Nursing Career Paths: How to Map Out Your Nursing Career

A nurse holding a clipboard and medication bottle talks to a patient in a hospital bed.

More job opportunities will open up for registered nurses through 2022 than for any other profession in the United States, according to the American Nurses Association. Nursing roles, and the career paths to reach them, are as diverse as the populations they serve. By understanding the education required for various nursing jobs, students can make the nursing career decisions that align with their professional goals.

When exploring the many nursing career paths, prospective nursing students should consider:

  • Nursing settings (e.g., clinic vs. hospital)
  • Nursing roles (e.g., nurse practitioner vs. RN)
  • Nursing-adjacent careers (e.g., nurse administrator vs. nurse educator)

Students and professionals interested in nursing can benefit from exploring the many routes to working in a nursing role today.

Consider the Setting: Clinic vs. Hospital

Hospital nursing and clinic nursing can look different. A significant difference between hospitals and clinics is patient acuity, a measurement of the severity of a patient’s illness or injury. Given that hospitals deal with emergency patients, nurses who work at hospitals typically provide a higher level of care than those who work in a clinic. Nurses working in hospitals must be ready to handle emergencies, as well know how to stabilize and monitor patients.

Another major difference between hospital nursing and clinic nursing is the type of care nurses deliver. In clinics, nurses may focus on preventive health. They may educate patients and families on topics such as healthy diets, living with diabetes, and blood pressure management. In hospitals, nurses also educate patients about the acute illness or injury that the patient was admitted for.


Providing Healthcare Services Without a Four-Year Degree: Certified Nursing Assistants and Licensed Practical Nurses

For students looking to start a career in nursing, working as a certified nursing assistant (CNA) or licensed practical nurse (LPN) can be a great entryway into the field.

Both CNAs and LPNs provide direct patient care in nursing homes, home healthcare settings, and assisted living facilities, for example.

CNAs assist the nursing team with a limited scope of basic care duties. They may help patients with bathing, eating, and walking. CNAs are typically supervised by LPNs or registered nurses (RNs), who may provide more extensive care, including administering medications.

CNA training programs are significantly shorter than LPN programs, enabling aspiring CNAs to begin their careers in a matter of months but often at a much lower wage than other care professionals.

Becoming an LPN requires completing an accredited practical nursing certificate program, which is usually offered at community colleges and takes about a year to complete. Students can expect to take courses in biology, pharmacology, and nursing while also participating in hands-on clinical experiences.


How to Become a Registered Nurse

In the United States, prospective registered nurses (RNs) must pass the National Council Licensure Exam for Registered Nurses, also called the NCLEX-RN. Registered nurses make a median salary of $75,000 a year, according to the U.S. Bureau of Labor Statistics (BLS). The BLS also predicts that registered nursing jobs will grow by 9% from 2020 to 2030.

To register for and prepare to take the NCLEX-RN, students typically earn one of the following degrees:

  • A four-year Bachelor of Science in Nursing (BSN)
  • A two-year Associate of Science in Nursing (ASN)

The National Council of State Boards of Nursing reported that about 88% of first-time, U.S.-educated NCLEX-RN takers passed in 2019. Students who complete these programs usually gain classroom experience in: 

  • Biology
  • Anatomy
  • Physiology
  • Medical ethics
  • Critical thinking 

Four-year BSN programs also typically offer students clinical experience, where students work in hospitals, clinics, and other health settings. 

Check for Regional Requirements

Every state has its own regulatory board for licensing nurses. The National Council of State Boards of Nursing website provides information on state-specific requirements.

When considering nursing career paths, thinking about whether to earn an advanced degree is important. In 2018, a little over 17% of RNs in the United States held a master’s degree, and only 1.9% held a doctorate, according to the National Nursing Workforce Study. The majority of nursing professionals who earn advanced degrees work as advanced practice registered nurses (APRNs).


How to Become an Advanced Practice Registered Nurse

After gaining experience in the nursing field, a registered nurse may be ready to assume more responsibility. Becoming an APRN allows registered nurses to do just that.

APRNs are trained extensively to care for patients, deliver services, and diagnose illnesses. Their combination of education and specialized training affords them greater autonomy in the workplace.

Nurses who earn a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) often specialize. Some common specialties include:

  • Nurse practitioner 
  • Clinical nurse specialist 
  • Certified registered nurse anesthetist
  • Certified nurse midwife
  • Clinical nurse leader

Nurse Practitioner

A nurse practitioner (NP) is an advanced practice registered nurse who has received at least 500 hours of clinical training. NP education covers disease prevention, care coordination, and health promotion in around 1.5 years or more of post-baccalaureate training.

In some states, NPs are required to work under the supervision of a physician. In other states, NPs can practice independently.

The primary roles for NPs include:

  • Assessing patient needs
  • Ordering and interpreting tests (diagnostic and laboratory)
  • Diagnosing disease
  • Formulating and prescribing treatment plans

How to Become an NP

Aspiring nurse practitioners must become licensed registered nurses through a program such as a master’s of science in nursing before earning their advanced practice registered nurse certification. Several programs combine an undergraduate degree in nursing with nurse practitioner training. As a result, experience as a registered nurse is not required to become a nurse practitioner.

To become a nurse practitioner, nurses must:

  • Pass the NP certification exam
  • Apply for NP state licensure
  • Start working as an NP

The BLS reports a median nurse practitioner salary of around $114,500 per year. 

Clinical Nurse Specialist

Clinical nurse specialists (CNS) are responsible for supporting a specific patient population, such as adult acute and critical care, in a clinical setting. In contrast to nurse practitioners, clinical nurse specialists often function as educators and consultants to the nursing staff.

Core competencies for clinical nurse specialists include: 

  • Direct care
  • Consultation
  • System leadership
  • Staff coaching
  • Research
  • Interpreting evidence

Clinical nurse specialists typically focus on a specific subset of the population. For example, they may work with a specific group, such as children or adults; in a specific setting, such as the emergency room; or a certain health specialty, such as oncology and gynecology. Their specialized expertise enables them to be expert consultants and coaches to other staff members.

How to Become a CNS

To become a clinical nurse specialist, professionals must:

  • Pass the CNS certification exam
  • Apply for CNS state licensure
  • Apply for work as a CNS

Certified Registered Nurse Anesthetist

Certified registered nurse anesthetists (CRNAs) are APRNs who administer anesthesia and other medications to patients. They also monitor patients who are recovering from anesthesia. CRNAs have acquired a minimum of a master’s degree focusing on anesthesia, have completed extensive clinical training, and have passed a certification exam approved by the National Board of Certification and Recertification of Nurse Anesthetists.

How to Become a CRNA

To become a certified registered nurse anesthetist, professionals should:

  • Pass the CRNA certification exam
  • Apply for CRNA state licensure
  • Apply for work as a CRNA

The BLS reports a median salary of $167,950 per year for certified registered nurse anesthetists — the highest median pay for all nursing professionals in 2021. 

Certified Nurse-Midwife

A certified nurse-midwife (CNM) is a primary healthcare provider. CNMs focus on gynecologic and family planning services, as well as:

  • Preconception
  • Pregnancy
  • Childbirth
  • Postpartum care
  • Newborn care

CNMs also provide primary care such as conducting annual exams, writing prescriptions, and offering basic nutrition counseling.

How to Become a CNM

Certified nurse-midwives are APRNs backed by the American College of Nurse-Midwives. To become a CNM, registered nurses must graduate from a master’s or doctoral-level nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) and pass the national Certified Nurse-Midwife Examination through the American Midwifery Certification Board. All CNMs must hold state licensure.

To become a certified nurse midwife, professionals need to:

  • Pass the CNM certification exam
  • Apply for CNM state licensure
  • Apply for work as a CNM

The BLS reports the median salary for certified nurse midwives is $115,500 per year. 

Clinical Nurse Leader

The American Association of Colleges of Nursing (AACN) recently developed the clinical nurse leader (CNL) role out of a need to improve patient care and nurse preparation in the modern healthcare system.

CNLs are nursing administrators responsible for acting as a liaison between nursing administration and staff nurses, serving as a resource to front-line care providers. Their primary responsibilities include:

  • Assessing risk across groups of patients
  • Coordinating care among healthcare teams
  • Developing or revising care plans
  • Evaluating patient outcomes

How to Become a CNL

To become a clinical nurse leader, nurses can:

  • Pass the CNL certification exam
  • Apply for work as a CNL

The Clinical Nurse Leader (CNL) Certification Program is managed by the Commission on Nurse Certification (CNC), an autonomous arm of AACN. More information on the CNL certification exam is available on the AACN website. 

Nurse Educator

Nurse educators train RNs and other nurses to prepare for practice-based nursing roles. In addition, a nurse educator can support the licensed nursing staff of healthcare organizations with continuing patient care education. A nurse educator’s main responsibilities include:

  • Teaching patient care techniques to nursing students in universities or clinical settings 
  • Educating and acting as a role model to recently graduated licensed nurses
  • Acclimating newly licensed nurses to a healthcare facility’s culture
  • Evaluating, supporting, and mentoring to develop confident, competent novice nurses

How to Become a Nurse Educator

To become a nurse educator, nurses can:

  • Earn a master’s degree in nursing
  • Gain experience in a specialty teaching area if desired
  • Apply for work as nurse educator

According to the BLS, as of May 2020, the median annual salary for nursing instructors and teachers at the postsecondary level was $84,060.


Travel Nurse Jobs

When healthcare organizations face staffing shortages, they call on travel nurses. As skilled traveling professionals, these nurses take on temporary positions in hospitals and clinics that need additional nursing support. 

How to Become a Travel Nurse

Becoming a travel nurse requires a nurse to:

  • Become a registered nurse
  • Gain experience on the job, typically in a specialty (e.g., neonatal nursing)
  • Get licensed
  • Sign with a travel nurse staffing agency

Nursing professionals interested in travel nursing should look ahead and gain experience in the specialties they desire — while still working full time in nursing — so that they can work in specialized care environments as a travel nurse.

The benefits offered by each staffing agency will vary, along with the alliances the agency may have with specific hospital or healthcare networks, geographic areas, or even nursing specializations.


Nursing From Afar: Nurses in Telehealth

As telehealth becomes more accessible, especially to patients in rural areas, more nurses will be needed to interface with patients over online platforms.

Nurses working in telehealth will continue to provide patient education, especially on preventive health topics. Telehealth nurses may also be able to diagnose conditions from afar and recommend treatment plans. As this healthcare delivery method continues to become more common, opportunities abound for nurses working in telehealth.


Support Patient Health by Becoming a Nurse

As telehealth becomes more accessible, especially to patients in rural areas, more nurses will be needed to interface with patients over online platforms.

Nurses working in telehealth will continue to provide patient education, especially on preventive health topics. Telehealth nurses may also be able to diagnose conditions from afar and recommend treatment plans. As this healthcare delivery method continues to become more common, opportunities abound for nurses working in telehealth.

Nurses are needed now more than ever, and people interested in this in-demand career have many routes to becoming a nurse in today’s healthcare landscape. The ongoing shortage of nurses challenges hospitals and clinics to meet staffing needs. For anyone with a drive to develop the future of healthcare in their community, becoming a nurse presents an exciting career move.

Learn more about opportunities for nursing pre-professionals with ÑÇÉ«Ó°¿â’s accredited nursing degree programs. Plus, if you are an RN looking to take your career to the next level, the University’s Department of Nursing (DoN) offers advanced master’s and doctoral programs. These include St. Kate’s Doctor of Nursing Practice (DNP) program for RNs interested in earning a practice-focused doctorate degree that will equip them to become an ethical, versatile, forward-thinking nurse leader.

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