Nurses are vital to the healthcare workforce and the delivery of care. Nurses handle a wide variety of functions, from allergy skin tests to leading a team of nursing leaders as part of hospital management. This article will cover the levels of education available to nurses and the options you have to move forward with your nursing career on and after these levels.

Level 0: Nursing assistant certificate

The requirements for becoming a certified nursing assistant vary in different states, but typically the training program is state approved. It only takes four to eight weeks to become a certified nursing assistant.

However, as the name might indicate, a certified nursing assistant is not actually a nurse. Certified nursing assistants instead help patients with their immediate needs and perform limited care, under the supervision of a registered nurse. The responsibilities of certified nursing assistants vary widely, but some of them include moving, bathing and grooming patients; providing nutrition and documenting intake; checking vitals; answering the phone; stocking shelves; and taking care of smaller wounds and sores.

The nursing assistant certificate allows you to get work in the healthcare sector very quickly. If you would like to get to work now, earn some money, and perhaps study more at a later time, then the nursing assistant certificate may be a fit for you. You will have to start at the basic level. The next step could be a diploma in practical nursing, an associate degree in nursing or even a bachelor’s degree, the first being the easiest, and the last two allowing you to become a registered nurse.

Level I: A diploma in practical nursing

A diploma in practical nursing is the lowest level of nursing education. The diploma allows a quick entry to the nursing labor market, as holders become licensed practical nurses. This is particularly suitable if you do not have the time, funds or energy for more intensive education. The education itself takes one and a half to two years. Under the supervision of registered nurses and doctors, licensed practical nurses provide a basic level of care.

With a diploma, you can quickly get started as a nurse, but because of the short-term education, it is difficult to advance without further education. Thankfully, it is quite easy to find a licensed public nurse to associate nursing program, allowing you to reach the next level of nursing quickly and cost-effectively, gaining knowledge, more responsibility and more interesting tasks. You can also consider looking for a licensed public nurse to bachelor’s degree in nursing program, skipping the associate level entirely.

Level II: An associate degree in nursing

An associate degree in nursing takes around two years and is the first step towards becoming a registered nurse. Afterwards, you need to pass the National Council Licensure Examination (NCLEX-RN), as well as living up to the standards required by the board of nursing in your state. As such, it is still a fairly quick entry into the nursing labor market. However, the tasks and responsibilities are both greater and more varied than as a licensed practical nurse. Importantly, the median annual wage for registered nurses is over 50% higher than for licensed practical nurses.

As a registered nurse, you can specialize in a particular area of nursing. A few examples are oncology nursing, ambulatory care, cardiac care, emergency nursing, flight or transport nursing, geriatric nursing or hematology nursing.

Aside from specialization, as an associate degree holder and registered nurse, if you want further education, your next step is likely to be a master’s degree in nursing, skipping the bachelor’s degree entirely. 

Level III: A bachelor’s degree in nursing

A bachelor’s degree in nursing also allows you to become a registered nurse, after passing NCLEX-RN and meeting the other requirements in your state. As opposed to the associate degree in nursing, the bachelor’s degree in nursing typically takes three or four years. The advantage is that it provides a more rigorous education than an associate degree. This allows for a somewhat higher median salary and may give you greater opportunities for education and career development in the future.

A bachelor’s degree in nursing was previously considered an intermediate to advanced degree. Now, it is quickly becoming required of registered nurses at many hospitals. The demand for registered nurses with a bachelor’s degree is rising sharply, and the job market is looking good. You can decide to specialize in one of the fields mentioned above or something completely different. If you have a medium-sized appetite for education and would like to get it all done at once, then the bachelor’s degree in nursing is the highest degree available for students off the street.

After earning a bachelor’s degree and becoming registered, you can earn your master’s degree, which opens new opportunities for you. It’s also possible, though rarer, to go straight for a doctorate in nursing, provided that you have stellar academic credentials.

Level IV: A master’s degree in nursing

A master’s degree in nursing is an advanced degree, typically requiring two further years of study and a pre-existing qualification. This pre-existing qualification could be a bachelor’s degree, but it could also be holding an associate degree in nursing and a valid registered nursing license. Both paths are perfectly valid, but not all institutions offer programs for associate degree holders.

There are various reasons why you might want to pursue a master’s degree in nursing. A master’s of science in nursing gives you an opportunity to progress in your nursing career. Aside from an insatiable appetite for learning, a common reason could be to attain a high-level specialization or a management role.

Master’s in nursing specialties include becoming a nurse educator. As the name implies, nurse educators educate and train future nurses. This is particularly important as the demand for registered nurses is rising, and educators are required to train them. Also, a nurse educator might be employed at a hospital, allowing you to educate your colleagues. If you would like to teach or you think that you might be good at it, becoming a nurse educator can be very giving. However, you must realize that this means that opportunities to practice your craft as a nurse will be limited or even non-existent.

Another master’s in nursing specialty is civil study nurse leadership and administration. A master’s degree in nurse leadership and administration will allow you to become a leader in a clinical setting. If you are dreaming of management, becoming a chief nursing officer or director of nursing, then this could be a great opportunity for you. You could oversee the nursing unit or even all nurses in a large hospital complex.

However, if you want to remain an ‘actual nurse’, a good option is to become a nurse practitioner. A nurse practitioner is a highly educated nurse, holding a master’s degree or higher. A nurse practitioner is highly independent and has a lot of responsibility, but those responsibilities can vary widely depending on the field of employment – for example, as a family nurse practitioner. The demand for nurse practitioners is increasing more quickly than any other nursing specialty. Nurse practitioners are generally paid very well.

At the master’s level, you have many options. You can attain further education through post-master’s nursing certificates, or you can apply for a doctoral program in nursing, allowing you to perform research or other advanced nursing work. 

Level V: Post-master’s nursing certificates

Master’s level certificates let nurses add specialized knowledge and experience. A nurse could increase their employability or wage by taking certificates – for example, in nurse midwifery, as a woman’s health nurse practitioner, or an AGACNP post-master’s certificate, allowing nurses to become certified in caring for adults and older adults with acute illness. In the latter, nurse practitioners learn to care for acute and complex conditions in fields such as cardiology, oncology and endocrinology.

These certificates are voluntary, but they offer nurses interesting opportunities to advance their career. As a practitioner in any field, but particularly in an always-changing one such as nursing, it is important not to stagnate and stand still. A certificate can be a good option if you would like to do something new for a while. You can always take another certificate later.

The most driven and curious nurses go all the way and attain a doctorate in nursing.

Level VI: PhD-level certification

In this level, we look at the various nursing doctorates available. Relatively few nurses go on to attain a doctorate, but the numbers have risen in recent years.

·       Doctor of Philosophy in Nursing (PhD)

The Doctor of Philosophy in Nursing is one of three doctorates in nursing. It is a research-focused nursing education, requiring a bachelor’s or master’s degree in nursing. It can be helpful to be a registered nurse with clinical practice experience, but it is not a requirement. 

·       Doctor of Nursing Science

Similar to the Doctor of Philosophy in Nursing but considerably rarer, the Doctor of Nursing Science is an advanced academic research degree in nursing.

·       Doctor of Nursing Practice

The Doctor of Nursing Practice is an advanced and specialized nursing education leading to advanced leadership and research roles. What differs from the above two roles is that it is still possible to perform clinical work as a Doctor of Nursing Practice. A Doctor of Nursing Practice can also work in leadership roles at a hospital or other large medical institutions.

The Doctor of Nursing Practice curriculum is a more direct continuation of traditional nursing master’s programs. Typically, participants learn about evidence-based practice, quality control and systems leadership. Some programs, such as certain nurse anesthetist programs, will have specialized versions of the doctorate, such as the Doctor of Nursing in Anesthesia Practice.

Job options as a Doctor of Nursing Practice include becoming a clinical nursing specialist, an advanced practice nurse. Clinical nursing specialists choose an area of specialization, which can, for example, be focused on individuals, the type of care, or a diagnostic system. Today, clinical nursing specialists typically have master’s degrees, but in the future, clinical nursing programs will become doctorate level only.

Becoming a registered nurse

In short, becoming a registered nurse has three steps:

• Step one – Attain a degree, which could either be an associate or a bachelor’s degree in nursing. In some states, both are acceptable. However, it is more and more common that states require that registered nurses hold at least a bachelor’s degree in nursing. If you are new in the field, then it is probably best to go directly for the bachelor’s degree in nursing.

• Step two – Pass the National Council Licensure Examination. The NCLEX-RN, as it is known, is designed to test your knowledge and ensure that you are ready to become a registered nurse. When considering nursing programs, check out how many participants pass the National Council Licensure Examination in their first go.

• Step three – Get licensed in the state in which you want to practice. If you would like to work in multiple states, then you will need to be licensed in each one, as they all have their own individual requirements. Licensing is handled by the state’s board of nursing – for example, the California Board of Registered Nursing handles registered nurse licenses in California.

How to ensure that you keep developing as a nurse

Nursing is a dynamic, ever-changing and diverse field. As you have learned in the article above, nurses with varying degrees and specializations perform everything from routine care and practical tasks to the highest level of research and nursing leadership.

No matter where you are at in your career, it is important to keep progressing. Every year, the field gets more formalized. More and more states are requiring registered nurses to have bachelor’s degrees to get licensed, and clinical nursing specialist programs are increasingly offering doctorates instead of master’s degrees. It is important to keep up your level of education.

Nursing career development strategies

In any career, there are several strategies you can pursue to avoid stagnating.

As a new or budding entrant in the field, it is particularly important to keep your ambition level in mind, and to understand it in detail. If your aspiration is to become a registered nurse, then go straight for a bachelor’s degree. If you would like to perform advanced work, then you should start out aiming for a master’s degree at the least. It is always possible to move from one level of education to the next, but going back to school can be very difficult, for career, financial and family reasons. Also, you may end up spending more years in total on education than if you had gone for the right option at the start. However, all nurses should have a clear career goal, allowing them to measure their progress.

It is also important to make a habit of updating your skills. As an active nurse, whether you are employed in a clinical setting, or as a leader, it is important to keep your knowledge up to date. There are a few ways to do this. You can either pursue a new specialization or a post-master’s certificate. Both options will allow you to learn new skills, informing and developing your practice, whether as a clinician or a leader. As a nurse educator or a researcher holding a doctorate, your learning is likely to be more self-directed, either based on your own interests or the needs of your employer.

Also, whether you’re pursuing further education or not, it is important to keep up with the latest changes in nursing practice and technology. If you are not aware of what is changing, you won’t be able to spot opportunities as they arise. A good place to start is to subscribe to and make a habit of reading a trade publication or journal – for example, Nursing Management if you are a nursing leader, or the Clinical Journal of Oncology Nursing if you work with cancer patients.

One of the most impactful things you can do is keep looking for new challenges. If you stay in the same role for too long, you can lose your enthusiasm, and your days become routine. You could do a lot, even in your current role, by being on the lookout for new responsibilities. You can take charge of the next new treatment type, or take on administrative work, such as shift planning. If that fails, you could always look for a new job. It is better to apply for new, exciting nursing jobs before you get so bored that your performance starts to suffer.

Finally, make sure that you network. Connect with your colleagues in other departments and other facilities. Join an online discussion forum or go to a local network meeting. You can use a solid professional network for a thousand things.