Nurses have played a big part in the ever-evolving scope of health care over the years.
More opportunities and ever-increasing responsibilities and decision-making have made a nursing career more exciting than ever.
"Nurses now have the autonomy to craft their nursing practice," said Crystal Muthler, vice president of nursing and associate nursing officer at Geisinger Health System.
Muthler, a registered nurse for 32 years, has seen first-hand how things have changed in her profession.
No longer are nurses merely bedside practitioners.
"In the past, patients interacted with nurses when they were sick," said Muthler, who has worked as a staff nurse on a medical/surgical telemetry unit, an administrative supervisor and operations manager. "Today, nurses are involved in a person's care from early on and their wellness continuum through periods when they may be sick."
It can mean interacting with patients in their home settings and managing disease processes.
Nurses follow best practices medicine, striving to produce optimal outcomes.
Beyond that, nurses now have greater opportunities beyond the traditional hospital setting, Muthler said.
They write articles for national publications and lobby on behalf of good health care.
Joshua Pauling, a critical care nurse at Susquehanna Health, noted that nurses more than ever participate in the decision-making process for patients.
Nurses are likely to accompany physicians on their patient rounds and discuss strategy of care.
"It helps us with the plan of care," added Stacey Cole, a registered nurse for 22 years at Susquehanna Health.
Cole said nurses are expected more than ever to have a kind of one-on-one relationship with patients.
"Patients want that," she said. "They want to have nurses be empathetic."
Taking part in the decision-making process of patient care now falls more heavily on nurses.
"We go to physicians with our suggestions," Cole said. "They come to us more, and we go to them more."
It's all for the better, according to Muthler.
"They (nurses) want to be more involved now, and in the decision process," she said. "Research has shown that the more active they are in their care, the better they do."
Cole said the chance to help people is a big reason she chose a career in nursing.
She studied to become a nurse at Pennsylvania College of Technology and Lycoming College and hasn't looked back.
"It was everything I thought it would be," she said. "Every day there is something new to learn. You meet so many new people."
Being a nurse can mean making a difference in peoples' lives.
"It's a very fulfilling job," she said.
She conceded, however, that nursing has its ups and downs, too, and can be a physically and mentally challenging job.
Keeping up with the technology and the patient needs presents nurses with some of their biggest challenges.
"My expectations are high," she said. "I want to go in there and give my best."
She stared her career in orthopedics before eventually becoming a medical/surgical nurse.
Pauling, a nurse for five years, said he wasn't sure what his career path would be.
He pondered majoring in criminal justice but his thinking changed after meeting a male nurse at a job fair.
"He pushed the idea of flexibility in nursing," Pauling recalled. "It fed into my thought of going into a field where you serve."
And, he's found that there really do exist plenty of opportunities in nursing.
He's considering furthering his education to become a certified registered nurse anesthetist.
"There are so many more specialties nurses can go into. Nursing goes far beyond the hospital," Muthler said. "It's exciting for young people. Nursing is a place where you can be exposed to many different types of the care experience. You can be a hospital nurse, a cath lab nurse, or work for the health care plan. You really have a lot of choices."
Cole and Pauling noted that new technology has brought sweeping changes to health care.
"There are lots of safety things in place now," Pauling said.
Computerized physician order entries and electronic medical prescriptions have helped reduce patient errors.
The whole realm of medical records technology has helped streamline health care.
"I can't think of anything that is paper anymore," Cole said.
Muthler said she wonders precisely what health care will bring for nurses in coming years.
Her belief, she said, is that the career will present even more challenges and opportunities.
"Because of their clinical care expertise and critical thinking, I see them doing more," she said.