How to Become a Nurse: Nursing Programs & Careers

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September 16, 2021

What Does a Nurse Do?

Nursing Career Basics

Nurses’ responsibilities vary by specialization or unit, but most share more similarities than differences. Nurses provide and monitor patient care, educate patients and family members about health conditions, provide medications and treatments, give emotional support and advice to patients and their family members, and more. They also work with healthy people by providing preventative health care and wellness information.

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Nursing at Every Level

Readers hooked by articles ranking the “best” and “top” jobs are likely already savvy to the idea that health care is one of the fastest-growing and highest-paying industries in the nation, and that nurses are leading the charge. From diploma to doctorate, the nursing field offers rewarding careers for nurses at every education level. Learn more about some of the most popular nursing careers below.

Licensed Practical Nurses

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Licensed practical nurses and licensed vocational nurses are entry-level nurses; which title they use is dictated more by geography than job function. LPNs and LVNs provide basic patient care, though specific duties are dictated by each state’s board of nursing. They might feed or bathe patients, monitor patient vitals and check and apply bandages. Some states also permit practical nurses to administer certain medications. Practical nurses must usually complete certificates or associate degrees and the National Council Licensure Exam for Practical Nurses, or NCLEX-PN

Registered Nurses

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Registered nurses are the most prevalent nurses in the profession and often serve as a fulcrum of patient care. They work with physicians and communicate with patients and their families. They engage in more sophisticated care than LPNs. Board certification allows RNs to become highly specialized in areas like critical care, oncology, geriatrics, neurology and other key health disciplines. All states require RNs to earn at least an associate degree, but some employers prefer candidates with bachelor’s degrees. RNs must also be licensed to practice, a process that requires that they complete an accredited nursing program and pass the National Council Licensure Exam for Registered Nurses, or NCLEX-RN.

Neonatal Nurses

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Neonatal nurses are typically RNs who are certified to care for infants born prematurely or with other health complications. Neonatal nurses may also calm anxious parents, explain conditions and procedures and teach families how to care for their babies upon discharge. Some neonatal nurses offer lactation support to moms visiting and feeding patients in the intensive care nursery. Working with small and sometimes underdeveloped infants and newborns requires specialized skills, training and equipment. Because they are RNs, neonatal nurses must earn at least an associate degree in nursing and pass the NCLEX-RN. Organizations like the American Association of Critical Care Nurses and the National Certification Corporation offer additional RN certifications in neonatal care, pediatrics and critical care.

Nurse Practitioners

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As some of the most advanced nursing professionals, nurse practitioners make more decisions when it comes to exams, treatments and next steps. They go beyond the reach of RNs and may work with physicians closely. Some states with large rural populations or shortages in primary care physician have even passed legislation allowing NPs to stand in for physicians in certain situations. Nurse practitioners typically earn a Master of Science in Nursing (MSN) or, increasingly, a Doctor of Nursing Practice (DNP). They also earn additional certifications in specialized disciplines such as critical care, family medicine and pediatrics.

Licensed practical nurses and licensed vocational nurses are entry-level nurses; which title they use is dictated more by geography than job function. LPNs and LVNs provide basic patient care, though specific duties are dictated by each state’s board of nursing. They might feed or bathe patients, monitor patient vitals and check and apply bandages. Some states also permit practical nurses to administer certain medications. Practical nurses must usually complete certificates or associate degrees and the National Council Licensure Exam for Practical Nurses, or NCLEX-PN

Career Trends in Nursing

Hot Jobs in Nursing

Nursing has long been a hot job, but aging baby boomers, health care reform and medical advances have kicked demand for these professionals into even higher gear. The Bureau of Labor Statistics (BLS) expects employment for registered nurses, licensed practical and vocational nurses and advanced practice nurses, including nurse practitioners and clinical nursing specialists, to significantly outpace the national average in the decade preceding 2022. These groups also include a number of more specialized nurses, such as the following:

Hot Nursing related careers

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As the list above suggests, nursing is a tremendously diverse field extending well beyond the traditional hospital circuit. It is not uncommon for new nurses and nursing students to stumble across fields they did not even know existed. Here are just a few of these specialized professionals, along with their job functions, earnings and training requirements.

Informatics Nurse Specialist

Median salary (2014): $82,710

All nurses working in today’s high-tech world must be acquainted with computers and a variety of programs, but informatics nurse specialists take this tech-career integration to a whole new level. These professionals help design, develop and modify software and systems to make them more efficient and improve patient outcomes. In other words, informatics nurses ensure the technology other nurses rely on is practical, reliable and safe. They are also in such high demand that O*NET classifies informatics nursing as a “bright outlook” occupation projected to grow nearly twice as fast as the national average for all fields between 2012 and 2022.

Education and Training: Most employers require bachelor’s degrees, but about 25 percent of informatics nurses go on to earn master’s degrees.

Nurse Midwife

Median salary (2014): $96,970

Nurse midwives provide gynecological and obstetrical care to women of nearly all ages, but their birth-related services have become especially popular among women seeking a more personalized birth experience or fewer medical interventions. To say this trend is creating new opportunities for midwives in hospitals, birthing centers, private practices and even home-based care would be an understatement: The Mayo Clinic reports that demand for nurse midwives has grown exponentially in the last two decades and is expected to soar through at least 2022.

Education and training: Nurse midwives must hold master’s degrees to practice. About 15 percent of professionals earn additional certificates, particularly at the post-master’s level.

Nurse Anesthetist

Median salary (2014): $153,780

There is a reason CNN once named nurse anesthetist among the best jobs in America: These professionals typically enjoy solid earnings and booming demand. Nurse anesthetists support surgeons and physicians in a number of ways, but their primary role is administering anesthesia and monitoring patients during and after sedation. This work carries a great deal of risk, which at least partly contributes to their heftier-than-average paychecks. It also explains why they are considered advanced practice nurses and are required to complete more education than RNs and many other specialized nurses.

Education and training: Nurse anesthetists need at least a master’s degree to practice, but about 12 percent of professionals hold professional or doctoral degrees.

Exploring Academic Paths

Nursing can be a tremendously rewarding career both personally and professionally. However, it is also tightly regulated. States and employers have strict training requirements that dictate not only whether nurses can practice, but also what types of duties they can perform. The type of nurse that one becomes often depends not only on whether they have earned an associate, bachelor’s or graduate degree, but also on the board or professional certifications they hold. This table helps readers considering nursing school determine which educational path makes sense for them.

Career Goal and/or educational needs Associate Bachelor’s Master's Doctorate Online
I know I want to go to nursing school OR I am a practicing nurse interested in advancing my education, but I am worried work, family, and other commitments will make school difficult.
I’m interested in nursing, but I would like to test the waters with a quicker-entry degree before committing to the field.
I want to become a licensed practical/licensed vocational nurse, OR I would like to become a registered nurse and live in a state that does not require a bachelor’s degree.
I want to become a registered nurse in a state that requires a bachelor’s degree OR I am a practicing LPN or RN who would like to advance my education and career.
I would like to become an advanced practice nurse, such as a nurse practitioner, clinical nurse specialist, nurse midwife or nurse anesthetist.

Did You Know?

Demand for qualified nurses is soaring. A study published in Health Affairs projects a shortage of between 300,000 and 1 million nurses by 2025 – greater than any nursing shortage experienced in the United States in more than half a century.

Overview of Nursing Degrees

Nursing schools offer an array of degree options, from associate degrees through postgraduate programs. Each level is designed to meet different career needs, so courses, curricula, and skills learned vary. Understanding how nursing degrees differ--and how these differences translate to the workplace--allows future nursing students to choose programs that are in line with their goals and interests. In addition to the degree information provided below, students can visit this nursing program search tool and rankings page to help round out their research.

Associate Degrees

The Associate Degree in Nursing (ADN), sometimes called the Associate of Science in Nursing (ASN) or Associate of Applied Science in Nursing (AASN), is a popular training pathway for registered nurses (RNs) as it qualifies them to sit for the National Council Licensure Examination for Registered Nurses, or NCLEX-RN. Some licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) also earn associate degrees to gain a competitive edge in the job market or to advance to managerial or registered nursing careers. Community colleges, vocational schools, and a small number of four-year nursing schools offer ADNs.

Associate-level nursing degrees typically require two to three years of full-time study, but some schools offer accelerated programs, including programs for LPNs to get an ADN. Courses vary, but often include foundational science and nursing courses, general education courses, hands-on labs, and a supervised clinical practicum. The following table represents associate degree courses required by nursing schools from all across the country.

Introduction to Nursing

Offers basic knowledge about the field of nursing and its evolution over time

Nursing Skills & Knowledge Gained

    Roles, career options, and desired qualities of nurses Legal and ethical issues related to the field Basic communication, collaboration, and other professional skills nurses use in the workplace Concepts and trends impacting the field, including patient-centered care, holism, and the modern health culture

Pharmacology

Introduces clinical pharmacological applications as they relate to modern nursing

Nursing Skills & Knowledge Gained

    Medication classifications Pharmacological indications, side effects, contraindications, and interactions Legal statutes and standards that regulate the administration of medications by nurses Responsibilities of nurses administering drugs

Informatics Essentials

Exposes students to computer-based technologies nurses use in the field

Nursing Skills & Knowledge Gained

    The role of technology in general, and computers specifically, in the field of modern nursing Common software and Internet resources used in the health care community, including electronic medical records, scheduling software, spreadsheets, databases, and basic communication tools Privacy rules and best nursing practices when working with informatics

The Fundamentals of Clinical Nursing

Gives students hands-on training in providing basic nursing care

Nursing Skills & Knowledge Gained

    Basic knowledge, judgment and skills nurses rely upon to do their jobs effectively, such as taking patient vitals and performing first aid Selection, use and maintenance of basic nursing tools and instruments Provision of safe, patient-centered care that improves outcomes

Bachelor’s Degrees

Bachelor of Science in Nursing (BSN) degrees offer more advanced training than ADN programs, making them a good fit for LPNs who want to become RNs, RNs who want to advance their careers and educations, and aspiring advanced practice nurses. Programs usually require about four years of full-time study, but some nursing schools offer ADN to BSN, LPN to BSN, and RN to BSN bridge programs that streamline coursework and reduce time to completion. Vocational, career, and four-year nursing schools award most BSNs, although some community colleges offer them through partnerships with higher education institutions.

Bachelor’s degrees in nursing usually require students to complete a combination of general education, core nursing, and elective courses. Many nursing schools also offer specialty tracks that allow students to balance general and core coursework with more targeted training in specific areas of the field.

This table details some of the courses BSN students take at nursing schools nationwide.

Anatomy & Physiology

Explores the human body’s parts and functions

Nursing Skills & Knowledge Gained

    Structure of the human body Organ names, locations, and functions Names and functions of key body systems, including the skeletal, cardiovascular, nervous, and respiratory systems Relationships between body systems, including the principles of homeostasis and complementarity

Health Assessment & Promotion

Teaches students how and why to assess patients’ health

Nursing Skills & Knowledge Gained

    The knowledge, skills, and attitudes nurses need to perform comprehensive medical history interviews and physical assessments Recognition of cultural differences when assessing patients of diverse backgrounds and orientation Recognition and documentation of abnormal findings Formulation of accurate nursing diagnoses Communication with patients about their health and disease prevention

Introduction to Research - The Foundations for Evidence-Based Clinical Practice

Trains nursing students in how to appropriately review and apply research in professional health care practices

Nursing Skills & Knowledge Gained

    Basic components of research studies, including theoretical, conceptual and clinical ideas and findings Appraisal of the quality of research studies and interpretation of key findings Integration of research findings into evidence-based nursing practices

Clinical Adult & Elder Nursing

Emphasizes the basic knowledge, skills, and values nurses rely upon when caring for adult and senior adult patients

Nursing Skills & Knowledge Gained

    Foundational nursing processes and competencies when caring for older patients with common acute health conditions Basic skills and processes nurses use when caring for adult patients with chronic health conditions Hands-on experience assessing patient health using the appropriate tools, equipment, and procedures Documentation of health histories, vitals, and other findings Formulation of relevant diagnoses

Master of Science in Nursing

Master of Science in Nursing (MSN) degrees prepare students for a variety of advanced nursing roles, including administrative, teaching, research, and direct patient care professions. Advanced practice nurses (APNs) – defined as nurse practitioners, nurse anesthetists, clinical nurse specialists, and nurse midwives – are often required to earn at least a master’s degree to practice, but clinical nurse leaders, health policy consultants, research nurses, and nurse educators often pursue MSN degrees, too. MSN degrees tend to require 18 months to three years of study, depending on the program and individual student. Recent nursing school graduates and practicing RNs can often enroll in RN to MSN or BSN to MSN bridge programs designed to streamline coursework and minimize overlap.

Research and graduate universities as well as career and vocational schools typically offer MSN programs, some of which can be completed partly online. Courses and curricula vary, but most schools offer students advanced training in the theories, research methods, and leadership skills APNs and nursing administrators employ in a wide variety of clinical settings. The table below highlights a few MSN courses offered by graduate nursing schools.

Medical-Surgical Nursing

Focuses on the role of advanced nurses and performance of tasks in a clinical setting

Nursing Skills & Knowledge Gained

    The role of advanced nurses in patient assessment and treatment Physiological, cultural, psychosocial, and cultural principles that impact wellness Clinical practice providing comprehensive care for acutely ill adults with an emphasis on nursing processes, basic and holistic assessment, diagnosis, and the delivery of care Awareness of patient perception and promotion of coping strategies and health understanding to achieve optimal outcomes Cooperation on an interdisciplinary health care team

Introductory Pathophysiology

Explores diseases and its effects on the body’s systems

Nursing Skills & Knowledge Gained

    Recognition of diseases in patients of all ages, particularly as they relate to major transitions on the lifespan continuum Minimization of risks and chronicity in patient care Patients’ perceptions of their own illnesses and the impact on clinical outcomes Understanding of symptoms present in certain populations and how culture shapes patient experiences

Advanced Assessment Residency

A hands-on practicum that focuses on advanced patient health assessment

Nursing Skills & Knowledge Gained

    Honing and exercising of skills and competencies advanced nurses need when evaluating patient health in a real clinical setting Detection and documentation of symptoms, pathophysiological changes, and psychosocial variation in patients, families, and communities Practical training addressing advanced health care issues, including treatment, health promotion, patient education, and holistic care

Foundations of Nursing Leadership

Discusses nursing leadership and management theories across various health settings

Nursing Skills & Knowledge Gained

    The role of nurse leaders in the context of dynamic health organizations Application of nursing leadership and organizational theories Strategies for incorporating change management theories Promotion of colleague and employee collaboration, communication and morale

Doctoral Degrees

Doctoral nursing degrees generally fall into two categories: Doctor of Nursing Practice (DNP) degrees and Doctor of Philosophy (Ph.D.) in Nursing degrees. Below is a breakdown of each degree as well as a look at common skills that graduates gain.

Doctor of Nursing Practice Doctor of Philosophy in Nursing
Objective Provide advanced practical training Prepares nurse scientists to develop new knowledge to advance the field and practice
Curriculum Focus Translation of nursing theories and existing research to practice. Students learn how to apply theories to improve health care systems and overall patient care delivery. Academic and/or research-focused. Students learn how to conduct extensive research to advance the field, serve as leaders and experts, and educate the next generation of nurses.
Duration of Program 2-3 years for MSN degree holders 4-6 years
Dissertation Typically no Yes
Required Clinical Hours Yes, amount varies by school No

SKILLS GAINED AT THE DOCTORAL LEVEL

DNP and PhD in nursing programs may cater to students with different long-term career goals, but they offer many of the same advanced skills and competencies. The following are among them:

Research skills

Ph.D. candidates usually complete a research-intensive curriculum that allows them to participate in, design, and conduct their own research studies, but DNP students also receive their fair share of research training, including instruction in how to critically analyze, interpret, and apply studies within their own clinical practices. Both types of programs emphasize research ethics and practices that promote safety and positive patient outcomes.

Advanced clinical training

DNP candidates learn and apply advanced clinical care through practicums, residencies, and hands-on labs and simulations. These skills span the full spectrum of patient care, from disease prevention and assessment through treatment and post-treatment care. For students enrolled in research-oriented Ph.D. programs, most practical training takes place in laboratories and research sites and emphasizes adherence to best research practices, medical research laws, and safety regulations.

Specialized knowledge

Both doctoral degree programs allow students to specialize in certain areas of medicine and nursing. DNP programs in particular tend to offer a number of specialty tracks, including nursing administration, midwifery, critical care, and family medicine concentrations. Ph.D. in Nursing programs frequently allow students to specialize in areas that reflect their career goals, such as nursing research, health care innovation, leadership, and nursing education.

Historical and theoretical perspective

Doctoral programs in nursing do not just teach students how to provide care, teach, lead, or conduct research. Students also learn what drives these practices. Knowing how to view training, research, and skills in their proper historical and theoretical context prepares graduates to make better decisions in their own careers and practices, become stronger mentors, and help advance the field of nursing.

Leadership

The careers doctoral nursing graduates assume may vary distinctly, but almost all of them serve as mentors and leaders in some capacity. DNP and PhD in nursing programs usually teach students general and health leadership theories, how and when to apply them in the workplace, and how to promote a safe, collaborative work environment.

Concentration Areas

Nursing degrees offer students the baseline training they need to practice nursing, while concentrations transform them into specialists. LPNs, RNs, and APNs can all specialize in certain areas of health care or in working with certain populations. There are two primary ways students and nurses hone this targeted training: nursing degree specialty tracks and board or professional certifications. In either case, these concentrations can help nurses secure work in the areas that interest them most.

The following list details some of the most popular and in-demand nursing specialties available and the types of nurses that pursue them.

Critical, Acute or Intensive Care Nursing

Critical or intensive care nursing specializations prepare students to care for critically ill or unstable patients, usually in intensive care units. Some nurses choose to concentrate on a particular age group, such as adult or pediatric critical care. A 2014 report from the medical recruiting firm HEALTHeCAREERS states that critical care is consistently among the most in-demand nursing specialties in the country.

Pediatrics

Nursing schools with pediatric specializations prepare students to care for infants and young children, often in hospitals and pediatric medical practices. A 2012 longitudinal study published in the Journal of Nursing Administration reports that pediatrics is one of the fastest-growing nursing specialties in the country, particularly when combined with additional training in critical care. Villanova University notes that pediatrics is a high-paced specialty area that calls for a great deal of stamina and patience.

Nursing Management

Nursing management, administration and leadership specialty tracks are common among MSN and DNP degree programs, but some organizations offer professional RN certifications in these areas, too. The American Organization of Nurse Executives offers nursing management certifications to candidates with an MSN, Master of Healthcare Administration or relevant MBA degrees. These programs teach practicing nurses and students how to lead, organize, motivate, and effectively direct nursing teams in preparation for leadership and executive positions.

Online Nursing Schools

Online learning has redefined educational accessibility on a truly global scale, and according to a 2008 study from the Lippincott Nursing Center, nursing schools quickly adopted it in hopes of bolstering enrollments and addressing the looming nursing shortage. Technological advances and innovative programs that allow online students to complete clinical training at local health facilities fueled the movement. Today, online nursing schools are everywhere, but potential students should still make sure the programs they choose are credible and effective. This list of top online nursing programs is an excellent starting point for research. The following criteria should also be considered.

Licensure-Focused Coursework and Exam Preparation

All nurses must be licensed to practice. For registered and advanced practice nurses, that means passing the National Council Licensing Examination in Registered Nursing (NCLEX-RN); LPNs/LVNs take the NCLEX in Practical Nursing (NCLEX-PN). Prospective students researching nursing schools, online or otherwise, should take the time to learn about the NCLEX and confirm that their chosen program teaches the skills and provides the training they need to pass. Exam preparation support, tutoring, and mentorship programs can also help. Readers can visit the National Council of State Boards of Nursing online to learn more.

Accreditation

When a nursing school is accredited, it means an independent organization has verified that its courses, instructional methods and other practices meet certain standards. Accreditation offers some assurance of quality and consistency, but for nursing students, it means much more: All U.S. states and territories require future nurses to complete accredited nursing programs before they can even sit for the NCLEX. In other words: no accreditation, no license. Look for online nursing schools accredited by either the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

Opportunities for Clinical Training

Nursing is by nature a hands-on career, so it requires some degree of hands-on training. Both the NLNAC and the CCNE require nursing schools to integrate on-site clinical training with real patients in order to be accredited. Most online nursing schools allow students to complete these practical requirements under the supervision of licensed nurses or physicians at local health facilities while tackling their more academic coursework online. Future students should clarify schools’ expectations before committing to any one program.

Bridge, Completion, and Accelerated Programs

Almost anyone can benefit from the flexibility of online nursing schools, but for working nurses and other professionals, saving time can be more of a sanity-saver than a perk. Many online nursing schools offer bridge or degree completion programs – such as ADN to BSN, RN to BSN, BSN to MSN, and similar programs – that factor in students’ previous education and training when establishing a course of study so that they do not have to repeat coursework. Some schools offer similar online nursing programs for students with degrees in different fields. By not requiring students to retake basic nursing and general education classes, these programs cut down the time to completion.

Components of a Successful Nursing Career

What Kinds of Skills Are Required?

Good nurses:

Credentials

All states require nurses to complete some degree of formal training through accredited nursing schools, but employers often look for candidates with professional certifications. Board and professional certifications allow nurses to become more specialized, keep their skills current and show employers they are invested in their careers. Credentials usually cover specific health care areas or patient populations. Here are just a few of the many certifications acknowledged by organizations like the American Nurses Association and National Association for Practical Nurse Education and Service. Their formal designations are noted in parentheses.

Nursing Tools and Technology

Nurses rely on a broad set of tools to do their jobs effectively, including:

Nurses must also be computer savvy and familiar with several software programs, among them:

Did You Know?

Roughly 40% of nurses do not work in hospitals.

Related Careers at a Glance

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