The field of nursing is constantly growing laterally and vertically. New layers and hierarchies are being added, and more people can work under those hierarchical levels. The profession is expanding to address the changes taking place in healthcare. Historically, nurses have been working as a link between doctors and patients. They had been the ones spending the most time at the bedside of the patients. Though nurses are still taking care of patients, giving them compassionate care, and educating the masses, there are considerable changes in their work. Today, nurses are allowed at the top of the hierarchies too. Many states have authorized nurses to diagnose, treat and prescribe medications to the patients. They are now sharing the work of the physicians.
Overall, there are three types of nurses you may find in the hospitals. They are degree, non-degree and advanced degree nurses. The certified nurse assistants (CNAs) and licensed practical nurses (LPNs) fall under the category of non-degree nurses. They have the basic nursing education, but their education does not culminate into a degree. The next is the non-degree nurses. They include those who practice with a Bachelor of Science in Nursing (BSN) or an Associate of Science in Nursing (ASN). The last category is advanced practice nurses, including those with a graduate degree such as an MSN or a DNP/Ph.D degree in nursing. DNP is more famous among nurses than PhD. in nursing. The difference between DNP and PhD is that the former is a practice-oriented degree, while the latter is geared towards research. However, both are terminal degrees in nursing. Below we will look at each level and the job duties at each of these levels in depth.
- Certified Nurse Assistants
At the start of the hierarchy are the CNAs who have a CNA certification exam and state license. You can become a CNA with a diploma in nursing. The length of the program is 3 to 8 weeks. But working as a nurse requires you to have a certain number of training hours, lab or clinical hours, and classroom hours. The job duties of a CNA include working in the home care and the long-term care settings in the nursing homes. They are often the primary point of contact between the patients’ families and healthcare. They provide compassionate care and companionship to their patient. Their routine jobs include helping the patients eat, bathe, change clothes, and ambulating. Depending on the state’s authorization, they can administer medications, take vital signs, and fill out the patients’ medical charts using the software.
- Licensed Practical Nurse
Next comes LNAs; they are ready to work in the field with a practical nursing program, hence, do not require any degree education. They are often work-study programs suitable for professionals working alongside. An LNA needs to pass (NCLEX-PN) the National Council Licensure Examination for Practical Nurse to practice nursing.
LNAs are the primary contact between the patients and the healthcare organization in the field. They take care of the patients, monitor their condition, and perform tasks like taking blood pressure, starting IVs, changing bandages, and inserting catheters.
- Registered Nurse Practitioner
Now comes the degree nurses. RNs are the most commonly known nurses, and often their job duties are toned down, considering them similar to CNA or LNA. In reality, RNs are at a higher level of hierarchy. To become an RN, you need a BSN or an Associate of Science in Nursing (ASN) degree. Later, you must pass the state licensing test to practice in the field.
Working as a nurse with an Associate degree is easier, and it does not require you to study for four years. Initially, these programs were offered in community colleges. But four-year program colleges are also offering them under Associate Degree in Nursing (ADN) programs.
On the contrary, you must attend a four-year college for a BSN program. BSN degrees increase your earning potential and open more job opportunities. You can also participate in an online BSN program and work simultaneously.
The specific test for an RN is the NCLEX-RN exam, and it must not be confused with an NCLEX-PN. Some states are okay for their nurses to have BSN or an ASN. However, other states are pushing legislation to mandate having a BSN degree to work as an RN. Their job duties include collaboration to develop patient care plans, administer medications, and collaborate with doctors. In some places, they might oversee CNAs and LPNs too.
- Advanced Practice Registered Nurse
Next comes the Advanced Practice Registered Nurses, who are higher in ranks than RNs. For working as an APRN, you need a state RN license and at least one year of working experience. You can become an APRN with a Master’s degree. But some hospitals and states prefer their APRNs with a DNP.
The graduate degrees open the path of specialization and focus on one area of nursing. You can focus your knowledge on the area of your choice. It could be providing direct care to the patients or working as nurse educators in educational institutions. On the contrary, A DNP program takes you to the pinnacle of nursing education. With DNP, you will learn about healthcare policy, health information systems, and organizational leadership. You can work with an MSN too, but DNP is a treat for nurses who want to challenge, solve critical problems and be part of policymaking.
A graduate-level education makes you a Nurse Practitioner. In this capacity, you are eligible to diagnose, treat and prescribe medications. You can work in hospitals, long-term facilities, and private care clinics. Besides, leadership roles in these work settings are also open to you. You might have heard about some nurse practitioners, including clinical nurse specialists, nurse anesthetists, and nurse-midwives.
- Nurse executives
Now comes the managerial side of this profession. Many of you might be more interested in managing a facility or looking after the administrative side than engaging in bedside care. For that, you have nurse manager and executive jobs in healthcare. You can run the whole hospital at the executive level and develop strategic care plans for patients. In the top-level administration, you might be less involved with direct patient care, but your decisions have a much bigger impact. Leadership, communication, problem-solving, and critical thinking skills are essential for working in executive positions.
There are various levels in the nursing profession, though most people from the outside cannot differentiate. As your level increases, so do your earning potential and job opportunities. You can assume more responsibilities and have more meaningful roles in healthcare. But the prerequisite for an uphill journey in nursing requires you to have the right education and skills.