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8 Surgical Specialties for Registered Nurses

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Becoming a Surgical Nurse

surgical nurses, nursing specialties, nursing, registered nurses, nursing careersArticle at a Glance

In our nursing articles you have read about post-secondary degrees in nursing. You have even learned how to improve your application for getting into nursing school. In today’s article you’ll read about 8 surgical specialties you can pursue once you are a licensed registered nurse. For each one you’ll see:

A brief description of the career.

A list of typical duties.

The educational path to follow.

The type of experience to obtain.

Certification and re-certification requirements.

Snapshot of 8 surgical nursing specialties

Below is a chart that lists the eight surgical nursing specialties this article covers. The table provides the name of the position and the type of nursing environment to expect. All of the roles require you to be a licensed, registered nurse.

Specialty Name

 Nursing Environment(s)
Cardiac Cath Lab Nurse – Registered Nurse-Board Certified (RN-BC) Clinical; emergency; surgical
Nurse Anesthetist – Certified Registered Nurse Anesthetist (CRNA) Advanced Practice; surgical
Ophthalmic Nurse – Certified Registered Nurse in Ophthalmology (CRNO) Clinical; surgical
Otorhinolaryngology Nurse – Certified Otorhinolaryngology Nurse (CORLN) Clinical; surgical
Perianesthesia Nurse – Certified Post Anesthesia Nurse (CPAN) and/or Certified Ambulatory Perianesthesia Nurse (CAPA) Surgical
Perioperative (Surgical) Nurse – Clinical Nurse Specialist-Certified Perioperative (CNS-CP) Surgical
Plastic Surgery Nurse – Certified Plastic Surgical Nurse (CPSN) or Certified Aesthetic Nurse Specialist (CANS) Clinical; surgical
Transplant Nurse – Certified Clinical Transplant Nurse (CCTN)

Surgical

As you read details about the positions, you’ll learn the general duties performed, the educational path to follow, and information on the certification process.

To become a type of surgical nurse requires dedication and significant training. However, if you pursue any of these roles, you will find yourself with a gratifying career.

1. Cardiac Cath Lab Nurse – RN-BC

Another name for a cardiac cath lab nurse is a cardiac-vascular nurse. This type of surgical nurse assists surgeons with the insertion of a catheter into a chamber or vessel of the heart. This procedure is used to diagnose or treat heart conditions. It’s possible you’ll also assist with coronary catheterization. These procedures are performed in highly specialized labs using advanced technologies in cardiac care.

Typically a cardiac cath lab nurse will assist in some, if not all of the following types of procedures:

  • Angioplasties.
  • Pacemakers and cardioverter-defibrillators (ICDs) implants.
  • Stent placements.
  • Valvuloplasties.

To become a certified cardiac cath lab nurse, you’ll take the following steps:

  • Obtain an associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Obtain a Cardiac Vascular Nursing Certification (RN-BC) from the American Nurses Credentialing Center (ANCC). As stated on their site, eligibility for this certification is extensive and requires the following:
    • Hold a current, active, unencumbered RN license.
    • Participate in a six-month cardiac cath lab training program run by a hospital.
    • Work two years in an ER, ICU or coronary care unit.
    • Have practiced the equivalent of 2 years full-time as a registered nurse.
    • Have a minimum of 2,000 hours of clinical practice in cardiac-vascular nursing within the last 3 years.
    • Have completed 30 hours of continuing education in cardiac-vascular nursing within the last 3 years.

Once you receive the RN-BC credential, it will have to be renewed every five years.

Because eligibility requirements, fees and continuing education information changes as the industry does, check the ANCC website for details when you’re ready to begin the education process.

You may be interested in watching this video about the cardiac nursing specialty.

2. Nurse Anesthetist – CRNA

As the name implies, a nurse anesthetist gives anesthesia and anesthesia-related care to patients before, during, and after surgery. A CRNA faces a variety of situations and unexpected events during operations. That’s why the path into this field is so intensive. Nurse anesthetists are among the most in-demand, and highest-paid, of all nursing professions.

Some of the responsibilities of a nurse anesthetist include:

  • Assisting with outpatient procedures.
  • Helping patients with pain management.
  • Performing epidurals.
  • Providing operating and emergency room care.

The steps to becoming a nurse anesthetist are:

The Continued Professional Certification (CPC) is their recertification program. It consists of two four-year cycles. The CPC is a relatively new program, so it is always best to check the NBCRNA website for current details. They provide detailed manuals and samples of test questions.

3. Ophthalmic Nurse – CRNO

As you may know, the field of ophthalmology involves eyecare beyond optometry. An ophthalmic nurse cares for individuals faced with severe eye disorders and serves as a vital member of surgical teams.

Some duties of an ophthalmic nurse include:

  • Conducting pre-operative assessments.
  • Helping patients with glaucoma, cataracts and other eye trauma.
  • Positioning patients and verifying surgical sites.
  • Serving as a circulating or scrub nurse during eye surgeries.

To become an ophthalmic nurse, the steps you follow are:

  • Obtain your nursing diploma, associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Work a minimum of two years as a registered nurse in ophthalmic nursing.
  • Pass the Ophthalmic Nursing certification exam administered by the National Certifying Board for Ophthalmic Registered Nurses (NCBORN). As their site states, eligibility requirements to take the test are:
    • Hold a current, active, unencumbered RN license.
    • Have two years of full-time or the equivalent (4,000 hours) experience in ophthalmic registered nursing practice.

Continuing education and recertification is required for a Certified Registered Nurse in Ophthalmology (CRNO) every five years. The certification exam itself is only given twice a year. It is always advisable to check the NCBORN website for current details. You can also download manuals and outlines about requirements and the test itself.

4. Otorhinolaryngology Nurse – CORLN

Otorhinolaryngology nurses provide care for patients facing illnesses, diseases, or disorders related to the head. Areas include the skin, neck, ears, nose, oral cavities, and cranial nerves.

Some responsibilities of an otorhinolaryngology nurse are:

  • Assisting with radiation treatments.
  • Diagnosing patients.
  • Providing support for patients undergoing medical and surgical procedures.

The steps to becoming an otorhinolaryngology nurse are:

  • Obtain your nursing diploma, associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Work a minimum of three years as a registered nurse.
  • Pass the Certified Otorhinolaryngology Nurse (CORLN) exam facilitated by the Society of Otorhinolaryngology and Head-Neck Nurses (SOHN). As you will note from their site, eligibility requirements are:
    • Hold a current, active, unencumbered RN license.
    • Have at least three years of experience in otorhinolaryngology and head-neck nursing practice.

Upon passing, you will become a Certified Otorhinolaryngology Nurse (CORLN). The test is only offered twice a year, so checking the SOHN website for updated information is always the best practice. Currently, CORLN recertification is required every five years.

5. Perianesthesia Nurse – CPAN and/or CAPA

Perianesthesia nurses, or recovery room nurses, carefully monitor patients as they recover from the effects of anesthesia after surgery. Perianesthesia nurses are well trained on how to handle patients with unexpected reactions upon awakening such as confusion or pain. They often consult with patients before and after surgery, and provide information about ongoing care at home once the patient is discharged.

Typical duties of a perianesthesia nurse include:

  • Caring for patients in recovery.
  • Giving patients recovery tips for home.
  • Prepping patients for surgery.

There are two certifications for a perianesthesia nurse. Each covers a specific phase of anesthesia. The first, the CPAN, certifies a nurse to care for patients in the post-anesthesia phase. The second, CAPA, is more extensive. It certifies a nurse to care for patients in preanesthesia, the day of the surgery, and post-anesthesia and extended care. You can be certified in one or the other, or opt for dual certification.

The educational flow to become a perianesthesia nurse is:

  • Obtain an associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Apply to take your certification through the American Board of Perianesthesia Nursing (ABPANC).
    Per the ABPANC site, eligibility requirements for a Certified Post Anesthesia Nurse (CPAN) are:

    • Hold a current, active, unencumbered RN license.
    • Have 1,800 hours of direct clinical experience caring for patients in post-anesthesia Phase I obtained within the two years prior to applying for initial certification.

Per the ABPANC site, eligibility requirements for the Certified Ambulatory Perianesthesia Nurse (CAPA) are:
Hold a current, active, unencumbered RN license.

  • Have 1,800 hours of direct clinical experience caring for patients in preanesthesia phase, day of surgery/procedure, post-anesthesia Phase II and/or extended care obtained within the two years prior to applying for initial certification.

Per the ABPANC site, eligibility requirements for dual certification:

  • Hold a current, active, unencumbered RN license.
  • Direct clinical experience hours required for both CPAN and CAPA (1,800 hours each).

Because of the complexity of two potential exams and dual certification, and specific testing dates, it is recommended you visit the ABPANC for details and updates to their handbook.

This two-minute video entitled We are Perianesthesia Nurses may be of interest to you.

6. Perioperative (Surgical) Nurse – CNS-CP

Perioperative nurses care for patients during the entire course of their surgical experience. They monitor patients to ensure they are receiving the best quality of care during surgery. They also serve as intermediaries between the surgical team and the patients’ families. They can be seen assisting in the recovery room, and sharing post-operative tips patients should follow when they return home.

Typical duties of perioperative nurses include:

  • Giving patients recovery tips for home.
  • Interviewing and assessing patients for surgery.
  • Maintaining a sterile operating room throughout surgery.
  • Monitoring patients and coordinating care during surgery.

The educational path to becoming a perioperative nurse is:

  • Obtain a bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Gain experience working in critical care and in the ER.
  • Pass the Certified Nurse Operating Room exam (CNOR) through the Competency and Credentialing Institute (CCI). As their site indicates, eligibility requirements are:
    • Hold a current, active, unencumbered RN license.
    • Be currently working full-time or part-time in perioperative nursing an area of nursing education, administration, research or clinical practice.
    • Complete a minimum of 2 years and 2,400 hours of experience in perioperative nursing, with a minimum of 50% (1,200 hours) in an intraoperative setting.

Recertification for a Clinical Nurse Specialist-Certified Perioperative is required every five years. The CCI site contains updated information on initial certification and renewal.

A Day in the Life of a Perioperative Nurse may give you additional insight about this career.

7. Plastic Surgery Nurse – CPSN or CANS

Plastic surgery nurses help patients facing or recovering from plastic surgery procedures. They with procedures that range from small and elective, to more complicated operations like facial reconstruction.

Typical duties of a plastic surgery nurse include:

  • Explaining procedures to patients.
  • Prepping the surgery room.
  • Working with surgeons and other members of a surgical team.

The educational flow for a plastic surgery nurse is:

  • Diploma, associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Work for two years as a registered nurse in surgical nursing with half the hours being in plastic surgery.
  • Pass the Certified Plastic Surgical Nurse (CPSN) exam facilitated by the Plastic Surgical Nursing Certification Board (PSNCB) exam. Their site provides details on the following eligibility requirements:
    • Hold a current, active, unencumbered RN license.
    • Have a minimum of two 2 years of plastic surgery nursing experience as a registered nurse in a general staff, administrative, teaching, or research capacity within 3 years prior to application.
    • Have a minimum of 1,000 practice hours in plastic surgery nursing during 2 of the preceding three 3 years before making application.

There is also a Certified Aesthetic Nurse Specialist (CANS) certification exam, also facilitated by the PSNCB. Details on the following eligibility requirements can be located on their site:

  • Hold a current, active, unencumbered RN license.
  • Work in collaboration or in a practice with a physician that is Board Certified within one of the following core specialties: Plastic/Aesthetic Surgery, Ophthalmology, Dermatology, or Facial Plastic Surgery (ENT).
  • Have a minimum of 2 years of nursing experience as a registered nurse within one of the listed core specialties above in a general staff, administrative, teaching, or research capacity within 3 years prior to application.
  • Have spent at least 1,000 practice hours within the core specialties during the preceding 2 years before making application.

Recertification for either credential is every three years. Because there are two exams with different eligibility requirements, and the tests are given only during certain times of the year, it’s best to check the PSNCB website.

You may want to view this short video on What is a Plastic Surgery Nurse?

8. Transplant Nurse – CCTN

Transplant nurses work with patients who donate and receive organs. These nurses are highly skilled at preparing living donors for transplant operations, including any risks involved in the donation. They perform similar services for patients receiving transplant organs from deceased individuals. Transplant nurses assist medical teams during surgery and work in post-operative care. They carefully monitor patients for post-transplant complications like organ rejection.

Typical duties of a transplant nurse include:

  • Clearing patients and donors for surgery.
  • Monitoring patients’ vital signs after surgery.
  • Ordering lab tests to confirm an organ match.
  • Taking medical histories.

The path to becoming a transplant nurse is:

  • Get diploma, associate or bachelor degree in registered nursing.
  • Pass the NCLEX-RN.
  • Get a few years experience in critical care, intensive care or medical-surgical nursing.
  • Pass the Transplant Nurse certification exam through the American Board for Transplant Certification (ABTC). Their site outlines the following eligibility requirements:
    • 24 months general experience as a registered nurse.
    • 12 months experience while working as a transplant nurse, which can occur concurrently with RN experience.

Recertification for a Certified Clinical Transplant Nurse (CCTN) is every five years. Check the ABTC website for updated information when you are prepared to embark on this career path.

Exam Preparation

As you have read, all of these specialties require experience in the field before you are eligible to take the exam. It is essential to understand that practical field experiences do not adequately prepare you to pass any of the certification tests.

You have invested substantial time and financial resources for your education, so it is recommended that you take a preparatory course for your selected exam. You should also use the review materials and practice tests provided to you on each site. Most successful candidates spend two to three months consistently studying before attempting their exam. Since there are fees involved, you want to pass your exam the first time. So, create a study routine and follow it faithfully.

It can also be helpful for you to join a professional organization associated with the surgical specialty that most interests you. In some cases, the organization can offer you reduced exam fees and special training materials.

No matter what surgical specialty you prefer, you will have to obtain a degree in registered nursing and gain practical experience in the field. If you dedicate yourself to becoming a surgical nurse, you will find more career opportunities open to you.

Still interested?

If any of these nursing specialties has sparked an interest in a nursing career, you can get started today with one of two kits from The Apprentice Doctor. There’s no need to wait until you are in an official nursing program, or even in college. Either kit enables you to practice skills you’ll need in any nursing career.

The Apprentice Doctor® Suturing Course and Kit is a resource that teaches you how to suture wounds in a short period of time. As a nurse, you’ll use this skill almost daily. The kit contains everything you need to get started. Take a look at the following video for a closer view of the contents of the kit.

The Apprentice Doctor® Phlebotomy Course and Kit is another handy resource at your fingertips. This program teaches you how to confidently perform phlebotomy procedures. Drawing blood is a skill nurses perform frequently – and they have to be very good at it to minimize any discomfort for the patient. If you want to start your education being a great nurse, why not begin phlebotomy training right away? Take a quick look at the following video for an introduction to the kit.

If you are interested in the education you need to get started in registered nursing, the following articles will be of interest to you:

Associate Degree versus a Bachelor Degree in Registered Nursing
5 Reasons Your Application Gets Rejected by Nursing Schools

For an podcast interview with a surgical nurse, click here.

application gets rejected by nursing schools

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5 Reasons Your Application Gets Rejected by Nursing Schools

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Story at a Glance

Do you want to become a nurse, but can’t get into a program? There are 5 probable reasons your application gets rejected by nursing schools.

Do your nursing school applications contain any of the following weaknesses?

You haven’t completed the pre-requisites (or you may not know what they are).

Your grade point average is too low.

Your test scores don’t meet the minimum admissions criteria.

Your preferred school won’t accept you (but perhaps another one does).

The lack of acceptance has made you frustrated and discouraged.

If even one reason is true for you, read on. If you’re serious about becoming a nurse, learn the ways to overcome these difficulties.

 5 Reasons Your Application Gets Rejected by Nursing Schools; and how you can overcome them.

 

We read a lot about why students stay in nursing school and the reasons they drop out. Lots of articles and FAQ sheets tell you what to expect in nursing school. They also go over the licensing exam and details about the career. But few review the reasons an application gets rejected by nursing schools or what to do about it.

If your dream is to become a nurse, but you can’t get accepted, read on. Listed below are the top 5 reasons this may be the case and what you can do to overcome each one.

1 – You haven’t completed the prerequisites

application gets rejected by nursing schools, you haven't completed the prequisitesNursing schools prefer their students to have some foundational knowledge when they begin training. They don’t expect you to know about nursing. But they do want you to have completed courses in the sciences. They scan your transcript for curriculum like anatomy and physiology, chemistry, nutrition, and microbiology. They also expect to see general education courses such as English, sociology, and psychology. Without them, your application is probably rejected by nursing schools.

If you are serious about entering a nurse training program, talk with an admissions representative about prerequisites. Once you have a list, review the courses you have and then make a dedicated effort to complete the rest.You can pick up most, if not all the necessary classes at a community college or online. But before taking this step, talk to your intended nursing school to make sure the credits will transfer into their program. Always keep in mind that transfer of credit, also known as TOC, is still at the discretion of the receiving institution.

2 – Your grade point average is too low

grade point average too low

Like medical school, nursing school is very competitive. If your grade point average in high school, or college, was lower than a 3.0, admissions committees will probably pass over your application. Sometimes they will consider you if you demonstrate an improved grade trend. But there are enough applicants with consistently high grades that they don’t have to. So don’t count on that.

If you haven’t taken any pre-requisites, you can probably overcome a low grade point average. As you complete the necessary courses and do well, your grade point average will rise. If you already have the pre-requisites, don’t give up. Bolster your application with letters of recommendations, a snappy admissions essay or even community work in a hospital or clinic. Reference those right away in your cover letter and make sure you include them in your application package.

3 – Your test scores don’t meet the minimum admissions criteria

test scores don't meet the minimum admissioins criteria

As you investigate nursing schools, you’ll discover they want you to pass the Test of Essential Academic Skills (TEAS), which assesses your skills in reading, math, science, English and language use. The scores predict your chances of doing well in nursing school. Or they may require the Health Education Systems, Inc. (HESI) A2 exam. Your score on this exam assesses the likelihood of your passing the National Council Licensure Examination (NCLEX). A license is essential because without it, you can’t practice in the field. No school wants you expending your time and financial resources if you’re not going to be successful. Plus, you don’t want to take on debt and have nothing to show for it at the end of the line. It’s a protective type of step.

Both the HESI and the TEAS are standardized tests scored by independent third parties, so the accuracy of their predictive ability is very high. If you’ve taken one of these tests and not reached a school’s minimum threshold score, you need to study more.

You can’t avoid facing one of the two tests. Without a high score, an application gets rejected by nursing schools. So prepare yourself to do well. There are many live review courses for these exams as well as study materials and practice tests. A small investment in your future now may earn you big rewards with a satisfying, rewarding career later.

4 – Your preferred school won’t accept you

As you’ve gathered by now, nursing schools are very selective. You might have a school preference, but don’t limit yourself to only one. That specific school may not see you as a good match for their training program. If that happens and you don’t have a pool of other schools to choose from, where does that leave you?

Ask yourself what’s more important to you – going to your dream school or becoming a nurse? If you complete a nurse training program and pass your licensing exam, you are a nurse no matter what school you attended. So keep your options open.

5 – The lack of acceptance has left you frustrated and discouraged

lack of acceptance has left you frustrated

No matter what anyone says, if a nursing school declines your application, your feelings will be hurt. If you have everything you need and are still not accepted, remember that it probably isn’t personal.The need for nurses is high. But the number of nursing schools and qualified instructors can’t meet the demand. So schools can only accept so many students. Sometimes it’s a numbers game. That works in your favor. If you apply enough times and to enough schools, your chances of being accepted improve. So even if you feel discouraged and want to give up, submit applications anyway. One day you may be pleasantly surprised.

Your next steps

SMART goals

Overcoming some of these obstacles requires perseverance, time and planning. To achieve your dream, establish SMART goals. Doing so keeps things manageable for you and will help you reach your dream. They also allow you to weave your objective naturally into the busy life you have. But what are SMART goals?

SMART is an acronym for the following:

Specific or Simple – Your overall goal of “getting into nursing school,” is too general and too big. Keep your steps to tiny specifics, like making one phone to one nurse to interview her about school. When you keep things simple, you won’t get overwhelmed.

Measurable – Measurable refers to numbers, or quantities such as one phone call, two classes, three applications. When you hit the number, you know you’ve accomplished the step.

Achievable – This is related to simple and specific. In other words, only do what you can do. Try not to take on everything at once. If your test scores are too low, don’t make your first goal passing the test. That may not be achievable. Plus, it’s too general of a target. What you can do is find a practice test. Or sign up for a review course. Each one of those tasks is achievable. When you have a series of achievable steps, you will feel successful all the time. That has the added benefit of reducing your frustration.

Realistic – If you need five pre-requisite courses, it might not be practical to take all five at once. It’s better to take more time by completing one class at a time than it is to do all five and possibly fail, or drop out.

Timely, or Time Limited – You may have heard the cliche that goals are dreams with deadlines. Without a firm deadline for each task, it probably won’t get done because other elements of life will overtake you. When they do, you’ll be tempted to push your deadline farther down the road. So set timeframes for each task, and hold yourself to them.

Establishing your SMART goals is simpler than you think. Here are a few examples:

  • Call one nursing school admissions office and make an appointment – By May 2.
  • Make a list of questions for the admissions appointment – By May 4.
  • Attend my appointment – May 10.

Imagine you discovered you need four pre-requisite courses. The next set of SMART goals would look something like this:

  • Investigate online schools or community colleges – By May 15.
  • Sign up for at least one course – By May 29.
  • Take the course – a start date and end date for classes are built in for you by the college. You can then create the rest of these goals based on the school’s calendar.

You can continue your list from here putting in the tasks that you need to submit a competitive application. The critical factor is staying on track. Time slips away faster than you realize. More than any other reason contained in this article, failing to take the steps you need to get into school may be the top reason you don’t get into a program. But since you have total control over your activities, it’s a straightforward challenge to master. If necessary, ask friend or family member to keep you on task.

If you need a little more motivation, find some pictures of nurses. Hang one on your computer, in your car, or even on your refrigerator. Every time you glance at one, say, “That’s going to be me.” It may sound a little silly, but over time, it improves your perspective and keeps you going.

If you can stick with your plan and draw upon the courage and dedication it takes to be accepted into nursing school; then you can be confident you have the characteristics you need to become a licensed registered nurse.

Thank you for stopping by today.

If you want to become a nurse, you may be interested in the following nursing articles:
OR Nurses; A Podcast Interview
Associate Degree versus a Bachelor Degree in Registered Nursing

In the alternative, you may want to learn about these alternative allied health careers:
Becoming a Certified Phlebotomist
Becoming a Certified Surgical Technologist

Want to beef up your nursing school application? Why not take a suturing or phlebotomy course from The Apprentice Doctor! It’s a fun and inexpensive way to demonstrate you have some of the practical skills used by nurses every day.

The Apprentice Doctor® Suturing Course and Kit is a resource that teaches you how to suture wounds. As a nurse, you’ll use this skill, so why not get started now? The kit contains everything you need to get started. Take a look at the video for a closer view of kit items.

The Apprentice Doctor® Phlebotomy Course and Kit is another handy resource at your fingertips. This kit teaches you how to confidently perform phlebotomy procedures. Drawing blood is another skill nurses use – and they have to be very good at it if they are to minimize discomfort to the patient. If you want to start your education in nursing, why not begin phlebotomy training right away? Take a quick look at the video to see all the items contained in the kit.

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6 Nursing Career Options for Registered Nurses

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Six General Nursing Career Options

Whether you graduate with an associate degree (ADN) or a bachelor’s degree (BSN) in nursing, you’re still a registered nurse. Six nursing career options are available to all nurses holding a valid RN license – even if you’re brand new in the field. All six can provide you with a respectable salary

Hospital nurse

Many individuals with an RN apply for floor nurse positions in hospitals. Registered nurses in this setting may work standard eight-hour shifts. In other cases they may only work three, twelve-hour days per week, leaving the balance of the week for their own pursuits. Some nurses work weekends only. Most nurses can’t pick their own schedules since hospitals themselves determine how shifts are arranged.

Registered nurses can be assigned to almost any floor, or department in a hospital. As a hospital nurse, you may find yourself in the emergency room, on a pediatric floor, or even a geriatric unit. In striving for the best health and comfort of patients, most of the tasks you perform in a hospital are general in nature, and may include:

  • Adjusting patients’ medications as needed.
  • Creating and evaluating customized care plans as well as maintaining charts and medical histories.
  • Maintaining inventory levels of supplies.
  • Observing and recording patients’ behaviors, including changes in condition, physical activities and personal care routines.
  • Providing triage care in medical emergencies.
  • Preparing rooms, decontaminating equipment and instruments and prepping patients for doctor examinations.
  • Serving as informed advocates for patients’ families, sometimes providing information on illnesses or diseases.

Outpatient care nurse

Registered nurses can also work in outpatient care facilities. Due to advances in healthcare, illnesses and injuries that used to require hospital stays can be taken care of in outpatient settings. As a result, an RN employed in an outpatient care clinic will assist in treating a multitude of conditions. Job duties often include some of the following:

  • Assisting patients with the navigation of the healthcare system and/or insurance requirements.
  • Evaluating patient outcomes.
  • Health education to patients and families.
  • Identifying and clarifying patient needs.
  • Patient and family advocacy.
  • Reporting on the progression of surgery or other procedure to family members.

If you want to work as an outpatient care nurse, but prefer to become skilled in working with one disease, illness or condition, you can seek out a specialization clinic. Podiatry or ophthalmology are two examples that fall into that category.

RegisteredNurseRn created a video about working as an outpatient care nurse, which they refer to as an ambulatory care nurse.

Private Duty Nurse

Private duty nurses are also known as home health nurses, home care nurses or even personal care nurses. This is one of the top fields registered nurses can enter. Private duty nurses care for patients who are at home as opposed to in hospitals. If a person requires 24/7 care, there may be three nurses who regularly assist that individual in a 24-hour period. Other patients may only need daytime care while their family is working.

Tasks performed by private duty nurses sometimes just focus on assisting individuals with activities of daily living, also known as ADLs. Other times total care is required. Assignments can be relatively short-term, such as working with someone recovering from a knee or hip replacement. On the other hand, if a person is only partially recovered from a stroke, the job  may be longer, or even permanent. There is also respite care, which is very short term. In respite care, family members tend to the person most of the time but may decide to take a weekend off, or even go a week’s vacation. A private duty nurse manages the patient in the family’s absence, but the job concludes when the family returns.

Job duties for a private duty nurse are dependent upon the type of care being provided, but in most cases, they will include:

  • Administering or adjusting medication as needed.
  • Observation of the patients’ condition and subsequent reporting of it to the family and possibly the attending physician.
  • Providing companionship to the patient.

Hospice care is a highly specialized area for a home care nurse. Hospice duty is a growing field for registered nurses. As difficult as this specialty can be, if patients can be home during their final days they will generally choose to do so.

RegisteredNurseRn created a video that gives some insight on this career.

Physician’s office nurse

In this employment setting, registered nurses work for medical doctors or even a team of medical doctors. Their primary role is treating individual patients who are well enough to make appointments.

In some offices you may be the only person there with the doctor. Other practices are large enough that other people will be on staff, such as a receptionist and medical assistant. Regardless, your duties change from day-to-day. Stress levels also vary depending upon how many appointments are scheduled. There are also times when appointments are urgent and must be squeezed in between those already on the books. Those kinds of days run long and frequently involve a nurse interacting with worried and frustrated people as well as crying children.

A sample of duties for a physician office nurse include:

  • Ascertaining patient priority about when or how quickly someone needs to be seen.
  • Assigning clinical staff specific responsibilities.
  • Interacting with walk-in patients and assessing their condition.
  • Maintaining medication sample closet.
  • Managing clinical staff schedules.
  • Ordering office medications and medical supplies.
  • Problem-solving anything from patient issues to insurance concerns.
  • Taking incoming calls from patients and providing them with medical information according to office policy.

If you are the only staff member in a private office, you may also have some administrative duties like answering the phone, pulling and replacing files and maintaining an atmosphere of calm hospitality in the waiting area.

Nursing care facility nurse

If you are someone who enjoys providing high levels of care, being a registered nurse in a skilled nursing facility is a career option. Although these care units are frequently associated with caring for the senior population, in some cases accidents occur to younger people that make it necessary for them to have managed care away from home. Because people are living longer, but not necessarily healthier, the demand for nurses in skilled care is growing.

As a registered nurse in this environment, duties are similar to those of hospital nurses. Responsibilities may involve:

  • Administering medication.
  • Creating treatment plans and providing case management.
  • Interacting with family members, or reporting on a patient’s condition or status.
  • Supervising staff, including licensed practical nurses and certified nurse assistants.

In some states, responsibilities like preparing IVs and administering respiratory care may require some additional education and certification. If you believe you would like to include these types of tasks as part your job, check with your state on certification requirements.

Telenurse

With advancements in technology and the growing preference of people gathering information online, one of the newest registered nursing positions is telenursing.

A telenurse is someone who interacts with patients, or clients, in a type of virtual environment. Communication is conducted over the phone, or through video applications such as Skype. Telenursing is especially convenient in rural settings where getting out to a clinic or hospital is difficult for people and the service needed is not urgent or the condition is not life-threatening.

Engaging a telenurse does not replace the need for in-person appointments. And a telenurse may well recommend for someone to see a doctor face-to-face. However, talking to a nurse in this setting may eliminate the need for someone to make a physical visit, thereby reducing co-payment and insurance costs. It may also prevent worry.

Telenurses may be required to perform some or all of the following:

  • Checking in with patients electronically.
  • Listening and asking appropriate questions about someone’s symptoms.
  • Recognizing signs of more serious medical conditions and recommending a course of action.
  • Responding to hotlines or advice lines.
  • Using video technology to evaluate conditions like rashes or other skin ailments.

A telenurse must excel at listening and providing careful communication. Since a great deal of this position involves phone and video work, a registered nurse in this position must possess a clear voice, a great amount of confidence and the ability to work independently.

As helpful and knowledgeable as telenurses are, they are not permitted to diagnose conditions. The primary focus of their role is to gather information so that they can guide a patient to the next steps.

Still interested?

If any of these careers has sparked an interest in a nursing career, stop back for even more information on different careers in the nursing field.

In the meantime, you can get started right now with one of two kits from The Apprentice Doctor. There’s no need to wait until you are in an official nursing program, or even in college. Either kit enables you to practice skills you’ll need in any nursing career.

The Apprentice Doctor® Suturing Course and Kit is a resource that will teach you How to Suture Wounds in a short period of time. As a nurse, you’ll use this skill frequently, so why not get started now? The kit contains everything you need to get started. Take a look at the following video for a closer view of the contents of the kit.

The Apprentice Doctor® Phlebotomy Course and Kit is another handy resource at your fingertips. This program teaches you how to confidently perform phlebotomy procedures. Drawing blood is a skill you may need as a nurse. And you have to be very good at it to minimize discomfort to the patient. If you want to start your education being a great nurse, why not begin phlebotomy training right away? Take a look at the following video to see all the items contained in the kit.

You can also read about 8 Surgical Specialties for Registered Nurses.

Continue stopping by to remain up-to-date about medical education.

 

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Becoming a Certified Phlebotomist

All, Nurses

Did you know that you can become a phlebotomist in a year or less? You can even get certified, which a lot of employers prefer.

If you have visited The Apprentice Doctor previously, you know we are a group of professionals dedicated to supporting individuals interested in pursuing careers in allied health professions. If you’d like to enter the healthcare field quickly consider become a certified phlebotomist. If needles make you uncomfortable with needles, don’t worry. You may be able to overcome any initial discomfort, or fear, through practicing with a venipuncture kit at school or even at home.

certified phlebotomistWhat does a certified phlebotomist do?

[collapse show=”Video – What does a Phlebotomist do?”hide=”Hide”]

Hi, my name is Holly.

Earlier today I had to give blood as part of my annual physical. If you are anything like me, you’d almost rather do anything else than give blood, but sometimes you just have to do it. Today the phlebotomist, the person who took the blood vials, was really great. She kept me calm because she understood my nervousness. She explained everything she did before she did it and I don’t think I felt anything – not even that little bee sting that they say it always feels like. I really appreciate phlebotomists who try to make that experience as pleasant and as painless as possible. I don’t always get a phlebotomist like that, but today I did.

Now, as you’ve probably gathered, a phlebotomist is a person who draws your blood. They also facilitate transfusions and they help with blood donations. A big part of their job is keeping people calm. And if anyone has an adverse reaction, like fainting, they have to know how to handle that.

Like always, my phlebotomist today took a lot of information. She confirmed my identity. She made sure they blood she drew matched the doctor’s orders. She arranged it for transport and she entered everything in the database so that it was finished before I left. That meant that my blood work, and the results stayed with my medical records and would remain confidential between my doctor and me.

I could tell by the condition of the lab that everything was sanitary. That meant it was tidy, organized and all the instruments were clean. That meant that the potential for contamination was low and that made me feel really good about going back to that lab. It’s up to the phlebotomist to make sure that the workplace stays that way all the time.

You, yourself, may have encountered a phlebotomist in an outpatient setting like I was in today. But they work in hospitals, doctors’ offices and other types of diagnostic labs.

Did you know that you can become a certified phlebotomist in a year or less? Many employers prefer hiring phlebotomists who have a certification backing them.

If you’re interested in this allied health profession and would like to find out more, visit The Apprentice Doctor at www.theapprenticedoctor.com
Thanks for watching today.
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Work environment

Where a phlebotomist works dictates the pace of the schedule. For example, phlebotomists who work in hospitals go from room to room to draw blood from patients. The day may feel hectic and create stresses not present in an outpatient diagnostic lab. There are also traveling phlebotomists who work in more rural areas where labs are less plentiful than in urban spaces. Regardless of where a phlebotomist works, they are always caring for individuals who may be ill, and many times afraid. So a person entering this profession must maintain high levels of compassion and patience all the time. Being able to draw blood with confidence goes a long way to keeping a patient calm, and sometimes even preventing them from fainting. The more you practice the skill, the more proficient you’ll be.

Hours

The work environment of a phlebotomist determines your hours, and even within the same organization they may vary from location to location. If there are only certain times you can work, inform a potential employer of this up front. But as with all allied health careers, schedules are hectic and demanding.

If you choose to work in an outpatient facility, chances are good you will work days and your shift may approximate a 9-5 schedule. However, if you work in an inpatient facility or hospital, your shifts and hours will vary and could include holidays, nights and weekends.

In some places you may be assigned to work three days consisting of 12-hour shifts, which is considered full time. In some cases, this may be 7:00 a.m. to 7:00 p.m. Or, if you are new, you may be assigned to the 7:00 p.m. to 7:00 a.m. shift. Transitioning to a 12-hour schedule, morning or night can be stressful. But the advantage is that you’ll have more free days during the week for family time or personal hobbies.

Required education

Phlebotomists can enter the field with a high school degree, or equivalent, and some postsecondary training. Almost all phlebotomy programs are non-degree programs. They are offered in many places, including vocational or technical schools and take a year or less to complete.

Training incorporates classroom and practical application. A certain number of needle sticks, or venipunctures (drawing blood from veins) and arterial punctures (drawing blood from arteries) are almost always required. Programs leading to certification require a minimum number of documented “sticks” to meet testing eligibility criteria. Phlebotomy kits are helpful for practicing in off hours.

Phlebotomy curriculum includes the following types of courses:

  • Anatomy and physiology – Students learn about the circulatory, lymphatic and urinary systems as well as about other bodily functions.
  • Blood and cell composition – These courses teach how blood and cells are affected by infection and disease, which is the heart of the phlebotomy field.
  • CPR and first aid – Since many people are afraid of needles and may also react negatively to blood draws, phlebotomists learn how to manage these situations. Adverse reactions include fainting, dizziness or more severe reactions.
  • Lab safety – Almost all lab courses teach students how to safely handle all the lab equipment and how to clean up spills without endangering yourself or others.
  • Phlebotomy – A phlebotomy course prepares students to perform venipuncture and arterial punctures on different types of people – newborns, children, adults, and seniors. Every kind of person requires a different technique.
  • Medical terminology – Learning medical vocabulary and how to spell medical terms may be woven throughout the curriculum, or presented as a separate course early in a training program.

In addition to the theory courses, programs include hands-on lab classes and a short externship under the supervision of a phlebotomist or other seasoned professional such as a doctor or a nurse.

If you decide phlebotomy is the right field for you, your next step is selecting an appropriate program that fits your needs, timeframes and financial resources.

When considering your options, keep in mind several items:

  • Type of certification – Not all schools prepare you for all the available certifications. And not all certifying agencies accept all the institutional or programmatic accreditations. Review the upcoming section on certifications before selecting a school. You may find once you determine a specific certification, your program choices narrow. Then you can consider other factors.
  • Location – If you need something close to home, search for a program nearby. If you can commute, your options are broader.
  • Time to complete – How quickly do you want to enter the field? Some programs may take as long as a year to complete while others may only take six months. Consider your schedule and narrow your search that way.
  • Accreditation – If you plan is to obtain certification at the conclusion of your program, you must ensure the program you select is accredited. Accreditation may also allow you to apply for some federal financial assistance.

You may wonder if you can obtain phlebotomy education online. There are no fully online programs. However, you may be able to locate a blended program that offers the theory portion online. But in every case, you must physically perform the minimum number of finger and needle sticks. If you enroll in a blended program, the challenge will be finding places that can provide you with the required supervised, practical experience. It would be up to you to find a site and set it up for yourself. If this makes you uncomfortable, you’re better off going through a 100% on-ground program. In all cases you can purchase an inexpensive venipuncture kit and get needle stick practice at home.

Certifications

Is certification necessary to practice phlebotomy? The answer is: Not always. While some employers will hire phlebotomy technicians who are not certified, others may require it as part of their hiring practices. In certain states certification is required by law.

Certification gives employers the confidence that the education you received, and the practice you obtained has been verified by a third, non-school affiliated organization. Since you’ll be dealing with needles and people, which do represent specific risks, employers are very particular about the people they hire. The primary advantage of being certified is that you have a broader set of employment options and may have fewer employment barriers. Obtaining certification may earn you slightly higher wages because it verifies you possess a competent, enhanced skill set.

Each of the five available certifications has its own set of requirements. All of them are similar, but none of them are the same.

When considering a training program, if you want to seek certification, first identify the type of certification you want. Knowing that will help you select the appropriate training program. Sometimes certification preferences are determined by geographic region. It’s best to check with employers in your area to see which one they prefer when hiring.

Agency Title
National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT)
American Society for Clinical Pathology (ASCP) Phlebotomy Technician (PBT)
American Medical Technologists (AMT) Registered Phlebotomy Technician (RPT)
National Center for Competency Testing (NCCT) National Certified Phlebotomy Technician (NCPT)
American Certification Agency (ACA) Certified Phlebotomy Technician (CPT)

Candidates for certification must meet the eligibility requirements laid out by each organization. Most require some classroom education and clinical experience. All exams are written, but a few may also ask you to apply some of your skills, such as drawing blood, a skill you can perfect with an in-home venipuncture kit.

The charts below show the various eligibility routes of each organization. It is always advisable to refer to the organization’s website for the most current information. Unless otherwise indicated, all routes require you to pass the written and practical exams.

National Healthcareer Association (NHA)

Although the NHA offers some provisional and limited certifications, we will only cover the Certified Phlebotomy Technician (CPT) since it is the most popular one. With a high school diploma or GED, there are three eligibility routes.

Titles Eligibility Requirements Additional Information
Certified Phlebotomy Technician (CPT) •   High school graduate or GED.

PLUS

•   Certificate of completion from an accredited phlebotomy training program.

OR

•   Formal medical services military training in phlebotomy.

OR

•   One year of supervised work experience in phlebotomy within the past three years.

PLUS

•   30 venipuncture.

•   10 capillary sticks.

 •   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

You can refer to the NHA video on how to apply for certification through them:

American Society for Clinical Pathology (ASCP)

Although the ASCP offers a Phlebotomy Technician (PBT) certification. They’ve established four eligibility routes. If you select this certification, you’ll have to ensure the program you enroll in is approved by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). A list of their accredited programs is on their site.

Titles Eligibility Requirements Additional Information
Phlebotomy Technician (PBT) •   High school graduate or GED.

•   Complete NAACLS-approved phlebotomy program within the past five years.

OR

•   High school graduate or GED.

•   Complete two-part formal structured program of:

•   40 hours classroom training and 100 hours of clinical training.

•   100 successful unaided blood collections.

OR

•   High school graduate or GED

•   One or more years working full time as a phlebotomy technician.

•   NOTE: Lab must be accredited and work must have been in the last five years.

OR

•   High school graduate or GED.

•   Possession of an RN, LPN or other allied health degree that included phlebotomy training. Must have included 100 skin and venipunctures.

 •   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

•   It may take up to three months to receive a testing date.

Their video explains their credentialing process:

American Medical Technologies (AMT)

The AMT Registered Phlebotomy Technician (RPT) may be the most widely recognized certification. AMT provides three eligibility routes.

Titles Eligibility Requirements Additional Information
Registered Phlebotomy Technician (RPT) •   High school graduate or GED.

•   Graduation from an accredited phlebotomy training course in the last four years. Must include 120 didactic clock hours. More hours may be required by state law.

OR

•   High school graduate or GED.

•   1040 or more hours of experience as a phlebotomy technician in last three years.

OR

•   Possess another organization’s certification PLUS

•   Meet one of the other two AMT eligibility requirements.

•   This route does not require an exam; you only have to pay a fee.

 

NOTE: All applicants must have completed:

•   50 successful venipunctures.

•   10 successful capillary punctures.

 •   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

 

Although AMT does not provide a video on how to become certified with their organization, the following video reviews value of AMT certification.

 

National Center for Competency Testing (NCCT)

If you decide you’d like the certification for the National Certified Phlebotomy Technician (NCPT), you will have to ensure the school you select is NCCT-approved. There may or may not be a school in your area. Their website provides a list of their approved schools. The NCCT allows for two eligibility options.

Titles Eligibility Requirements Additional Information
National Certified Phlebotomy Technician (NCPT) •   High school graduate or GED.

•   Graduation from NCCT-approved training program within the past five years.

OR

•   One year documented full time experience as a phlebotomy technician within the past five years.

OR

•   Completion of phlebotomy technician training or equivalent during US military service within the past five years.

•   2080 hours or one year of phlebotomy work experience.

 •   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

•   Site does provide detailed information if an applicant is testing and wishes to practice in California.

American Certification Agency (ACA)

Like many of the other organizations, ACA provides you with more than one eligibility route. Their certification is a Certified Phlebotomy Technician (CPT).

Titles Eligibility Requirements Additional Information
Certified Phlebotomy Technician (CPT) from ACA •   High school graduate or GED.

•   Completion of phlebotomy training program.

•   Proof of:

•   100 clinical hours.

•   100 venipunctures.

•   10 dermal punctures.

OR

•   High school graduate or GED.

•   One year experience as phlebotomy technician.

•   Proof of:

•   100 venipunctures.

•   10 dermal punctures.

OR

•   Have current, valid certification from another certification agency approved by ACA.

•   Meet recertification requirements.

 •   They do not guarantee their certification complies with state requirements. It is up to the applicant to determine individual state differences.

Almost all these agencies provide practice tests, review courses and other materials to help you pass their exam. Regardless of the certification you select, it is always a good idea to take advantage of these materials. Doing so goes a long way toward helping you pass the exam.

Re-certification and continuing education

As with all healthcare professions, continuing education (CEU) and periodic re-certification are required.

Phlebotomy re-certification cycles differ from organization to organization, although most have adopted a program where they convert CEU credits to points. All require a re-certification fee. Each agency provides detailed manuals on how to become certified and re-certified. Once you are certified as a phlebotomist, it is strongly advised you carefully review the appropriate manual immediately so that you understand the re-certification process and the documentation required.

Agency Type of Certification Re-Certification Cycle Additional Information
National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT by NHA) Every two years from date of initial certification. •   10 CEUs.

•   Two hours of attendance equals one CEU credit.

•   See their manual for details.
American Society for Clinical Pathology (ASCP) Phlebotomy Technician (PBT) Every three years from date of initial certification. •   Utilizes a CEU credit to point conversion system.

•   See their manual under Credential Maintenance Program (CMP) for details.
American Medical Technologists (AMT) Registered Phlebotomy Technician (RPT) Every three years from date of initial certification. •   Utilizes a CEU credit to point conversion system.

•   See their manual for details.
National Center for Competency Testing (NCCT) National Certified Phlebotomy Technician (NCPT) Every five years from date of initial certification. •   System includes process of annual re-certification status which is incorporated into the five-year cycle.

•   Utilizes a clock-hour to point conversion system.

•   See their manual for details.
American Certification Agency (ACA) Certified Phlebotomy Technician (CPT by ACA) Every month/year. •   CPTs must obtain .05 CEUs monthly (Example: For one year, you will need 0.5 hours x 12 months, or 6 CEUs).

•   See their manual for details.

Job outlook

As you may have determined, blood work is of vital importance in diagnosing illnesses. It can also determine minimal and optimal levels of nutrients in the body so that doctors and dietitians can assist people in improving their diets. The U.S. Department of Labor expects the employment of phlebotomists is projected to grow 25 percent from 2016 to 2026.

Job prospects improve for phlebotomists who receive certification from one of the several reputable organizations mentioned in this article. Employers also value phlebotomists who can draw blood smoothly with minimal discomfort to the patient; a skill you can perfect by practicing at home.

General skills needed for a phlebotomist

When interviewing a person for a phlebotomy position, employers always look beyond education and certification. They also want phlebotomists with softer skills that assure them you have the personality, and aptitude to work with people who need blood work. They may be ill, and/or afraid of needles. So the phlebotomist must be self-assured, and very smooth when inserting shunts and needles. It also helps if you are:

  • Compassionate – Since some individuals are afraid of having their blood drawn, phlebotomists must be caring in performing their duties.
  • Detail oriented – Blood work is vital to doctors so they can diagnose health issues accurately. So phlebotomists must draw the correct vials of blood for the tests ordered, track them and then accurately enter data into a database. Attention to detail is critical. Lack of precise information could result in a misdiagnosis or patient injury.
  • Dexterous – The best phlebotomists perform needle sticks successfully on the first attempt, regardless of the type of patient. Excellent hand-eye coordination is a characteristic that contributes to this level of competence, as does ongoing practice.

One of the most difficult challenges you may face in your job search is how to secure employment without experience.

A video from the Center for Phlebotomy Education discusses this. Watching it and following the advice given may provide you with a slight edge over your competition:

Phlebotomist organizational support

Six organizations support phlebotomists and students of phlebotomy. Some of them have membership options. Membership may reduce your certification and recertification fees.

Some of the organizations only certify and re-certify phlebotomists and other healthcare professionals. Others include additional resources, continuing education, conferences, legal information, and updates on policy, safety standards, and healthcare reform.

  • American Certification Agency for Healthcare Professionals – They provide and promote competency certification and recertification for some healthcare professionals, including phlebotomists.
  • American Medical Technologists – AMT is nationally and internationally recognized as a certification and membership society for many allied health professions. This group ensures programs meet the highest standards of education. Their mission is promoting and supporting their members.
  • American Society for Clinical Pathology – They provide support, advocacy, and education for a variety of allied health careers. Their goal is improving patient care and advancing laboratory medicine.
  • Center for Phlebotomy Education – Their mission is to support and provide additional education for phlebotomists.
  • National Center for Competency Testing – The NCCT is a certifying agency for healthcare professionals. However, they also provide types of ongoing education for various healthcare providers.
  • National Healthcareer Association – The NHCA certifies and educates various healthcare professionals. Their mission is improving health care by advocating for greater competency in healthcare workers.

Phlebotomy course from The Apprentice Doctor!

There is no need to wait on getting practice with needle sticks. Before you step into any situation on a campus, or in a medical office, you can perfect your phlebotomy skills. The Apprentice Doctor® Phlebotomy Course and Kit teaches you how to confidently perform phlebotomy procedures. If you want to start your education toward becoming a great phlebotomist. Begin training today!