The backbone of patient care. The beating heart of our medical system. Registered nurses (RNs) shoulder multifaceted jobs and duties in various hospital units with composure, compassion, and courage.
As the largest healthcare workforce in the United States, nurses are vital to medical facilities, and they are in high demand, with a projected 16 percent growth over the coming decade and growing prestige.
As of 2023, according to an annual Gallup poll, nursing is the most trusted profession in America for the 21st year running. Also, 79 percent of those surveyed said nurses have the highest ethical standard of all occupations, coming in well above the second and third-place rankings. Registered nurses with jobs in hospitals, schools, nursing facilities, and doctor’s offices have earned trust and respect.
What Is a Nurse?
Nurses are indispensable healthcare professionals devoted to caring for individuals, families, and communities in hospitals and across the entire spectrum of healthcare environments, often working on a healthcare team with doctors and other clinicians. Armed with expertise, qualifications, skills, and compassion, they deliver exceptional care precisely when and where it’s most needed.
What Is Nursing?
Nursing is unwavering attention and care for health, from diligently and tenderly monitoring a preterm baby’s fragile condition to comforting an older patient with metastatic bone cancer.
“Constant attention by a good nurse may be just as important as a major operation by a surgeon.” – Dag Hammarskjöld
What Do Nurses Do in Hospitals?
Across all hospital units, RNs undertake a myriad of essential duties daily. They skillfully perform physical exams and health histories, monitor the patient’s condition, understandingly provide health education to patients and their families, meticulously administer medication, promptly coordinate care with physicians and the rest of the medical team, capably handle the direct care needed by the patients, and conscientiously update charts, patient files, and medical records.
In addition to these responsibilities, RNs have some distinctive duties in each unit.
Hospital units or departments range from the emergency room (ER) to the post-anesthesia care unit (PACU) and are areas for specialized care, often requiring relevant nursing certifications. Keep reading for some of the most common hospital units and the RN duties typical of each.
1. Emergency Room Nurses
The emergency room specializes in emergency medicine, and ER RN jobs are at the front line of care for the most urgent cases in the hospital.
ER nurse duties include the following:
- Assessing the patient’s condition
- Identifying the severely critical cases
- Providing immediate attention to patients with conditions that are life-threatening or require urgent care
- Performing life-saving interventions
Because of the unplanned nature of accidents or needs for medical attention, RNs learn to treat a wide variety of illnesses and injuries.
Here are certifications for ER nurses available through the Board of Certification for Emergency Nursing (BCEN):
- Certified Emergency Nurse (CEN)
- Certified Pediatric Emergency Nurse (CPEN)
- Trauma Certified Registered Nurse (TCRN)
The Academy of Emergency Nursing (ENA) offers further ER certifications.
Certifications and an advanced nursing degree can open the door to nurse leader or nurse manager positions within an ER, empowering nurses to take on greater responsibilities, lead healthcare teams, and provide guidance in the efficient and compassionate delivery of emergency medical care.
2. Intensive Care Unit (ICU)
In the ICU, specialized RNs provide comprehensive care for critically ill patients in a highly controlled medical environment.
The following are typical duties of ICU nurses:
- Close monitoring for changes in status or indications of conditions such as sepsis or shock and ensuring appropriate interventions
- Using specialized equipment, such as ventilators, to assist patients with breathing until they can breathe on their own
- Measuring patients’ liquid intake and output for early detection of emerging problems such as fluid and electrolyte divergences
- Assisting physicians with procedures such as bronchoscopy, endoscopy, or intubation
- Ensuring that the medical equipment and devices function correctly and storing the equipment properly after use
The American Association of Critical Care Nurses offers the following certifications for ICU nurses:
- Certification for Adult Critical Care Nurses (CCRN) with distinct certification for CCRN-Adult, CCRN-Pediatric, and CCRN-Neonatal
- Tele-ICU/Critical Care Nursing (CCRN-E)
- Progressive Care Nursing (PCCN)
- Cardiac Medicine (CMC)
ICU nurses can also work in the ER or find positions in the post-anesthesia or progressive care units, thanks to their versatile expertise in handling critical medical situations, making them valuable assets across various healthcare settings. Their adaptability and proficiency in patient care extend beyond the ICU, contributing to the broader healthcare team’s success.
3. Labor and Delivery Unit (L&D)
RNs in the labor and delivery unit play a critical role in ensuring a safe and positive childbirth experience for the mother and the newborn while providing emotional support and education to the family.
The following are typical responsibilities of L and D nurses:
- Monitoring vital signs of mother and infant, especially uterine contractions and the fetal heart rate
- Evaluating the progress of labor, assessing for any complications or changes in the mother’s condition
- Offering emotional support and comfort to laboring mothers, including pain management, positioning, and coaching during contractions
- Assisting with procedures like amniotomies (rupturing the amniotic sac), episiotomies (surgical cuts to enlarge the vaginal opening), and deliveries
- Providing immediate care to the newborn, including assessing vital signs, conducting initial assessments, and ensuring proper bonding between the mother and baby
- Offering guidance and support to mothers who choose to breastfeed, helping with latching, positioning, and addressing breastfeeding concerns
- Assisting with postpartum recovery
The National Certification Corporation offers the following certifications for nurses specializing in labor and delivery:
- Inpatient Obstetric Nursing (RNC-OB®)
- Neonatal Resuscitation Program (NRP)
- Electronic Fetal Monitoring (C-EFM)
Experience in labor and delivery is valuable for a neonatal intensive care unit (NICU) specialty. It also provides essential insights into career paths focusing on neonatal care, breastfeeding support, or pursuing a midwifery profession rooted in compassionate maternity care.
4. Post-Anesthesia Care Unit (PACU)
In the post-anesthesia care unit, which is usually close to the operating room, nurses closely monitor patients after surgery until the anesthesia wears off, ensuring their safe recovery and providing the necessary care and support during the critical post-anesthesia period.
PACU nurses usually carry out the following duties:
- Monitoring patients’ levels of consciousness, responsiveness, and recovery from anesthesia after surgery
- Continually checking and ensuring that their blood oxygen levels and other vital signs are stable
- Treating patients’ pain, nausea, confusion, or other symptoms of anesthesia
- Administering medication according to doctor's instructions
- Keeping bandages and dressings clean and dry
The American Board of Perianesthesia Nursing Certification, Inc. (ABPANC) offers the following specialized certifications:
- Certified Post Anesthesia Nurse (CPAN®)
- Certified Ambulatory Perianesthesia Nurse (CAPA®)
Experience in the PACU and related certifications can lead to other RN hospital jobs, such as in the oncology department or the progressive care unit.
5. Operating Room (OR)
Surgical nurses assist in the operating room, specializing in peri-operative care—before, after, or during surgery. OR nurses often have a sub-specialty in intraoperative nursing, specifically to work alongside surgeons and anesthesiologists during operations.
The duties of OR nurses include the following:
- Sterilizing the room and hand instruments
- Anticipating the surgeon’s needs during surgery and being ready to hand the surgical instruments and supplies
- Directly assisting surgeons during the operation by helping to control bleeding, suturing, dressing wounds, monitoring vitals, and watching for signs of complications—only registered nurse first assistants (RNFAs)
The Competency and Credentialing Institute (CCI) offers the following certifications in the area of surgery:
- Certified Perioperative Nurse (CNOR)
- Certified Surgical Services Manager (CSSM)
- Certified Ambulatory Surgery Nurse (CNAMB)
- Certified Foundational Perioperative Nurse (CFPN)
OR RN jobs provide valuable experience for transitioning into various nursing roles and hospital units, including the PACU, surgical leadership positions, cardiac catheterization labs, labor and delivery, and more. Their skills in sterile technique, patient monitoring, and surgical assistance make them adaptable to different healthcare settings.
6. Progressive Care Unit (PCU)
Progressive care units, also known as step-down or sometimes telemetry, are intermediate care units between the ICU and Med-Surg. In a broader sense, PCUs assist in mitigating the demand for ICU beds and alleviating ICU-related expenses, all while upholding the quality of patient care.
The duties of PCU nurses include the following:
- Reading rhythm strips with a strong understanding of cardiac conditions
- Integrating discharge care planning within the comprehensive multidisciplinary care plan
- Performing drug dose titration—personalizing medication doses depending on the severity of the pain, especially when dealing with a flare of pain
PCU nurses can pursue an Adult Progressive Care Nursing (PCCN) certification through the American Association of Critical-Care Nurses (AACN).
The certifications supporting ICU nursing also validate your performance as a PCU or telemetry nurse. According to the National Institutes of Health, PCUs are becoming increasingly common in hospitals in the US due to their cost-effective, safe, and high-quality care.
Find Further Information on Progressive Care Unit Nursing
7. Cardiovascular Intensive Care Unit (CVICU)
The cardiovascular intensive care unit is a specific ICU that specializes in diseases and surgeries related to the heart.
The duties of CVICU RNs are similar to those of an ICU RN, with the addition of specific skills and knowledge in the use of cardiac support equipment and life-sustaining interventions.
In addition to the certifications related to ICU nursing, CCU and CVICU RNs can obtain the Cardiac Vascular Nursing Certification (CV-BC™) through the American Nurses Credentialing Center (ANCC).
Other intensive care units with jobs needing specialized RNs are neonatal intensive care units, pediatric intensive care units (PICUs), trauma intensive care units (TICUs), and burn centers.
Impact of Certifications on Hospital Quality and Status
Certifications favor both nursing careers and hospital quality. A study of over 20,000 nurses, published by the National Library of Medicine, shows that in the average Magnet hospital, over half of RNs are certified compared to one-third of RNs in non-Magnet hospitals. The Magnet Recognition Program® honors hospitals and healthcare organizations with an institutional culture and environment that supports high-quality nursing. It represents a hard-earned commitment to excellence in health care.
To earn certifications, first, you have to become an RN. What is an RN? In contrast to a certified nursing assistant (CNA) or a licensed practical nurse (LPN), a registered nurse has completed an associate or a bachelor of science degree in nursing and, due to higher education, handles more complex work, increased job autonomy, and higher salaries.
Find Out How to Transition from a CNA to an RN
How Can a Nurse Find Per Diem Jobs in a Hospital?
Today, technology is helping resolve many dilemmas. In this case, open healthcare marketplaces, such as Nursa, connect RNs, LPNs, and CNAs with facilities to find jobs and fill shifts in various hospital units, relieving that all-too-familiar job-hunt frustration.
Explore Nursa to Find Per Diem Jobs in Hospitals near You
