and Expertise Among Members of the Nursing Workforce
Each type of nursing personnel is educated differently. An overview of the education received by each is provided below.
Education for RNs Basic RN education can be attained through three routes: 3-year diploma programs, 2-year associates degree (AD) nursing programs, and 4-year baccalaureate degree programs. In addition to any of these three types of academic preparation, individuals must pass a state examination to be licensed as an RN.
The route chosen to receive entry-level, prelicensure RN education has changed considerably over the past two decades, with decreasing use of 3-year diploma programs and increased use of AD and baccalaureate programs. Between 1980 and 2000, the proportion of nurses receiving their
Although there were approximately 2.7 million RNs in the United States in 2000, only approximately 2.2 million of them were working actively as nurses.