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Because of the rapidly growing U.S. elderly population and continued advances in medical technology, the U.S. Department of Labor (USDL) projects that employment in the health services industry will increase 28 percent through 2012, adding about 3.5 million new jobs over the 2002 - 12 period. This makes it one of the fastest-growing segments of the U.S. job market. By far, the largest group of workers in the health field are those in the nursing occupations: registered nurses, physician assistant licensed practical nurses, home health care nurses, and nurse assistants. The employment outlook for all kinds of nurses is very favorable. In fact, the USDL projects the occupation of registered nurse to be one of the top 25 occupations with fastest growth, high pay, and low unemployment in the next decade. Many hospitals don’t have enough nurses; the demand is simply bigger than the supply. As health care services expand, even more nurses will be needed. Currently, there are about 2.3 million registered nurses. Nurse practitioners (registered nurses who have advanced training in areas such as family medicine or anesthesia) are in very high demand, with recent graduates having an average of four job offers from which to choose. Nursing offers more diverse career paths than ever before. Registered nurses, in particular, may work in many settings besides hospitals. For example, occupational health nurses oversee the health needs of business and government employees in their workplaces. Public health nurses specialize in promoting good health practices to prevent illness and restore health; they may provide care and counseling in schools, clinics, or other settings. Office nurses generally assist physicians, surgeons, and sometimes dentists in private practice or in clinics, often performing routine office and laboratory work in addition to nursing services. Other registered nurses teach, staff nursing organizations, act as administrators, or work as part of a legal team. Advanced practice nurses are a broad category of registered nurses who have completed advanced clinical nurses’ educational practice requirements beyond the two to four years of basic nursing education required for all RNs. Under the advanced practice nursing designation fall four categories of nursing specialties: clinical nurse specialists, nurse practitioners, nurse-midwives, and nurse anesthetists. Advanced practice nurses embody the expanding and increasingly powerful role of nurses in health care. In particular, nurse practitioners and physician assistants are becoming key personnel in many medical practices, as they provide many of the same types of basic care as a physician would, but at a reduced cost. They also enable medical practices to treat a larger patient base. The strong demand for nurses is not limited to the United States. There is a need for nurses all over the world, especially in developing countries struggling with overpopulation, malnutrition, infectious diseases, and a lack of medical facilities. Nurses who choose to work in rural areas of developing countries usually do not have the equipment and medicine available in the United States. Thus, a large part of their work is education—teaching basic health and wellness principles to the general population and training local people to be nurses. Such international opportunities are often temporary and done on a volunteer basis. These opportunities exist in the United States, as well. Entry-level nurses or nurses who are re-entering the workforce can volunteer to gain additional career experience. There is no denying that nursing is a challenging and stressful career. It is physically demanding, requiring strength, stamina, and speed. It is emotionally draining, particularly for those who work with chronically ill and dying patients. Nursing demands a ready knowledge of medical techniques and procedures, keen observation skills, and meticulous attention to detail. Nurses must be able to communicate effectively with patients, physicians, administrators, and patients’ families. Nurses’ work is often taken for granted. Because of these pressures, there is significant burnout in the nursing professions. Even though those who go into nursing soon learn about these pressures, most nurses say that the rewards of their careers are far greater than any drawbacks. Nurses are caring, nurturing individuals. They get great satisfaction from caring for sick or injured patients, guiding them through the healing process, and watching them respond to treatment. Nurses who care for terminally ill patients find accomplishment in knowing that they are providing comfort and relief from physical and emotional pain. Nurses are a vital link between patients and other medical professionals, and they often act as patient advocates and spokespersons. Simply put, the health care industry could not exist without nurses. Although nursing has typically been a profession for Caucasian women, that profile is rapidly changing. Today, men and women of all ages, ethnicities, and socioeconomic backgrounds choose careers in nursing. Many come to the field after working in other areas of health care or in other industries, which has resulted in a richer, more diversified nursing workforce than ever before. Each article in this guide discusses a particular nursing occupation in detail. The articles are continuously updated and revised with the latest information from the U.S. Department of Labor professional organizations, and other sources. In addition, this revised edition of the book includes a new article on physician assistants. This edition also contains informative sidebars, photos of nurses at work, and interviews with nurses. Since many advanced nursing careers, such as clinical nurse specialists, nurse managers, and nurse-midwives, require that the individual first become a registered nurse, it is recommended that you read the article “Registered Nurses” first, as it discusses in detail the education requirements and other specifics of that career. The FAST FACTS section provides a brief summary of the career including recommended school subjects, personal skills, work environment, minimum educational requirements, salary ranges, certification or licensing requirements, and employment outlook. This section also provides acronyms and identification numbers for the following government classification indexes: the Dictionary of Occupational Titles (DOT), the Guide for Occupational Exploration (GOE), the National Occupational Classification (NOC) Index, and the Occupational Information Network (O*NET)-Standard Occupational Classification System (SOC) index. The DOT, GOE, and O*NET indexes have been created by the U.S. government; the NOC index is Canada’s career classification system. Readers can use the identification numbers listed in the FAST FACTS section to access further information about a career. Print editions of the DOT (Dictionary of Occupational Titles. Indianapolis, Ind.: JIST Works, 1991) and GOE (The Guide for Occupational Exploration. 3d ed. Indianapolis, Ind.: JIST Works, 2001) are available at libraries. Electronic versions of the NOC (http://www23.hrdc-drhc.gc.ca) and O*NET (http://online.onetcenter.org) are available on the World Wide Web. When no DOT, GOE, NOC, or O*NET numbers are present, this means that the U.S. Department of Labor or Human Resources Development Canada have not created a numerical designation for this career. In this instance, you will see the acronym “N/A,” or not available. The Overview section is a brief introductory description of the duties and responsibilities involved in this career. A career may have a variety of associated job titles. When this is the case, alternative career titles are presented. The History section describes the history of the particular job as it relates to the overall development of its industry or field. The Job describes the primary and secondary duties of the job. Requirements discusses high school and postsecondary education and training requirements, any certification or licensing that is necessary, and other personal requirements for success in the job. Exploring offers suggestions on how to gain experience in or knowledge of the particular job before making a firm educational and financial commitment. The focus is on what can be done while still in high school (or in the early years of college) to gain a better under standing of the job. The Employers section gives an overview of typical places of employment for the job. Starting Out discusses the best ways to land that first job, be it through the college placement office, newspaper ads, or personal contact. The Advancement section describes what kind of career path to expect from the job and how to get there. Earnings lists salary ranges and describes the typical fringe benefits. The Work Environment section describes the typical surroundings and conditions of employment—whether indoors or outdoors, noisy or quiet, social or independent. Also discussed are typical hours worked, any seasonal fluctuations, and the stresses and strains of the job. The Outlook section summarizes the job in terms of the general economy and industry projections. For the most part, Outlook information is obtained from the U.S. Bureau of Labor Statistics and is supplemented by information taken from professional associations. Job growth terms follow those used in the Occupational Outlook Handbook. Growth described as “much faster than the average” means an increase of 36 percent or more. Growth described as “faster than the average” means an increase of 21 to 35 percent. Growth described as “about as fast as the average” means an increase of 10 to 20 percent. Growth described as “more slowly than the average” means an increase of 3 to 9 percent. Growth described as “little or no change” means an increase of 0 to 2 percent. “Decline” means a decrease of 1 percent or more. Each article ends with For More Information, which lists organizations that provide information on training, education, internships, scholarships, and job placement. 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