A Beginner's Guide to Understanding the Levels of Nursing
You’ve finally made the decision to answer your calling to become a nurse—now all you need to do is find a Nursing program and earn that degree, right? If only it were that easy.
The truth is there are many different levels of nursing, and many specialties and job titles under each umbrella. So a Nursing degree isn’t exactly one-size-fits-all. There is a precise educational path you must follow in order to pursue the position you have your sights set on. So how is a nursing hopeful supposed to navigate this course?
Don’t be intimidated by the countless credentials you’ve come across. When it all comes down to it, it’s not as confusing as it may seem. We created this handy guide to help simplify it for you. Keep reading to gain a clearer understanding of the different levels of nursing so you can identify which educational path aligns with your career aspirations.
Breaking down the 4 main levels of nursing
The fact that there are different tiers in the nursing profession is exciting news. It signifies that there are a variety of opportunities out there for those wanting to make an impact in this field. And the options don’t end once you’re employed either—you can cater your career to fit your passions and priorities.
“The opportunities for advancement in nursing are too numerous to count,” says Nancy Brook, RN, MSN, APRN and author. Whether you have hopes of specializing, climbing the ranks or pursuing entrepreneurial endeavors, there are degrees or certifications available to prepare you for your professional goals.
Let’s learn about the four core levels of nursing.
1. Nursing assistant (CNA)
Nursing assistants also go by the title of nursing aides or CNAs (Certified Nursing Assistants). They are the frontline of contact between medical staff and patients, assisting patients in daily activities. Nursing assistants bathe their patients and help them dress, eat and use the bathroom. They measure vital signs and listen to their patient’s health concerns and transfer patients between beds and wheelchairs.
Some CNAs also may dispense medication, according to the Bureau of Labor Statistics (BLS), depending on their state. The BLS also states that CNAs are often the principal caregivers in nursing homes and residential care facilities, having more direct contact with the residents than other staff members.
Median annual salary (2014): $25,7101
Projected job outlook (2014–2014): 18%
How to become a one: To become a CNA, you must complete a state-approved education program. These programs can often be found in nursing homes, technical colleges and even through the American Red Cross. A CNA program can take three weeks to eight weeks depending on if it is full- or part-time.
Upon completion of the program, aspiring nursing assistants must pass an exam to earn their CNA (or related) title. After successful completion, CNAs are state-certified.
2. Licensed practical nurse (LPN)
LPNs, sometimes known as licensed vocational nurses, are responsible for a variety of patient duties. They monitor patient health and administer basic care. Their tasks might include taking blood pressure, inserting catheters, starting IV drips (in some states) and changing bandages. They communicate with patients and sometimes patient family members to educate them in the care plan.
State regulations vary for LPNs on administering medication and supervision requirements.
Median annual salary (2015): $43,1701
Projected job outlook (2014–2014): 16%
How to become one: LPNs get their start by successfully earning a Practical Nursing Diploma. These programs can be found at technical schools, community colleges or career colleges and typically last about one year.2 After graduation, you’ll be required to pass the National Council Licensure Examination (NCLEX-PN) to receive your license and be qualified to work.
Additional certification is also available for nurses at the LPN level. Certifications show that an LPN or LVN has an advanced level of knowledge about a specific subject, according to the BLS. To gain an edge in the job market or to acquire some specialty training, LPNs can earn certification in specialized areas like IV therapy, developmental disabilities, childbirth and more.
3. Registered nurse (RN)
Registered nurses (RNs) tend to be the group most people associate with the term “nurse.” They assume a wide variety of roles in patient care. They are responsible for recording patient medical history, monitoring symptoms and medical equipment, administering medicine, establishing or contributing to a plan of care, performing diagnostic tests and collaborating with doctors.
Some RNs are responsible for overseeing LPNs, CNAs and other healthcare staff, the BLS reports. Specific job titles and duties will vary depending on where you work and the types of patients you care for. There are also opportunities for RNs to limit their work to caring for specific patient populations, such as addiction nursing, critical care nursing, neonatal nursing, rehabilitation nursing and more.
RNs also have a plethora of choices outside of direct patient care. The BLS notes that RNs might also work to promote public health, run health screenings or blood drives, or staff the health clinics in schools. RNs could also become healthcare consultants, public policy advisors, researchers, hospital administrators, salespeople for pharmaceutical and medical supply companies or medical writers and editors.
Median annual salary (2015): $67,4901
Projected job outlook (2014–2014): 16%
How to become one: There are two educational paths that can lead to a career as an RN: Earning an Associate’s Degree in Nursing (ADN) or earning a Bachelor’s of Science in Nursing (BSN). An ADN program typically lasts 18 to 24 months.2 On the other hand, earning your BSN could be done in about 33 months, or as few as 18 months with a prior degree under your belt.2
When choosing which track to take, it’s important to think ahead and determine what the educational preferences are for the type of work you want. Some employers (especially hospitals) require RNs to have a Bachelor’s degree. Many RNs with an ADN opt to go back to school to earn their Bachelor’s degree through an RN-to-BSN program, which can take as few as 12 months.2
But whichever educational avenue you take, you will still have to pass the National Council Licensure Examination (NCLEX) if you want to start working as an RN. Additional requirements may also exist depending on your state, so be sure to look into statewide RN qualifications as well.
4. Advanced practice registered nurses (APRNs)
Nurses who earn their Master's of Science in Nursing (MSN) can become advanced practice registered nurses (APRNs). These nurses have all sorts of options when it comes to career choices. They can work independently as well as in collaboration with physicians, according to the BLS. They can perform all of the duties of an RN as well as more extensive tasks like ordering and evaluating test results, referring patients to specialists and diagnosing and treating ailments.
MSN nurses could also become nurse educators and teach at a nursing school. The BLS adds that APRNs also may conduct research or teach staff about new policies or procedures. Others may provide consultation services based on a specific field of knowledge, such as oncology or geriatrics.
For a better idea of how these nurses fit in the healthcare system, see this handy breakdown the American Nurses Association offers to highlight the four types of APRNs: nurse anesthetists, nurse midwives, certified nurse practitioners and clinical nurse specialists.
Average annual salary: $104,7401
How to become an APRN: The first step toward becoming an advanced practice registered nurse is becoming an RN. MSN programs typically require candidates to first have an RN license, with most preferring a BSN degree as opposed to an ADN or diploma, according to the BLS.
The next step is to gain acceptance into an accredited MSN program and earn your degree. Depending on the specialty you wish to pursue, there might be additional requirements, including clinical experience or certification.
After graduation, the BLS states that you’ll likely need to pass a national certification exam in their area of expertise. Requirements vary slightly by state, so check out the National Council of State Boards for Nursing for specifics in your area. Some advanced practice certifications will also need to be renewed after a certain number of years to remain valid.
Where do you want to go?
This simple breakdown of the different levels of nursing should help you have a better understanding of your options in the field. Even so, these only scratch the surface of the career options available within each level.
Now that you’ve been introduced to the educational options in nursing, it’s time to figure out which path makes the most sense for you personally. Get started weighing your options with our handy flowchart, Types of Nursing Degrees: Diagnosing Your Ideal Healthcare Career.
1Salary data came from the US Bureau of Labor Statistics. Data represent national averaged earnings for the occupations listed and include workers at all levels of education and experience. Ranges do not represent starting salaries and employment conditions in your area may vary.
2Time to complete is dependent on accepted transfer credits and courses completed each quarter.