California Occupational Guides

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Detailed Guide for

Registered Nurses in San Diego County

May also be called: Nurse Practitioners; Clinical Nurse Specialists; Certified Nurse Midwives; Certified Registered Nurse Anesthetists; Nurse Administrators; Nurse Supervisors; Nurse Educators; Staff Nurses; Charge Nurses

Specialties within this occupation include: Hospital Nurses; Critical Care Nurses; Emergency or Trauma Nurses; Operating Room Nurses; Pediatric Nurses; Psychiatric Nurses; Office Nurses; Home Health Care Nurses; Public Health Nurses; Addictions Nurses; Cardiac and Vascular Nurses; Gynecology Nurses; and Holistic Nurses.

What Would I Do?

Registered Nurses (RN) are the largest group among all the health care occupations. Most RNs work in acute care hospitals but some of them care for patients in private clinics or work in private homes. They evaluate patient’s health problems and needs and provide nursing care to ill, injured, convalescing, and/or disabled patients. Nurses record patients’ medical histories and symptoms and administer treatment and medications. They help perform diagnostic tests, analyze results, and may advise patients on health maintenance and disease prevention. Registered Nurses develop and apply nursing care plans and maintain medical records. They educate patients and the public about various medical conditions. They also assist with patient follow-up and rehabilitation and provide advice and emotional support to the patients’ family members.

Registered Nurses can specialize in one or more patient care specialties. The most common specialties can be divided into four categories: by work setting or type of treatment; disease, ailment, or condition; organ or body system type; and population.

Hospital Nurses make up the largest group of nurses. They provide bedside care for hospital in-patients and monitor all aspects of patient care, including diet and physical activity. Hospital Nurses administer treatment and give medications to patients under the direction of physicians. They also observe the patient, assess and record symptoms, and note reactions and progress.

Office Nurses work in doctors' offices, clinics, emergency care centers, and Health Maintenance Organizations (HMO). They prepare patients for and administer physical examinations. They also dress wounds, give injections or medicines, and assist in minor surgeries. Office Nurses may help with the management of the office and supervise other staff.

Home Health Nurses provide health care in patients' homes. They travel to patients' homes and administer medications, check the physical and mental condition of patients, and instruct patients on proper home care. They educate the patient and family in various aspects of home health. Home Health Nurses may teach, counsel, and supervise other home health workers. They often act as an intermediary between the physician, hospital, staff, and the patient.

Public Health Nurses work for governmental agencies, schools, clinics, and retirement communities. They work in concert with local governments to remedy health problems that are present in the community. Public Health Nurses arrange immunization clinics, blood pressure testing, cholesterol level testing, and other health screening clinics. They lecture groups on healthy living, disease prevention, nutrition, and how to identify health risks in the community. They also work to decrease the incidence of infectious diseases and assist in quarantine efforts. Public Health Nurses make field investigations and help in epidemiological health studies.

Nurse Practitioners are Registered Nurses with graduate level training in diagnostic and health assessment skills. Their training allows them to provide basic medical care and relieve physicians of many time consuming tasks. Under the direction of a supervising physician, they interview patients, take medical histories, and perform physical examinations. Nurse Practitioners order laboratory tests, make tentative diagnoses, and prescribe appropriate treatments. They also prescribe medication and medical devices if they have a Nurse Practitioner furnishing number. They may refer patients to physicians for consultation or to specialized health resources for treatment.

Important Tasks and Related Skills

Each task below is matched to a sample skill required to carry out the task.

View the skill definitions
TaskSkill Used in this Task
Monitor, record and report symptoms and changes in patients' conditions.Medicine and Dentistry
Modify patient treatment plans as indicated by patients' responses and conditions.Active Listening
Maintain accurate, detailed reports and records.Reading Comprehension
Order, interpret, and evaluate diagnostic tests to identify and assess patient's condition.Critical Thinking
Direct and supervise less skilled nursing or health care personnel or supervise a particular unit.Instructing
Record patients' medical information and vital signs.Problem Sensitivity
Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.Oral Expression
Instruct individuals, families and other groups on topics such as health education, disease prevention and childbirth, and develop health improvement programs.Speaking
Assess the needs of individuals, families or communities, including assessment of individuals' home or work environments to identify potential health or safety problems.Inductive Reasoning
Monitor all aspects of patient care, including diet and physical activity.Time Management
Source: U.S. Department of Labor Occupational Information Network (O*NET)

Working Conditions

Nurses generally work in well-lit, comfortable health care facilities. They need physical strength and stamina to lift or move patients and must be able to cope with human suffering and frequent emergencies. Registered Nurses may spend considerable time walking and standing.

Patients in hospitals and nursing care facilities require 24-hour care. Consequently, Nurses may work nights, weekends, holidays, per diem (per day), and on call. They may also work as a Travel Nurse. Nurses who work in office settings are more likely to work regular business hours.

Dangers from infectious agents are also part of the work environment. Diseases such as AIDS, hepatitis, and tuberculosis present the possibility of infection to the RN. Nurses must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. Nurses may suffer emotional strain from observing patient suffering and close personal contact with patients’ families. They may also be assaulted by patients.

Registered Nurses may work on emergency response teams that treat patients while traveling by helicopter to hospitals or in triage centers at disaster sites, such as earthquakes or floods. Nurse Midwives, who are licensed to provide care and treatment to pregnant women, often deliver babies in patients' homes.

Nurses operate medical machinery such as acute care fetal, maternal, and cardiac output monitors. They use hypodermic needles, forceps, hemostats, and catheters. They also use computer software for calendar and scheduling and time accounting. Nurses use data base user interface and query software and Microsoft Office programs.

Registered Nurses may belong to the California Nurses Association.

Will This Job Fit Me?

The job of Registered Nurse will appeal to you if you enjoy activities that involve assisting others and promoting learning and personal development. This occupation satisfies those with social interests. Social occupations involve teaching, offering advice, helping, and being of service to people.

What Wages and Benefits Can I Expect?

Wages

The median wage in 2015 for Registered Nurses in California was $97,818 annually, or $47.03 hourly. The median wage for Registered Nurses in San Diego County was $84,666 annually, or $40.70 hourly. The median is the point at which half of the workers earn more and half earn less.

Change to Hourly Wages
Annual Wages for 2015Low
(25th percentile)
Median
(50th percentile)
High
(75th percentile)
California$77,700$97,818$121,818
San Diego County$69,244$84,666$104,185
Source: EDD/LMID Occupational Employment Statistics Survey, 2015 Wages do not reflect self-employment.
View Wages for All Areas

Benefits

Benefit packages vary among employers. Generally, RNs receive medical, dental, and retirement benefits. In addition, most employers provide vision, life, vacation, and sick leave to RNs that work full-time.

What is the Job Outlook?

The California Board of Registered Nursing (BRN) reports that there are more than 330,000 Nurses and over 14,000 Nurse Practitioners with an active RN license. Despite this large number, shortages still exist and are expected to occur over the next ten years. This is due to workers who are expected to retire or leave Nursing for other reasons. Hospital and clinics continue to have ongoing, active recruitment programs, some offering unique benefits, to attract applicants.

Some HMOs employ Nurse Practitioners in addition to physicians. This trend, which has heightened the demand for Nurse Practitioners, is expected to continue. Competition may be keen for the higher paying jobs in large cities.

Projections of Employment

In California, the number of Registered Nurses is expected to grow faster than average growth rate for all occupations. Jobs for Registered Nurses are expected to increase by 16.9 percent, or 42,900 jobs between 2012 and 2022.

In San Diego County, the number of Registered Nurses is expected to grow slower than average growth rate for all occupations. Jobs for Registered Nurses are expected to increase by 9.1 percent, or 2,150 jobs between 2012 and 2022.

Estimated Employment and Projected Growth
Registered Nurses
Geographic Area
(Estimated Year-Projected Year)
Estimated
Employment
Projected
Employment
Numeric
Change
Percent
Change
Additional Openings
Due to Net
Replacements
California
(2012-2022)
254,500297,40042,90016.949,300
San Diego County
(2012-2022)
23,75025,9002,1509.14,600
Source: EDD/LMID Projections of Employment by Occupation
View Projected Growth for All Areas

Annual Job Openings

In California, an average of 4,300 new job openings per year is expected for Registered Nurses, plus an additional 4,930 job openings due to net replacement needs, resulting in a total of 9,230 job openings.

In San Diego County, an average of 215 new job openings per year is expected for Registered Nurses, plus an additional 460 job openings due to net replacement needs, resulting in a total of 675 job openings.

Estimated Average Annual Job Openings
Registered Nurses
Geographic Area
(Estimated Year-
Projected Year)
Jobs From GrowthJobs Due to
Net Replacements
Total Annual
Job Openings
California
(2012-2022)
4,3004,9309,230
San Diego County
(2012-2022)
215460675
Source: EDD/LMID Projections of Employment by Occupation
View Data for All Areas

How Do I Qualify?

Education, Training, and Other Requirements

Registered Nurses must possess a high school diploma, or the equivalent, and complete a nursing program approved by the BRN. There are two types of programs that will prepare a nursing student for the NCLEX-RN.

  • Community colleges offer a two-year Associate Degree in Nursing (ADN) program.
  • Colleges and universities offer a four-year Bachelor of Science Degree in Nursing (BSN) program.

These programs include clinical experience in one or more hospitals and clinics in addition to classroom instruction. Although the number of training programs in California has grown considerably in recent years, competition for admission into these programs is often intense.

Another path to becoming a Registered Nurse is by becoming a Licensed Vocational Nurse (LVN) first, and then taking classes to get an RN license. Most community colleges give LVNs credit for their basic nursing course work and experience. Typically, they go to school for about one year and perform tasks under the supervision of a Registered Nurse. Although the activities of the LVN are not as complex as those of the RN, they provide clinical care that has a direct impact on the patients recovery. They can complete the requirements for an associates degree in nursing in two years. At that point, they can apply for an RN license or transfer to a four-year college to obtain a bachelors degree in nursing.

There are two alternative routes to become an RN. The California Board of Nursing approved and instituted the 30-Unit Option Candidacy Program to allow experienced LVNs a more rapid path to qualify for the national exam for RN licensure. The program takes approximately 18-24 months; however, no degree is granted upon completion. In addition, California law permits military corpsmen to take the national exam for RN licensure if they have completed RN level education and clinical experience.

Experience

Experience varies among specialty. For instance, employers may require Emergency or Trauma Nurses to have a minimum of six months acute care experience. Newly graduated RNs generally enter a training program or internship where they spend the first few weeks of their job working very closely with experienced staff for training and ongoing support.

Early Career Planning

To prepare for nursing school, high school students should take the following classes:

  • Four years of English.
  • Three to four years of math including algebra and geometry.
  • Two to four years of science including biology and chemistry. Physics and computer science are recommended.
  • Three to four years of social studies.
  • Two years of foreign language is also recommended, but not required.

Continuing Education

Registered Nurses in the State of California are required by law to complete 30 hours of continuing education every two years, in addition to paying a renewal fee, to maintain an active license. Courses must be taken through a continuing education provider recognized by the BRN.

Licensing and Certification

Contact the agency that issues the license for additional information. Click on the license title below for details.

Registered Nurses may hold one or several certificates such as: Certified Critical Care Nurse, Certified Addiction Specialist, Nurse Practitioner Certification, or Certified Nurse Midwife. For more information, go to the U.S. Department of Labor's Career InfoNet Web site and scroll down to "Career Tools." Click on "Certification Finder" and follow the instructions to locate certification programs.

Where Can I Find Training?

There are two ways to search for training information:

  • Search by Field of Study to find what programs are available and what schools offer those programs. You may use keywords such as: Keywords (use exact wording): Registered Nursing/Registered Nurse, Adult Health Nurse/Nursing, Clinical Nurse Specialist, Nurse Midwife/Nursing Midwifery, Critical Care Nursing, and Family Practice Nurse/Nurse Practitioner.
  • Search by Training Provider to find schools by name, type of school, or location.

Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work.

Where Would I Work?

The largest industries employing Registered Nurses are as follows:

Industry TitlePercent of Total Employment for Occupation in California
General Medical and Surgical Hospitals 60.2%
Outpatient Care Centers 7.9%
Offices of Physicians 6.1%
Nursing Care Facilities 4.4%
Home Health Care Services 4.2%
Source: EDD/LMID Staffing Patterns

Finding a Job

Direct application to employers remains one of the most effective job search methods. Nursing schools graduate placement service links RNs and Nurse Practitioners to jobs. Newspaper ads also have job leads. State, county, city, and federal personnel administration offices provide announcements of jobs and requirements.  Online job opening systems include JobCentral at www.jobcentral.com and CalJOBSSM at www.caljobs.ca.gov.

To find your nearest One-Stop Career Center, go to Service Locator. View the helpful job search tips for more resources. (requires Adobe Reader).

Yellow Page Headings

You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Registered Nurses.

    Find Possible Employers

    To locate a list of employers in your area, go to "Find Employers" on the Labor Market Information Web site:

    • Select one of the top industries that employ the occupation. This will give you a list of employers in that industry in your area.
    • Click on "View Filter Selections" to limit your list to specific cities or employer size.
    • Click on an employer for the street address, telephone number, size of business, Web site, etc.
    • Contact the employer for possible employment.

    Where Could This Job Lead?

    Experienced RNs may advance from bedside nursing to supervisory positions or clinical specialist positions, such as Critical Care Nurse. Those with bachelor's degrees may become nursing administrators, consultants, educators, or researchers. Some take special courses, often earning a master's degree, to become Nurse Practitioners.

    A Registered Nurse may promote to Director of Nursing, who is responsible for hiring the nursing staff and overseeing all nursing functions.

    Nurse Practitioners may advance into administration, but most view themselves as health care professionals trained to diagnose and treat patients for illnesses and injuries formerly treated only by doctors. Most Nurse Practitioners stay in this occupation throughout their career.

    Related Occupations

    Below is a list of occupations related to Registered Nurses with links to more information.

    OccupationOccupational
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    ChiropractorsProfile
    Medical AssistantsGuide
    Nursing Instructors and Teachers, PostsecondaryProfile
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    Psychiatric AidesProfile
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    Other Sources

    These links are provided for your convenience and do not constitute an endorsement by EDD.

    For the Career Professional

    The following codes are provided to assist counselors, job placement workers, or other career professionals.

    SystemCode
    SOC - Standard Occupational Classification29-1141
    O*NET - Occupational Information Network
       Registered Nurses29-1141.00
       Interest Codes (RIASEC)SIC
       Acute Care Nurses29-1141.01
       Interest Codes (RIASEC)SIR
       Advanced Practice Psychiatric Nurses29-1141.02
       Interest Codes (RIASEC)SIA
       Critical Care Nurses29-1141.03
       Interest Codes (RIASEC)SIR
       Clinical Nurse Specialists29-1141.04
       Interest Codes (RIASEC)ESC