Maegan Baker, BSN, RN, CCM

Nurse Types / Obstetric Nurse

Some nurses know they want to be an obstetric nurse before they even enter nursing school. A specialty very different from other areas of nursing, obstetric nurses seem to possess endless amounts of patience and compassion. OB nurses typically care for laboring mothers and their newborns through childbirth and the postpartum phase.

Don’t let their soft voices and smiles fool you. They possess specific knowledge and skills to care for the most vulnerable patients. Curious if you’re prepared to care for pregnant moms and new little bundles of joy? Keep reading to learn:

• What is an obstetric nurse?
• What do obstetric nurses do?
• Where do obstetric nurses work?
• What are specific types of obstetric nurses?
• How do you become an obstetric nurse in 3 steps?
• What are the additional requirements of obstetric nurses?
• What are the salary and career outlooks for obstetric nurses?
• Obstetric nurse FAQs

What is an obstetric nurse?

Obstetric nursing, also known as OB nursing, focuses on the care of women through their pregnancy journeys including labor and childbirth to ensure a healthy delivery and newborn. Obstetrics can be thought of as an umbrella term used to describe different phases of nursing care depending on the stage of reproduction. 

Qualities of a successful obstetric nurse

It goes without saying that OB nurses love babies. Supporting a mother through pregnancy and childbirth requires compassion and understanding. Childbirth is a special experience and no two deliveries will be the same. Successful OB nurses possess the following traits:

Empathy. OB nursing requires constant empathy. You must have an impeccable bedside manner, listening skills, and the ability to quickly build a trusting rapport with your patients.

Attention to detail. While emotional skills are a large part of successful OB care, there is no lack of critical thinking or medical intervention when required. Emergencies can arise in a flash and you must be on alert and react promptly.

Tolerance. A universal trait required of all nurses, this can be especially difficult when children are involved. Family dynamics come in all shapes and sizes so nurses must not be judgmental.

What do obstetric nurses do?

OB nurses monitor both mom and baby for complications. Responsibilities will depend on the setting.

Gynecological care often precedes and follows pregnancy and takes place in an OB/GYN setting. You will play a large role in:

• Educating on overall reproductive health
• Assessing the health of mom and baby through pregnancy by monitoring vital signs, glucose levels, and weight gain
• Diet recommendations and lifestyle modifications such as exercise or quitting smoking
• Collecting blood and urine samples for screenings
• Assessing and directing to resources for financial or psychosocial assistance

Once it’s time for the baby to make an appearance, labor and delivery (L&D) nurses take over. These responsibilities include:

• Monitoring fetal heart rate and contractions
• Administering Pitocin and pain medication as prescribed
• Providing emotional support for the mother and interventions for comfort
• Monitoring for complications in both mom and baby
• Closely communicating updates with the MD
• Preparing for C-section if necessary 

Once the baby is born, you will quickly perform an assessment of the newborn and ensure both mom and baby are stable.

Postpartum nurses care for mom and baby following delivery. The couplet may be transferred to the post-partum unit for ongoing assessment and teaching. You will perform the following tasks:

• Assess for bleeding complications by monitoring lochia, incisions, and fundal height
• Teach and assess newborn care such as bathing, swaddling, and feeding
• Provide lactation support if necessary
• Aid in comfort of mom by providing ice packs, sitz baths, and breast care interventions
• Promote bonding between newborns and parents

Most facilities promote keeping the baby with mom as much as possible but there may be situations when the newborn is taken to the nursery for assessments or to allow mom to rest. OB nurses in the nursery setting change diapers, feed babies, and provide cuddles which may be more of a perk than a responsibility.

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A day in the life of an obstetric nurse

As mentioned above, the responsibilities of an OB nurse vary by setting. The interesting part of this specialty is that you may frequently rotate through all of these roles which means you will never be bored and no two days will be the same.

For most obstetric nurses, you will provide care in an acute care hospital. This usually involves 12-hour shifts, weekend, and on-call requirements. Labor and delivery (L&D) units are unique in that they may be empty or overflowing. Unless an induction is scheduled, labor progresses at its own pace. 

You may spend your shift simply interpreting fetal monitors and frequently assessing dilation and effacement until it’s time to deliver. Other shifts may be fast-paced with multiple deliveries, management of complications, or preparation for cesarean sections.

In the postpartum setting, you’re now responsible for mom and baby – known as a couplet. Your assignment will contain multiple couplets. Your shift will include monitoring mom post-delivery, assessing vital signs of both mother and baby, keeping mom comfortable, and educating prior to discharge.

Common conditions treated by obstetric nurses

For the most part, women of childbearing age are relatively healthy and usually do not have a long list of chronic conditions. L&D can be complicated by pregnancy-related complications that you must assess, monitor, and prevent such as:

• Endometriosis
• Postpartum hemorrhage
• Preeclampsia and eclampsia
• Miscarriage
• Multiple gestation pregnancy
• Placenta abnormalities
• Preterm labor
• Premature birth
• Fetal distress
• HIV disease and sexually transmitted infections

Where do obstetric nurses work?

Most OB nurses work in hospitals on maternity units. Your time may be divided between the labor and delivery unit, the postpartum unit, and the nursery. You can expect to work 12-hour shifts.  

Some OB nurses work in obstetric-gynecologic clinics and offices or birthing centers. These settings likely operate on a scheduled 9-5 workweek.

What are specific types of obstetric nurses? 

Obstetric nurses have a thorough understanding of maternal and reproductive health. OB nurses may rotate between the following settings or may work strictly in one department:

• Prenatal and gynecological care
• Labor and delivery
• Postpartum

Closely related fields 

OB nursing is centered around women’s health. Additional specialties related to maternal health, pregnancy, and infants include:

• Fertility nurse
• Lactation consultant
• Birth doula
• NICU (neonatal) nurse
• Nurse midwife

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How do you become an obstetric nurse in 3 steps?

Step 1 – Become a registered nurse

You must first complete nursing school and pass the NCLEX exam to become a licensed registered nurse.

Earn a nursing degree 

You may complete either an Associate Degree in Nursing (ADN) program or a Bachelor of Science in Nursing (BSN) program to prepare for the NCLEX exam. Bachelor’s-degree prepared nurses are highly sought after by employers and give you a competitive edge among peers. 

RN to BSN programs are popular if you desire to start your nursing career immediately and advance your education later.

Pass the NCLEX exam

Once you graduate from your nursing program, you will be eligible for the NCLEX exam. This rigorous exam tests your foundational nursing knowledge and ability to provide safe care.

Step 2 – Accumulate experience

Obstetrics is a specialty that accepts new graduate nurses. Your hospital may offer a residency program that provides additional classroom and precepting to transition safely into this specialty.

Helpful skills and experience

Accredited nursing programs require a clinical OB rotation with maternal nursing as a traditional lecture component. The length of time spent in L&D, maternity wards, or pediatric units will depend on your nursing program. 

As a student, if you quickly recognize obstetrics is for you, you may be able to request a preceptorship in obstetrics to gain additional experience.

Changing specialty to an obstetric nurse

Changing your specialty from one hospital setting to obstetrics may not require much adapting regarding work hours or nursing skills such as starting IVs or medication administration. The bulk of the transition will come in the form of refreshing your knowledge on maternal and newborn health. A great place to start is taking continuing education courses to prepare.

Step 3 – Obtain certifications

The National Certification Corporation offers the Inpatient Obstetric Nursing (RNC-OB) certification. After completing 2 years and at least 2,000 hours in the specialty of obstetrics, you are eligible to take the exam. 

Additional certifications OB nurses may acquire include:

• Pediatric Advanced Life Support (PALS) 
• Electronic Fetal Monitoring (C-EFM®)
• Certified Lactation Counselor

What are the additional requirements of obstetric nurses? 

OB nursing is often thought of as a ‘cheerful’ specialty bringing new life into the world. Not all pregnancy situations are happy and tragic outcomes do occur. There may be times when you are a laboring person’s only support system and they rely on you for coaching and emotional guidance. 

In times of infant or maternal death, OB nursing can be emotional and mentally exhausting. While it’s certainly normal and expected to feel upset during these times, your resiliency and strength are required to support grieving parents and to continue to provide excellent care for other patients. 

What are the salary and career outlooks for obstetric nurses? 

L&D is often a higher-paying specialty. Salaries will depend on location and experience. The states that pay the most for OB nurses are found on the West coast in Alaska, California, Nevada, Oregon, and Washington. The average salary for OB/GYN nurses is just over $84,000 which equals $40 per hour. 

Reproduction is a natural part of life and as long as people keep having babies, they will need obstetric nurses. The outlook for registered nurses as a whole is expected to grow 9% within the decade.

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Job satisfaction

Research is lacking on job satisfaction specifically for obstetric nurses. The pandemic was detrimental to the field of nursing causing interrupted care and high turnover which impacted job satisfaction as a whole. In one study, 25% of maternity nurses screened positive for burnout and almost 20% reported job dissatisfaction.

In a Nebraska Medicine report, the following findings contribute to a fulfilling career:

• Connecting with patients and making a difference
• Positive work environment
• Finding your niche
• Professional growth and advancement

OB nursing certainly checks these boxes and may offer nurses a heightened sense of job satisfaction.

Next steps 

Obstetrics is a broad specialty with options for growth. As you gain experience you may find a deeper niche you are passionate about such as caring for the frailest little ones in the NICU. 

Another option is to advance your education and become a certified nurse midwife.

If you are interested in advocacy and further professional development you may consider becoming a member of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN).

For additional nursing career resources, Incredible Health offers license resources and a question and advice forum.

FAQs

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Nurse Types / Director of Nursing

Are you a nurse who stands out as a leader? Do other nurses often come to you with questions or for your opinion? Becoming a director of nursing might be for you! This management position is perfect for nurses with supervisory experience who are ready for a larger challenge away from the bedside. If you’re intrigued, keep reading to find out:

• What is a director of nursing?
• What do directors of nursing do?
• Where do directors of nursing work?
• What are closely related fields?
• How do you become a director of nursing in 3 steps?
• What are the additional requirements of directors of nursing? 
• What are the salary and career outlooks for directors of nursing?

What is a director of nursing?

The director of nursing is an upper management role responsible for leading and overseeing nursing staff in a healthcare setting. Most commonly, you will receive the title Director of Nursing (DON) but may also be called Nursing Director, Wellness Director, Clinical Director, or Director of Nursing Services (DNS). No matter the title, you are responsible for supervising clinical staff and ensuring your unit runs smoothly. 

Qualities of a successful director of nursing 

Directors of nursing are leaders. Effective leadership results in personal, staff, and workplace success. Your role can be conflicting at times when delegation or discipline is required. You cannot become too friendly or overly strict with your subordinates. You must be able to lead fairly and objectively. Successful directors of nursing are:

• Communicators. Your constant contact with staff, other administrators, vendors, patients, and families requires clear instruction. 

• Confident. This leadership role requires you to be confident in your decisions. You cannot please everyone all the time and sometimes tough calls have to be made.

• Organized. Running a unit, department, or an entire facility requires keeping detailed documentation and staying on schedule for meetings and tasks.

What do directors of nursing do?

The list of responsibilities of a director of nursing are endless. While you are not usually working at the bedside, you should always be prepared to do so when the need arises. Usually, you’ll be in a dedicated office handling the following:

• Policies and procedures. These are often changing and you’ll play an active part in creating policies for your department and staff often related to patient care.

• Budgets and inventory. Directors of nursing are involved in the financial aspects of their workplace and monitor costs of resources, staff, and services. You may also be tasked with placing orders for supplies and tracking equipment usage.

• Ensuring compliance. An integral part of healthcare is remaining compliant with regulations. This is often how hospitals and facilities receive funding.

• Staffing. Directors hire and fire employees. You’ll also complete performance reviews and be heavily involved in day-to-day staffing shifts. You must also ensure staff completes necessary training and professional development activities. 

• Reports. You will often run daily reports and quality improvement checks on incident reports, chart audits, narcotic logs, restraint use, admissions and discharges, and more.

A day in the life of a director of nursing

Most directors of nursing begin their day with a staff huddle. These short 10-minute meetings review any high-priority needs that need to be addressed. This can include a patient concern, staffing needs, and equipment requests.

If you haven’t already done so, you’ll respond to emails and return phone calls. Get prepared for several more meetings and huddles. You’ll have either conference calls, virtual, or in-person meetings with other members of leadership to discuss internal operations, safety, staffing issues, and more.

As a director of nursing, you should check in with your staff and physicians several times a day for any concerns that require your assistance or delegation. You will often be involved in conflict resolution and must be a neutral party that listens and knows when to intervene.

Depending on the facility, you may also interact with patients and families. Directors of nursing in nursing homes, for example, frequently check on and form relationships with residents.

Before ending your day, you’ll follow up on last-minute emails and prepare for tomorrow.

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Where do directors of nursing work?

Directors of nursing are found in virtually every healthcare setting. Along with hospitals, they work in:

• Outpatient settings. Ambulatory care centers, surgical clinics, urgent care settings, dialysis clinics, and free-standing emergency rooms.

• Home health/Home care. These may be private practices or a department within a healthcare system. As a director of nursing, you ensure these settings are staffed accordingly and meet strict regulations.

• Skilled nursing facilities and nursing homes. This also includes rehabilitation and Veterans Administration settings.

• Hospice. Inpatient hospice as well as home care hospice requires the supervision of a director of nursing.
  
• Physician offices. Large primary care or specialty offices need directors of nursing to manage nursing and other clinical staff.

Closely related fields

Directors of nursing are part of a nursing hierarchy. You are considered one step below a Chief Nursing Officer (CNO) which is an executive-level position. Other similar roles that include leadership or organizational improvement include:

• Clinical nurse manager
• Quality assurance nurse
• Charge nurse
• Clinical nurse educator

How do you become a director of nursing in 3 steps?

Step 1 – Become a registered nurse

Graduating from nursing school is the first step to becoming a director of nursing. There are several degree pathways you can choose to take to become an RN.

Earn a nursing degree

You can enter the nursing profession with the minimum of an Associate Degree in Nursing (ADN) and gain experience as you advance your education. Most management positions will require a minimum of a Bachelor of Science in Nursing (BSN) degree. Bridge programs such as the RN to BSN program are a cost-effective way to accomplish this. 

Pass the NCLEX exam

After completing either your ADN or BSN program, you are eligible to take the NCLEX. The NCLEX is the board exam that allows you to practice as a registered nurse. This pass/fail test will assess your nursing knowledge and understanding of clinical concepts.

Earn an advanced degree

Larger health systems may require a Master of Science in Nursing (MSN). RN to MSN programs are also available to get you to your end goal faster. Many schools offer these programs online.

You work hard for your degrees and license. Don’t let them lapse! Each state has their own licensing and renewal requirements that must be met. Incredible Health offers free continuing education courses to make renewals easy.

Step 2 – Accumulate experience

Directors of nursing often have years of professional experience as a nurse. You have to master the clinical aspect of nursing and gain the expertise to lead which takes time and can’t simply be taught.

Helpful skills and experience

Being familiar with the roles of your colleagues is essential to understanding their concerns and meeting their needs. Staff nurses are much more likely to respect the rules and perspectives of a director of nursing if they know their boss has been in their shoes before.

It’s also usually a requirement for you to have supervisory experience. Not everyone is meant to be a leader. Effective leaders are not afraid to delegate tasks, discipline, or make decisions for the greater good.

Changing your specialty to a director of nursing 

As you gain experience in nursing you may feel called to change your specialty or seek a new challenge. You may stand out as a resource to colleagues and a dependable nurse with useful ideas. These skills alone may earn you a promotion as a director of nursing. Often, nurses desire a position away from the bedside yet still want to be involved in clinical outcomes.

It’s helpful if you have experience in the setting you will be supervising. For example, if you apply for a position as a director of nursing of an outpatient surgical center, it’s helpful if you have experience in surgery as an operating room nurse or PACU nurse. This gives you an advantage in understanding the expectations of staff and patients. 

Incredible Health offers resume and interview resources to help you land your new role.

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Step 3 – Obtain certifications

Certifications are proof of mastering a skillset and can help you advance as a leader. 

The DNS-CT (Director of Nursing Services-Certified) is one certification that indicates your leadership strengths and ability to improve facilities. To be eligible for this certification you must:

• Hold an active RN license
• Obtain 2 years of full-time post-acute experience, with at least one year as a DNS or other similar leadership experience
• Take the DNS-CT courses and exams and pass with an 80% score or better

The Certified Director of Nursing Exam (CDONA) is a certification for nursing directors in long-term care. The only prerequisite for this certification is that you have been employed or volunteered as a director of nursing for at least 1 year.

What are the additional requirements of directors of nursing? 

Directors of nursing must be flexible. While this is often a salaried position with 40-hour work weeks, administrative roles often require you to frequently work longer days and fill in staffing holes. Be prepared for phone calls and emails that require your response even when away from the office.

As a problem-solver, you must be:

• Patient
• Able to manage and prioritize your time 
• Remain calm under pressure

What are the salary and career outlooks for directors of nursing? 

Management positions are expected to come with larger salaries to match the increase in responsibilities. This list shows the average director of nursing salary by state. California is usually the highest paying state for nurses, but Nevada has the highest annual salary at $102,573 while the national average is $90,335.

The expected career growth for medical and health services managers is astounding. Employment is expected to grow 32% within the decade, faster than the average for most occupations.

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Job satisfaction

Burnout is a common finding in healthcare workers, with approximately two-thirds of nurses impacted. Factors contributing to the burnout of directors of nursing are their professional responsibility and lack of work-life balance. Not only are you responsible for patients and staff, but you must ensure documentation is compliant with regulations.

Luckily, as a director of nursing, you are in a position to make lasting changes to the healthcare system. You have the authority to propose and implement schedule alterations, documentation procedures, and mental health programs. This can be very rewarding.

Next steps 

As a director of nursing, you likely enjoy managing, making decisions, and the dual responsibilities of nursing and business. The next administrative step is to become a Chief Nursing Officer (CNO). This is a top nursing executive position that often works directly with the CEO of a hospital and oversees all nursing services.

This position at the very least will require a Master’s degree or higher. It’s beneficial to also have additional degrees in business administration, such as a Masters in Business Administration (MBA). 

Incredible Health is here to help you succeed in your nursing journey. Along with our many career resources, we offer access to real-life answers on our nurse advice forum.

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Nurse Types / Aesthetic Nurse Practitioner

Aesthetic medicine is a specialty that has gained exponential popularity within the past two decades. Research shows that the aesthetics injectables market will continue to grow at least 12% per year for the next 5 years. As the interest in beauty and anti-aging trends increase, so will the demand for aesthetic practitioners.

Working as an aesthetic nurse practitioner is a dream for some nurses, but this highly competitive specialty takes dedication, experience, and sometimes the right connection. Keep reading to learn more about this niche role and what you can expect as an aesthetic nurse practitioner.

• What is an aesthetic nurse practitioner?
• What do aesthetic nurse practitioners do?
• Where do aesthetic nurse practitioners work?
• What are closely related fields?
• How do you become an aesthetic nurse practitioner in 3 steps?
• What are the additional requirements of aesthetic nurse practitioners? 
• What are the salary and career outlooks for aesthetic nurse practitioners?

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What is an aesthetic nurse practitioner?

An aesthetic nurse practitioner (NP) is an advanced practice registered nurse who has received specialized training to provide cosmetic procedures to patients. Depending on the practice, services may be limited to facials and fillers. Aesthetic NPs may also assist plastic surgeons in more invasive surgical procedures.

Qualities of a successful aesthetic nurse practitioner

• Personality. Your bedside manner must be personable and professional. Since you’re consulting with patients before their procedure and hopefully building a long-term relationship, they need to feel like they can trust you.
  
• Clinical judgment. NPs possess advanced education and training. Even when working under the guidance of a physician you are usually given autonomy to make decisions. If you are running your own practice, patient outcomes depend on your judgment.
  
• Expert anatomical understanding. Injecting toxins into someone’s face requires expert knowledge. Your anatomy training goes beyond the basics to include the nerves and vessels below the skin.

What do aesthetic nurse practitioners do?

Aesthetic NPs have a unique opportunity to function as an assistant to a physician or surgeon or work autonomously in their own practice setting. Your advanced degree allows you to provide the following:

• Consultation and interviewing before a procedure
• Pre and post-operative care
• Hands-on assistance with surgical procedures
• Follow-up assessment to monitor recovery
• Injection or administration of aesthetic and cosmetic services

If you own your practice you may take an even larger role as you provide most, if not all, services. Depending on the size of the practice, you may schedule appointments, perform consultations, and provide the service. 

A day in the life of an aesthetic nurse practitioner

Let’s consider you’re an aesthetic NP working in a thriving medical spa with a full staff. There will be receptionists to answer calls, field emails, and schedule or confirm appointments. Additional medical staff such as a medical assistant or nurse may complete intake histories or vital signs. 

Your role as the NP will likely be to consult with the patient, perform a medical screening, or prepare them for their procedure. You may provide education, describe what to expect from the procedure, and offer discharge instructions. 

If you have your own clients, their complete care may be under your direction as you listen to their goals, examine their skin, and prescribe the best treatment for them. You will then provide the service such as botox or collagen injections. You will continue to follow-up with your patients and monitor and adjust further treatments based on their results.

Regardless of the setting, aesthetics usually operate on a 9-5 schedule. Medical spas and outpatient clinics are not open on holidays and rarely on weekends. Your patient encounters are always scheduled so you know what to expect and can prepare accordingly. 

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Common conditions treated by aesthetic nurse practitioners

The type of services and procedures provided by aesthetic NPs is wide and varied. It will depend on the type of practice. A cosmetic office that offers surgical procedures may employ aesthetic NPs to assist with the following under the supervision of a surgeon:

• Abdominoplasty (tummy tuck)
• Liposuction
• Rhinoplasty
• Facelift
• Hair transplants
• Breast augmentation or reconstruction
• Mohs surgery
• Burn repairs

Aesthetic NPs who either own their practice or provide non-invasive services may offer:

• Dermal fillers
• Botox or other neurotoxin injections
• Laser hair removal
• Chemical peels
• Microneedling
• Sclerotherapy
• Coolsculpting
• Tattoo removal

Where do aesthetic nurse practitioners work?

Aesthetic medicine normally does not take place in an acute care setting. Hospitals that provide plastic surgery are likely necessary for improved functionality or quality of life, not luxury. Aesthetic NPs will most likely work in outpatient settings like:

• Medical spas
• Dermatology offices
• Outpatient surgical settings
• Plastic & cosmetic surgery clinics
• Privately-owned medical offices

What are closely related fields?

Aesthetic NPs have a desire for beauty and to build the confidence of their clients. You may choose a surgical specialty that offers patients improved quality of life through weight-loss procedures or facial reconstruction. Similar specialties include:

• Plastic surgery nurse
• Aesthetic/cosmetic nurse
• Ophthalmic nurse
• Otorhinolaryngology (ENT) nurse
• Bariatric nurse practitioner

How do you become an aesthetic nurse practitioner in 3 steps?

Step 1 – Become a registered nurse

The first step to any nurse practitioner specialty is to become a registered nurse. 

Earn a degree

A nurse must start with either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree. Nurses who already possess an ADN can easily obtain their BSN in about a year through an RN to BSN program. 

If you have a degree in an unrelated field you can earn an Accelerated Bachelor of Science (ABSN). This usually takes 1-2 years to complete.

Pass the NCLEX exam

Obtaining your associate’s or bachelor’s degree in nursing prepares you for the NCLEX. This exam tests your ability to apply nursing concepts into practice. Passing the NCLEX allows you to begin working as a registered nurse.

Step 2 – Accumulate experience

Helpful skills and experience

It is recommended to work for at least a year or two in nursing before advancing your credentials. Real-world experience as a nurse with patients is crucial to developing critical thinking skills and nursing judgment. 

Breaking into the aesthetic industry isn’t easy, especially as a new nurse. Don’t give up on your dream if you aren’t able to find a job in aesthetics immediately. It may take a personal connection, an internship, or simply luck to land a job in this competitive field. 

Aesthetic nurse practitioners often begin as a nurse injector or another role within aesthetics. Some practices may agree to train nurses without additional certifications or degrees. This experience is vital before you continue to devote time and money to an advanced degree. 

Changing your specialty to an aesthetic nurse practitioner 

Nurses with acute care experience such as in the ICU, emergency room, or med-surg are valued in aesthetics because of their ability to assess, manage complications, and respond if an emergency occurs. 

Aesthetic nursing is vastly different in terms of the patient population from most nursing specialties but your time management, judgment, and communication skills will continue to be an asset.

Step 3 – Obtain additional education and certifications

Advance your education

Becoming a nurse practitioner requires a graduate degree of a Masters of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). The BSN to MSN program is often the fastest and most cost-effective path to becoming an NP.

You will likely choose a Family Nurse Practitioner program that prepares you for the American Nurses Credentialing Center (ANCC) certification exam to obtain your APRN license.

Obtain certifications

If you aren’t already immersed in the aesthetic medicine world, getting certified is your next step. Many spas and cosmetic institutes provide hands-on training. 

• American Med Spa Association offers injection training for medical professionals. 

• Esthetic Skin Institute offers accredited courses in cities around the country. 

• The American Association of Aesthetic Medicine and Surgery (AAAMS) offers accredited beginner-level courses on botox and fillers up to advanced liposuction and rhinoplasty training and more. 

For aesthetic NPs working in plastic surgery centers or providing more advanced procedures, the Plastic Surgical Nursing Certification Board (PSNCB) is for nurses who have at least 1,000 hours in the specialty and work in collaboration with a Board-Certified physician. The two certification routes include:

• Certified Aesthetic Nurse Specialist (CANS)
• Certified Plastic Surgical Nurse (CPSN)

What are the additional requirements of aesthetic nurse practitioners? 

Aesthetic nursing is a new and evolving field. Cosmetic treatments continue to grow and revolutions in anti-aging, beauty, and weight loss are highly sought after. 

Aesthetic NPs must stay on the cutting-edge of treatments and techniques. This likely involves additional certifications, conferences, and continuing education.

What are the salary and career outlooks for aesthetic nurse practitioners? 

Salaries in aesthetic nursing vary greatly. California pays the most, with aesthetic nurse practitioners making an average of $102,571. This is below the average NP salary in the US of  $118,040 in 2021. Aesthetic nurse practitioners who are ambitious to open their own practices have the opportunity to make a higher income based on their location, certifications, and hours.

Nurse practitioners are among the highest-paid nursing specialties and are in high demand. The growth of NPs is expected to increase by 45% this decade. 

Job satisfaction

Aesthetic nursing is often a fulfilling career. If you are seeking this specialty you likely have a vested interest in beauty and making others feel their best. The benefits of aesthetic nursing include:

• Stable weekday hours often without weekend requirements 
• Appointments are scheduled with little deviation 
• Work environments are often calm, welcoming, and luxurious
• Services are elective and insurance usually isn’t involved
• Dress code is often fashionable or scrub attire
• Patients are pleasant and healthy enough to receive services

Next steps 

The transition from interested student to practicing aesthetic nurse practitioner requires a generous commitment of time and effort. Though a highly competitive specialty, as the aesthetic and cosmetic industry continues to grow, there will be a demand for more aesthetic nurse practitioners. 

Whether you desire to be a part of an upscale medical spa or dream of opening your own one-nurse practice, this specialty offers a unique opportunity not found in other areas of nursing. 

If you’re starting at square one with the intention of becoming an aesthetic nurse practitioner, our nurse advice forum is the perfect place to learn from other nurses. Incredible Health’s career resources can also help you plan and prepare for your nursing goals.

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Nurse Types / Ambulatory Care Nurse

Ambulatory care nurses provide medical care to patients outside of the hospital. Patients are often seen for follow-up treatment, observation, tests, or same-day surgeries. Ambulatory care is often described as a busy yet fun environment with less stress.

Nurses seek this specialty for a healthier work/life balance while still maintaining hands-on skills and interacting with less critical patients.

Ambulatory care nursing is a growing field open to nurses of all backgrounds and experience levels. Whether you are a new graduate nurse or interested in changing your specialty, this article will cover the following to help you decide whether ambulatory care is right for you:

• What is an ambulatory care nurse?
• What do ambulatory care nurses do?
• Where do ambulatory care nurses work?
• What are closely related fields?
• How do you become an ambulatory care nurse in 3 steps?
• What are the additional requirements of ambulatory care nurses? 
• What are the salary and career outlooks for ambulatory care nurses?

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What is an ambulatory care nurse?

Ambulatory care nurses provide non-acute medical care usually in outpatient settings. They may treat a specific population or a mix of patients such as:

• Pediatrics
• Geriatrics
• Families 
• Communities 

One way to differentiate between an ambulatory care nurse from other types of nursing is to consider the word ‘ambulate.’ A patient typically ambulates, or walks, into a clinic, office, or outpatient facility to receive treatment from this type of nurse, and is not brought in due to an emergent situation. 

Qualities of a successful ambulatory care nurse

Ambulatory care nurses often work in fast-paced settings and transition between tasks and patients frequently. These are some of the traits that make for a successful ambulatory care nurse:

• Communication. As an ambulatory care nurse, you may treat a revolving door of patients throughout the day and must be able to communicate clearly not only with patients but with your colleagues and other healthcare providers to ensure safe and timely care.

• Attention to detail. While most patients you will care for are stable and not experiencing life-threatening emergencies, nurses must be alert for changes and concerns. A patient receiving a simple procedure may have a rare allergic reaction or a sudden change in condition that requires prompt recognition and intervention.

• Time management. Prioritization can make or break your day. From coordinating follow-ups, administering medications, performing intake assessments, triaging, and more, the responsibilities of the ambulatory care nurse are varied. The ability to manage your time effectively keeps you, your patients, and your coworkers on schedule.

What do ambulatory care nurses do?

One advantage of ambulatory care nursing is interacting with different patients and performing a multitude of tasks and skills. It’s never boring and each day can bring something new. You will likely provide many of the following services:

• Hold telehealth consults to follow-up with patients  
• Conduct health education on treatments, illnesses, and medication
• Start IVs for procedures and administer sedatives or medications
• Assess and monitor vital signs
• Delegate tasks to other staff members
• Coordinate care between other healthcare providers
• Triage or answer health questions telephonically
• Draw lab work or obtain cultures and specimens
• Assist with procedures, tests, and simple surgeries
• Perform wound care, suture removal, or splinting

A day in the life of an ambulatory care nurse

Ambulatory care nursing is very different from the day-to-day activities of an acute care hospital nurse. You won’t likely experience seriously ill patients or manage complex situations. Each setting and specialty will have different functions, but you can usually expect a scheduled day unless you work in a walk-in clinic. 

Another difference is that ambulatory settings often operate according to normal business hours and aren’t open on weekends or holidays. This can be a huge advantage for some nurses. 

Your day may begin with administrative tasks, preparing charts, or making phone calls. As patients arrive you will check them in or perform intake assessments including vital signs and possibly starting IVs if the patient is undergoing a procedure. 

Depending on the reason for the patient’s visit you may monitor them after a procedure, follow up on a chronic issue, or educate them on symptoms, diets, or medications. As you monitor or discharge a patient you will document accordingly. 

Throughout the day you may make phone calls, respond to secure messages, or complete telehealth visits. Your role may also include administrative duties like monitoring equipment and stocking supplies.

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Common conditions treated by ambulatory care nurses

Along with the opportunity to provide hundreds of procedures, you will encounter various patient conditions depending on your specialty.

Ambulatory surgery nurses may assist with:

• Colonoscopies
• Biopsies
• Weight-loss surgeries
• Eye procedures
• Endoscopy procedures

Ambulatory care nurses in medical offices may treat common chronic conditions like:

• Asthma
• Diabetes
• Congestive heart failure
• Hypertension

Ambulatory care nurses in specialty settings may interact with more niche patients. For example, if you are in an ambulatory wound care clinic, your patients may often present with pressure ulcers, surgical wounds, or ostomies.

Where do ambulatory care nurses work?

The AAACN defines a characteristic of ambulatory care nursing as a patient encounter that can occur once or as a series of interactions that last less than 24 hours. Some hospitals may have ambulatory care units, but ambulatory care centers operate differently from the hospital and do not treat critical patients. Common settings for ambulatory care nurses include:

• Private or specialty medical clinics or offices
• Primary care offices
• Ambulatory surgery or diagnostic procedure centers
• University or college health clinics
• Veterans Administration facilities
• Freestanding community clinics

What are closely related fields?

Ambulatory care nurses have the unique opportunity to interact with patients, continue to provide nursing-specific care, and make a difference without the stress of a hospital environment. The common theme is an outpatient setting similar to:

• Urgent care nursing
• Dialysis nurse
• Public health nursing
• Radiology nursing
• Outpatient clinic nurse
• Pain management clinic
• Chemotherapy infusion or oncology offices

Another central theme of ambulatory care nursing is surgical services. Closely related surgical roles include:

• Surgical/perioperative nurse
• Post-anesthesia care unit (PACU) nurse
• Cardiac Cath lab nurse

How do you become an ambulatory care nurse in 3 steps?

Whether you are a new graduate nurse or a nurse looking for a change, ambulatory care nursing is a great specialty to hone your skills or change your pace. 

Step 1 – Become a registered nurse

Attending nursing school and obtaining a nursing degree is the first step to this specialty.

Earn a BSN degree 

A Bachelor of Science in Nursing (BSN) degree is often recommended by most employers and sets you apart from other candidates. It may make switching from another specialty to ambulatory care nursing easier. If you are already an RN with an Associate Degree in Nursing, there are many options for obtaining a BSN degree.

The RN to BSN program a great way to save time and money. You can continue working while you finish your degree.

If you are interested in entering the ambulatory care field from another profession and already hold a bachelor’s degree, an Accelerated Bachelor of Science in Nursing (ABSN) is another option.

Pass the NCLEX exam

After graduating from nursing school, you must pass the NCLEX to assess minimum competency as an RN. Modifications were introduced to the NCLEX due to the pandemic, though difficulty and passing standards were not impacted. The minimum exam length remains at 75 questions, though the maximum number of questions is 145 items. Candidates have five hours to complete the exam.  

Step 2 – Accumulate experience

While this specialty often accepts new graduate nurses, it is in your best interest to have at least 1-2 years of experience as a nurse. 

Helpful skills and experience

Many of the skills needed for ambulatory care nursing can be learned on the job, but it will be less of a learning curve if you have a few years of acute care experience. The reason for this is you will be transitioning between different patients, scenarios, diseases, and skills frequently. Having confidence in your assessment skills and clinical knowledge will allow you to better serve your patients.

Changing your specialty to an ambulatory care nurse 

If you are a nurse considering a change to ambulatory care nursing, being proficient with the patient population you will be caring for will be a huge advantage. For example, if you have experience in telemetry, your skills will translate perfectly to a cardiology ambulatory clinic. 

Incredible Health offers a wide variety of free continuing education courses. These courses are valuable for nurses transitioning into a new specialty and offer education on conditions and patients you may not have direct experience with.

[ MORE: Earn your CEUs online, 100% free with Incredible Health. ]

Step 3 – Obtain certifications

• American Academy of Ambulatory Care Nursing (AAACN) offers nurses the opportunity to take an extra step in their specialty. This certification is for you if you wish to increase your credibility, validate your knowledge, and potentially increase your position and earning power.
• Certified Ambulatory Perianesthesia Nurse (CAPA) is for nurses who work in an ambulatory surgery center. They regularly care for patients under sedation, analgesia, or anesthesia. This certification is proof of your commitment and excellence in the field. 

What are the additional requirements of ambulatory care nurses? 

Ambulatory care nurses should be empathetic, personable, team players. You will have frequent and nearly constant contact with patients and staff. You will collaborate daily with healthcare providers and act as part of a multi-disciplinary team.

Critical thinking and clinical judgment abilities are also very important. Triaging is often a large component of some ambulatory care settings. You may triage patients in person, over the phone, or virtually and must have strong clinical and nursing judgment experience to appropriately manage patient questions and concerns.

What are the salary and career outlooks for ambulatory care nurses? 

Median salaries for ambulatory care RNs range from approximately $75K-85K, depending on the location. The lowest hourly income is around $28 while the highest can be $45 or more. 

Ambulatory care resources are growing to accommodate patient needs and changing healthcare access trends. Nurses are needed in roles and settings beyond the bedside. 

Job satisfaction

One study conducted on ambulatory care nurses in an oncology setting found over 80% of nurses were satisfied with their job and over 87% intended to stay. 

Consistent work hours that align with family schedules are often a benefit to nurses. If you are interested in escaping 12-hour shifts or mandatory weekends, ambulatory care nursing may offer improved job satisfaction. Ambulatory surgery centers often operate on four 10-hour shifts and are usually closed on holidays. 

If you are an acute care nurse who is easily stressed from high-acuity patients or heavy workloads, ambulatory care nursing offers a more scheduled, predictable environment with less uncertainty.

Next steps

If you are an ambulatory care nurse who is interested in advancing your career, consider a certification in your specialty. Another option is advancing your education by obtaining your Master of Science in Nursing (MSN) degree or becoming a Nurse Practitioner to have a larger role in supervising or performing advanced procedures.

Incredible Health’s real nurse advice community is always available to answer your questions and help you navigate the many options and opportunities available. Don’t forget to check out our career resources for interview and resume tips to help you land your ambulatory care dream job.

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Nurse Types / Registered Nurse / RN to MD

If you’re an experienced nurse who is eager to advance your career, the RN to MD path is a great option. Being an RN is often the easiest way to begin a medical career.

Maybe medical school seemed too hard or expensive in the past. Or raising a family took priority over career achievements. Whatever the reason, if you are feeling the urge to take on medical school, let Incredible Health guide you from becoming a registered nurse to a medical doctor.

• What are some reasons to go from RN to MD?
• What are the steps to becoming an MD?
• How much does medical school cost?
• What are alternatives to an MD?

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What are some reasons to go from RN to MD? 

Focus on a specialty. One of the greatest benefits in healthcare is experiencing different patient populations and specialties. As a nurse, you may discover you have a passion for pediatrics or crave being in the operating room. You can expand on this as an MD by delivering babies or performing complex surgeries.

Spark change. While all medical professionals can improve the outlook of healthcare, physicians are often given the opportunity and funding for research. MDs are often pioneers in innovative technology and hold roles on medical boards, in prestigious medical schools, and in research facilities.

Better pay. Let’s be honest. Physicians (specifically surgeons) are the highest-paid medical professionals. If your goal is to maximize your income, this is one way to do it. It’s highly recommended this not be your only reason as the increase in pay comes with substantial responsibility.

A desire to advance. If you are experiencing a strong interest and desire to advance your education, credentials, and patient care, this may be the motivation you need to be successful.

The career outlook for RNs vs MDs

The job outlook for registered nurses is expected to increase by .

However, the employment outlook for MDs is projected to grow 3% from 2021 to 2031.

Since MDs tend to be more specialized career paths, there are usually fewer of them. There is still a need for physician services as our population continues to grow and age with an average of 22,700 job openings each year. 

Salary 

Salary differences between RNs and MDs vary depending on experience, location, and specialty. According to the Bureau of Labor and Statistics, the median annual salary for physicians and surgeons in 2021 is over $208,000, or $100 per hour. 

The average RN salary is $82,750 or $39.78 per hour. See how your nursing salary stacks up to nurses in other states.

Level of responsibility 

One area to consider is the degree of responsibility that comes with being a licensed physician. As an RN, you understand the importance of the actions you take each day and the potential consequences they can have on the lives of your patients. The responsibility is increased as a doctor who is diagnosing, prescribing, and making critical decisions. 

As an MD, you must be prepared to be a leader. You need to remain confident in your judgment, stay up to date on evidence-based practices, and collaborate with your colleagues when additional expertise is needed. 

What are the steps to becoming an MD?

Educational requirements 

A nurse must first possess a Bachelor of Science in Nursing (BSN). This is likely to meet prerequisite requirements, though this will depend on the medical school you choose. If you don’t have a BSN, there are bridge programs that can help you achieve an RN to BSN degree. 

Take the MCAT

The Medical College Admission Test, or MCAT, is a multiple-choice examination that assesses problem-solving, critical thinking, and knowledge of principles related to medicine. This exam is taken to determine your eligibility before applying to medical schools. According to the Association of American Medical Colleges, the type of content on the MCAT is learned in prerequisite courses such as chemistry and biology which are covered in nursing school.

Apply to medical school

The American Medical College Application Service (AMCAS) makes it easy to apply to medical schools. AMCAS collects and verifies your MCAT score, coursework and official transcripts, and letters of evaluation and submits them to the medical schools you designate.

Attend medical school

Congratulations! You’ve been accepted to medical school. Now the real work begins. As a nurse, you’re familiar with the dedication and time commitment a healthcare degree requires. Just like with most nursing programs, the first two years include a mixture of classroom and lab time. You’ll build on your ability to assess patients by adding in the complexities of diagnosis, pharmacology, and pathology. How long is medical school is an essential consideration when planning your transition from RN to MD. On average, it takes 4 years to complete medical school, followed by 3 to 7 years of residency training depending on your chosen specialty.

Attend a residency program or fellowship

Next comes clinical experience. Again, you may feel a sense of deja vu back to the days in nursing school when you were a student learning from your nursing instructor and preceptor. The stakes are higher now as you are not following doctor’s orders, but deciding them. Now is the time to hone your skills and decide on a possible specialty. 

Just like nursing school, you’ll experience rotations in hospitals and clinics from surgery to pediatrics. Residency programs last anywhere from 3 to 7 years, with surgical residencies on the longer end.

After residency, you may choose to obtain further specialized training through a fellowship. Fellowships are not required but provide 1-3 additional years of subspecialty training in areas such as anesthesia, neurology, gastroenterology, and more.

How much does medical school cost?

Attending medical school isn’t cheap. The cost will depend on the school you choose and its location. The average total cost of a medical school degree is $218,792 which equals over $54,000 per year. Medical residents do make a small annual salary of around $60,000 which is just enough to cover a year of tuition and not much to live on. 

How to pay for it

Paying for medical school is often a huge barrier for students. It’s very common for MDs to begin practicing with hundreds of thousands of dollars in debt. For RNs transitioning to MD, it’s very likely you’re also supporting a family and have other financial commitments. It’s imperative to consider the cost of medical school and the health of your finances before applying. 

While student loans are the most obvious course for paying for medical school, there are other options. Some medical schools may offer financial aid. Scholarships are another possibility and there are numerous loan forgiveness or repayment programs, especially for public service careers.

What are alternatives to an MD?

If you feel a calling to advance your degree, there are several career paths for RNs that can save you years of additional school and thousands of dollars in student loan debt. Advanced Practice Registered Nurses (APRNs) are alternatives to medical doctors. They are nurses who specialize in certain areas, such as the following:

Nurse practitioner (NP)

Nurse practitioners often work directly under the supervision of an MD or PA (physician’s assistant). This advanced education provides you with autonomy and opens up opportunities to have your own practice in some settings such as aesthetics. NPs usually work in primary care or family practice offices but may also assist in acute care settings.

Certified registered nurse anesthetist (CRNA)

CRNAs are the highest-paid APRNs, earning an average of $202,470. Becoming a nurse anesthetist is perfect for you if you like surgical settings and have extreme attention to detail as you will be administering anesthesia.  

Certified nurse midwife (CNM)

Nurse midwives often work with OB/GYN providers and take an active role in supporting pregnant patients and delivering babies. The advanced skills and training prepare you for high-risk pregnancies and working in hospitals, birthing centers, or caring for patients in their homes.

If you’re feeling stagnant in your nursing job and are craving a challenge or a new adventure, there are more types of nurses than you can imagine. 

Next steps

Transitioning from RN to MD isn’t an easy feat and requires a time and financial commitment that deserves contemplation and preparation. As a nurse, you possess the tenacity to achieve any goals you set for yourself, and the Incredible Health team is here to support you. You can receive advice from real nurses by asking questions in our nurse community.

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