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    Nursing Career Paths: How to Become a Nurse and Advance Your Career

    There are many paths to becoming a Registered Nurse. You can start as an LPN and then work towards becoming a Registered Nurse, earn an ADN or BSN and then sit for the NCLEX immediately upon graduation, or take an alternative route. There’s no right way to become a nurse. But when you’re just starting out, the sheer number of options can be daunting. Read on to find out:

    • What your nursing career path options are
    • The differences in nursing levels and careers
    • Education requirements for each option 
    • Common career paths for nurses
    • And alternative career paths 

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    Why Nursing Is An Excellent Career Path

    Nurses are in HIGH demand. According to the BLS, in 2018 there were 3,059,800 Registered Nurses in the United States. By 2028, there will be a need for an additional 371,500 nurses, which is an expected growth of 12%. With the aging population, this number is expected to be even higher. Meaning that nurses should never have trouble finding work.

    Pathways into Nursing

    While there are different degree programs you can choose, becoming a nurse is ultimately about what type of license you have–you can have a Bachelor’s degree, for instance, but you will still need to pass the NCLEX to earn an RN degree. Check out the graphic below for the differences between the 4 primary pathways into nursing. 

      CNA LPN ADN-RN BSN-RN
    Salary Avg. $28,530 per year  Avg. $46,240 per year  Avg. $69,000 per year Avg. $83,000 per year
    Education 4-12 week state-approved training program 12-15 month diploma program or a 2 year Associate's Degree program 2-3 year Associate’s degree program, followed by NCLEX licensing exam to earn your RN license. 4-5 year Bachelor’s degree program followed by NCLEX licensing exam to earn your RN license.
    Role CNAs help patients with activities of daily living and other healthcare needs under the direct supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN).  LPNs responsibilities are more limited than an RN. They monitor patients’ health and administer basic patient care. ADNs work directly with patients, monitor and record vital signs, administer medication and provide medical guidance. BSN nurses are qualified for more complex procedures and more leadership opportunities than ADNs. They also have more opportunities for career advancement and specialization.

    CNA - Certified Nursing Assistant 

    A certified nursing assistant, or CNA, helps patients with activities of daily living and other healthcare needs. They work under the supervision of an RN or LPN. 

    Pros and Cons of Becoming a CNA

    Because the training process to become a CNA is just 4-12 weeks, it’s a great way for individuals to get their first experience in nursing and determine if they want to further their career to become an LPN or RN. Many CNAs are already in a nursing school program and use this career as a chance to learn more about the healthcare world and gain additional real world application and knowledge. 

    >> Related: How To Become A Certified Nursing Assistant (CNA)

    LPN - Licensed Practical Nurse

    An LPN license provides a nurse a functioning nursing license, but in many states, an LPN is more limited in the care he or she can provide than an RN. An LPN, for instance, may not be able to deliver certain types of medications, so their work opportunities may be more restricted. 

    Pros and Cons of Becoming an LPN

    Becoming an LPN can be a desirable choice for many looking to fast track into the nursing field, because you can achieve your LPN degree sometimes much faster than an RN degree. In some cases, you can get your LPN degree in as little as 12 to 15 months if you choose a diploma based-program. With an associates-degree program, you will complete your associate’s degree in about 18 to 24 months. 

    As an LPN, you earn significantly less than a registered nurse. According to the Bureau of Labor and Statistics, the average pay for an LPN in the United States is $46,240 per year or $22.23 per hour, while RN’s earn on average $75,510. 

    >> Related: Learn more about becoming an LPN

    RN - Registered Nurse

    Becoming a registered nurse (RN) is the gold standard in nursing. There are three main ways to become an RN: 

    Bachelor of Science degree in nursing (BSN). You will earn a Bachelor’s degree through a traditional university and then earn your RN degree upon completion of the program and successful passing of the NCLEX licensing exam. 

    Associate’s degree in nursing (ADN). Similar to a BSN, you will earn your associate’s degree from a licensed program, than earn your RN upon program completion and NCLEX passage, so you will have an ADN-RN. 

    RN diploma program. Diploma programs are more limited, but are based on clinical hours and prepare you to take the NCLEX degree, which will award you an RN license. Upon completion of this program, you will be an RN. 

    >> Related: Learn more about becoming an RN 

    ADN-RN vs. BSN-RN 

    If you decide on an RN license, the second decision you will have to make for your nursing degree is if you would like to choose a diploma RN program, an Associate’s degree-nursing program (ADN), or a Bachelor’s of Science in Nursing (BSN) program. 

    Each program will ultimately lead you to receiving your RN license, which you can only earn once you have completed an approved state program and passed your NCLEX test. Therefore, no matter which degree path you choose, you will be a Registered Nurse, but the education behind your license will be different. 

    Pros and Cons of an ADN Degree

    The appeal of an Associate’s degree for many people looking to become a nurse is that it can be a more affordable and faster route to nursing, especially if you are not looking to do anything besides direct patient care. 

    If you only have an Associate’s degree you will not be able to obtain an advanced practice nursing degree such as Certified Nurse Midwife, Nurse Practitioner, or Certified Registered Nurse Anesthetist. You’ll also typically earn less than RNs that hold a BSN. According to Payscale, the average salary for ADN nurses is $69,000, while BSN nurses earn an average salary of $83,000. 

    >> Related: Learn more about earning an ADN degree

    Pros and Cons of a BSN Degree

    The American Association of College of Nurses encourages a Bachelor’s of Science in Nursing as the minimum education requirement for nursing professionals. Obtaining a BSN is considered the gold standard for an RN and an increasing number of hospitals will only hire nurses with a BSN, especially those that are magnet hospitals or major teaching hospitals. 

    BSN’s take longer to complete and are costlier than ADN degrees. They are also often difficult to get into and can have long waitlists. 

    The Cost of a BSN Degree

    Four-year BSN programs cost an average of between $72,000 and $104,000 for tuition, plus there are additional costs for housing, meals, books, fees and more.

    But there are many factors that contribute to the cost of a BSN degree. These include where the school is located, whether you choose to enroll at a private college or a state school, and if the latter, whether you are attending as an in-state student or an out-of-state student. 

    Though cost is always an important consideration, it is also important that you remember the significant benefits and increased earnings that follow earning your BSN degree, as well as that you can lower your costs significantly by attending public institutions, seeking financial aid, and applying for governmental grants. 

    BSN Degree Paths

    The most direct (and common) route to a Bachelor of Science in Nursing is to graduate from a four-year baccalaureate program that offers two years of prerequisite and general education classes, followed by two years of advanced nursing and clinical training. Options exist for those who have already earned their Associate of Nursing Degree or who have earned a Bachelor’s degree in another field. The three paths to a BSN are:

    • BSN program – This is the most common route to a BSN and is the one pursued by students who have not graduated from a previous post-graduate program. If you attend a BSN program full time, you will complete it in four years. 
    • RN-to-BSN program – This program is the next step for Registered Nurses who have earned their Associate’s degree and who want to advance their careers and knowledge. With the advantage of already having learned a great deal of the pertinent information and having extensive clinical exposure, an ADN can often take exams to test out of some of the required coursework. Many of these programs are offered online to allow students to continue working while taking classes. Most students can complete the RN-to-BSN program in less than two years.
    • Accelerated BSN – This is a unique program that offers those who have already earned a Bachelor’s degree in another area of study to take the additional coursework and clinical work to become a BSN-degree nurse. These programs generally take between 11 and 18 months to complete and have a strong focus on all of the coursework and practice that specifically focuses on nursing and nursing theory. These programs have also been made available online, which is particularly attractive for those who are currently working and have “overwhelmingly positive outcomes” in terms of high NCLEX scores and low attrition rates.

    >> Related: Learn more about earning your BSN degree

    Advancing Your Nursing Education

    Nurses looking to increase their salary and career opportunities can do so by earning an advanced degree. 

      MSN DNP
    Salary  Avg. $113,930 per year Avg. $135,830 per year
    Education The average cost of an online MSN program is between $35,000 and $60,000. The average total cost of an in-state, online, accredited DNP program is $27,745.
    Role MSN-degreed nurses can work in any medical environment in which hands-on healthcare is needed, as well as in healthcare leadership, technology, and policy roles. An individual with a DNP can function in a provider capacity but most also work to generate new scientific and clinical knowledge in nursing and healthcare.

    MSN Nursing

    Obtaining a MSN in Nursing is becoming increasingly common, as there are more job opportunities available to nurses that hold a MSN degree. If you are interested in doing anything more than direct bedside nursing then you will need a MSN degree. 

    Pros and Cons of MSN degrees

    As an MSN, you will find yourself eligible for many more positions and offered much higher compensation, while at the same time finding yourself highly respected by colleagues and sought after for counsel and consensus. 

    MSN degrees do not always lead to huge salary increases, although, in general, you can expect to make more with an MSN degree. If you are a floor RN with an MSN degree that is not an advanced nursing practice degree, you may not see an immediate change in your pay. 

    APRNs including Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners earn an average of 113,930 per year, or $54.78 per hour, according to the BLS

    MSN programs are available online or in-person. According to U.S. News and World Report, the average cost of an online MSN program is between $35,000 and $60,000.

    Types of MSN Degrees

    1. A non-clinical MSN degree on its own is more suitable for nurses who are looking for a management degree or to become a nurse educator
    2. An MSN advanced practice-nursing degree (APRN) is the type of degree you would choose if you are looking to become an advanced practitioner, such as a Certified Nurse Midwife or Certified Registered Nurse Practitioner. 

    MSN Jobs

    Individuals with an MSN can fulfill the following roles, depending on the program chose:

    • Clinical nurse leaders
    • Nurse practitioners
    • Certified nurse midwives
    • Clinical nurse specialists
    • Certified Registered Nurse Anesthetists
    • Nurse administrators
    • Nurse educators
    • Nurse informatics

     >> Related: Learn more about getting your MSN Degree

    DNP Nursing 

    Doctors of Nursing Practice (DNP) deliver high-quality advanced nursing care in a clinical setting, similarly to an NP; however, these individuals have taken their career a step farther.

    Essentially, DNP graduates are leaders in advanced nursing practice that bring evidence-based knowledge into the clinical setting to help improve healthcare outcomes and strengthen the leadership role of nurses in both the clinical and academic setting. 

    Pros and Cons of DNP Degrees

    Nurses benefit from earning their DNP in both knowledge, career satisfaction, and salary. 

    1. Knowledge: According to the AACN, nurses who have earned their DNP have enhanced knowledge to improve nursing practice and patient outcomes, enhanced leadership skills, increased supply of faculty for clinical instruction and development of needed advanced competencies for increasingly complex clinical, faculty and leadership role
    2. Job Duties: An individual with a DNP can function in a provider capacity but most also work to generate new scientific and clinical knowledge in nursing and healthcare. A nurse practitioner with a doctorate does not change the scope of practice. DNPs that work solely in the clinical setting will rarely conduct scientific research or teach. For this reason, most DNPs also work in academia, as administrators, and/or researchers. 
    3. Salary: The U.S. Bureau of Labor Statistics has very limited data on DNP salaries but the reported average is $135,830. Hospital administrators, DNP-prepared certified nurse midwives, and DNP-prepared certified nurse anesthetists earn the highest salaries. According to the 2019 U.S. Bureau of Labor Statistics, Certified Midwives can earn on average $147,820 in the San Francisco, California area while certified nurse anesthetists can earn $285,460 in Akron, Ohio.

    Earning your DNP does not come cheap. The average total cost of an in-state, online, accredited DNP program is $27,745, with the most affordable costing under $12,000 and the costliest adding up to over $60,000 in 2017. 

    >> Related: Learn more about earning your DNP degree

    Common Career Paths for Nurses

    The most common path taken by Registered Nurses is through a traditional four-year undergraduate BSN program. With the IOMs recommendations of BSN by 2020, there has been an increasing number of students obtaining undergraduate BSN degrees. This number will only continue to rise. 

    The Institute of Medicine reported on the future of nursing in 2010, making a strong recommendation that 80 percent of the nursing workforce have a baccalaureate degree (BSN) by 2020. At the time of the report’s release, only 50 percent of the nursing workforce had a BSN. Now, there is an estimated 55-60 percent of nurses who have such a degree. “Research has shown a higher percentage of baccalaureate nurses on a unit reduces morbidity and mortality,” says Tina Gerardi, the Deputy for the Academic Progression in Nursing Programs (APIN).

    Alternative Career Paths for Nurses

    Nursing is a complex and ever changing profession that provides individuals with countless job opportunities. Most know about pediatric, medical surgical, operating room, and even hospice nursing; however, there are less popular but still exciting career paths for nurses. 

    How to Decide Which Path is Right for You?

    Becoming a nurse is a dream for many, but knowing where to start can be daunting. There are hundreds of nursing programs and many different paths to take. Before starting on your journey, ask yourself,

    • Do I want to advance my career upon graduation and become a CRNA or CRNP?
    • How will I pay for this program?
    • Will I be working throughout the program?
    • Will I go to school part-time or full time?
    • Can I move away from home for undergraduate school?

    Determining what your goals are for nursing will help narrow down the choices.  Nursing is a fulfilling and amazing career- regardless of the path chosen; becoming a nurse is an amazing accomplishment. 

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