A registered nurse (RN) is a licensed healthcare professional who assesses patients, creates care plans, administers treatments, and coordinates with doctors and other providers to manage patient health. While many people picture an RN taking vitals and giving medications, the role is far broader, spanning independent clinical judgment, patient education, team leadership, and advocacy. About 59% of RNs work in hospitals, but the profession extends into clinics, schools, government agencies, and long-term care facilities.
Core Responsibilities of an RN
Everything an RN does revolves around a five-step process known as ADPIE: assessment, diagnosis, planning, implementation, and evaluation. It’s a repeating cycle that applies whether a nurse is caring for a post-surgical patient in a hospital or managing chronic conditions in an outpatient clinic.
Assessment comes first. The RN gathers vital signs, reviews medical history, and evaluates a patient’s physical, psychological, and emotional state. This isn’t just checking boxes. It requires interpreting what the data means, spotting patterns, and identifying problems that might not be obvious. Based on that assessment, the RN formulates a nursing diagnosis, a clinical judgment about the patient’s condition that guides the rest of care. This is distinct from a medical diagnosis made by a physician. It focuses on how the patient is responding to their illness or situation and what nursing interventions can help.
From there, the RN builds a care plan with short- and long-term goals, then puts it into action: administering medications, performing procedures, educating the patient and family, and delegating tasks to other nursing staff. Finally, the RN evaluates whether the plan is working and adjusts it as needed. This cycle repeats throughout a patient’s stay or treatment.
How RNs Differ From LPNs
Licensed practical nurses (LPNs) and RNs both provide direct patient care, but their scopes of practice are significantly different. RNs are responsible for the initial comprehensive assessment of a patient. LPNs can collect data, but they cannot independently interpret clinical findings or perform that first full assessment. RNs also formulate nursing diagnoses and develop care plans. Both of these are outside an LPN’s scope of practice.
On the implementation side, RNs direct and supervise LPN practice, not the other way around. When a patient becomes unstable, the RN assumes primary care. Certain clinical tasks, including specific components of intravenous therapy, are restricted to RNs. In short, the RN carries greater independent decision-making authority, particularly in complex or rapidly changing situations.
Patient Advocacy and Care Coordination
One of the less visible but most important parts of an RN’s job is coordinating care across providers and settings. RNs develop care plans guided by patients’ needs and preferences, educate patients and families at discharge, and work to maintain continuity of care when a patient moves between a hospital, a rehab facility, and home. They act as the connective tissue between physicians, therapists, social workers, and the patient’s own goals.
This coordination role also involves advocacy. If a patient doesn’t understand their treatment options, the RN explains them. If a care plan isn’t working or a patient’s condition changes, the RN is typically the first to flag it and push for adjustments. Because nurses spend more continuous time with patients than most other providers, they often catch subtle changes in condition before anyone else on the care team.
Where RNs Work
Hospitals employ the majority of registered nurses, accounting for 59% of the workforce. The next largest setting is ambulatory healthcare services (outpatient clinics, surgical centers, urgent care) at 19%. Nursing and residential care facilities employ about 6%, government roles outside of hospitals and education make up 5%, and educational services account for 3%. Within these settings, day-to-day work varies enormously. A nurse in an emergency department triages incoming patients under time pressure. A school nurse manages chronic conditions like asthma and diabetes across hundreds of students. A clinic nurse might spend most of the day on patient education and follow-up calls.
Specialties and Career Paths
After gaining experience, RNs can specialize in dozens of areas and earn board certifications to formalize that expertise. Common specialty certifications include medical-surgical nursing, cardiac-vascular nursing, pediatric nursing, psychiatric-mental health nursing, pain management, and gerontological nursing. Nurses who want to move into leadership can pursue nurse executive certification. Those interested in technology and data can specialize in nursing informatics.
RNs can also pursue advanced practice roles by earning a graduate degree. Nurse practitioners, for instance, can diagnose medical conditions and prescribe medications in most states. Advanced practice certifications include family nurse practitioner, psychiatric-mental health nurse practitioner, and adult-gerontology acute care nurse practitioner, among others. These roles come with greater autonomy, broader scope of practice, and higher compensation.
Education and Licensing
Becoming an RN requires completing an approved nursing education program. The two most common pathways are an Associate Degree in Nursing (ADN), which typically takes two to three years, and a Bachelor of Science in Nursing (BSN), which takes four years. Both qualify graduates to sit for the NCLEX-RN, the national licensing exam that every registered nurse in the United States must pass. Some employers, particularly hospitals pursuing certain quality designations, prefer or require a BSN.
After passing the NCLEX-RN, nurses are licensed by their state’s board of nursing. Licensure must be maintained through continuing education, and requirements vary by state. Many nurses who start with an ADN later complete an RN-to-BSN bridge program while working, since a bachelor’s degree opens more doors for advancement and specialization.