RN Careers in Oklahoma: Becoming an RN
Registered nurses are essential to Oklahoma’s health. They plan, provide, and delegate nursing care. Their broad training allows them to carry out many tasks: those that require assessment and evaluation as well as those that require technical know-how and a steady hand.
RN Roles and Job Settings
The Board provides information about the nursing population as part of its annual report. More than half of Oklahoma’s RNs count the hospital as their work setting: 22,722 out of a total of 36,427 registered nurses employed within the state. Hospitals settings are diverse; the Oklahoma Hospital Association has provided a listing (http://www.okoha.com/OHA/Hospital_Directories/OHA/Directory/Hospital_List_Public.aspx?hkey=d87455ef-ec45-49ac-8fd6-fff05ad0116c).
The next largest groups (discounting the “other” category) are home health, ambulatory care, and long-term or extended care.
Board data confirms a general trend: Registered nurses in long-term care are more likely to be in nurse management positions. This is to be expected as there are more nursing personnel with credentials below that of RN. In nursing homes, one finds many nursing assistants carrying out basic nursing duties.
The vast majority of hospital RNs are staff nurses — 18,225 out of 22,772. 1,331 are nurse managers. Nurse executives number 375; nurse consultants, 79.
Of the 1,652 RNs employed in long-term care, 747 — not quite half – are staff nurses; 477 are nurse managers, 111 are nurse executive, and 78 are nurse consultants.
Of the 2,560 employed in home health, 1,205 are staff nurses, 783 are nurse managers, 170 are nurse executives, and 24 are nurse consultants.
There are other possible roles. A significant number, in fact, selected the “other” category.
The following, drawn from early 2018 Oklahoma job postings, give a sense of the diversity of RN emloyment:
- Remote Telephonic RN Case Manager
- Pain Center RN
- Pre-Op Registered Nurse
- Health Coach – Registered Nurse
- Health Care Management Nurse II
- RN Case Manager Home Health
Many RNs of course have fairly broad roles like “med surg” (medical surgical).
RN Training and Scope of Practice
RNs complete approved diploma or degree programs (RN programs in Oklahoma). Licensure is dependent on successful examination.
RNs have a scope of practice beyond that of LPNs. This means they are critical in a range of settings, even those where many duties are handled by LPNs and nursing assistants. IV medications are an example. An Oklahoma LPN can administer IV medication if he or she has had appropriate preparation, but an RN must be available for patient assessment. There are some settings where an RN would likely need to administer the treatment himself or herself; home health and hospice settings are unlikely to meet delegation criteria.
The Oklahoma Nursing Practice Act allows RNs to carry out duties beyond those included in the basic nursing program when they have been adequately prepared. An example is Sexual Abuse Nurse Examiner. The Oklahoma Board considers the International Association of Forensic Nurses to be the standard setter with regard to pediatric and adult/ adolescent sexual abuse examination.
Registered Nurse First Assistant is another role that requires training beyond what is include in a basic RN educational program. Here the Association of periOperative Registered Nurses (AORN) is the standard setter.
The Board has declared that school nursing is an RN specialty — e.g. not a specialty for nurses below this level.
Magnet hospitals reward excellent nursing care, excellent overall quality, and an excellent nurse work environment. Oklahoma boasts two magnet hospitals: INTEGRIS Baptist Medical Center in Oklahoma City and St. John Medical Center in Tulsa.
Some distinguished nursing students gain experience in premier facilities even before they’re licensed. St. John, for example, offers a senior nursing externship. The catch: It’s competitive. Up-and-coming nurses may find another opportunity straight out of college: residency. One of the current opportunities is a one year program on the St. John progressive cardiopulmonary renal unit.
Another new grad option is to complete a 16-week exploration program with the opportunity to interview in areas of interest after program completion. Among the specialties that participants are exposed to: med/ surg, medical telemetry, and pediatrics. It’s not necessary to wait 16 weeks, though, or to do post-college exploration. One can apply to other positions that note that new grads are welcome.
Critical Access Hospitals
Magnet hospitals tend to be large facilities. Small, rural hospitals offer unique challenges. Among their needs: highly skilled generalists.
Critical access hospitals are small facilities with 25 or fewer acute care beds. Two Oklahoma CAHs made the Becker’s Hospital Review list of “62 Critical Access Hospitals to Know” in 2017: Mercy Hospital- Kingfisher and Mercy Hospital-Logan County.
The Indian Health Service is another organization on the lookout for good nurses. Oklahoma represents one of 12 IHS geographic areas (https://www.ihs.gov/nursing/locations/).
Career Outlook, Salary, and Benefits
Oklahoma registered nursing has been predicted to see 14% occupational growth over the course of the 2014 to 2024 decade.
Oklahoma RNs earned average wages of $29.15 an hour in 2016. The Bureau of Labor Statistics figures this at $60,630 a year.
Medical centers are often able to offer very good benefits packages. Keeping their employees health is part of the strategy. The Oklahoma Hospital Association reports that the WorkHealthy Hospitals program has more than 40 hospitals and that it’s been very successful in the area of smoking cessation.
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