One day several years ago, my mother, then a resident of an assisted-living facility, didn't feel right. A licensed practical nurse checked her blood pressure and heart rate but found nothing wrong.

Fortunately, a registered nurse, who had more thorough training, recognized that my mother's pallor and breathing pattern suggested a serious problem related to congestive heart failure. She probably saved my mother's life.

At one time, all nurses received the same training. Now there are many types of nurses, and each represents a different level of training. Because nurses collectively are responsible for more direct patient care than any other type of health-care provider, it's important to know what the titles mean. Here's what I've learned over the years about each type of nurse…

  • Nurse assistants (NAs) help nurses perform their duties, such as taking blood pressure and changing bed pans. No formal training is required. Most NAs work in non-hospital settings, such as nursing homes or assisted-living facilities.
  • Licensed practical nurses (LPNs) must have a high school diploma and one year of additional training at an accredited hospital or community college program. LPNs work in hospitals, nursing homes, home care agencies and assisted-living facilities. They typically provide general care to patients, including changing bandages and monitoring catheters.
  • Registered nurses (RNS) must complete a two-year, community college RN program... a three-year, hospital-affiliated diploma program...or a four-year bachelor's degree program in nursing from an accredited university. They then must pass a state licensing examination.

Inside information: Studies show that the more RNs there are on a hospital staff, the better the care.

If you're hospitalized, make sure that, at a minimum, one RN is on your unit 24 hours a day.

Many RNs go on to become advanced practice nurses, requiring graduate-level educational courses at a university. Some of the most common types of advanced practice nurses...

  • Nurse practitioners (NPS) are highly trained RNs who are certified to handle some of the functions of an MD, such as diagnosing medical conditions and, in some states, prescribing medications. NPs, who often are employed by pediatricians and family doctors, treat less complicated problems, such as common viruses, ear infections and gynecological problems.
  • Certified registered nurse anesthetists (CRNAs) are RNs who have completed a two-year university program with extensive training in the administration and monitoring of anesthesia. They must pass a CRNA certification test.

Inside information: Although an anesthesiologist usually decides which anesthetic is used, it usually is administered by a CRNA. Ask to meet with either or both of them before the procedure.

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