What Are The Different Levels Of Nursing In The USA?

By ShiftMed Team/August 4, 2022/Nursing

The fact that there are various levels in the nursing field is exciting news to many. It means that there are numerous potential opportunities for individuals who want to make a difference in the medical field—regardless of their level of educational attainment.

So if you wish to specialize, climb the ranks or pursue entrepreneurial endeavors, nursing offers different degrees or certifications to prepare you for your professional goals.

Besides, the opportunities don't end once you get employed. You can mold your career to match your priorities and passions by continuing to climb the nursing hierarchy.

In general, nurses are categorized into three: non-degree, degree, and advanced degree. The first group, non-degree nurses, includes licensed practical nurses (LPNs) and certified nursing assistants (CNAs) who undergo nursing education programs that don't end up at a degree level.

Degree nurses comprise those with an undergraduate degree in nursing, such as a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN). Lastly, advanced nurses have a graduate degree in nursing, such as a Doctor of Nursing Practice (DNP) or a Master of Science in Nursing (MSN).

This article explores the different levels of nursing, giving you an in-depth understanding of education requirements and the growth rate of each, starting from entry-level positions up to masters and doctoral-level nursing roles.

Level 1 - Certified Nursing Assistant (CNA)

Certified nursing assistants (CNAs) are also known as nursing assistants or nursing aides. They typically work in home care and long-term care facilities and are the primary point of contact between patients and the medical staff.

The nursing assistant role can be a perfect starting point for many individuals who aspire to be nurses.

Nursing assistants help with patients' daily activities such as dressing, bathing, eating, and ambulating. They also provide companionship for their patients together with compassionate care.

Depending on training and the regulations of the state in which they practice, CNAs can measure vital signs, administer medication, and fill out patient records and charts using electronic medical software and other tasks that don't demand advanced training. In addition, they listen to patients' concerns and transfer them between places.

According to the Bureau of Labor Statistics (BLS), CNAs are often the frontline caregivers in nursing homes and health care facilities, having more direct contact with residents than other medical staff members.

CNA education requirements

Those aspiring to become CNAs must have a high school diploma or GED and also complete a state-approved CNA program.

A nursing assistant training program usually takes a couple of weeks to finish with a specified number of classroom hours, training hours, and lab or clinical practice.

Upon completing the program, aspiring nursing assistants must pass a state-approved exam to earn their CAN, or related, title and become state-certified.

The programs are typically found at local community colleges, vocational or technical institutions, or hospitals.

Recommended Reading - How to Become a Certified Nursing Assistant (CNA)?

CNA length of education program

4-12 week program
CNA certification exam

CNA salary

Entry-level: $24,000
Median average: $31,000
Senior-level: $40,000

CNA career progression prospects

Projected employment growth (2020–2030): 8% with more than 119,500 expected job openings.

Level 2 - Licensed Practical Nurse (LPN) or Licensed Vocation Nurse (LVN)

Licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) are used interchangeably depending on where you practice in the US. In California and Texas, the term LVN is used while the rest of the US states use LPN.

LPNs and LVNs are responsible for various patient support duties. First, they provide patient care as the primary communication between the patient and the healthcare team.

They monitor patients' health and administer basic care tasks such as inserting catheters, taking blood pressure, changing bandages, and starting IV drips.

Whether or not the LPNs require supervision to perform some of these tasks varies by state.

LPNs and LVNs work in nursing homes, hospitals, and other medical facilities under the supervision and guidance of an MD or RN.

LPN/LVN education requirements

To become an LPN or LVN, you must have a high school diploma or GED and complete a Practical Nursing Program.

These programs are available at community colleges, technical schools, or career colleges and can usually be completed within one year.

After successfully graduating, you must pass the National Council Licensure Exam (NCLEX-PN) to earn your state license, which qualifies you to practice.

Additional certification is also offered for nurses at the LPN level. These certifications show that an LPN or LVN has advanced knowledge about a subject.

To gain a competitive edge in the job market or acquire specialty training, LPNs and LVNs can earn certification in specialized areas such as developmental disabilities, IV therapy, childbirth, and more.

Recommended Reading - What is a Licensed Practical Nurse (LPN) or an LVN

LPN/LVN length of education program

1-year program
NCLEX-PN licensing exam

LPN/LVN salary

Entry-level: $36,000
Median average: $48,000
Senior-level: $65,000

Recommended Reading - How Much Do LPNs or LVNs Make in The USA?

LPN/LVN career progression prospects

Projected employment growth (2020–2030): 9% with more than 65,700 expected job openings.

Level 3 - Registered Nurse (RN)

A registered nurse (RN) administers active, hands-on patient care in various settings, including medical offices, hospitals, nursing homes, and other health care facilities. This level is what many people tend to associate with the term "nurse."

RNs assume the duties of recording patient medical history, administering medication, monitoring symptoms, establishing or contributing to a treatment or care plan, performing diagnostic tests, and monitoring medical equipment.

Registered nurses collaborate with doctors, physicians, and other medical team members to provide patients with the best course of treatment.

According to the BLS, some RNs can oversee LPNs, CNAs, and other healthcare staff. They also help to educate patients and their family members about health issues.

Specific duties and job titles vary depending on the work location and the types of patients needing care. RNs also have numerous opportunities outside direct patient care. For example, they can work to run health screenings or blood drives, promote public health, or staff the school health clinics.

Additionally, they can focus on their patient care duties but specific populations like emergency care, pediatric, neonatal, or psychiatric nursing.

Recommended Reading - What is a Registered Nurse (RN)?

RN education requirements

Becoming an RN requires either an Associate of Science in Nursing (ASN) or a Bachelor of Science in Nursing (BSN).

Upon graduation from either program, you must pass the NCLEX-RN exam to qualify as an RN. This exam should not be confused with the NCLEX-PN for practical nurses.

When choosing which program to take, it's crucial to think and determine the educational preferences for each type of work you want in the future.

Some employers, especially hospitals, like RNs with a bachelor's degree. Below is more information on how the two degrees differ and their long-term impact on your career path.

Associate Degree in Nursing

Completing an associate degree in nursing program to become an RN is ideal for individuals who do not want to go through a four-year program. Previously, these programs were available through community colleges. However, some four-year institutions offer ADN programs, also known as ASN.

Bachelor of Science in Nursing

A BSN leads to better opportunities and salaries in today's employment market. A BSN degree program typically takes four years and may require a full-time commitment. But a hybrid BSN program is open for those who need to study while working.

RNs are now required to complete the BSN program in some states like New York. This trend is driven by various studies demonstrating better patient results when RNs have a BSN.

RN length of education program

Associate Degree in Nursing (ADN)
- 2-3 year program
Bachelor of Science in Nursing (BSN)
- 4-year program

RN salary

Entry-level: $46,000
Median average: $72,000
Senior-level: $110,000

Recommended Reading - How Much Do (Registered Nurses) RNs make?

RN career progression prospects

Projected employment growth (2020–2030): 9% growth rate

Level 4 - Nurse Practitioner (NP)

Becoming a registered nurse (RN) is one step toward becoming a nurse practitioner (NP). NPs assume all typical duties of an RN and prescribe medication (under physician supervision in some states), diagnose and treat health issues, provide advanced interventions and advise on public health issues.

They work in hospitals, long-term care settings, and private community clinics. As an RN, you can continue with graduate education to have more responsibilities and autonomy as an NP.

Recommended Reading - What is a Nurse Practitioner in the USA?

NP education requirements

The first step to becoming an NP is to earn a bachelor's degree in nursing. You must then pass the NCLEX-RN examination and obtain an RN licensure.

The next step is to complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a specialty in the family nurse practitioner (FNP) role. Along with FNP, MSN, or DNP, students can choose other role specialties depending on what's offered in the university, including nurse executive, pediatric nurse practitioner (PNP), nurse educator, psychiatric mental health nurse practitioner (PMHNP), etc.

To become licensed as a nurse practitioner, you must take a national certification exam through any of the national certification boards, including the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), or the National Certification Corporation (NCC).

Each board's exam is different, so you should research the format and focus of each and consider your personal testing preferences and goals when deciding which exam to take. In addition, some schools require applicants to obtain clinical experience before joining the graduate nursing program, so it's crucial to check each university's requirements before applying.

Recommended Reading - How to Become a Nurse Practitioner in The USA?

NP Length of education program

MSN: 6-8 years

NP salary

Entry level: $77,000
Median average: $104,000
Senior-level: $141,000

Recommended Reading - How much do Nurse Practitioners Make in the USA?

NP career progression prospects

According to the U.S. Bureau of Labor Statistics, the employment growth rate of nurse practitioners is projected to be 28.2% from 2018 to 2028, with about 53,300 new job openings.

Level 5 - Advanced Practice Registered Nurse (APRN)

Nurses who complete either their Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) are ready to become advanced practice registered nurses (APRNs).

As an APRN, you must be willing to take on more leadership roles in patient care. These nurses have numerous career choices. They can perform their duties independently or in collaboration with physicians.

APRNs administer all responsibilities of an RN as well as more extensive roles like referring patients to specialists, ordering and evaluating test results, and diagnosing and treating health issues.

APRNs include nurse anesthetists, practitioners, midwives, and clinical nurse specialists.

There are other notable career paths APRNs could pursue outside their typical roles, like becoming a nurse educator to help train the next generation of nurses. APRNs can also advance into leadership roles like becoming a director of nursing.

APRN education requirements

To become an APRN, you must first become an RN. Applying for an MSN program requires candidates to first hold an active RN license, with most preferring BSN.

Specific graduate programs exist for each type of APRN. For example, nurse practitioners need to enroll in a program that matches specialized licensure options like pediatric care, psychiatric-mental health, adult-gerontology, or primary family care.

Once you've decided which APRN career option, you'll need an MSN or DNP program and earn your graduate degree. Depending on your APRN specialty, additional requirements to obtain licensure, including further certification or clinical experience.

Once you've graduated, you'll need to pass a national certification exam in your specialty. Finally, APRNs get licensed through the state board of nursing in which they work.

APRN length of education program

Master of Science in Nursing (MSN)
- 2-3 years post-graduate program
- APRNs must also pass a certification exam in the area of specialization and complete in-person clinical hours.

Doctor of Nursing Practice (DNP)
- 3-4 years post-graduate program

APRN salary

Entry-level: $74,000
Median average: $106,000
Senior-level: $151,000

APRN career progression prospects

Projected employment growth (2020-2030): 45% growth rate.

Choosing Your Desired Path

There are various types of nurses and several nursing specialties to choose from. Every type has a unique set of educational and clinical requirements, and different job responsibilities and salary rates define each level.

There are five nursing levels in the US with educational needs ranging from weeks-long vocational courses to a six or eight-year advanced degree at the highest level. And within each level, there are other sub-levels based primarily on additional certifications, experience, and job performance.

Whether you are just starting your nursing career or hoping to advance, there are many pathways to help you achieve your career goals.

Depending on your interests, income needs, budget, and overall objectives, you can find the best level of nursing that suits you. Learn more about nursing programs and get all the help you need.