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By: Sarah Jividen

RN, BSN

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Levels of Nursing Credentials (Ranked From Lowest to Highest) Levels of Nursing Degrees (Ranked from Lowest to Highest) Opportunities for Career Advancement in Nursing Nursing Levels FAQs
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Whether you are interested in becoming a nurse, or you're an APRN who already has many years under your belt, it is essential to understand the nurse levels and hierarchy so that you know what options you have in your career. Generally speaking, the higher the degree level a nurse has, the more education and experience they have received.
Between starting as a novice nurse and the highest ranks of nursing, there is a wide range of positions. Read on to understand the ranks and levels of nursing.
A certified nursing assistant, or CNA , helps patients with activities of daily living and other healthcare needs under the direct supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN).
Certified nursing assistants must complete a state-approved training program. These programs are generally found at local community colleges, high school, vocational or technical schools, or local hospitals.
LVNs and LPNs are interchangeable titles depending on where you work in the US. California and Texas use the title LVN, and the rest of the US uses LPN.
LPNs and LVNs work in hospitals, nursing homes, and other medical facilities and are typically responsible for more basic kinds of patient care and comfort measures. Usually, they work under the guidance of an RN or MD.
To become an LVN/LPN, you need a high school diploma or GED and to graduate from an accredited LVN/LPN program and pass the National Council Licensure Exam. LPN programs typically include one year of coursework and training at a hospital, community college, or technical school. There are also LPN to RN programs where LPNs can go back to school to become either an ADN RN or a BSN RN through accelerated programs.
A registered nurse administers hands-on patient care in a variety of settings including hospitals, medical offices, nursing homes, and other facilities.
RNs work with physicians and other members of the health care team to provide the best course of treatment possible. They also help to educate patients and their families about health issues.
To become an RN you'll need to complete either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree, followed by your NCLEX-RN.
An APRN is a master’s degree prepared RN with a post-master's certificate, or a DNP in one of the following four roles:
APRN’s are licensed through the state board of nursing in which they practice. In many states, APRNs can prescribe medication and practice independently, while in other states, they do so under the oversight of a Medical Doctor (MD).
Many nurses who are APRNs also have a DNP, but you can have one without the other. An APRN with a DNP is considered a practicing doctorate.
Nurses can increase their earning potential and advance their careers away from the bedside by pursuing a non-clinical advanced nursing career.
An RN diploma is another route to becoming a registered nurse. Like the ADN, these programs typically take around two years to complete and they both prepare students to take the NCLEX-RN. The main difference is that the ADN is a college degree while the diploma is not. Diploma programs are typically offered at hospitals, but may also be available at technical or vocational schools.
An ADN is a 2-year degree and is the minimum amount of education required to obtain a license to work as an RN, other than an RN diploma (See next section).
Most RN’s begin their careers working at the bedside performing direct patient care. This experience is usually preferred for nurses who wish to advance their careers and eventually earn a BSN, MSN, APRN, or DNP. However, there are also many career paths that an RN can take outside of the hospital setting, including case management, or aesthetic nursing.
A BSN is a 4-year nursing degree for students who want to be a registered nurse (RN), or for RNs who currently only have an associates degree in nursing (ADN). Many nurses who start their careers with an ADN eventually advance their careers by achieving a BSN.
Bachelor’s trained nurses work in nursing specialties throughout the hospital setting. For example, cardiac, neuro, pediatrics, labor & delivery, emergency room, and ICU, to name a few.
Nurses are encouraged to become certified within their chosen specialty after they have gained at least one or more years of direct nursing experience. For example, a nurse on an ICU neuro/trauma can study and sit for the Certified Neuroscience Registered Nurses Certification (CNRN). Achieving certification within your chosen specialty shows that you are an expert nurse in a particular nursing field. In addition, many institutions will pay nurses more when they are certified within their specialty.
Both ADN and BSN graduates must pass the NCLEX-RN examination to become licensed to work as an RN.
There are several types of master's degrees in nursing . Advanced practice registered nurse degrees prepare a registered nurse for an advanced clinical role. Other types of MSN degrees focus on preparing nurses for non-clinical roles such as public health or nursing informatics.
It takes about 2-3 years to earn a master’s in nursing but online options are available.
A Doctorate Of Nursing Practice (DNP) is the highest level of nursing education and expertise within the nursing profession. DNP’s work in nursing administration or direct patient care as an Advanced Practice Registered Nurse (APRN). As thought leaders, DNP’s also implement health policy and influence healthcare outcomes.
In the healthcare setting, DNP’s work in:
Education to obtain a DNP requires three to six years of study, depending on what level of nursing education you currently have. Most DNP programs require that you have a master’s degree in nursing, although some will start at the BSN level and require more years of study.
There will be more opportunities than ever for nursing career advancement in the coming years. Nationwide employment of RNs is projected to grow 9 percent from 2020 to 2030 . This is partially due to an increased emphasis on preventative care, higher rates of chronic conditions such as obesity and type 2 diabetes, and an aging baby boomer population.
Advancing your education has never been more attainable, especially with the rise of online learning . A few educational opportunities you may want to consider are RN to BSN , BSN to MSN, and MSN to DNP programs.
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+ Relias Learning Management System ∨
Relias is committed to helping your organization get better through training, performance, and talent solutions that address your specific areas of focus.
+ Hiring, Onboarding, & Retention ∨
+ Management & Leadership Training ∨
Relias helps healthcare leaders, human service providers, and their staff take better care of people, lower costs, reduce risk, and achieve better results.
+ Intellectual & Developmental Disabilities and ABA ∨
+ Intellectual & Developmental Disabilities ∨
+ Applied Behavior Analysis & Autism ∨
+ Skilled Nursing & Long-Term Care ∨
+ CCRCs and Life Plan Communities ∨
+ Addiction & Substance Use Disorders ∨
Count on Relias to support your journey toward better care and financial outcomes with reliable thought leadership and expert advice.
+ State of Healthcare Training & Staff Development ∨
+ Diversity, Equity, & Inclusion ∨
Nurses are one of the most sought after roles in healthcare, and with a 12% projected job growth rate by 2028—much faster than the average for all occupations—the demand for nurses is only increasing. Given the current and future need for nurses, healthcare organizations must focus on recruiting new nurses, but perhaps more importantly—keeping the current nursing staff engaged with their clinical practice. Understanding how to retain nurses is a timely challenge, faced by nearly every healthcare organization across the country.
Healthcare leaders are pushed to think outside the box and must consider innovative nurse retention strategies to retain nurses. New graduate nurse retention statistics suggest that as many as 30% of new graduate nurses will leave during their first year of practice, increasing to as many as 57% within the second year. With the average cost of turnover per nurse between $37,700-$58,400 , healthcare organizations can’t afford to continue to lose the nurses they have. Organizations can quickly focus their retention efforts, starting with these five nurse retention strategies:
The first step in developing a successful nursing retention plan includes a strategic recruitment initiative. With new graduate nurses making up a large percentage of overall nursing turnover, attracting the best-fitting nurses from the start will make retaining them that much easier.
Just as nurse candidates aim to make a solid first impression, so should organizations/recruiters. Given the demand for nurses, it’s likely that candidates will have their choice between different healthcare organizations and positions. A seamless interview process that includes clear directions, and maintains a high level of professionalism can help HR teams at healthcare organizations make a great first impression.
While a candidate’s application will provide an overview of their clinical practice knowledge and skillset, it’s less likely to include their behavioral competencies which are telling signs of how well they’ll fit within an organization. Ensuring alignment of values between an organization and a nursing candidate promotes solidarity from the start. Personality attributes such as accountability, honesty, and conscientiousness can help determine a candidate’s behavioral characteristics and likelihood for success within a specific role.
Research shows a direct link between nurse residency programs and retention. Participants also reported higher satisfaction with orientation/onboarding compared to those without a formal nurse residency program. Organizations with a nurse residency program provide new nurses with additional support, while also engaging experienced nurses as preceptors—fostering new connections and a healthy, collaborative culture. In addition to improving nurse retention, nurse residency programs instill a sense of community and confidence in new nurses.
Nursing leaders are gaining more recognition than ever, and more nurses are pursuing advanced degrees in preparation to take on new roles in their careers. To support nurses on their career journey, organizations must establish a culture that promotes learning and leadership development. Not only will additional resources impact a nurse’s ability to care for their patients, continuing education and clinical training will help prepare them as decision makers within the larger scope of the healthcare industry.
Organizations focusing on how to improve nurse retention often overlook something as simple as recognition for high-performing nurses . Even a quick and informal celebration or mention during a huddle at the beginning of each shift can reiterate a nurse’s value, increasing their likelihood to stay in their role.
This approach for how to retain nurse staff is also a small effort with a big reward. Taking a moment to celebrate those nurses with work anniversaries for their dedication and loyalty to the organization is especially important for millennial nurse retention, as these nurses may be more comfortable with change (leaving their practice or an organization).
Providing nurses with an ongoing opportunity for lifelong learning is truly worth the investment. Not only will they improve their overall clinical practice knowledge, but an investment in learning also impacts the quality of the organization, and shows nurses they’re valued beyond their direct contributions to their unit and patients. Ensuring nurses feel valued is key to retaining nurses in the workplace.
Promoting a healthy work-life balance is an important key to improving nursing staff retention. Nurses endure physically and emotionally demanding shifts (typically 12 hours), leaving little room for additional energy. Especially important for new nurse retention, organizations should create a culture that encourages time away from work and the chance to recharge.
Nurses that consistently work overtime shifts experience more burnout, reducing their engagement and satisfaction. By limiting overtime work, organizations promote the health of their nurses versus only focusing on the organization’s immediate operational needs—ultimately greatly benefiting both in the long run.
Nurses that have input into their schedule are more likely to feel empowered and trusted in their careers. While a new nurse likely understands that working weekends and holidays is part of the job, having a say in which ones can make them feel less dissatisfied about it. As an outside the box solution to staffing, nurse managers might implement a shared governance approach, allowing nurses to sign up for their shifts as opposed to being assigned a set schedule.
Read our post on 4 Steps to Hire and Retain Your Best Nurses to keep your staff engaged even more effective.
As the national leader in holistic healthcare assessments, Relias Assessments empowers nurse managers to leverage assessments to make informed hiring and placement decisions thereby helping them achieve better long-term nurse success, satisfaction, and retention. Assessment data helps nurse managers identify developmental areas, continuously measure competencies, and cultivate future leaders.
Additionally, CE Direct (known for its reputation as the leading provider in continuing education) offers a wealth of knowledge to nurse managers on management and leadership education, including:
Nurse shortages, challenging work environments, and a lack of professional development contribute to high nurse turnover rates. High turnover adversely impacts the quality of care and is costly to organizations. To help your organization increase nurse engagement, satisfaction, and retention, Relias has developed a resource kit that includes 8+ white papers, webinars, guides and more.
Alisha Cornell, DNP, MSN, RN, is an experienced nurse leader, clinical consultant, and nurse informaticist, who understands the role of executive nurse leaders as well as the impact of healthcare on the lives of nurses. Her combination of formal education and lived experiences provides a platform of inspiring others through self-awareness and a purpose driven life. Her commitment to impacting the lives of nurses through servant leadership is driven by her history of managing dynamic nursing teams and conquering life one day at a time. She is a strong advocate for improving self-care among nurses, equal access to healthcare in underserved populations, and improving community health education concerning mental health and social determinants of health.
Natalie Vaughn has worked in marketing and communications for more than 15 years, with
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