View source for Nursing

{{Short description|Health care profession}}
{{Other uses|Nursing (disambiguation)}}
{{protection padlock|small=yes}}
<references group="The U.S. Nursing Workforce in 2018 and Beyond Journal of Nursing Regulation , Volume 8, Issue 4, S3 - S6" />
{{Use dmy dates|date=July 2021}}
{{Infobox Occupation
| name= Nursing
|image = File:Nurse checks blood pressure.jpg
|caption = A nurse checks a patient's blood pressure. 
| official_names=
| Occupation =
| activity_sector= Nursing
| competencies= 
Caring for general and specialized well-being of patients
| formation=
Qualifications in terms of statutory regulations according to national, state, or provincial legislation in each country 
| employment_field= 
*[[Hospital]]
*[[Clinic]]
*[[Laboratory]]
*[[Research]]
*[[Education]]
*[[Home care]]

| related_occupation=
*[[Medicine]]
*[[Glossary of medicine]]
}}

'''Nursing''' is a [[health care]] profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence".<ref>{{Cite book |last=Association |first=American Nurses |url=https://books.google.com/books?id=nBH1zQEACAAJ&q=Nursing:+Scope+and+Standards+of+Practice,+Fourth+Edition |title=Nursing: Scope and Standards of Practice |date=2021-05-30 |publisher=American Nurses Association |isbn=978-0-9993088-6-8 |language=en}}</ref> Nurses practice in many [[List of nursing specialties|specialties]] with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments.<ref>{{Cite journal |doi=10.1097/01.NEP.0000000000000659|title=Who Wants to be a Nurse? Understanding Emirati Female Students' Knowledge and Attitudes About Nursing as a Career |year=2020 |last1=Maymoun |first1=Nazneen |last2=Sohail |first2=M. Sadiq |journal=Nursing Education Perspectives |volume=41 |issue=3 |pages=E14–E19 |pmid=32310910 |s2cid=216046198 }}</ref><ref>{{Cite journal |doi=10.1186/s12960-017-0223-2 |doi-access=free|title=The Human Resources for Health Effort Index: A tool to assess and inform Strategic Health Workforce Investments |year=2017 |last1=Fort |first1=Alfredo L. |last2=Deussom |first2=Rachel |last3=Burlew |first3=Randi |last4=Gilroy |first4=Kate |last5=Nelson |first5=David |journal=Human Resources for Health |volume=15 |issue=1 |page=47 |pmid=28724381 |pmc=5518138 }}</ref> There are shortages of qualified nurses in many countries.<ref>{{Cite journal |doi=10.1515/emj-2017-0019 |doi-access=free|title=Nurses in Poland — Immediate Action Needed |year=2017 |last1=Haczyński |first1=Józef |last2=Skrzypczak |first2=Zofia |last3=Winter |first3=Małgorzata |journal=Engineering Management in Production and Services |volume=9 |issue=2 |pages=97–104 }}</ref>

Nurses develop a plan of care, working collaboratively with [[physicians]], [[therapist]]s, patients, patients' families, and other team members that focuses on treating illness to improve quality of life.

In the United Kingdom and the United States, clinical nurse specialists and nurse practitioners diagnose health problems and prescribe medications and other therapies, depending on regulations that vary by state.<ref>{{Cite web|title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society |url=https://search.credoreference.com/content/entry/sageeas/nursing/0|access-date=2022-02-18|website=search.credoreference.com|language=en}}</ref> Nurses may help coordinate care performed by other providers or act independently as nursing professionals. In addition to providing care and support, nurses educate the public and promote health and wellness.<ref>{{Cite web |last=Freeman |first=Veronica |title=The role of nurses in our society today |url=https://www.cerner.com/ae/en/blog/the-role-of-nurses-in-our-society-today |access-date=2023-03-31 |website=cerner.com |language=en}}</ref>

In the U.S., nurse practitioners are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications. They practice independently in a variety of settings in more than half of the United States. In the [[Post-war|postwar]] period, nurse education has diversified, awarding [[Nursing credentials and certifications|advanced and specialized credentials]], and many traditional regulations and roles are changing.<ref>Coulehan J. L., Block M. R. (2005): The Medical Interview: Mastering skills for clinical practice, 5th Ed. F. A. Davis. {{ISBN|0-8036-1246-X}}. {{OCLC|232304023}}.</ref><ref>Dunphy L. M., Winland-Brown J. E. (2011): Primary care: The art and science of advanced practice nursing. F.A. Davis. {{ISBN|9780803626478}}.</ref>{{TOC limit|3}}

==History==
{{Main article|History of nursing|Timeline of nursing history}}

===Premodern===
Nursing historians face challenges of determining whether care provided to the sick or injured in antiquity is called nursing care.<ref name="OLYNN2007">{{cite book|last1=O'Lynn|first1=CE|editor1-last=O'Lynn|editor1-first=CE|editor2-last=Tranbarger|editor2-first=RE|title=Men in Nursing: History, Challenges, and Opportunities|date=2007|publisher=Springer Pub.|location=New York|isbn=9780826103499|pages=6–8|chapter=History of men in nursing: a review}}</ref> In the fifth century BC, for example, the [[Hippocratic Collection]] in places described skilled care and observation of patients by male "attendants," who may have provided care now provided by nurses.<ref name="LEVINE1965">{{cite journal|last1=Levine|first1=EB|last2=Levine|first2=ME|title=Hippocrates, father of nursing, too?|journal=The American Journal of Nursing|year=1965|volume=65|issue=12|pages=86–8|pmid=5319739|doi=10.1097/00000446-196512000-00022|s2cid=38921319}}</ref> Around 600&nbsp;BC in India, it is recorded in ''[[Sushruta Samhita]]'', Book 3, Chapter V about the role of the nurse{{citation needed|date=November 2024}} as "the different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examining its different parts."

In the [[Middle Ages]], members of [[religious orders]] such as [[nuns]] and [[monks]] often provided nursing-like care.<ref name="BLOY">{{cite web|last=Bloy|first=M|url=http://www.victorianweb.org/history/crimea/florrie.html|title=Florence Nightingale (1820–1910)|website=The Victorian Web|access-date=24 November 2014}}</ref> Examples exist in [[Christianity|Christian]],<ref name="FERNGREN2009">{{cite book|last1=Ferngren|first1=GB|title=Medicine & health care in early Christianity|date=2009|publisher=Johns Hopkins University Press|location=Baltimore|isbn=9780801895227|page=121}}</ref> [[Islamic]],<ref name="SACHEDINA2009">{{cite book|last1=Sachedina|first1=Abdulaziz|title=Islamic biomedical ethics: principles and application|url=https://archive.org/details/islamicbiomedica00sach_109|url-access=limited|date=2009|publisher=Oxford University Press|location=Oxford|isbn=9780195378504|pages=[https://archive.org/details/islamicbiomedica00sach_109/page/n103 93]–94}}</ref> [[Buddhist]],<ref name="DEBARY2011">{{cite book|editor1-last=de Bary|editor1-first=WT|title=The Buddhist tradition in India, China & Japan|date=2011|publisher=Vintage eBooks|location=New York|isbn=9780307778796|pages=35–36|edition=Unabridged.}}</ref> and other traditions. The biblical figure of [[Phoebe (biblical figure)|Phoebe]] is described in many sources as "the first visiting nurse".<ref name="EGENES2009">{{cite book|last1=Egenes|first1=KJ|editor1-last=Halstead|editor1-first=J|editor2-last=Roux|editor2-first=G|title=Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow|date=2009|publisher=Jones and Bartlett|location=Sudbury, MA|isbn=9780763752255|page=[https://archive.org/details/issuestrendsinnu0000unse/page/2 2]|chapter=History of nursing|chapter-url=https://archive.org/details/issuestrendsinnu0000unse/page/2}}</ref><ref name="STRIEPE1992">{{cite journal|last1=Striepe|first1=JM|title=Reclaiming the church's healing role|journal=Journal of Christian Nursing|year=1992|volume=10|issue=1|pages=4–7|doi=10.1097/00005217-199310010-00002|pmid=8418284}}</ref> These traditions were influential in the development of the [[ethos]] of modern nursing. Its religious roots remain in evidence in many countries. One example in the [[United Kingdom]] is the use of the historical title "sister" to refer to a senior nurse.<ref name="WAND2004">{{cite journal|last1=Wand|first1=T|title=The 'Sister' title: past the use by date?|journal=Collegian|date=January 2004|volume=11|issue=1|pages=35–39|doi=10.1016/S1322-7696(08)60442-4}}</ref>

During the [[Reformation]], [[Protestant]] reformers shut down monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe. Nuns who had been serving as nurses were given pensions or told to marry and stay home.<ref>{{cite book|last1=Leonard|first1=AE|chapter=Female religious orders|page=244|editor1-last=Hsia|editor1-first=RP|title=A Companion to the Reformation World|date=2008|publisher=Blackwell Publishers|location=Oxford|isbn=978-1405149624|edition=1st paperback}}</ref> Nursing care went to the inexperienced as traditional caretakers, rooted in the [[Roman Catholic Church]], were removed from their positions. The nursing profession in Europe was extinguished for approximately 200 years.<ref>{{cite book|last1=Lundy|first1=KS|editor1-last=Masters|editor1-first=K|title=Role Development in Professional Nursing Practice|date=2014|publisher=Jones & Bartlett Learning|location=Burlington, MA|isbn=9781449681982|pages=11–12|edition=3rd|chapter=A history of health care and nursing}}</ref>

===19th century===
[[File:Сестры Крестовоздвиженской общины, Севастополь, 1855.jpg|upright|thumb|Russian Sisters of Mercy in the Crimea, 1854–1855]]
During the [[Crimean War]], [[Princess Charlotte of Württemberg|Grand Duchess Elena Pavlovna]] called for women to join the Order of Exaltation of the Cross (''Krestodvizhenskaya Obshchina'') for a year of service in military hospitals. The first section of twenty-eight "sisters", headed by Aleksandra Petrovna Stakhovich, the Directress of the Order, reached Crimea early in November 1854.<ref>{{Cite journal |jstor=2492652|last1=Curtiss |first1=John Shelton |title=Russian Sisters of Mercy in the Crimea, 1854-1855 |journal=Slavic Review |year=1966 |volume=25 |issue=1 |pages=84–100 |doi=10.2307/2492652 |pmid=11633166 |s2cid=43448185 }}</ref>

[[File:Florence Nightingale (H Hering NPG x82368).jpg|upright|thumb|[[Florence Nightingale]] was an influential figure in the development of modern nursing. No uniform had been created when Nightingale was employed during the [[Crimean War]]. Often considered the first nurse theorist, Nightingale linked health with five environmental factors: (1) pure or fresh air, (2) pure water, (3) efficient drainage, (4) cleanliness, and (5) light, especially direct sunlight. Deficiencies in these five factors resulted in a lack of health or illness.<ref>Professional Nursing Practice: Concepts and perspective, Koernig & Hayes, sixth edition, 2011, p.100, {{ISBN|978-0-13-508090-0}}</ref> Both the role of nursing and education were first defined by Nightingale.]]

[[Florence Nightingale]] laid the foundations of professional nursing after the [[Crimean War]],<ref name="WINKEL2009">{{cite journal|last1=Winkel|first1=W|title=Florence Nightingale|journal=Epidemiology|year=2009|volume=20|issue=2|pages=311|doi=10.1097/EDE.0b013e3181935ad6 |doi-access=free|pmid=19234417}}</ref> in light of a comprehensive statistical study she made of [[sanitation]] in India, leading her to emphasize the importance of sanitation. "After 10&nbsp;years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per&nbsp;1,000".<ref name="Cohen1984">{{cite journal |last=Cohen |first=I. Bernard |author-link=I. Bernard Cohen |date=March 1984 |title=Florence Nightingale |journal=Scientific American |volume=250 |issue=3 |pages=128–137 |bibcode=1984SciAm.250c.128C |doi=10.1038/scientificamerican0384-128 |pmid=6367033 |s2cid=5409191}} (alternative pagination depending on country of sale: 98–107, bibliography on p. 114) [http://www.unc.edu/~nielsen/soci708/ online article – see documents link at left] {{Webarchive|url=https://web.archive.org/web/20100705052627/http://www.unc.edu/~nielsen/soci708/|date=5 July 2010}}</ref>{{rp|page=107}}

Nightingale believed that nursing was a social freedom and mission for women. She believed that any educated woman could help improve the care of the ill.<ref>{{Cite web |title=nursing {{!}} History, Education, & Practices |url=https://www.britannica.com/science/nursing |access-date=2022-03-31 |website=britannica.com |language=en}}</ref> Her ''[[Notes on Nursing]]'' (1859) was a popular call to action. The Nightingale model of nursing education led to one of the [[Florence Nightingale Faculty of Nursing and Midwifery|first schools of nursing]] to be connected to a hospital and medical school. It spread widely in Europe and North America after 1870.<ref name="Quinn">{{cite book|last=Quinn|first=Shawna M.|title=Agnes Warner and the Nursing Sisters of the Great War|url=http://www.gooselane.com/media/741.pdf|publisher=Goose Lane editions and the New Brunswick Military Heritage Project |date=2010|isbn=978-0-86492-633-3|access-date=29 November 2014|archive-url=https://web.archive.org/web/20150924023052/http://www.gooselane.com/media/741.pdf|archive-date=24 September 2015}}</ref>

Nightingale included five factors that helped nurses in her time who worked amidst poor sanitation and little education. These factors include fresh air, clean water, a working drainage system, cleanliness, and good light. Nightingale believed that a clean working environment was important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around patients for the betterment of their health.<ref>{{Cite web  |first=Angelo |last=Gonzalo |date=August 4, 2014 |title=Florence Nightingale: Environmental Theory |url=https://nurseslabs.com/florence-nightingales-environmental-theory/ |access-date=2022-09-02 |website=Nurseslabs |language=en-US}}</ref>

Nightingale's recommendations built upon the successes of Jamaican "doctresses" such as [[Mary Seacole]], who like Nightingale, served in the Crimean War. Seacole practised hygiene and the use of herbs in healing wounded soldiers and those suffering from diseases in the 19th century in the Crimea, Central America, and Jamaica. Her predecessors had great success as healers in the [[Colony of Jamaica]] in the 18th century, and they included Seacole's mother (Mrs. Grant), Sarah Adams, [[Cubah Cornwallis]], and Grace Donne, the mistress and doctress to Jamaica's wealthiest planter, [[Simon Taylor (sugar planter)|Simon Taylor]].<ref>{{Cite book |last=Ferguson |first=Moira |url=https://www.taylorfrancis.com/books/mono/10.4324/9780203760697/nine-black-women-moira-ferguson |title=Nine Black Women: An Anthology of Nineteenth-Century Writers from the United States, Canada, Bermuda and the Caribbean |date=2016-01-04 |publisher=Routledge |isbn=978-0-203-76069-7 |location=New York |doi=10.4324/9780203760697}}</ref>

Other important nurses in the development of the profession include:
*[[Agnes Hunt]] from [[Shropshire]] was the first [[Orthopaedic nursing|orthopedic nurse]] and was pivotal in the emergence of the orthopedic hospital, the Robert Jones & Agnes Hunt Hospital in [[Oswestry]], Shropshire.
*[[Valérie de Gasparin]] opened, with her husband [[Agénor de Gasparin]], the world's first nursing school: {{ill|École La Source|lt=La Source|fr|Institut et haute école de la santé La Source|vertical-align=sup}}, in [[Lausanne]], [[Switzerland]]. 
*[[Agnes Jones]] established a nurse training regime at [[Brownlow Hill infirmary]], [[Liverpool]], in 1865.
*[[Linda Richards]] established [[nursing schools]] in the United States and Japan, and was officially the first professionally trained nurse in the US, graduating in 1873 from the ''[[New England Hospital for Women and Children]]'' in Boston. 
*[[Clara Barton|Clarissa Harlowe "Clara" Barton]] was a pioneer American teacher, patent clerk, nurse, and humanitarian, and the founder of the [[American Red Cross]].
* Saint [[Marianne Cope]] was a [[Sisters of St. Francis of Assisi|Sister of St. Francis]] who opened and operated some of the first general hospitals in the United States, instituting cleanliness standards that influenced the development of America's hospital system.<ref>[https://edition.cnn.com/2012/10/20/health/saint-marianne-cope/index.html?hpt=hp_t3 Mother Marianne becomes an American saint]. CNN. Retrieved 28 July 2013.</ref>

[[Red Cross]] chapters, which began appearing after the establishment of the [[International Committee of the Red Cross]] in 1863, offered employment and professionalization opportunities for nurses (despite Nightingale's initial objections).<ref>{{cite book |last1=Dromi |first1=Shai M. |title=Above the fray: the Red Cross and the making of the humanitarian NGO sector |date=2020 |publisher=University of Chicago Press |location=Chicago |isbn=9780226680248 |pages=93–101 |url=https://press.uchicago.edu/ucp/books/book/chicago/A/bo46479924.html |access-date=27 June 2021}}</ref> Catholic orders such as [[Little Sisters of the Poor]], [[Sisters of Mercy]], [[Sisters of St. Mary]], [[Franciscan Alliance, Inc.|St. Francis Health Services, Inc.]] and [[Sisters of Charity]] built hospitals and provided nursing services during this period.{{citation needed|date=November 2014}}<ref>{{Cite journal|last=Paradis, Raphael|first=Mary|date=10 March 2017|title=The Sisters of Mercy in the Crimean War: Lessons for Catholic health care|journal=The Linacre Quarterly|volume=84|issue=1|pages=29–43|doi=10.1080/00243639.2016.1277877|pmid=28392597|pmc=5375655|via=NCBI}}</ref> The modern [[deaconess]] movement began in Germany in 1836.<ref name="NAUMANN2008">{{cite book|last1=Naumann|first1=CD|title=In the footsteps of Phoebe: a Complete History of the Deaconess Movement in the Lutheran Church—Missouri Synod|date=2008|publisher=Concordia Pub. House|location=St. Louis, MO|isbn=9780758608314|page=4}}</ref> Within a half century, over 5,000 deaconesses had surfaced in Europe.<ref name="BLACKMORE2007">{{cite book|editor1-last=Blackmore|editor1-first=H|title=The Beginning of Women's Ministry: the Revival of the Deaconess in the Nineteenth-century Church of England|date=2007|url=https://books.google.com/books?id=8LQxO03zXygC&pg=PA131|publisher=Boydell Press|location=Woodbridge|isbn=978-1-84383-308-6}}</ref>

Formal use of nurses in the military began in the latter half of the nineteenth century. Nurses saw active duty in the [[First Boer War]], the [[Anglo-Egyptian War|Egyptian Campaign]] (1882),<ref>{{cite web|title=Our History|url=http://www.army.mod.uk/army-medical-services/qaranc/9910.aspx|publisher=British Army Website|access-date=31 October 2011|archive-url=https://web.archive.org/web/20111028190846/http://www.army.mod.uk/army-medical-services/qaranc/9910.aspx|archive-date=28 October 2011}}</ref> and the [[Mahdist War|Sudan Campaign]] (1883).<ref>{{Cite web|title = History of the School of Nursing|publisher = University of Maryland School of Nursing|url = https://www.nursing.umaryland.edu/about/community/museum/virtual-tour/foundation/|access-date = 19 January 2016|archive-date = 24 January 2016|archive-url = https://web.archive.org/web/20160124130200/https://www.nursing.umaryland.edu/about/community/museum/virtual-tour/foundation/|url-status = dead}}</ref>

===20th century===
{{Further|Women in nursing}}
[[File:RedCrossNursen.jpg|thumb|left|A recruiting poster for Australian nurses from the [[World War I|First World War]].]]

In the 19th and early 20th century, nursing was considered a woman's profession, just as doctoring was a profession for men. With increasing expectations of workplace equality during the late 20th century, nursing became an officially [[Gender marking in job titles|gender-neutral]] profession, though in practice the percentage of male nurses remained well below that of female [[physician]]s in the 21st century.<ref>{{Cite web |title=Total Number of Professionally Active Nurses, by Gender |url=http://kff.org/other/state-indicator/total-number-of-professionally-active-nurses-by-gender/#table |access-date=19 January 2016 |website=kff.org |language=en-US}}</ref><ref>{{Cite web |title=Distribution of Physicians by Gender |url=http://kff.org/other/state-indicator/physicians-by-gender/ |access-date=19 January 2016 |website=kff.org |language=en-US}}</ref>

Hospital-based training became standard in the US in the early 1900s, with an emphasis on practical experience. The Nightingale-style school began to disappear. Hospitals and physicians saw women in nursing as a source of free/inexpensive labor. Exploitation of nurses was not uncommon by employers, physicians, and education providers.<ref name="CHIN2008">{{cite book|last1=Chin|first1=PL|last2=Kramer|first2=MK|title=Integrated Theory and Knowledge Development in Nursing|date=2008|publisher=Mosby Elsevier|location=St. Louis|isbn=9780323052702|pages=[https://archive.org/details/integratedtheory0000chin/page/33 33–34]|edition=7th|url=https://archive.org/details/integratedtheory0000chin/page/33}}</ref>

Many nurses saw active duty in the [[World War I|First World War]], but the profession transformed again during the [[World War II|Second World War]]. British nurses of the Army Nursing Service were part of every overseas campaign.<ref>{{cite web|title=QA World War Two Nursing|url=http://www.qaranc.co.uk/qa_world_war_two_nursing.php|publisher=qaranc.co.uk|access-date=31 October 2011}}</ref> More nurses volunteered for service in the US [[United States Army|Army]] and [[United States Navy|Navy]] than any other occupation.<ref>D'Ann Campbell, ''Women at War with America: Private Lives in a Patriotic Era'' (1984) ch 2  [https://archive.org/details/womenatwarwitham0000camp/mode/1up online]</ref><ref>Philip A. Kalisch and Beatrice J. Kalisch, ''American Nursing: A History'' (4th ed. 2003)</ref> The Nazis had their own Brown Nurses, numbering 40,000.<ref>Bronny Rebekah McFarland-Icky, ''Nurses in Nazi Germany'' (Princeton University Press, 1999)</ref> Two dozen German Red Cross nurses were awarded the [[Iron Cross]] for heroism under fire.<ref>Gordon Williamson, ''World War II German Women's Auxiliary Services'' (2003) pp 34–36</ref>

[[File:Registered nurse philadelphia 1952 common history 2.jpg|thumb|Registered nurse at Jefferson Medical College Hospital 1952]]
The development of undergraduate and post-graduate [[Nurse education|nursing degrees]] came after the war. Nursing research and a desire for association and organization led to the formation of [[professional organizations]] and [[nursing journal|academic journals]]. Nursing became recognized as a distinct academic discipline, initially tasked to define the [[Nursing theory|theoretical basis]] for practice.<ref name="ALLIGOOD2013">{{cite book|last1=Alligood|first1=MR|editor1-last=Alligood|editor1-first=MR|editor2-last=Tomey|editor2-first=AM|title=Nursing Theorists and their Work|date=2013|publisher=Mosby/Elsevier|location=Maryland Heights, MO|isbn=9780323056410|pages=5–6|edition=7th|chapter=Introduction to nursing theory}}</ref>

====Shortages====
Nurses are perceived to be in short supply around the world, particularly  in South East Asia and Africa.<ref>{{cite news |title=Nursing and midwifery |url=https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery |access-date=30 June 2022 |publisher=WHO |date=18 March 2022}}</ref> A global survey by [[McKinsey & Company]] in 2022 found that between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan, and France said they were likely to leave their role in direct patient care in the next year. The top five factors which they said would make them stay were:
*Safe working environment
*Work-life balance
*Caring and trusting team-mates
*Meaningful work
*Flexible work schedule 
Pay ranked eighth on the list.<ref>{{cite news |title=Around the world, nurses say meaningful work keeps them going |url=https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/around-the-world-nurses-say-meaningful-work-keeps-them-going |access-date=30 June 2022 |publisher=McKinsey |date=12 May 2022}}</ref>  A 2023 American survey found that around 30% were considering leaving patient care.<ref>{{cite news|title= 2023 AMN Healthcare Survey of Registered Nurses | url= https://www.amnhealthcare.com/amn-insights/nursing/surveys/2023 | access-date=2 May 2023 | date=May 2023}}</ref>

==Definition==

According to the traditional interpretation physicians are concerned with curing or treating medical conditions, while nurses focus on care. In healthcare settings this line is often blurred, complicating the task of distinguishing the professions.{{sfn|Mulhall|1998|p=4–5}} Although nursing practice varies both through its various specialties and countries, nursing organizations offer the following definitions:

{{Blockquote | Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well, and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. | [[International Council of Nurses]]<ref name="ICN"/>}}

{{Blockquote|The use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.|[[Royal College of Nursing]] (2003) <ref>{{cite web |url=https://www.rcn.org.uk/professional-development/publications/pub-004768 |title=Defining nursing 2014 |publisher=[[Royal College of Nursing]] (RCN) |date=22 December 2014 |access-date=2016-10-08 |archive-date=10 October 2016 |archive-url=https://web.archive.org/web/20161010184708/https://www.rcn.org.uk/professional-development/publications/pub-004768 |url-status=dead }}</ref>}}

{{Blockquote|Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations.|[[American Nurses Association]]<ref>[https://www.nursingworld.org/practice-policy/scope-of-practice/ ANA Considering Nursing] Retrieved Dec 2018</ref>|source=}}

{{Blockquote|The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.|[[Virginia Avenel Henderson]]<ref>[http://www.contemporarynurse.com/archives/vol/5/issue/3/article/3027/virginia-henderson-a-contemporary-nurse-18971996 Contemporary Nurse Virginia Henderson] {{webarchive|url=https://web.archive.org/web/20090914053915/http://www.contemporarynurse.com/archives/vol/5/issue/3/article/3027/virginia-henderson-a-contemporary-nurse-18971996 |date=14 September 2009 }} Retrieved July 2009</ref>}}

==Professional nursing==
[[File:Indonesian nurse examines patient.JPG|thumb|A nurse in Indonesia examining a patient]]
[[File:ASC Leiden - Coutinho Collection - 10 04 - Nurses in Ziguinchor hospital, Senegal - 1973.tif|thumb|A nurse treating a patient with burns, [[Ziguinchor]] [[PAIGC]] hospital, 1973]]
The practice of nursing is based upon a [[social contract]] that delineates professional rights and responsibilities as well as accountability mechanisms. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at the national or state level.

The nursing community worldwide aims for professional nurses to ensure quality care, while maintaining their credentials, code of [[Nursing ethics|ethics]], standards, and competencies, and continuing their education.<ref name="ICN">[http://www.icn.ch/abouticn.htm International Council of Nurses] {{Webarchive|url=https://web.archive.org/web/20100429141916/http://www.icn.ch/abouticn.htm |date=29 April 2010 }} Retrieved August 2007</ref> Multiple educational paths lead to becoming a professional nurse; these vary by jurisdiction; all involve extensive study of [[nursing theory]] and practice as well as training in clinical skills.

Nurses provide care based on the individual's physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology.

Nurses typically hold one or more formal credentials. Roles and responsibilities follow the level of education. For example, in the United States, [[Licensed Practical Nurse]]s (LPN) have less education than [[Registered Nurse]]s (RN) and accordingly, a narrower scope of practice.

===Diversity ===
{{Main article|Men in nursing}}
[[File:Male Nurses- Life at Runwell Hospital, Wickford, Essex, 1943 D14313.jpg|thumb|right|upright=0.9|A male nurse at Runwell Hospital, Wickford, Essex, in 1943]]

Nursing is a female-dominated profession in many countries; according to the [[World Health Organization|WHO's]] 2020 ''State of the World's Nursing,'' approximately 90% of the nursing workforce is female.<ref>{{cite web|url=https://apps.who.int/iris/bitstream/handle/10665/331673/9789240003293-eng.pdf|publisher=World Health Organization|title=State of the World's Nursing 2020|access-date=16 March 2021}}</ref> For instance, the male-to-female ratio of nurses is approximately 1:19 in Canada and the United States.<ref>{{cite journal|author=Patrick Sullivan |url=http://www.cmaj.ca/cgi/content/full/164/12/1738-b?ck=nck |title=Canada Medical Association Journal 12 June 2001; 164 (12) |journal = CMAJ|publisher=Cmaj.ca |date=12 June 2001 |volume = 164|issue = 12|pages = 1738–1738–b|access-date=4 September 2013}}</ref><ref>[http://bhpr.hrsa.gov/healthworkforce/reports/nursing/samplesurvey00/chapter3.htm 2000 National Sample Survey of Registered Nurses] {{webarchive |url=https://web.archive.org/web/20110422161539/http://bhpr.hrsa.gov/healthworkforce/reports/nursing/samplesurvey00/chapter3.htm |date=22 April 2011 }}</ref> This ratio is matched in many other countries. Notable exceptions include [[Francophone Africa]], which includes the countries of Benin, Burkina Faso, Cameroon, Chad, Congo, [[Côte d'Ivoire]], the [[Democratic Republic of Congo]], [[Djibouti]], [[Guinea]], [[Gabon]], [[Mali]], [[Mauritania]], [[Niger]], [[Rwanda]], [[Senegal]], and [[Togo]], which all have more male than female nurses.<ref name="MIN">{{cite book|first1=Chad E. |last1=O'Lynn |first2=Russell E. |last2=Tranbarger |title=Men in Nursing: History, Challenges, and Opportunities|url=https://books.google.com/books?id=-Ag7TqTyIC0C&pg=PA225|year=2006|publisher=Springer Publishing Company|isbn=978-0-8261-0349-9|page=225}}</ref> In Europe, in countries such as [[Spain]], [[Portugal]], [[Czech Republic]] and [[Italy]], over 20% of nurses are male.<ref name="MIN"/> As of 2016, 11% of nurses and midwives registered with the Nursing and Midwifery Council (NMC) in the UK were male.<ref>{{cite web|url=https://www.nmc.org.uk/globalassets/sitedocuments/annual_reports_and_accounts/equality-and-diversity-report-2015-16.pdf |title=Annual Equality and Diversity Profile, NMC 2015–2016}}</ref> The number of male nurses in the United States doubled between 1980 and 2000.<ref>{{cite news|last1=Weintraub|first1=Arlene|title=Nursing: On the Critical List|work=Business Week|date=3 June 2002}}</ref> On average, male nurses in the US receive more pay than female nurses.<ref>{{Cite web|url = https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf|title = Men in Nursing Occupations|date = February 2013|access-date = 6 October 2015|website = Census.gov|publisher = American Community Survey|archive-url = https://web.archive.org/web/20170713210226/https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf|archive-date = 13 July 2017}}</ref>

== Theory and process ==

{{Main article|Nursing theory|Nursing process}}
Nursing practice is the actual provision of nursing care. In providing care, nurses implement a [[nursing care plan]] defined using the [[nursing process]]. This is based around a specific [[nursing theory]] that is selected based on the care setting and the population served. In providing nursing care, the nurse uses both nursing theory and best practice derived from [[nursing research]].<ref name=Weber2014>{{cite book | last = Weber | first = Janet | title = Nurses' handbook of health assessment | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2014 | isbn = 9781451142822 }}</ref> Many nursing theories are in use.<ref name=":3" /> Like other disciplines, the profession has developed multiple theories derived from reflecting varying philosophical beliefs and [[paradigm]]s or [[worldview]]s.

In general terms, the nursing process is the method used to [[Nursing assessment|assess]] and [[Nursing diagnosis|diagnose]] needs, plan outcomes and interventions, implement interventions, and evaluate outcomes. The nursing process as defined by the [[American Nurses Association]] comprises five steps: 1) evaluate, 2) implement, 3) plan, 4) diagnose, and 5) assess.<ref name=":3">{{Cite web |title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society - Credo Reference |url=https://search.credoreference.com/content/entry/sageeas/nursing/0 |access-date=2022-02-18 |website=search.credoreference.com |language=en}}</ref>

== Healthcare staffing platforms ==
[[Digital health]] platforms connect nurses and nurse assistants with job openings in healthcare facilities such as skilled nursing homes, home health agencies, and hospitals. Platforms offer an app to facilitate communication and allow nurses to find work opportunities based on their preferences. Healthcare partners and facilities benefit from access to qualified nurses.<ref>{{Cite journal |last1=Han |first1=Xinxin |last2=Pittman |first2=Patricia |last3=Barnow |first3=Burt |date=2021-09-09 |title=Alternative Approaches to Ensuring Adequate Nurse Staffing |url=http://dx.doi.org/10.1097/mlr.0000000000001614 |journal=Medical Care |volume=59 |issue=Suppl 5 |pages=S463–S470 |doi=10.1097/mlr.0000000000001614 |issn=0025-7079 |pmc=8428863 |pmid=34524244}}</ref> In 2017, the UK's National Health Service began trialing such a platform.<ref>{{Cite magazine |title=The NHS is going to trial a gig economy app for nurses |url=https://www.wired.co.uk/article/nhs-app-nurses-flexible-working-jeremy-hunt-gig-economy |access-date=2024-01-24 |magazine=Wired UK |language=en-GB |issn=1357-0978}}</ref>

Platforms such as [[United States]]–based ConnectRN, Nomad Health, Gale Healthcare solutions or Lantum add resources, career development tools, and networking opportunities.<ref>{{Cite journal |last1=Mayer |first1=Miguel Angel |last2=Rodríguez Blanco |first2=Octavi |last3=Torrejon |first3=Antonio |title=Use of Health Apps by Nurses for Professional Purposes: Web-Based Survey Study (Preprint) |date=2019-06-26 |journal=JMIR mHealth and uHealth |doi=10.2196/preprints.15195 |doi-access=free}}</ref>

== Nursing as a science ==
{{Main article|Nursing research}}

Florence Nightingale's [[Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army|seminal epidemiological study]] examining mortality among British soldiers during the [[Crimean War]] was published in 1858.{{sfn|Boswell|Cannon|2014|p=30–31}} With the exception of her works, nursing practice remained an oral tradition until the mid-20th century. The inaugural issue of ''[[Nursing Research]]'', the first scientific journal specialized in nursing, came in in 1952. During the 1960s, interest in attaining PhDs increased among nurses in the US, but nursing remained a fledgling area of research, with few journals until the 1970s.{{sfn|Watson|2021|loc=From Oral Tradition to Written Scholarship}} Nursing research is increasingly presented as a valid discipline, although lacking a prevailing definition.{{sfn|Manhart Barrett|2017|p=129}} The question is further complicated by the numerous interpretations of nursing's defining essence.{{sfn|Manhart Barrett|2002|p=51}}{{sfn|Mulhall|1998|p=4}}

=== Evidence-based practice ===
{{Main article|Evidence-based nursing|Evidence-based medicine}}

During the 1980s there was an increased focus on [[research utilization]] (RU). Nursing research took an interest in clinical issues and US nursing schools began teaching research methods to facilitate interpretation and integration of scientific findings in routine practice. Several RU initiatives were active during the late 20th century, but the RU movement was superseded by evidence-based practice in the 1990s.{{sfn|Polit|Tatano Beck|2014|p=21}} Evidence-based practice (EBP) is about using research, but unlike RU it allows for the integration of research findings with clinical expertise and patient preferences.{{sfn|Polit|Tatano Beck|2014|p=20–21}} The EBP movement had originated in the field of [[medicine]] with [[Archie Cochrane]] publishing ''Effectiveness and Efficiency'' in 1972, leading up to the founding of the [[Cochrane Collaboration]] in 1993.{{sfn|Nieswiadomy|2012|p=278–279}} The emerging area of evidence-based medicine also applies to nursing.{{sfn|Boswell|Cannon|2014|pp=3–4}} Common barriers to the study and integration of research findings into clinical decision making include: a lack of opportunity, inexperience, and the rapid pace of evidence accumulation.{{sfn|Mulhall|1998|p=4}}{{sfn|Nieswiadomy|2012|p=268–270}}

==Scope of activities==
Nurses perform a variety of different tasks. Their activities vary based on their level of training and their specialty. For example, [[Perioperative nursing|operating room nurses]] work in surgical settings and perform tasks that other nurses do not.<ref>{{Cite web|url=https://www.aorn.org/career-center|title=AORN Career Center - Career Advice Consider a Career in the OR |publisher=Association of periOperative Registered Nurses |language=en|access-date=2019-05-29}}</ref> Nurses may receive additional training and certifications to perform a variety of tasks. For example, in the United States, RN first assists (RNFAs) perform basic surgical procedures.<ref>{{cite web |title=RN First Assist Resources |url=https://www.aorn.org/guidelines-resources/clinical-resources/rn-first-assistant-resources |website=AORN |publisher=[[Association of periOperative Registered Nurses]]}}</ref> 

===Assessment===
{{Main|Nursing assessment}}
Assessment is an essential nursing skill. Nurses assess patients' physical and mental health. In hospital settings, nurses regularly perform assessments to notice any acute changes in their patients. Nurses also assess a patient's response to medication or other treatments, such as physical activity and blood transfusions. Nurses may also take health histories. Nurses also must assess a patient's understanding of their health status and their medications. Critical thinking is an important skill for nurses to have: in emergency situations, nurses must quickly assess a patient and determine the best course of action.<ref>{{cite journal |last1=Toney-Butler |first1=Tammy J. |last2=Unison-Pace |first2=Wendy J. |title=Nursing Admission Assessment and Examination |url=https://www.ncbi.nlm.nih.gov/books/NBK493211/ |website=StatPearls |date=2025 |location=National Library of Medicine|pmid=29630263 }}</ref>

===Medication===
[[Medication therapy management|Medication management]] and administration are common hospital nursing roles, although prescribing authority varies across jurisdictions. In many areas, RNs administer and manage medications prescribed by others. Nurses are responsible for evaluating patients throughout their care – including before and after medication administration – adjustments to medications are often made through a collaborative effort between the prescriber and the nurse. Regardless of the prescriber, nurses are legally responsible for the drugs they administer. Legal implications may accompany an error in a prescription, and the nurse may be expected to note and report the error. In the United States, nurses have the right to refuse to administer medication that they deem to be potentially harmful.<ref>Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 735-736.</ref> Some nurses take additional training that allows them to prescribe medications within their scope of practice.<ref name="rcn">{{cite web|url=https://www.rcn.org.uk/about-us/policy-briefings/pol-1512#tab1|title=RCN factsheet on nurse prescribing in the UK|website=rcn.org.uk|access-date=20 July 2019|archive-date=4 May 2020|archive-url=https://web.archive.org/web/20200504140113/https://www.rcn.org.uk/about-us/policy-briefings/pol-1512#tab1}}</ref>

===Patient education===
{{See also|Patient education}}
Effective patient/family education leads to better outcomes. Nurses explain procedures, recovery, and ongoing care, while helping everyone cope with the medical situation.<ref name=":4">{{Cite news |title=nursing {{!}} History, Education, & Practices {{!}} Britannica |url=https://www.britannica.com/science/nursing |access-date=2022-03-07 |newspaper=Encyclopedia Britannica |language=en}}</ref>

Many times, nurses are busy, leaving little time to educate patients.<ref name=":6" />

Patients' families needs similar education.<ref name=":6">Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 468.</ref>  Educating both patients and their families increases the chance for a better outcome.<ref>{{Cite journal |last1=Smith |first1=Jackie A. |last2=Zsohar |first2=Helen |date=October 2013 |title=Patient-education tips for new nurses |journal=Nursing |language=en-US |volume=43 |issue=10 |pages=1–3 |doi=10.1097/01.NURSE.0000434224.51627.8a |pmid=24045809 |issn=0360-4039|doi-access=free }}</ref>

Nurses have to communicate in a way that can be understood by patients. Education techniques encompass conversations, visuals, reading materials, and demonstrations.<ref name=":4" />

===Daily living assistance===
{{main article|Activities of daily living}}
Nurses manage and coordinate care to support activities of daily living (ADL) such as hygiene and toileting. This includes assisting in patient mobility, such as moving an activity intolerant patient within a bed. They often delegate such care to [[nursing assistant]]s.

==Specialties ==
{{Main article|List of nursing specialties}}

Nursing is the most diverse of all [[:category:health care occupations|health care professions]]. Nurses practice in a wide range of settings, but generally follows the needs of their patients.

The major specialties are:
*[[Community nursing|communities]]/[[Public health nursing|public health]]
*family/individual care
*adult-[[Gerontological nursing|gerontology]]
*[[Pediatric nursing|pediatrics]]
*[[obstetrical nursing|obstetrics]]
*[[Neonatal nursing|neonatal]]
*women's health/gender-related
*[[Mental health nursing|mental health]]
*[[Health informatics|informatics]] ([[eHealth]])
*acute care
*[[Ambulatory care nursing|ambulatory settings]] (physician offices, urgent care settings, camps, etc.)
*[[School nursing|school]]/college/institutional infirmaries
*[[Military nurse|military]]
*[[cardiac nursing|cardiac care]]
*[[orthopedic nursing|orthopedic care]]
*[[palliative care]]
*[[perioperative nursing|perioperative]]
*[[oncology nursing|oncology]]
*[[telenursing]]
*[[radiology]]
*[[emergency nursing|emergency care]]

Nurses with additional degrees allow for specialization. Nursing professions can be separated into categories by care type, age, gender, certain age group, practice setting, individually or in combination.<ref name=":5">{{Cite web |title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society - Credo Reference |url=https://search.credoreference.com/content/entry/sageeas/nursing/0 |access-date=2022-03-31 |website=search.credoreference.com |language=en}}</ref>

== Settings ==
Nurses practice in a wide range of settings, including hospitals, private [[home care|homes]], [[school nursing|schools]], and [[pharmaceutical companies]]. Nurses work in [[Occupational health nursing|occupational health]] settings<ref>{{cite journal |author1=Draper Elaine |author2=LaDou Joseph |author3=Tennenhouse Dan J | year = 2011 | title = Occupational Health Nursing and the Quest for Professional Authority | journal = New Solutions | volume = 21 | issue = 1| pages = 57–88 | doi=10.2190/ns.21.1.i|pmid=21411426 |bibcode=2011NewSo..21...57D |s2cid=207317324 }}</ref> (also called industrial health settings), free-standing clinics, physician offices, [[nurse-led clinics]], [[long-term care]] facilities and camps. They work on [[cruise ships]], [[Armed Forces|military bases]], and in combat settings.

Nurses act as advisers and consultants to the health care and insurance industries. Many nurses also work in [[health advocacy]] and [[patient advocacy]], helping in clinical and administrative domains.<ref>Schneider, John. "Healthcare advocacy experts aid workers." Miami Herald 31 August 2010</ref> Some are [[lawyer|attorneys]] and others work with attorneys as [[legal nurse consultant]]s, reviewing patient records to assure that adequate care was provided and testifying in court.

Nurses can work on a temporary basis, which involves doing shifts without a contract in a variety of settings, sometimes known as ''per diem nursing'', ''agency nursing'' or ''travel nursing''. Nurses work as researchers in laboratories, universities, and [[research institutions]]. Nurses work in informatics, acting as consultants to the creation of computerized charting programs and other software. Nurse authors publish articles and books to provide essential reference materials.

==Occupational hazards==
[[File:Sleep Deprivation – Shift Work & Long Work Hours Put Nurses at Risk.webm|thumb|A video describing occupational hazards that exist among nurses]]
The international nursing shortage<ref>{{cite journal |last1=Buchanan |first1=J. |title=Global nursing shortages |journal= BMJ|volume=324 |issue=7340 |pages=751–2 |year=2002 |pmid=11923146 |pmc=1122695 |doi=10.1136/bmj.324.7340.751}}</ref> is in part due to their work environment. In a recent review of the literature specific to nursing performance, nurses were found to work in generally poor environmental conditions. Some jurisdictions have legislation specifying acceptable nurse-to-patient ratios.

The fast-paced and unpredictable nature of health care places nurses at risk for injuries and illnesses, including high [[occupational stress]]. Nurses consistently identify stress as a major work-related concern and have among the highest levels of occupational stress among all professions. This stress is caused by the environment, psychosocial stressors, and the demands of nursing, including mastering new technology, emotional labor, physical labor, [[shift work]], and high workload. This stress puts nurses at risk for short-term and long-term health problems, including [[sleep disorders]], [[major depressive disorder|depression]], [[Death|mortality]], psychiatric disorders, stress-related illnesses, and overall poor health. Nurses are at risk of developing [[compassion fatigue]] and moral [[distress (medicine)|distress]], which can damage mental health. They have high rates of [[occupational burnout]] (40%) and [[emotional exhaustion]] (43.2%). Burnout and exhaustion increase the risk for illness, medical error, and suboptimal care provision.<ref name=":0">{{Cite news|url = http://www.medscape.com/viewarticle/765974|title = Alleviating Job Stress in Nurses|date = 25 June 2012|newspaper = Medscape|publisher = Medscape and NIOSH|last1 = Roberts|first1 = Rashaun|last2 = Grubb|first2 = Paula L.|last3 = Grosch|first3 = James W.}}</ref>

=== Patient handling ===
Healthcare has consistently ranked among the industries with the highest rates of musculoskeletal injuries, largely related to patient handling. Anywhere from 30 to 70% of reported musculoskeletal injuries are related to patient handling. Nurses are routinely tasked with lifting, repositioning, and mobilizing patients. According to the [[National Institute for Occupational Safety and Health|National Institute for Occupational Safety and Health (NIOSH)]] the single greatest factor in overexertion injuries is the manual lifting, moving and repositioning of patients.<ref>{{Cite web |date=2023-04-17 |title=Safe Patient Handling and Mobility {{!}} NIOSH |url=https://www.cdc.gov/niosh/topics/safepatient/default.html |access-date=2024-04-16 |website=www.cdc.gov |language=en-us}}</ref> These tasks present unique ergonomic hazards that result in a high rate of acute and cumulative musculoskeletal injuries.<ref>{{Cite journal |last1=Morse |first1=Tim |last2=Fekieta |first2=Renee |last3=Rubenstein |first3=Harriet |last4=Warren |first4=Nick |last5=Alexander |first5=Darryl |last6=Wawzyniecki |first6=Patricia |date=2008-05-29 |title="Doing the Heavy Lifting: Health Care Workers Take Back Their Backs" |url=https://doi.org/10.2190/NS.18.2.j |journal=NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy |language=en |volume=18 |issue=2 |pages=207–219 |doi=10.2190/ns.18.2.j |pmid=18511397 |bibcode=2008NewSo..18..207M |issn=1048-2911|url-access=subscription }}</ref><ref name=":12">{{Cite journal |last1=Aslam |first1=Imran |last2=Davis |first2=Scott A. |last3=Feldman |first3=Steven R. |last4=Martin |first4=Willis E. |date=June 2015 |title=A Review of Patient Lifting Interventions to Reduce Health Care Worker Injuries |url=https://doi.org/10.1177/2165079915580038 |journal=Workplace Health & Safety |language=en |volume=63 |issue=6 |pages=267–275 |doi=10.1177/2165079915580038 |pmid=26135600 |issn=2165-0799}}</ref>

The most frequently injured body part is the back, with up to 72% of nurses reporting non-specific [[low back pain]].<ref>{{Cite web |title=Unsafe patient handling |url=https://www.who.int/tools/occupational-hazards-in-health-sector/unsafe-patient-handling |access-date=2024-02-22 |website=www.who.int |language=en}}</ref>  The US Bureau of Labor Statistics reported that for 2021-2022 the rate of overexertion injuries leading to days away from work for nurses was 45.4 per 10,000 full time employees, while nursing aids came in at 145.5 compared to the average for all industries of 26.1.<ref>{{Cite web |title=Survey of Occupational Injuries and Illnesses Data : U.S. Bureau of Labor Statistics |url=https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables.htm |access-date=2024-03-26 |website=www.bls.gov |language=en-us}}</ref>

Traditionally, nurses are trained in manual patient handling techniques.<ref name=":02">{{Cite journal |last=Waters |first=Thomas R. |date=2007 |title=For CE Credit: When Is It Safe to Manually Lift a Patient? |url=https://www.jstor.org/stable/29746479 |journal=The American Journal of Nursing |volume=107 |issue=8 |pages=53–59 |doi=10.1097/01.NAJ.0000282296.18688.b1 |jstor=29746479 |pmid=17667392 |issn=0002-936X|url-access=subscription }}</ref> The body of evidence has demonstrated, however, that such interventions are ineffective.<ref name=":02" />

=== Workplace violence ===
Nurses are at risk for workplace violence and abuse.<ref>{{cite web |url = http://blogs.cdc.gov/niosh-science-blog/2013/08/12/hcwviolence-prevention/ |title = Free On-line Violence Prevention Training for Nurses |date = 12 August 2013 |first1 = Dan |last1 = Hartley |first2 = Marilyn |last2 = Ridenour |access-date = 15 January 2015 |publisher = National Institute for Occupational Safety and Health}}</ref> Violence is typically perpetrated by non-staff (e.g. patients or family), whereas abuse is typically perpetrated by hospital personnel. In the US in 2011, 57% of nurses reported that they had been threatened at work; 17% were physically assaulted.<ref name=":0" />

The three types of workplace violence that nurses can experience are: physical violence (hitting, kicking, beating, punching, biting, and using objects);<ref>{{Citation|title=Gender Matters: Discourses of Violence in Early Modern Literature and the Arts|date=2014-01-01|work=Gender Matters|pages=5–15|publisher=BRILL|doi=10.1163/9789401210232_002|isbn=9789401210232 |last1=Wade |first1=Mara R. }}</ref> psychological violence (threats or coercion); sexual violence (attempted/completed non-consensual sex act).<ref>{{Cite web|date=September 2021|title=Sexual Harassment in the Workplace|url=https://www.workplacesrespond.org/harassment-facts/ |website=Work Places Respond}}</ref>

Workplace violence can be viewed in another way: interpersonal violence and organizational coercion. Interpersonal violence is committed by workers or patients and their families. Its predominant form is verbal abuse. Organizational coercion may include excessive workloads, mandatory shifts, involuntary placement in another part of the workplace, low salaries, denial of benefits/overtime, poor working environment, and other stressors.<ref>{{Cite journal|last1=Faghihi|first1=Mitra|last2=Farshad|first2=Aliasghar|last3=Abhari|first3=Maryam Biglari|last4=Azadi|first4=Nammamali|last5=Mansourian|first5=Morteza|date=2021-05-19|title=The components of workplace violence against nurses from the perspective of women working in a hospital in Tehran: a qualitative study|journal=BMC Women's Health|volume=21|issue=1|page=209|doi=10.1186/s12905-021-01342-0|pmid=34011330|issn=1472-6874|pmc=8136170 |doi-access=free }}</ref> These issues affect [[quality of life]]. Managers who lack understanding of the severity of these problems and do not support workers increase worker stress.

Many factors contribute to workplace violence. These factors can be divided into environmental, organizational, and individual psychosocial. The environmental factors can include the specific setting (for example the emergency department), long patient wait times, frequent interruptions, uncertainty regarding patients' treatment, and heavy workloads.<ref name=":1">{{Cite journal|last1=Zhang|first1=Liuyi|last2=Wang|first2=Anni|last3=Xie|first3=Xia|last4=Zhou|first4=Yanhong|last5=Li|first5=Jing|last6=Yang|first6=Lijun|last7=Zhang|first7=Jingping|date=July 2017|title=Workplace violence against nurses: A cross-sectional study|journal=International Journal of Nursing Studies|volume=72|pages=8–14|doi=10.1016/j.ijnurstu.2017.04.002|pmid=28412581|issn=0020-7489}}</ref> Organizational factors can include inefficient teamwork, organizational injustice, lack of aggression- and stress-management programs, and distrust between colleagues.<ref name=":1" /> Individual psychosocial factors may include nurses being young and inexperienced, previous experiences with violence, and a lack of communication skills.<ref name=":1" /> Misunderstandings may also occur due to the communication barrier between nurses and patients.<ref name=":2">{{Cite journal|last1=Alkorashy|first1=Hanan A. Ezzat|last2=Al Moalad|first2=Fawziah Bakheet|date=June 2016|title=Workplace violence against nursing staff in a Saudi university hospital|url=https://onlinelibrary.wiley.com/doi/10.1111/inr.12242|journal=International Nursing Review|language=en|volume=63|issue=2|pages=226–232|doi=10.1111/inr.12242|pmid=26830364|url-access=subscription}}</ref> An example of this could be patients' conditions being affected by medications, pain, or anxiety.

Workplace violence has many causes. The most common perpetrators of harassment or bullying of nursing students were registered nurses including preceptors, mentors, and clinical facilitators.<ref name=":2" /> However, the main perpetrators of workplace violence against nurses were patients. 80% of serious violent incidents in health care centers were committed by patients.

Workplace violence has many effects. It has negative emotional and physical impacts on nurses. They feel depersonalized, dehumanized, worn out, and stressed out.<ref>{{Cite journal|last1=Vrablik|first1=Marie C|last2=Chipman|first2=Anne K|last3=Rosenman|first3=Elizabeth D|last4=Simcox|first4=Nancy J|last5=Huynh|first5=Ly|last6=Moore|first6=Megan|last7=Fernandez|first7=Rosemarie|date=August 2019|title=Identification of processes that mediate the impact of workplace violence on emergency department healthcare workers in the USA: results from a qualitative study|journal=BMJ Open|volume=9|issue=8|pages=e031781|doi=10.1136/bmjopen-2019-031781|pmid=31462490|issn=2044-6055|pmc=6720251}}</ref> Nurses have reported burn-out due to frequent exposure to this violence.

=== Interventions ===
Interventions can mitigate these occupational hazards. They can be individual-focused or organization-focused. Individual-focused interventions include [[stress management]] programs, which can be customized to individuals. Stress management programs can reduce anxiety, sleep disorders, and other symptoms of stress. Organizational interventions focus on reducing stressful aspects of the work environment by identifying stress generators and developing solutions to them. Combining organizational and individual interventions is most effective at reducing stress.<ref name=":0" /> In some Japanese hospitals, [[Powered exoskeleton#Medical|powered exoskeletons]] are used to reduce physical loads.<ref>{{cite news|last1=Gilhooly|first1=Rob|title=Exoskeletons await in work/care closet|url=http://www.japantimes.co.jp/life/2012/06/17/general/exoskeletons-await-in-workcare-closet/|access-date=21 August 2013|work=The Japan Times|date=17 June 2012}}</ref> Lumbar supports (i.e. [[back belt]]s) have been trialed.<ref>{{cite journal | pmc=2078392 | year=2007 | last1=Dawson | first1=A. P. | last2=McLennan | first2=S. N. | last3=Schiller | first3=S. D. | last4=Jull | first4=G. A. | last5=Hodges | first5=P. W. | last6=Stewart | first6=S. | title=Interventions to prevent back pain and back injury in nurses: A systematic review | journal=Occupational and Environmental Medicine | volume=64 | issue=10 | pages=642–650 | doi=10.1136/oem.2006.030643 | pmid=17522134 }}</ref>

==Nursing ethics==
[[Professional abuse]] by nurses can be mitigated by [[nursing ethics]] and [[professional responsibility]].<ref name="l750">{{cite journal | last=Mansbach | first=Abraham | last2=Kushnir | first2=Talma | last3=Ziedenberg | first3=Hana | last4=Bachner | first4=Yaacov G. | title=Reporting Misconduct of a Coworker to Protect a Patient: A Comparison between Experienced Nurses and Nursing Students | journal=The Scientific World Journal | volume=2014 | date=2014 | issn=2356-6140 | pmid=25379527 | pmc=4214042 | doi=10.1155/2014/413926 | doi-access=free | pages=1–6}}</ref>

==By country==
===Africa===

==== Kenya ====
{{Excerpt|Nursing in Kenya}}

==== South Africa ====
{{Excerpt|Nursing in South Africa}}

===Americas===
====United States====
{{Excerpt|Nursing in the United States}}

====Canada====
{{Excerpt|Nursing in Canada}}

====Latin America/Caribbean====
Latin American nursing is based on three levels of training: (a) professional/registered, (b) technical, and (c) auxiliary.<ref>{{cite book|title=Siantz, de Leon, M.L., Malvárez, S., (31 May 2008) "Migration of Nurses: A Latin American Perspective" OJIN: The Online Journal of Issues in Nursing; Vol. 13 No. 2 Manuscript 2.}}</ref> Nursing education in [[Latin America]] and the [[Caribbean]] includes the principles and values of universal health and primary health care. These principles are based on critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning.<ref>{{citation|doi=10.1590/1518-8345.2232.2913|title=The situation of nursing education in Latin America and the Caribbean towards universal health|year=2017|last1=Cassiani|first1=Silvia Helena De Bortoli|last2=Wilson|first2=Lynda Law|last3=Mikael|first3=Sabrina de Souza Elias|last4=Peña|first4=Laura Morán|last5=Grajales|first5=Rosa Amarilis Zarate|last6=McCreary|first6=Linda L.|last7=Theus|first7=Lisa|last8=Agudelo|first8=Maria del Carmen Gutierrez|last9=Felix|first9=Adriana da Silva|last10=Uriza|first10=Jacqueline Molina de|last11=Gutierrez|first11=Nathaly Rozo|journal=Revista Latino-Americana de Enfermagem|volume=25|pages=e2913|pmid=28513769|pmc=5466053}}</ref><ref>{{cite web|author=Pan American Health Organization |title=Strategy for universal access to health and universal health coverage|url=http://www.paho.org/uhexchange/index.php/en/uhexchange-documents/technical-information/26-strategy-for-universal-access-to-health-and-universal-health-coverage/file}}</ref>

=== Europe ===

==== European Union ====
In the European Union, the profession of nurse requires a specific professional qualification. The qualification of nurses responsible for general care in the EU is regulated in [[Directive 2005/36/EC]].<ref name="Directive 2005/36/EC">[http://data.europa.eu/eli/dir/2005/36/oj Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications, Official Journal of the European Union, 30.9.2005]</ref> The list of regulated nursing professions is held in the regulated professions database.<ref name="europa2">{{cite web |title=Regulated professions database – European Commission |url=https://ec.europa.eu/growth/tools-databases/regprof/home |access-date=21 June 2024 |publisher=European Commission}}</ref>

===== Germany =====
{{Excerpt|Nursing in Germany}}

===== Spain =====
{{Excerpt|Nursing in Spain|paragraphs=1}}

====United Kingdom====
{{Excerpt|Nursing in the United Kingdom}}

=== Asia ===

====India====
{{Excerpt|Nursing in India}}

=== Hong Kong ===
{{Excerpt|Nursing in Hong Kong}}

====Japan====
{{Excerpt|Nursing in Japan}}

=== Pakistan ===
{{Excerpt|Nursing in Pakistan}}

====Philippines====
{{Excerpt|Nursing in the Philippines|paragraphs=1}}

====Taiwan====
{{main article|Nursing in Taiwan}}

In [[Taiwan]], the [[Ministry of Health and Welfare (Taiwan)|Ministry of Health and Welfare]] regulates nursing.<ref>{{cite web|title=Ministry of Health and Welfare|url=http://www.mohw.gov.tw/EN/Ministry/Index.aspx|access-date=6 May 2016|archive-date=28 April 2017|archive-url=https://web.archive.org/web/20170428230510/http://www.mohw.gov.tw/EN/Ministry/Index.aspx}}</ref> The Taiwan Union of Nurses Association (TUNA) organizes nurses.<ref>{{Cite web|url=https://www.nurse.org.tw/|title=中華民國護理師護士公會全國聯合會|website=www.nurse.org.tw}}</ref>

===Australia===
{{Excerpt|Nursing in Australia|paragraphs=1}}

=== Middle East ===

====Iran====
{{Excerpt|Nursing in Iran|paragraphs=1}}

=== Islam ===
{{Excerpt|Nursing in Islam}}

Historically, female nurses during the [[history of slavery in the Muslim world|era of slavery in the Muslim world]] where often slaves, a tradition which continued in Saudi Arabia until the abolition of [[slavery in Saudi Arabia]] in 1962, where nursing was considered a dishonorable profession.<ref>Drake, M. (2010). A Us Feminist in Saudi Arabia: 1980-1982. Storbritannien: iUniverse. p. 66</ref>

====Israel====
{{Unreferenced section|date=May 2024}}
Nurses in [[Israel]] has responsibilities including hospital care, patient education, wound care, prenatal and other monitoring, midwifery, and well-baby clinics.

Nurses and midwives are regulated by the [[Israeli Ministry of Health]].

Nursing in Israeli Jewish culture traces its origins to [[Shiphrah and Puah|Shifra and Puah]], two [[Hebrews|Hebrew]] midwives depicted in the [[Book of Exodus]] helping women in ancient Egypt give birth and keep their infants safe.

Modern-day nursing was established by nurses sent to [[Mandatory Palestine]] and later Israel by the [[Hadassah Women's Zionist Organization of America|Hadassah]] organization, as well as at a nursing school founded by [[Henrietta Szold]] in 1918.  The United Kingdom regulated midwifery in Mandatory Palestine, but nurses were not mentioned in the regulation decree.

== See also ==
{{Portal|Medicine}}
{{col div|colwidth=}}
*[[Advanced practice registered nurse]]
*[[History of nursing]]
*[[History of Nursing in the United Kingdom]]
*[[History of nursing in the United States]]
*[[History of Philippine nurses in the United States]]
*[[Index of nursing articles]]
*[[Licensed practical nurse]]
*[[List of nurses]]
*[[List of nursing specialties]]
*[[Men in nursing]]
*[[Nightingale Pledge]]
*[[Nurse uniform]]
*[[Nurse–client relationship]]
*[[Nurse scheduling problem]]
*[[Nursing care plan]]
*[[Nursing school]]
*[[Nurse stereotypes]]
*[[Nursing theory]]
*[[Registered nurse]]
*[[Transcultural nursing]]
{{colend}}

==References==
{{Reflist}}

=== Book sources ===
* {{cite book |date=2014 |edition=3rd |editor-last=Boswell |editor-first=Carol |editor2-last=Cannon |editor2-first=Sharon |isbn=9781449681968 |location=Burlington, MA |publisher=Jones & Bartlett Learning |title=Introduction to Nursing Research: Incorporating Evidence-based Practice}}
* {{cite book |date=2012 |edition=6th International |first=Rose Marie |isbn=978-0132756235 |last=Nieswiadomy |location=Boston, Mass. |publisher=Pearson |title=Foundations of nursing research}}<!-- auto-translated from Swedish by Module:CS1 translator -->
* {{cite book |date=2014 |edition=8th |first1=Denise F. |first2=Cheryl |isbn=9781451176797 |last1=Polit |last2=Tatano Beck |location=Philadelphia |publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins |title=Essentials of nursing research: appraising evidence for nursing practice}}<!-- auto-translated from Swedish by Module:CS1 translator -->

=== Journal articles ===
* {{Cite journal |last1=Manhart Barrett |first1=Elizabeth Ann |date=2002 |title=What is nursing science? |url=https://pubmed.ncbi.nlm.nih.gov/11873474 |journal=Nursing Science Quarterly |volume=15 |issue=1 |pages=51–60 |doi=10.1177/089431840201500109 |issn=0894-3184 |pmid=11873474}}
* {{cite journal|last=Manhart Barrett|first=Elizabeth Ann |year=2017|title=Again, What Is Nursing Science?|journal=Nursing Science Quarterly|volume=30 |issue=2 |pages=129–133|doi=10.1177/0894318417693313|pmid=28899250}}
* {{Cite journal |last=Mulhall |first=Anne |date=1998 |title=Nursing, research, and the evidence |url=https://ebn.bmj.com/content/1/1/4 |journal=Evidence-Based Nursing |language=en |volume=1 |issue=1 |pages=4–6 |doi=10.1136/ebn.1.1.4 |issn=1367-6539|url-access=subscription }}
* {{Cite journal |last=Watson |first=Jean |date=2021 |title=Watson's View of Nursing Science Quarterly's 35th Anniversary |url=http://dx.doi.org/10.1177/08943184211051366 |journal=Nursing Science Quarterly |volume=35 |issue=1 |pages=67–69 |doi=10.1177/08943184211051366 |pmid=34939483 |issn=0894-3184|url-access=subscription }}

==External links==
{{Wikiquote|Nursing}}
{{Wikibooks|Careers|Nursing}}
{{Commons category|Nursing}}
* [http://library.uncg.edu/dp/wv/itemSearch.aspx?t=1&k=nurse UNCG Library Betty H. Carter Women Veterans Historical Project: Nurse]
* {{Cite EB1911|wstitle=Nursing |short=x}}

{{Nursing}}
{{Reproductive labor}}
{{Medicine}}
{{Glossaries of science and engineering}}
{{Authority control}}

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