Arizona has 60,723 active Registered Nurses, 11,078 active Licensed Practical Nurses, 20,446 active Certified Nursing Assistants, 186 active Nurse Midwives, 136 Clinical Nurse Specialists, 435 active Nurse Anesthetists, and 2,609 active Nurse Practitioners. Arizona, along with the rest of the nation, is facing a nursing shortage. As the population grows, the amount of people entering the nursing field and the number of current nurses staying in the field is not enough to keep up with the nursing need caused by the population growth. In 2005, Arizona had only 628 nurses per 100,000 people. Arizona’s nurse/patient ratio ranks it as 51st in the nation in regards to registered nurses per capita. The national nurse/patient ratio is 782/100,000.1
Evidenced-Based Nursing has become an important approach to providing quality patient care. It “is a problem-solving approach to delivery of health care that combines the best evidence from well-designed studies with a clinician’s expertise and a patient’s preferences and/or values.”2 Evidence-Based Nursing is taught during nursing school and is becoming an integral part of nursing practice.
Registered Nurses provide patient treatment, patient education, and patient support. “RNs record patients’ medical histories and symptoms, help to perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation.” RNs can specialize in one or more patient care specialties such as surgery or pediatric oncology. “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,” such as Nurse Anesthetists, Nurse Midwives, Clinical Nurse Specialists, and Nurse Practitioners.3
Nurse Anesthetists are advanced practice nurses who administer anesthesia, monitor vital signs during surgery, and provide post-anesthesia care. Clinical nurse specialists are advanced practice nurses who provide direct patient care and expert consultations in one of many nursing specialties. Nurse midwives are advanced practice nurses who 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.”4
Licensed Practical Nurses care for patients under the supervision of physicians and registered nurses. They provide routine bedside care such as taking vitals, giving injections, caring for wounds, monitoring patients to report progress and adverse reactions, feeding assistance, bathing assistance, etc.5
Certified Nursing Assistants are also known as orderlies and patient care technicians. They work under the supervision of RNs and LPNs, providing basic care services to patients, including bathing, feeding, grooming, checking vitals, and assisting nurses when necessary.6
Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.7
