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Today nursing practices are performed in a wide range of settings, from hospitals to paying personal visits to peoples' homes. Educational institutions, like universities and schools, summer camps , pharmaceutical companies, non-profit organizations, or international organizations like the World Bank, hire nurses to work in occupational health settings, clinics and physicians' offices, elderly care facilities or cruise ships. This diverse medical profession can appear in diverse settings keeping its main goal identical in any situation; provide caring services to those in need. In pre-modern times, nuns and military officers often provided nursing services. In fact, the religious and military roots of modern nursing remain in evidence until today. For example, in Great Britain, senior female nurses are called "sisters" probably due to the people association with nuns. In recent times, nurses work within churches and community organizations in order to perform health education, counseling, provide referrals to community support agencies, and connect volunteers from the church community with those in need of assistance. Nursing flourished in response to the World Wars and New Zealand was the first country to regulate nurses nationally, with adoption of the Nurses Registration Act on the 12th of September 1901. Ellen Dougherty was the first Registered Nurse. In recent years, the American Nurses' Association (1980) has defined nursing as "the diagnosis and treatment of human responses to actual or potential health problems." Just as medical diagnoses help in the planning, implementing, and evaluation of medical care, nurses' diagnoses help in the planning, implementing, and evaluation of nursing care. Like other maturing disciplines, nursing has developed different theories that are aligned with diverging philosophical beliefs and paradigms or worldviews. Nursing theories help nurses to direct their activities in order to accomplish specific goals with people. Nursing is a knowledge based discipline committed to the betterment of humankind. Nursing has not only developed into a profession, but an art as well. As the world grew larger and larger a large number of specialties within nursing have developed. In fact, nursing has been divided into different specialties or classifications. With more than 200 nursing specialties and sub-specialties, a variety of professional organizations or certifying boards issue voluntary certification in many of these areas and nurses are interested in acquiring one of these accreditations, encompassing care throughout the human lifespan and based upon patient needs. Overall, the nursing career structure varies considerably throughout the world. Typically there are several distinct levels of nursing practitioner, distinguished by increasing education, responsibility and skills. The major distinction is between task-based nursing and professional nursing. At the top of the educational ladder is the doctoral-prepared nurse. Nurses may gain the PhD or another doctoral degree such as Doctor of Nursing Science (DNSc) or Doctor of Nursing Practice (DNP), specializing in research, clinical nursing, etc. These nurses practice nursing, teach nursing and carry out nursing research. As the science of nursing has advanced, so has the demand for doctoral-prepared nurses.
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