Nurses assess patients, administer medications, develop care plans, and serve as the primary point of contact between patients and the rest of the healthcare team. While the specific tasks vary by setting and experience level, the core of nursing is a continuous cycle of evaluating a patient’s condition, planning care, carrying out treatments, and checking whether those treatments are working. The median annual salary for registered nurses was $93,600 in 2024, and employment is projected to grow 5 percent over the next decade.
The Core Clinical Cycle
Every nurse’s work revolves around a four-step process: assessment, planning, intervention, and evaluation. Assessment means collecting and analyzing data about a patient’s health, from vital signs and symptoms to lab results and how the patient says they feel. That information feeds into a nursing diagnosis, which is different from a medical diagnosis. A doctor might diagnose pneumonia; a nurse identifies that the patient is struggling to breathe effectively and is at risk for dehydration.
From that nursing diagnosis, the nurse builds a care plan with specific goals and priorities. Intervention is where the hands-on work happens: administering medications, changing wound dressings, repositioning a patient to prevent bedsores, adjusting oxygen flow, or teaching a patient how to manage a new condition at home. Evaluation closes the loop. The nurse checks whether the patient is making progress, and if not, adjusts the plan. This cycle repeats continuously throughout a shift, sometimes hourly for critically ill patients.
Medication Administration
Giving medications is one of the most visible and high-stakes parts of a nurse’s job. Before any drug reaches a patient, nurses are required to confirm a set of safety checks often called “the rights of medication administration.” These include verifying the right patient, the right drug, the right dose, the right route (oral, IV, injection), and the right time. Errors at any step can cause serious harm, so hospitals build these checks into their electronic systems and expect nurses to follow them every single time, even during a chaotic shift.
Nurses also monitor patients for side effects and adverse reactions after a medication is given, flag drug interactions, and communicate concerns to the prescribing provider. In many situations, the nurse is the last safety checkpoint before a medication enters a patient’s body.
Documentation and Administrative Work
A significant portion of a nurse’s shift is spent on documentation. Electronic health records require nurses to chart vital signs, intake and output (how much fluid a patient drinks versus how much they produce), physiological assessments, wound care details, and daily care activities in digital flowsheets. They also maintain medication administration records, write clinical notes about patient progress, and update care plans.
On top of that, nurses track a patient’s journey through the hospital, from admission through any transfers between units to discharge. Many nurses describe documentation as one of the most time-consuming parts of the job. Common strategies for managing the workload include delegating certain patient care tasks to technicians to free up charting time, documenting only exceptions to normal findings, and catching up on less urgent notes at the end of a shift.
Shift Handoffs
At the start and end of every shift, nurses participate in a structured handoff, passing along critical details about each patient’s condition, recent changes, medications given, and what to watch for next. This step directly affects patient safety. Ineffective handoffs have been linked to medication errors, delayed treatments, longer hospital stays, and serious adverse events. Hospitals increasingly use standardized checklists and bedside handoff protocols to reduce those risks.
Patient Advocacy
Nurses spend more time with patients than any other member of the healthcare team, which puts them in a unique position to advocate. In practice, this means speaking up when a prescribed treatment doesn’t seem right for a patient, communicating concerns to doctors that a patient may be too intimidated to voice, mediating between family members and the medical team, and pushing back when a decision could put the patient at risk.
Advocacy can look like calling a physician at 2 a.m. because a patient’s pain isn’t being managed, or it can mean sitting with a family to explain what a diagnosis actually means in plain terms. Nurses describe themselves as “standing in the gap” for patients, acting as their voice when they can’t speak for themselves, whether due to sedation, confusion, language barriers, or simply not knowing what questions to ask.
Different Levels of Nursing
Not all nurses have the same training or authority. The profession has a clear hierarchy, and what a nurse can legally do depends on their credentials.
Licensed Practical Nurses (LPNs) complete about one year of training at a community college or technical school, then pass a national licensing exam. They provide basic patient care, including taking vital signs, assisting with hygiene, and administering certain medications. LPNs work under the supervision of a registered nurse, advanced practice nurse, or physician. They’re common in long-term care facilities and home health settings.
Registered Nurses (RNs) need either a two-year associate degree or a four-year bachelor’s degree in nursing, followed by passing the NCLEX-RN licensing exam. Many hospitals now prefer or require a bachelor’s degree. RNs have a broader scope: they assess patients independently, develop care plans, supervise LPNs and nursing assistants, administer a wider range of medications, and make clinical judgments about when to escalate care. RNs work in virtually every healthcare setting, from hospitals and clinics to schools and public health departments.
Advanced Practice Registered Nurses (APRNs) hold at least a master’s degree in nursing, and increasingly a doctoral degree. This category includes nurse practitioners, nurse anesthetists, clinical nurse specialists, and nurse-midwives. APRNs can diagnose conditions, order and interpret tests, and prescribe medications, including controlled substances in all 50 states (with some restrictions on specific drug schedules in a handful of states). In 22 states, nurse practitioners have full practice authority, meaning they can provide care with a level of independence comparable to physicians. In the remaining states, they work under varying degrees of physician oversight.
How Work Varies by Setting
A nurse in a hospital intensive care unit spends the shift monitoring critically ill patients on ventilators, managing IV drip rates, interpreting heart rhythms on a monitor, and responding to rapid changes in condition. An emergency department nurse triages incoming patients, stabilizes trauma cases, and moves quickly between patients with vastly different problems. A pediatric nurse adapts every assessment and communication technique for children and anxious parents, and may assist with end-of-life care for the youngest patients.
Outside hospitals, nurses work in outpatient clinics doing health screenings and chronic disease management, in schools monitoring student health, in home care helping patients recover after surgery, and in public health roles coordinating vaccination campaigns or disease surveillance. The core skills transfer across all of these settings, but the daily rhythm and specific tasks can look completely different.
Legal Boundaries
What a nurse can and cannot do is defined by law. Every state has its own Nurse Practice Act, a set of regulations that outline the scope of practice for each level of nursing, set standards for nursing education programs, define the licensing process, and establish grounds for disciplinary action. Nurses are legally accountable to the practice act in whichever state they’re currently working, not just the state where they got their license.
A system called the Nurse Licensure Compact allows nurses licensed in one of 34 participating states to practice in any other compact state without getting a separate license. However, they must still follow the laws of the state where they’re physically providing care. State boards of nursing have the authority to discipline nurses who violate these laws, up to and including revoking a license if a nurse poses a danger to the public.