The Meaning Behind Nursing Titles
Written By: Kathleen Colduvell RN, BSN, BA, CBC
In terms of educational options related to the nursing profession, there are a plethora of programs available to students. It is important to understand all of the available alternatives and determine which program or advanced degree fits your career goals and lifestyle. According to the Henry J. Kaiser Family Foundation, there are currently 3.1 million active registered nurses and approximately 800,000 licensed practical nurses in the United States.
LPN or LVN Degree
The quickest way to enter the nursing workforce is to become a licensed practical nurse (LPN) or licensed vocational nurse (LVN). These programs usually take a year to complete and can be done through local community colleges, vocational/technical schools, or hospital-based programs. This option is convenient for those who work or have families. Additionally, some courses can be taken online or during the summer, which gives students greater flexibility. These programs are faster paced than other nursing programs and only teach basic nursing skills vs. in-depth science and nursing classes.
While this may be the quickest avenue to enter the nursing profession, the use of LPNs is being phased out. In many facilities, LPNs are being replaced with Registered Nurses (RN) who hold Bachelors of Science in Nursing (BSN) degreesor those with Associates Degrees in nursing. Furthermore, LPNs have a smaller scope of practice than RNs. The scope of practice is determined by each state, and LPNs may or may not be able to:
- Take verbal or phone orders from a doctor
- Administer narcotics
- Care for central intravenous lines
- Administer medications that are given via intravenous push
According to the U.S. Bureau of Labor Statistics, LPNs can earn annual salaries as low as $33,300 in West Virginia, and up to $53,010 in Connecticut. LPNs average approximately $20 per hour. Fortunately, as LPNs are being phased out of hospital settings in some states, they are still able to find employment in nursing homes, rehabilitation centers, and home care.
Bachelor of Science in Nursing (BSN)
Obtaining a BSN requires a commitment to a four-year program through an accredited university. Some students enter these programs after completing high school. Nurse hiring committees often favor candidates with a BSN degree; nurses with their BSN will usually have better job opportunities and the potential to earn higher salaries.
BSN programs are a combination of lecture-based classes and clinical rotations completed at a local hospital or other medical facility. Nurses that plan on advancing their career and obtaining higher education degrees will need a BSN in order to enter those advanced programs. After completing a BSN program, students are able to sit for the National Council Licensure Examination (NCLEX) to become a registered nurse. A student needs to pass this exam before practicing as an RN.
Registered Nurse (RN)
A registered nurse is a nurse who has graduated from an accredited nursing program with a BSN, associate degree in nursing (ADN), or diploma from a hospital-based program in nursing. To obtain an RN license, an individual needs to pass the NCLEX in the state where they wish to obtain licensure. Students also need to check with their state of residence since some states have additional criteria for licensure. RNs are able to hold licenses in multiple states at the same time. A nurse is only required to pass the NCLEX once and then may apply for a license to practice in other states after the initial licensure.
Nurses are responsible for administering medication, monitoring patients' conditions, documenting nursing care, notifying medical staff about patient progress of the patient, and performing medical procedures that are within their scope of practice.
According to The U.S Bureau of Labor Statistics Occupational Outlook Handbook for 2016-17, the median expected annual salary for RNs is $66,640. California has the largest number of active registered nurses with an annual mean salary of $102,260. California, Alaska, Hawaii, Oregon, and Massachusetts have the highest mean salaries for nurses; however, they do vary within each state. West Virginia, Alabama, Mississippi, South Dakota, and Iowa have the lowest mean salaries for RNs.
Nurse Practitioner (NP)
Nurse Practitioners (NP) are advanced practice nurses (APRNs) who have taken masters-level classes and passed the American Academy of Nurse Practitioners Exam. Nurse Practitioners can specialize in adult, geriatric, pediatric, family, or women's health; within each of these specialties, a Nurse Practitioner can specialize even further. For example, a pediatric nurse practitioner (PNP) can specialize in cardiac care, intensive care, oncology, or become a general practitioner, to name a few. These subspecialties require additional classes and on-site training, and with more specialization comes potentially higher salary opportunities.
To become a nurse practitioner, one has to first be a current registered nurse. RNs interested in advancing their careers must apply to a graduate program that offers their specific program of interest. Applicants are required to submit resumes and letters of recommendation, as well as transcripts from their undergraduate education. Some programs require an applicant to take the GMAT (Graduate Management Admission Test) as well. NP programs generally require 2-3 years as a full-time student or 5 years if completed on a part-time basis.
The American Academy of Nurse Practitioners (AANP) released a statement, revised in 2015, outlining the scope of practice for an NP. "Nurse practitioners assess, diagnose, treat, and manage acute, episodic and chronic illnesses. NPs are experts in health promotion and disease prevention. They order, conduct, supervise, and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non-pharmacologic therapies, as well as teach and counsel patients, among other services." The AANP acknowledges that these practices will vary among individual states and institutions.
As of May 2015, the U.S Bureau of Labor Statistics reported the median salary for NPs was $98,190. California registered the highest median salary for NPs at $120,930. Currently, California, Hawaii, Alaska, Massachusetts, and Oregon have the highest median salaries for NPs. Pennsylvania, Kansas, South Carolina, Missouri, and Illinois have the lowest median salary for nurse practitioners.
Kathleen Colduvell, originally with a degree in journalism, has worked in numerous hospitals over her eight years as a NICU nurse. Currently, she works at one of the leading children's hospitals in the country in the NICU, PICU, and CICU and works as a Certified Breastfeeding Consultant.