Nursing careers offer many opportunities for employment in nursing. Nursing careers are some of the most challenging and rewarding careers in health care. Typically when one thinks of nursing as a career there is a mental image of working at the bedside of a hospitalized patient. However, advanced practice nursing provides interesting and challenging work for nurses who want to add to their basic education. Such nursing practice does not necessarily occur at the bedside.
Three different types of nursing that are considered advanced practice nursing jobs in Canada are the clinical nurse specialist, the nurse practitioner and the occupational health nurse. Each of these career specialities could occur in a variety of settings such as a hospital, a community, or even in industry.
Clinical Nurse Specialist
The role of the clinical nurse specialist can vary greatly depending on the needs of the community and the employer. The clinical nurse specialist may be directly involved with patients and families and often provides leadership to the nursing staff in a hospital or a community setting.
A clinical nurse specialist is a registered nurse with a master's degree who is specialized in a particular aspect of nursing with a specialized client group such as pediatrics or gerontology. The clinical nurse specialist may also be specialized within a particular clinical area such as oncology,cardiology, or critical care.
The role of a clinical nurse specialist falls within the legally defined scope of nursing practice for a registered nurse.
Occupational Health Nurse
The occupational health nurse (OHN) works in settings not typically associated with the nursing profession. Uniforms, nursing caps. and shoes have been traded for overalls, steel toe boots, and a hard hat. Patients are not in hospital beds but are able bodied workers in factories, paper mills, and chemical plants.
According to the Canadian Association of Occupational HealthNurses the scope of nursing practice for an Occupational Health Nurse includes:
"...managing and administering an occupational health service within legal and professional parameters; conducting health examinations; assessing the work environment; providing primary, secondary, and tertiary prevention strategies; providing health education programs; providing health promotion programs; providing counseling interventions and programs; managing the information system; conducting health surveillance programs; monitoring injury/illness trends; as well as program planning, policy development, and cost-containment strategies."
The main focus of the occupational health nurse is promoting and maintaining the health of workers in their work environment. Nursing practice in this specialty requires a strong knowledge base of :
- case management
- counselling and crisis intervention
- health promotion and risk reduction
- legal and regulatory requirements for worker safety
- occupational hazard detection and reduction including ergonomic risks
The occupational health nurse works within the same nursing scope of practice as the bedside nurse or the clinical nurse specialist and is responsible for maintaining the same practice standards as any other nurse registered with the regulatory nursing organization.
The nurse practitioner has been a legally defined part of nursing practice in the United states for many years but it is one of the newer types of nursing jobs in Canada. The nurse practitioner is still not a legally defined type of nursing in all provinces. British Columbia is one of the provinces that most recently made the move to include the category of nurse practitioner as one of the types of nursing regulated by the College of Registered Nurses of British Columbia.
Because a nurse practitioner practices in an advanced role as a registered nurse, an advanced education is necessary. Typically this requires a university degree plus two additional years of nurse practitioner education resulting in a educational qualification equivalent to a master's degree.
Specific competencies for the nurse practitioner must be in place. Within a legally defined scope of practice a nurse practitioner can engage in activities that may be outside the legal scope of practice of a registered nurse or even a clinical nurse specialist. Such activities include prescribing certain medications and treatments for specified medical problems and ordering diagnostic tests.
The clinical nurse specialist, nurse practitioner, and occupational health nurse are three different types of nursing careers in Canada. The clinical nurse specialist and the occupational health nurse practice within the same nursing scope of practice but the nurse practitioner practices outside of this scope of practice and therefore legislation must be in place that defines and regulates this type of nursing practice. Not all provinces have this in place so the nurse practitioner is not a legally defined type of nursing career in all provinces in Canada.
All nursing jobs in Canada provide for challenge, but these three types of nursing careers have diversity and challenge that goes beyond that typically associated with the bedside nurse in a hospital setting. However, all these three types of nursing careers are regulated in the public interest and nursing practice in each specialty must adhere to the nursing practice standards set by the regulatory organizations.