Overview of Nursing Degrees and Careers

Two nurse practitioners reviewing their recent cases.

One of the best things about nursing is that entry into this profession (and career advancement once you’re in) is both encouraged and facilitated. This is evident with bridge programs specifically designed for working nurses to further education as well as accelerated or second-degree programs allowing a “fast-track” for college graduates without a nursing background.

Nursing’s Multiple Education Pathways

Fortunately, many nursing schools have more than one entry option. For example, if you have an associates degree, you can still find master’s programs that will admit you even without a bachelor’s. Likewise, you don’t need a master’s to start a doctoral program. You can even apply to a grad program without a single nursing degree to your name. Of course, in each case, you’ll spend more time in the program than those who have previous nursing education.

Not only is nursing a field that truly cultivates professional growth – the high level of organization and internal communication within its academic infrastructure keeps redundancy at a minimum and makes advancing your career as seamless as possible.

To put it plain and simple: the nursing education infrastructure makes career transition/advancement easy.

Choose the degree level you are interested in to learn more:

Undergraduate Nursing Degrees

Illustrated profile of male nurseWith almost 3 million jobs, registered nurses occupy the largest health care profession in the United States. According to the American Nurses Association, about half of registered nurses (RNs) currently practicing hold either an associate’s degree in nursing (ADN or ASN) or a nursing diploma. However, the trend for new nursing students is toward four-year bachelor’s-degree programs.

This trend has much to do with the fact that nurses with associates degrees are restricted to less specialized roles and that a BSN or higher level of education is being anticipated for professional nurses in the future.

Associate’s

ADN and ASN programs take about two years (full-time) to complete are are usually offered at community colleges. They’re rigorous and focused on building core competencies in areas like health communications, health assessment, clinical decision making, medical intervention, health technologies, and care management. With their fast pace and their emphasis on clinical experience, these programs provide the quickest and least expensive path into a professional nursing career. In order to practice, you’ll need to pass the licensing exam for registered nurses (NCLEX-RN).

Some two-year colleges also offer a practical nursing diploma, which is a shorter program (usually about a year long) that concentrates on nursing basics. At the end of such a program, you’ll take the licensing exam for practical nurses (NCLEX-PN), which qualifies you to work in nursing support positions as a licensed practical nurse (LPN) or a licensed vocational nurse (LVN).


Bachelor’s

Although you can become a registered nurse (RN) with only an associate’s degree, nurses who commit to more years of education and earn the bachelor of science in nursing (B.S.N.) have access to better employment and advancement opportunities. The push is for the BSN degree to become the “gold standard” for entry-level RN roles. Nurses with associate’s degrees often go back to school to earn their bachelor’s. Many nursing programs have special admissions policies and streamlined curricula for LPNs and RNs who want to return to school but need to work, too. Employers often help pay tuition while their nurses study for the BSN.

If high school is your highest level of education, then you would apply to a 4-year BSN program. If you’re a non-nursing student already enrolled in school, you can change your major to nursing if your school has a program, otherwise consider transferring to another school which offers the BSN. For those of you already holding a non-nursing baccalaureate degree, you can enroll in a “second degree” or “accelerated” BSN program. These programs generally involve 1.5 to 2 years of schooling, though some can be completed as early as 12 months.


The National League for Nursing and the American Association of Colleges of Nursing accredit BSN programs that meet their criteria. These educational guidelines stress the experience of a broad-based liberal education, the teaching of ethics and professional values, the development of core nursing skills and knowledge, and the opportunity for clinical experience.

In your final year of nursing school, you’ll begin to pull together everything you’ve learned, from the basic science course work of the first year to the practical experiences of your clinical work, in order to prepare for the standardized NCLEX-RN exam.

Comparing LPN, ASN and BSN Paths

Choosing between an LPN, ASN/ADN and BSN program is a major choice for prospective nurses. Since each type of program has its advantages and disadvantages, your decision really depends on your nursing career goals.

Here’s a quick overview of your options to help you decide which path is most suitable for you.

The 1-Year LPN Path

LPN programs actually culminate in a certificate, not a degree. In the past, nursing was a dual-tiered structure of Licensed Practical Nurses (LPNs) and Registered Nurses (RNs). LPN training generally took 12 months to a year-and-a-half to complete.

LPNs were taught general patient care and a bit of nursing theory, in addition to fundamental human anatomy & physiology. They carried out more generalized patient care and functioned under the oversight of an RN. The advantage in becoming an LPN was you could complete school in shorter time, become employed sooner and making money. The disadvantage was you had a lesser degree of autonomy and earned considerably less income compared to an RN.

As a result, LPN programs have become significantly less popular than they once were, especially with the demand for nurses with degrees. Most medical centers have pushed to do away with the dual-tier arrangement, for financial and staffing purposes. Aside from that, LPNs have been restricted from practicing in specialized fields, including emergency and critical care.

The demand from LPNs wanting to get a degree and become licensed as an RN has been met with the availability and convenience of LPN to RN bridge programs. Most LPNs who were still permitted to work in areas of specialization due to being grandfathered in have been granted a predetermined grace period to return to school and earn their degree/RN license, for them to continue working in their chosen specialty.

The majority of LPNs now are found primarily in assisted living facilities and other residential care service providers, as well as hospitals.

The 2-Year ADN or ASN Path

Currently, the fastest means to become a professional nurse is to get an Associate of Science in Nursing (ASN) or an associate’s degree in nursing (ADN). These are 2-year programs offered by community, junior and even 4-year colleges. You take a foundational nursing curriculum for two years including a set amount of clinical education and training.

In this case, the advantage is that you wrap up your degree sooner (compared to BSN) and can start seeking employment. Two year programs also less expensive than a bachelor’s degree programs which take roughly twice the amount of time/cost. Also, you can complete most, if not all, prerequisites via distance education (online), at a rate that suits you best, or locally on campus if you choose – both scenarios would enable you to continue working simultaneously as you finish your associate’s degree coursework.

The drawback is you typically will need to take about a year’s worth (sometimes more) of prerequisite classes like psychology and human nutrition, prior to being admitted into an ASN or ADN course of study. Therefore, this extends into approximately a 3-year time frame before finally getting your associates. You may also discover that you get reimbursed less relative to nurses that hold a BSN. In addition, to move up into administrative, managerial or teaching roles, you’ll need to return to college or university to earn your nursing bachelors. This why many consider the ASN/ADN to be a stepping stone for entry into a BSN program later on in your nursing career.

The 4-Year BSN Path

A Bachelor of Science in Nursing program is the much lauded comprehensive, 4-year nursing degree traditionally offered by colleges and universities. With this level of education, you normally fulfill core liberal arts and science courses, such as English, biology, statistics, psychology, physics, microbiology and chemistry. You then are required to send an application to the school of nursing (even if you are currently a student at the college you’re applying to) to gain admittance.

You should know that every single student who meets the prerequisites and submits an application for enrollment will not be accepted: in most cases being admitted into a bachelor’s nursing program comes down to who has earned the highest grade point average (GPA) and the number of seats available for each class.

Upon acceptance, you will go on to take the core nursing curriculum the remaining 2 years. This applied coursework usually includes an introductory nursing class and applied nursing courses in the areas of surgery, mental health, obstetrics/gynecology, practice theory and clinical research. During your final year, you’ll most likely be required to work on and present a senior project. If you decide to go into a specialized field, then additional clinical training will be necessitated. For those who already hold a bachelors in a subject other than nursing, there are accelerated BSN programs available that only take 1 year to 18 months to complete.

Graduate Nursing Degrees

Silhouette of a nursing studentGraduate school opens many doors for nurses. With a master’s or doctoral degree, you can specialize and care for patients more independently or move away from direct patient care into another field such as administration. In fact, to get certified as an advanced-practice nurse, you’ll need at least a master’s degree – and in the future, you might need to earn an even higher degree, the doctor of nursing practice (DNP).

If you want to contribute to the foundation of nursing science and know-how, it’s a research career you’re looking for and a PhD program you should consider.

Master’s

MS and MSN programs both award a masters degree in nursing and usually take two years to complete. Depending on their emphases, they prepare students for advanced practice in nursing or for work that involves little or no direct patient care – for example, in administration, education, or forensic nursing. For students interested in blending patient care with administration, the more recent clinical nurse leader (CNL) programs are an option.

If you want to become an advanced practice nurse, you’ll typically choose between nurse practitioner, clinical nurse specialist, nurse anesthetist, and nurse-midwife. If you choose one of the first two options, you’ll also need to decide on a specialization.


These are the most widely offered tracks in master’s degree programs preparing nurse practitioners and clinical nurse specialists:

  • Acute care
  • Adult
  • Family
  • Geriatric
  • Neonatal
  • Oncology
  • Pediatric
  • Psychiatric/mental health
  • Women’s health

Whichever track you choose, you’ll take both core courses and courses that deal with your specialization. As you dig into your specialization, you’ll take courses focused on the population you’ll be serving and the role you’ll be filling. But you’ll also spend hundreds of hours in practicums, getting hands-on clinical experience with real patients in health-care settings. In addition to serving practicums and taking courses, you might have the opportunity to conduct independent research and submit a thesis paper or capstone project that shows off your new skills and knowledge.

What are direct-entry or MSN bridge programs?

If you have a baccalaureate in a non-nursing major, you can still earn an MSN degree through a “direct-entry” program. Designed for 4-year college graduates without a BSN or RN license (usually completely new to nursing), direct-entry MSN programs enable you to earn your RN in as little as 12 months, followed by another 1-2 years of schooling and clinical education according to the area you’re specializing in.

Also referred to an entry-level master’s (ELM) or MSN bridge, some direct-entry programs result in a master’s in general nursing. In this case, further training and certification is typically required to practice in a specific APRN role. However, a growing number of MSN bridge programs can put you in an advanced practice role right after graduation, however the lesser amount of nursing experience these students possess by virtue of moving directly from a non-nursing baccalaureate to a direct-entry nursing master’s can make securing jobs in advanced positions challenging without gaining more experience first. Because of this, for some the better option may be to complete an accelerated BSN program first and then go into a specific APRN master’s program.

What are dual degree MSN programs?

MSN/MBA or MHA joint-degree programs allow you to earn your MSN (or MS) in nursing and your master of business or health administration at the same time – in anywhere from two and a half to four years of full-time study. When you graduate, you’ll have the advanced nursing skills and business know-how to make business decisions, manage patient-care and health programs, and hold management positions in the health-care field. Usually these programs are offered jointly by a school of nursing and a school of business or public health.

The advantage to completing the joint program rather than two separate degrees is that you’ll be better able to integrate the two fields. Your business or administration courses will give you a strong foundation in general business or health management. And your nursing courses will help you apply your business knowledge to the field of nursing and give you a comprehensive understanding of nursing administration.

Online MSN Programs

If you hold a BSN, whether a recent grad or having been in the workforce for years, online MSN programs provide a convenient way to continue work obligations while furthering your education.

Click here to learn more about this option.

DNP

Nurse studying pathology

Formerly known as Nursing Doctorate (ND), DNP programs award a degree called the doctor of nursing practice, which is one of the two highest degrees you can earn in the field. The other, the Ph.D., is described below. While the Ph.D. program trains students to conduct original research as nurse scientists, the DNP is all about the practice of nursing. You’ll still learn a lot about research, but you’ll focus on applying it to patient care.

Although the DNP is very new on the scene, programs that award it are growing quickly. In the near future, the DNP has been targeted or proposed to become the academic requirement for new grads entering into advanced practice nursing. The two APRN professions which have proposed dates are nurse practitioning (by 2015) and nursing anesthesia (by 2025). For the former it’s not going to happen by that date, however, there is still an active push by various organizations for it to happen in the future. On the other hand, regarding CRNA education standards, there still is a chance of the transition being successful a decade from now.

Some schools admit students with only a bachelor’s degree in nursing to DNP programs. Others require the master’s for admission, but many of these schools are planning to make changes in the near future so that they can accommodate students who don’t hold a master’s.

If you enter with only a bachelor’s degree, you can expect to spend three to four years in the program. You’ll probably begin by earning an MS or MSN, choosing a specialization and following a program like the one described above. Once you finish that phase of your studies, you’ll fulfill the same requirements as your peers who entered with a master’s degree.

Students who enter with a master’s degree will probably take two years to graduate. They’ll build on their experience in advanced-practice nursing and their master’s-level course work with classes that cover the following topics:

  • Using research evidence to shape the ways in which patients are cared for in the future
  • Measuring the quality and safety of patient care
  • Leading, designing, and evaluating systems for delivering health care
  • Using information systems to improve health care
  • Health-care policy
  • Public health

But you won’t spend all your time in the classroom – far from it. In the post-master’s phase of your studies you’ll spend about five hundred clinical hours in practicums and residencies, getting more hands-on experience. Students who enter with a bachelor’s degree will rack up a total of at least one thousand clinical hours in the program.

DNP candidates also turn in a final project that synthesizes all they’ve learned in books and from patients. The final project takes many forms – such as a pilot study, program evaluation, quality improvement project, or literature review – but is always focused on applications to nursing practice.

PhD

Doctor of Philosophy (PhD) in Nursing programs prepare students primarily to lead original research projects and add to the body of knowledge about nursing, often at the most fundamental levels. Graduates find work at colleges and universities – where they also teach – and other organizations that foster research and shape health-care policy. PhD nurses carry out independent studies, take part in research of multiple disciplines and build and share data/information with the purpose of bettering the provision of health care and patient outcomes.

Most programs admit students with or without a master’s degree in nursing. If you enter with only a bachelor’s degree, you can expect to spend at least four years taking core courses and electives and researching your dissertation. If you enter with a master’s degree, you’ll finish more quickly, possibly in three years. However, it often takes longer to meet all the degree requirements.

Required core courses emphasize sophisticated research skills and concepts and typically cover the following subjects:

  • Advanced, multivariate statistics
  • Experiment design
  • Health-care policy
  • Nursing science
  • Philosophy of science or knowledge
  • Qualitative research methods
  • Quantitative research methods
  • Scientific measurement
  • Theory construction and development

As preparation for striking out on your own to research your dissertation, you’ll likely get hands-on, guided experience in a research practicum. Once you complete this requirement as well as your course work, you’ll probably take a qualifying exam. Finally, you’ll begin your dissertation research. Some programs also offer training in educational theories and practices so that students are well prepared for post-secondary teaching.

General Types of Nurses

Home Health Aide

Education Requirements

On-the-job training is accepted in some states. Other states require formal training. If agencies receive reimbursement from Medicare, federal law suggests at least 75 hours of training.

Certification/Licensure

The National Association for Home Care (NAHC) offers national certification for Home Health Aides, which may be required by some employers.

Employment Outlook

One of the fastest-growing occupations, at 48 percent, due in part to the high rate of turnover in this occupation and the large population of aging individuals.

Certified Nursing Assistant (CNA)

Education Requirements

Federal law requires at least 75 hours of training and passing of a competency evaluation exam that includes knowledge and skill test.

Certification/Licensure

The board of nursing or health in each state grants their specific title and placement on their registry for nursing assistants.

Employment Outlook

Expected growth of CNAs is 21 percent, which is faster than average, due in part to aging of the U.S. population and a high turnover rate for this job.

Licensed Practical/Vocational Nurse (LPN/LVN)

Education Requirements

Approximately 1 year of education. All states require the LPV/LVN to pass the NCLEX-PN licensing examination.

Certification/Licensure

License varies from state to state. Licenses may be issued by a state board of nursing or the department of labor\’s licensing and regulation agency.

Employment Outlook

25 percent; above average growth.

Registered Nurse (RN)

Education Requirements

Two to 4 years of education. All states require the RN to graduate from an accredited nursing program and pass the NCLEX-RN licensing exam.

Certification/Licensure

Licensure requirements vary among states. RN licenses are issued through the state of practice.

Employment Outlook

Faster than average growth (19 percent) due in part to the variety of RN positions available and an aging population of nurses currently employed.

Advanced Practice Nurse (APN)

Education Requirements

Registered nurse licensure with undergraduate degree plus 1-2 years of graduate-level education.

Certification/Licensure

Different professional associations provide advanced nursing certificates. Each state differs in licensure according to specialty.

Employment Outlook

Increasing growth due to demand for high-level practitioners in rural areas/underserved areas and lower cost than that relative to a physician.

Specific Nursing Roles

Administrative

Nurse Executive

photo_Nurse-ExecutiveNurse Executives work towards accomplishing the “big picture” objectives of healthcare facilities. Includes communicating productively with staff, promoting creative thinking and enforcing fiscal responsibility. Also facilitates continuing education courses for their personnel and urges them to become part of national nursing organizations. Has ability to form practice policies, in addition to overseeing quality of nursing team care.

Nurse Manager

photo_Nurse-ManagerNurse Managers assist patients by overseeing the nurses who treat them. Although these specialty nurses are primarily in charge of recruitment, management and retention of staff, from time to time they work with physicians on patient care, as well as helping patients and their families. Takes on numerous roles, including functioning as an intermediary between healthcare organizations, doctor groups and the nursing team.

Advanced Practice

Certified Registered Nurse Anesthetist

photo_CRNANurse Anesthetists are specifically skilled in the administration, regulation and monitoring of anesthetics to patients undergoing surgical procedures. CRNAs have the ability to work autonomously or under a some level of oversight from an anesthesiologist or other physician, as determined by local medical legislature. Dating back to the Civil War, nursing anesthesia is recognized as the earliest specialty role for nurses.

Certified Nurse Midwife

photo_CNMCertified Nurse Midwives typically work in medical centers and clinics, as well as help deliver newborns in birthing facilities and at patient homes. These advanced practice nurses provide guidance and care to women from adolescence through menopausal years and may work in tandem with an Obstetrics/Gynecology physician, offering support and treatment to patients who experience issues related to birth or reproduction.

Clinical Nurse Specialist

photo_CNSClinical Nurse Specialists have an advanced scientific proficiency in a distinct clinical specialty (i.e. neuroscience, hematology, oncology), providing expert patient care or carrying out clinical studies to improve patient results. Apart from medical practice or research, functions can also involve teaching and consulting, as well as administrative and managerial roles. CNSs commonly offer guidance and mentorship to other nurses.

Nurse Practitioner

photo_NPNurse Practitioners carry out a number of the duties and responsibilities customarily performed by physicians. For example, NPs are qualified in providing full patient examinations, diagnosing and treating basic emergencies, illnesses and injuries, giving immunizations, ordering lab and radiology work, prescribing medications and counseling patients. The NP can operate both as part of a team with physicians and autonomously.

Pain Management Nurse

photo_Pain-Management-NursePain Management Nurses treat patients with acute and chronic pain. Responsibilities of these advanced nurses include determining the cause of pain and collaborating with other nursing staff and physicians to organize a treatment and care plan with the patients comfort a priority. They are also educators, teaching patients ways to help control their own pain with medicine as well as non-medicinal methods to alleviate discomfort.

Academia and Research

Nurse Educator

photo_Nurse-EducatorNurse Educators strive to prepare the future generation of nurses. These advanced nurses may instruct students pursuing an Associate’s, Bachelor’s and graduate degree in nursing, or help nurses attain various certifications and continuing education credits. With this role, you also have the opportunity carry out studies, compose funding proposals and help uphold various clinical criteria in the field of nursing.

Nurse Researcher

photo_Nurse-ResearcherNurse Researchers are scientists who perform studies and analyze data in an effort to advance the nursing industry. These researchers coordinate and lead studies, evaluate results, and present their findings. Work can be very analytical and meticulous, however it can also be among the most fulfilling, given these advanced practice nurses can make breakthroughs that directly affect the lives of both patients and the healthcare team.

REFERENCES

1. http://www.aacn.nche.edu/students
2. http://www.discovernursing.com/explore-specialties

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