You will encounter many different attitudes about nurses. One of them is the strong belief by some that only hospital nurses are “real nurses.” Another is that LPNs are inferior and not really nurses at all. Some specialty nurses such as ICU nurses feel superior because of their highly technical skills. Others think that Quality Improvement (QI) and Utilization Review (UR) nurses are not real nurses either. Sometimes nurse educators are viewed as teaching because they are inept at nursing.

All nurses are an essential part of the overall health care picture. Many times you'll find LPNs whose skills and bedside manners are impeccable and who best teach the new nursing grads and physicians how to perform the most technical procedures. The argument should never be about who is better, but who is the most professional. The most professional nurse is the one who sees all nurses as necessary parts of the whole; she recognizes the contributions of their individual special talents and skills to the team effort and that they strive to make a difference in someone's life every day. Whether their role is direct care or a supportive role behind the scenes, they are all necessary roles and are vital to providing patients with improved outcomes.

There are many roles for nurses. Inside the hospital arena, these include, but are not limited to, staff nurses, surgical nurses, midwives, lactation specialists, rehab nurses, nurse anesthetists, IV specialists, staff educators, supervisors, clinical specialists, clinical managers, quality and utilization specialists, nursing directors, and administrators.

Outside the hospital, there are many roles such as clinic nurses, office nurses, school nurses, forensic nurses, industrial nurses, case managers for insurance companies and worker's compensation, sales reps for drugs and medical supplies, clinical research nurses, diabetic educators, wound ostomy nurses, legal nurse consultants, flight nurses, childbirth educators, dialysis nurses, home health nurses, hospice nurses, and private duty nurses. There are managers and health care administrators and many, many more. Travel nurses fill vacancies in all areas, primarily in hospitals and clinics, but their roles are expanding as well.

Nurse entrepreneurs are building a huge variety of independent businesses ranging from consultants in many diverse areas of health care to aestheticians to foot care specialists. Nurse practitioners have hung out their own shingles in many fields for many years such as mental health and women's health. These are expanding now and hopefully Congress will see its way to recognizing the cost savings and other benefits of NPs and will allow for Medicaid reimbursement of their services.

The area of patient education leaves many opportunities for nurses to provide individual and small group instruction on managing disease entities and care issues such as diabetic teaching and managing chronic pain. The job you hold five years from now probably doesn't even exist today. Be sure to keep your skills current and learn about techniques and diseases beyond your own realm. Keep your options open.