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The Levels of Nursing Practice

5 min readFebruary, 09 2024

If you are considering a career in nursing, you may find the various acronyms for nursing specialties, certifications, and education credentials confusing. Don't be discouraged, as the multiple levels of nursing and educational paths indicate the vast opportunities available within the nursing profession.

To choose your path in nursing, consider your short- and long-term goals, the amount of time you'd like to invest in your education, and the type of work environment you want to work in. After obtaining your initial nursing degree, you can still decide to expand your options or focus on a nursing specialty.

The Levels of Nursing

Each level of nursing begins with specific, required education through an accredited program. Before practicing as a nurse, you must also complete and pass a licensing exam. 

Let's break down the three main types of levels of nursing,  to help you answer the most common questions about the nursing profession.

Licensed Practical Nurse (LPN)

Becoming an LPN (Licensed Practical Nurse) may be the first step towards starting a career in nursing, although it is not a mandatory requirement. LPNs provide basic patient care and can work in various health settings such as long-term care and home care, but their job opportunities and earning potential may be limited compared to RNs (registered nurses). Depending on their state’s board of nursing, an LPN may supervise certified nursing assistants (CNAs), However, they generally usually work under the guidance and supervision of a RN, APRN (advanced practice registered nurse), or physician. 

A high-school degree or equivalent is required to apply, and some practical nursing programs may require a minimum high school GPA or minimum scores on the general educational development test (GED). Depending on the practical nursing program you choose, some may also require prerequisite courses in math and science. 

Once you've chosen an accredited practical nursing program, expect to commit to at least a year for your education at a hospital, community college, or technical school. The final step is passing the National Council Licensure Examination for Practical Nurses (NCLEX-PN).

Note that in California and Texas, an LPN may be referred to as an LVN (licensed vocational nurse). If you aspire to advance your career in nursing, some schools offer accelerated programs that allow you to advance from an LPN to an RN by obtaining an Associate Degree in Nursing (ADN), or a Bachelor of Science (BSN). 

Registered Nurse (RN)

An RN supervises their direct care staff (including CNAs and LPNs) and plays a crucial role in patient care. This multifaceted role includes assessing, monitoring, and treating patients. Other responsibilities include educating, supporting, and advocating for patients and their loved ones. RNs can work in traditional hospital settings or various nontraditional health areas such as education, forensics, and public health.  

There are various educational paths to becoming an RN, some of which build upon each other. The key difference is the type of nursing academic degree obtained, which influences education time and potential prerequisites. However, some organizations may require additional education (and offer higher salaries), like acquiring a Bachelor of Science in Nursing (BSN).

No matter what type of nursing degree you pursue to become an RN, you must pass the NCLEX-RN exam. Your state’s Board of Nursing (BON) also requires you to keep your credentials current.

RN nursing degree levels include:

  • Diploma Nurse: This program takes about two years but isn't a college degree. Instead, a hospital, technical, or vocational school may offer this nursing program.
  • Associate Degree in Nursing (ADN): This usually takes two to three years to complete, often at a community college and results in an entry-level college degree.
  • Bachelor of Science in Nursing (BSN): This nursing degree usually takes at least four years to complete. This four-year degree sets you up to pursue further opportunities.

As a Registered Nurse (RN), you have the opportunity to enhance your skills and advance your career through further education and training. There are several options to consider:

  • Certification in a Nursing Specialty: This is a great way to specialize in a particular area of nursing such as critical care, pediatrics, oncology, and more. Certification can help you gain advanced knowledge and skills, which can lead to higher pay or promotions.
  •  Master's Degree in Nursing (MSN): An MSN is an excellent choice if you're interested in nurse leadership, education, or advanced clinical practice. Typically taking 1.5 to 2 years, an MSN program can prepare you for roles as an APRN (advanced practice registered nurse) or other advanced clinical positions.
  • Doctorate in Nursing (PhD or DNP): A doctorate is the highest level of nursing education. A PhD focuses on research and advancing nursing knowledge, while a Doctor of Nursing Practice (DNP) is practice-focused, preparing nurses for the highest clinical positions or leadership roles. Pursuing a doctorate can open new career opportunities and help you make a significant impact in the nursing field.

Smiling young nurse with an afro holds a clipboard in a classroom with fellow nurses chatting behind.

Advanced Practice Registered Nurse (APRN)

APRNs, which include CRNPs (certified registered nurse practitioner), CRNAs (certified registered nurses anesthetist), and CRNMs (certified registered nurse midwife), play a pivotal role in healthcare. They often lead the care team, and depending on the state, have varying degrees of autonomy. The educational requirements for APRNs are indeed rigorous, typically requiring a Master of Science in Nursing (MSN) at minimum, and increasingly a Doctor of Nursing Practice (DNP) for the highest level of practice. The scope of practice for APRNs can include: . 

  • Independent Practice: Some states allow APRNs to practice independently without physician oversight.
  • Prescriptive Authority: Many states grant APRNs the authority to prescribe medications, including controlled substances.
  • Leadership Roles: APRNs often hold leadership positions, influencing healthcare policies and patient care standards.

An APRN offers many opportunities to specialize, and most states require successfully passing a certification exam in your chosen specialty. The American Nurses Credentialing Center (ANCC) offers many first-time certifications and renewals. Find more information here. 

Start Your Nursing Journey!

As with all levels of nursing, different states may have slight variations on the scope of care you're permitted to provide, and the level of supervision required. No matter where you decide to start your nursing degree, each level of licensure offers various job opportunities and a path to a satisfying career. 


Images sourced from Getty Images

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