Different Levels of Nursing
Nursing offers a range of career paths and opportunities for those passionate about healthcare. If you’re considering a career in nursing or are simply curious about the profession, understanding the different levels of nursing can help you appreciate the depth and breadth of this essential field.
Let’s explore the various levels of nursing, including their roles, educational requirements, and potential career trajectories.
Certified nursing assistants
While not formally one of the levels of nursing, certified nursing assistants (CNAs) are entry-level healthcare professionals who provide basic care to patients and are often a first step for many in their nursing careers. Their responsibilities include assisting patients with activities of daily living (ADLs), such as bathing, dressing, and eating, taking vital signs, and reporting changes in a patient’s condition to nursing staff or physicians. CNAs work under the supervision of registered nurses (RNs).
Educational requirements
Those interested in becoming a CNA must complete a state-approved education program, which typically lasts four to 12 weeks. These are offered by community colleges, vocational schools, and some hospitals. After completing the program, candidates must take and pass a state certification exam to become licensed to practice.
Career path
Many CNAs use their experience as a steppingstone to further their careers in nursing. They may choose to pursue additional education to become LPNs or RNs.
Licensed practical nurses or licensed vocational nurses
Licensed practical nurses (LPNs), also known as licensed vocational nurses (LVNs) in some states, provide more advanced care than CNAs. Their duties include administering medications, monitoring patients, performing basic diagnostic tests, and providing wound care. LPNs/LVNs work under the supervision of RNs and physicians.
Educational requirements
LPNs/LVNs must complete a state-approved nursing program, which can take up to one year to complete. These are offered by community colleges, technical schools, and some hospitals. After completing the program, individuals must take and pass the National Council Licensure Examination (NCLEX) to become licensed as an LPN or LVN. (The NCLEX-PN is for LPNs/LVNs, and the NCLEX-RN is for RNs.)
Career path
LPNs/LVNs often gain experience and may decide to pursue further education to become RNs. Many schools offer LPN-to-RN bridge programs that allow LPNs to advance their education and career more quickly.
Registered nurses
RNs perform a wide range of duties, including administering medications, coordinating patient care, conducting physical exams, and educating patients and their families about health conditions and treatments. RNs can specialize in areas such as pediatrics, critical care, oncology, and more.
Educational requirements
These are the primary educational pathways to becoming an RN:
- Associate Degree in Nursing (ADN): This is a two-year program, offered by community colleges, and provides foundational education in nursing.
- Bachelor of Science in Nursing (BSN): This is a four-year program, offered by colleges and universities, and provides a more comprehensive education in nursing, including leadership and research skills.
After completing their chosen program, individuals must pass the NCLEX-RN to become licensed.
Career path
RNs have numerous opportunities for advancement. They can pursue specialty certifications, advanced degrees, and leadership roles. Many RNs choose to obtain a BSN if they initially started with an ADN, as a BSN can open doors to higher-level positions and advanced practice roles.
Advanced practice registered nurses
Advanced practice registered nurses (APRNs) are RNs who have completed additional education and training in a specific area of nursing practice. APRNs include nurse practitioners (NPs), clinical nurse specialists (CNSs), certified registered nurse anesthetists (CRNAs), and certified nurse midwives (CNMs).
These professionals provide a higher level of care, often with a focus on primary care, specialty care, or anesthesia. Their responsibilities can include diagnosing and treating illnesses, prescribing medications, and providing advanced patient care.
Educational requirements
APRNs must complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program, which can take between two and four years to complete beyond the BSN. These programs provide specialized training in the chosen area of practice. After completing their advanced degree, APRNs must pass a national certification exam in their specialty area to become licensed.
Career path
APRNs can pursue further specialization within their field, engage in research, teach in nursing programs, or take on leadership roles in healthcare organizations. The demand for APRNs is growing, particularly in underserved areas where access to primary care providers is limited.
Advanced practice roles
Clinical nurse specialists
CNSs are a type of APRN who focus on improving patient outcomes and nursing practice within specific populations or settings. They provide direct patient care, consult with other healthcare professionals, conduct research, and educate staff and patients. CNSs often work in hospitals, outpatient clinics, and community health settings.
A nurse looking to become a CNS must complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program with a focus on clinical nurse specialist training. Certification in a specialty area, such as oncology or pediatrics, may be required.
CNSs can advance their careers by moving into administrative roles, engaging in healthcare policy, or becoming educators. Their expertise in improving patient care and outcomes makes them valuable in various healthcare settings.
Nurse practitioners
NPs are APRNs who offer comprehensive healthcare services, including diagnosing and treating illnesses, prescribing medications, and managing patient care. NPs often serve as primary care providers, especially in underserved areas. They can specialize in areas like family practice and mental health.
To become an NP, nurses must complete an MSN or DNP program focusing on nurse practitioner training. They must also attain national certification in their specialty area and meet state licensure requirements.
These nursing professionals can further specialize within their field, pursue leadership roles, or engage in research and education. The flexibility and autonomy of the NP role make it an attractive career path for many nurses.
Nurse anesthetist
CRNAs are APRNs who specialize in administering anesthesia and managing anesthesia care. They work in various settings, including hospitals, outpatient clinics, and pain management clinics. CRNAs are responsible for preoperative assessments, administering anesthesia during surgery, and postoperative care.
To become a CRNA, nurses must complete a specialized MSN or DNP program in nurse anesthesia, which typically takes two to three years beyond the BSN. They must pass a national certification exam to practice as a CRNA.
Nurses in this role can advance their careers by specializing in areas such as pain management or pediatric anesthesia, pursuing leadership roles, or engaging in education and research. The demand for CRNAs is high, particularly in rural and underserved areas.
Nurse midwife
CNMs are APRNs who specialize in women's health, particularly pregnancy, childbirth, and postpartum care. They offer prenatal care, deliver babies, and offer gynecological and reproductive health services. CNMs often work in hospitals, birthing centers, and private practices.
CNMs must complete an MSN or DNP program focusing on nurse midwifery. They must also pass a certification exam to practice. Nurse midwives can further specialize in areas such as high-risk obstetrics or reproductive health, pursue leadership roles, or engage in research and education. The holistic and patient-centered approach of midwifery makes it a fulfilling career path for many nurses.
The field of nursing offers a diverse and wide range of career paths. From CNAs who provide essential daily care to patients, to APRNs who offer advanced and specialized healthcare services, there is a level of nursing to match almost any interest and career goal.
Understanding these different levels of nursing can help individuals make informed decisions about their education and career paths, while also highlighting the critical contributions that nurses make to the healthcare system.