A Beginner's Guide to Understanding the Levels of Nursing Credentials
You’ve finally made the decision to answer your calling to become a nurse. Now all you need to do is find a program and earn your Nursing degree, right? If only it were that easy.
The truth is there are many different levels of nursing degrees and credentials, and many specialties and job titles under each umbrella. So a Nursing degree isn’t exactly one-size-fits-all. There is a precise path and various nurse education requirements you’ll need to meet to pursue the position you have your sights set on.
So how is an aspiring nurse supposed to navigate this course? Don’t be intimidated by the many credentials you’ve come across. When it all comes down to it, the nursing hierarchy isn’t as confusing as it may seem.
We created this handy guide to help simplify things for you. Keep reading to gain a clearer understanding of the different levels of nursing degrees so you can identify which educational path aligns with your career aspirations.
4 main levels of nursing degrees and credentials
The fact that there are different credentials in the nursing profession is exciting news. It means there are potential opportunities out there for those wanting to make an impact in the healthcare field—no matter their level of educational attainment. And the options don’t end once you’re employed, either—you can mold your career to fit your passions and priorities by continuing to climb the nursing hierarchy later on.
Whether you have hopes of specializing, climbing the ranks or pursuing entrepreneurial endeavors, there are types of Nursing degrees or certifications available to prepare you for your professional goals.
Let’s learn more 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). While these professionals are not actually nurses, they are on the frontline of contact between medical staff and patients—and the role can serve as a starting point for many nurses. Nursing assistants bathe their patients and help them dress, eat, use the bathroom and perform other daily activities. 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.1 They add 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.
How to become a one: To become a CNA, you must complete a state-approved education program. A nursing assistant training program can will typically take three to eight weeks to complete. 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.
- Median annual salary (2019)1: $29,640
- Projected employment growth (2018–2028)1: 9 percent
2. Licensed practical nurse (LPN)
LPNs, sometimes known as licensed vocational nurses (LVNs), 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.
How to become one: LPNs get their start by successfully completing a Practical Nursing Diploma program. These programs can be found at technical schools, community colleges or career colleges and can usually be completed in as few as 12 months.2 After graduation, you’ll be required to pass the National Council Licensure Examination (NCLEX-PN) to receive your state 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.1 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.
- Median annual salary (2019)1: $47,480
- Projected employment growth (2018–2028) 1: 11 percent
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 can be responsible for overseeing LPNs, CNAs and other healthcare staff, the BLS reports.1 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 pediatric nursing, emergency nursing, neonatal nursing, psychiatric 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.1
How to become one: There are two levels of nursing degrees 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 can be completed in as few as 18 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) prefer RNs to have a Bachelor’s degree. Many working RNs with an ADN opt to go back to school later to earn their Bachelor’s degree through an RN-to-BSN online program.
But whichever nursing degree level you decide on, you’ll 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.
- Median annual salary (2019)1: $73,300
- Projected employment growth (2018–2028) 1: 12 percent
4. Advanced practice registered nurses (APRNs)
Nurses who earn their Master 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.1 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.
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.
There are a few other notable career paths MSN nurses could pursue outside of these APRN roles. One option is to become a nurse educator and help train the next generation of nurses. Another possibility is to advance into leadership positions, like becoming a director of nursing.
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.1
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 further requirements, including clinical experience or additional certification.
After graduation, the BLS states that you’ll likely need to pass a national certification exam in your area of expertise.1 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.
- Median annual salary (2019)1: $115,800
- Projected employment (2018–2028)1: 26 percent
Find your ideal level of nursing degree
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’re more familiar with the nursing hierarchy, you may have a better idea of which path you'd like to pursue. Regardless of which level of nursing credential you choose, completing the TEAS test is a common education requirement you'll likely encounter. Learn more about what to expect from the exam in our article, "Don't Fear the TEAS Test: 5 Common Questions Answered."
1Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook [career information accessed May 2020]. Data represents national averaged earnings for the occupations listed and includes 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 transfer credits accepted and courses completed each term.
EDITOR’S NOTE: This article was originally published in 2015. It has since been updated to include information relevant to 2020.