Exploring Nursing Career Choices
Nursing. Now that's a career you can be proud of. Knowing that you're spending your days helping people when they need it the most will keep that warm, fuzzy feeling going long after you finish your shift at the hospital, nursing home, or doctor's office. No matter which area of nursing you choose, you'll be confident that you are contributing to the well-being of your community, and helping to make a difference. You know you fit here. You know that this is the path for you. The only problem is figuring out where to start.
Understanding the various nursing career paths is essential to choosing the nursing school that can help get you to where you want to be. Take the first step and discover what it means to be a registered nurse or vocational nurse, and explore other nursing career options. Learn more about nursing school requirements, nursing salaries, and other aspects of this career field.
Becoming a registered nurse (RN) usually requires the most training of all the nursing career options, but with that comes more responsibility, the chance to take on specialties, and the opportunity for greater career growth within various healthcare settings. Deciding to pursue this occupation can help you obtain employment in a variety of healthcare settings and open you up to some of the best job opportunities.
Common responsibilities—Most RNs work in hospitals and outpatient centers. In fact, almost 60 percent of RNs work in general medical and surgical hospitals.* However, there are many other work settings to choose from, which include schools, colleges, and community health centers. So your responsibilities can vary depending on where you work, but here are some of the more common tasks carried out by RNs:
- Coordinating patient care with doctors and other medical professionals
- Creating and reviewing patient care plans
- Delivering medications and offering a variety of treatments
- Modifying and changing patients' medications and treatments as their conditions change
- Supervising and directing other staff members like LPNs and nursing assistants
- Educating patients and their families
- Conducting physical exams and reviewing patients' health histories
- Providing critical care in emergency situations
Required education and certification—Depending on your state of residence, you could have several options for becoming a registered nurse. If you have no prior nursing training, then you will need to earn a state-approved diploma, or an associate or bachelor's degree. A lot of potential nursing students choose to obtain bachelor's degrees—a BSN (Bachelor of Science in Nursing)—since it provides them with a thorough education and offers the greatest opportunities for future training and advancement. Note that if you opt for a diploma or associate degree program, you will want to check with your state's board of nursing to ensure that it is an accepted level of education for the types of nursing jobs that you would like to pursue.
If you are currently licensed as a practical or vocational nurse, then you may be able to earn an associate or bachelor's degree more quickly because some schools will take your previous nursing education credits into account. Once you have met your state's requirements, you can then apply to take the NCLEX-RN licensure exam in order to become a fully licensed registered nurse.
Advancement potential—As an RN, you could have a number of options for advancing your career in nursing. Here are two of the more common ways that RNs can enhance their professional standing:
- Pursuing specializations—You can gain experience and additional continuing education from a school of nursing that helps you work in specialized areas of care such as ambulatory care, cardiac care, critical care, forensics, geriatrics, labor and delivery, medical-surgical, oncology, pediatrics, and rehab. There are over 100 specialized areas in which registered nurses can work.
- Becoming advanced practice registered nurses (APRNs)—You can earn one of the advanced nursing degrees—like a master's or doctorate degree—and obtain additional certifications in order to pursue advanced practice nursing positions. There are four types of APRNs: certified nurse anesthetists, certified nurse midwives, clinical nurse specialists, and nurse practitioners.
Salary range—The starting entry-level salary for RNs is around $46,000 annually, and the most experienced and educated RNs earn salaries of more than $100,000. And, although the nationwide average is $71,000, certain states are known to pay higher-than-average wages. For example, the average yearly salary in California is $101,260, and in Massachusetts, it is $88,650.*
Total projected job openings—Most experts agree that there is going to be a severe nursing shortage in the coming years. In fact, it is estimated that, during the decade from 2014 to 2024, there will be more than one million job openings for registered nurses alone. That includes new positions that are created due to growth as well as those that open up due to retiring workers.**
Practical nurses or vocational nurses (the title varies depending on where you'll be practicing) generally work in a hands-on role with patients. Providing care within hospitals, care homes, and other patient care facilities, this path would allow you to play a vital part on any healthcare team. Depending on the vocational nursing program you choose, you will learn everything from how to collect samples for lab tests to how to monitor medical equipment. Becoming an LPN or LVN might be the rewarding career that you have been searching for.
Common responsibilities—Unlike that of RNs, LPN employment is more distributed throughout different workplace types, rather than concentrated in hospital settings. For example, 30 percent of LPNs work in nursing care facilities, almost 14 percent work in general and surgical hospitals, over 13 percent work in doctors' offices, and almost 12 percent work in home healthcare services.* So you could find quite a wide variety of work settings to choose from. Additionally, your responsibilities can vary between employers. But here are some tasks that you may find included in a typical licensed practical nurse job description:
- Provide and monitor patient care
- Notify RNs or physicians if a patient's condition changes
- Record patients' vital signs and administer medications
- Update patients' charts
- Assist patients with needs such as getting dressed, going to the bathroom, and eating
- Change bandages, catheters, and dressings
- Manage IVs
Required education and certification—You can become an LPN or LVN by taking a certificate or diploma program that is approved by your state's board of nursing. Once you have successfully completed your training, which can take approximately one year, you will need to apply to take the NCLEX-PN exam in order to become licensed.
Advancement potential—When LPNs are ready to progress their careers, the most common choice is to become an RN. Since you are already licensed and have a basic nursing education, you may be able to apply your previous college credits toward your RN training in order to complete your academic program more quickly.
Salary range—As an entry-level LPN or LVN, you could expect to earn an annual salary of about $32,000. On the other end of the scale, the best-paid LPNs and LVNs earn almost $60,000 per year or higher. The national average salary is $44,000, but states such as Connecticut and Rhode Island are known to pay higher wages. The average annual salaries there are $55,630 and $55,230, respectively.
Total projected job openings—The nursing job outlook is quite strong. It is projected that over 320,000 LPN or LVN jobs will need to be filled in the period from 2014 to 2024.** That includes new jobs, which are estimated to grow in number by 16 percent, as well as worker replacement (mostly due to a high number of workers retiring).***
The role of a patient care technician can extend from monitoring vital signs and drawing blood to assisting with therapeutic care and performing CPR. Choosing this path would put you in a position that has the most contact with patients in a bedside setting.
Common responsibilities—There are a lot of similarities between the work of patient care technicians and nursing assistants. Some organizations even use the titles interchangeably. Although patient care technicians often perform the same duties as nursing assistants, techs typically have additional responsibilities like recording EKG readings and drawing blood. As a patient care technician, you can expect to assist nurses, doctors, and other medical staff by performing tasks such as the following:
- Cleaning and tidying patients' rooms
- Assisting patients with personal hygiene and other needs, like eating and going to the bathroom
- Monitoring and recording vital signs
- Taking samples and collecting specimens for diagnostic testing
- Assisting with basic treatments and providing basic care, like changing wound dressings and bandages
- Stocking patients' rooms and supply cupboards
Required education and certification—You can quickly prepare to become a patient care technician by earning a certificate or diploma, which typically takes less than a year to complete. Depending on your employment setting and job requirements, you may also require the following certifications:
- Certified Patient Care Technician/Assistant (CPCT/A)
- Certified EKG Technician (CET)
- Certified Phlebotomy Technician (CPT)
Advancement potential—When patient care technicians are ready to advance their careers, they usually move into different fields of nursing by becoming an LPN or RN. Depending on your prior education and experience, you may even be able to obtain credits toward your training in order to complete it more quickly.
Salary range—The annual salary range for nursing assistants (which is the occupational category that patient care technicians are included in) is $19,390 to $36,890 and higher. The average salary nationwide is $26,820, but states like New York and Nevada can offer higher pay. On average, annual salaries in those states are $33,390 and $32,710, respectively.*
Total projected job openings—Patient care technicians are included in the same occupational category as nursing assistants, and nursing assistant jobs are expected to grow in number by 17 percent from 2014 to 2024.*** It is estimated that, during that same decade, the total number of nursing assistant positions that will need to be filled will exceed 590,000.**
Choosing to become a nursing assistant can offer you the opportunity to work in nursing without having to commit the time required to complete licensed practical or registered nurse programs. A nursing assistant can perform a wide range of duties that includes helping patients with hygiene, post-operative care, and more.
Common responsibilities—As mentioned above, nursing assistants' job duties overlap quite a bit with those of patient care technicians. And nursing assistant job titles can vary. They can also be called certified nursing assistants (CNA), nursing aides, nursing attendants, and nursing care attendants. Often, nursing assistants are also qualified to pursue home health aide and personal care aid positions.
More than 40 percent of nursing assistants work in nursing care facilities, 24 percent work at general and surgical hospitals, and 11 percent work in continuing care and assisted living facilities for seniors.* So, just like the variety in work settings, you can expect variety in your job duties. Some of the tasks you may be responsible for include:
- Taking and recording vital signs
- Bathing and dressing patients
- Assisting patients with eating and drinking
- Helping patients get in and out of bed, wheelchairs, etc.
- Setting up equipment and assisting with basic procedures
- Collecting and recording information from patients and healthcare providers
- Cleaning and sanitizing rooms
- Changing linens
- Stocking rooms and supply closets
Required education and certification—You will need to complete a state-approved certificate or diploma program. Once you have graduated, you will likely want to take your state's licensing exam to obtain your CNA designation. Although certification is not required for all jobs, there are many organizations that will require it, and some states mandate certification for certain positions.
Advancement potential—Most nursing assistants progress their careers further into the field by becoming LPNs or RNs. You may be able to find bridging nursing programs that help you transition between careers more easily and quickly. Or some institutions may assess your prior education and experience in order to provide you with credits toward your nursing education.
Salary range—Entry-level nursing assistants could expect to earn annual salaries starting around $19,390, and the most experienced nursing assistants earn $36,890 annually, and higher. Furthermore, the state where you work can have an effect on your earnings. For example, Alaska is the top-paying state with an average salary of $37,300 annually, which is $10,480 higher than the national average.*
Total projected job openings—It is estimated that, in the 10-year span from 2014 to 2024, over 590,000 nursing assistant positions will become available.** This is largely due to the predicted 17-percent job growth in the sector, in addition to a high need to replace retiring workers.***
Once you become a registered nurse, you can gain an advanced education and build your experience and expertise in order to become a nurse educator or post-secondary nursing instructor. Nurse educators work in either academic or medical settings, and they are responsible for training the next generation of up-and-coming nurses and nursing assistants. In addition to teaching, most nurse educators continue working in a clinical capacity to some degree in order to keep current on the newest nursing methods and techniques.
Common responsibilities—Nurse educators and instructors work in settings like hospitals, career colleges, community colleges, and traditional four-year colleges and universities. In fact, more than 53 percent of nursing instructors work for colleges, universities, and professional schools. And an additional 33 percent work for junior colleges.* So, working in academic settings is definitely the most popular career path.
Your job responsibilities will vary depending on the type of setting you work in, but here are a few of the tasks that you may carry out:
- Creating lesson plans
- Teaching classes
- Tutoring students
- Marking assignments and exams
- Evaluating and modifying program curricula
- Supervising students' practicums and clinical rotations
- Developing continuing education courses
- Attending conferences and training seminars
Required education and certification—Nurse educators typically have many years of education and experience. Most people start out by earning bachelor's degrees and becoming RNs. Once you have spent several years working as an RN, you may be able to take on a nurse educator position with a teaching hospital. However, if you want to pursue faculty positions with colleges or universities, you will likely need to earn a master's or doctoral degree. A lot of nursing instructors also earn post-graduate certificates so that they can focus on teaching specific specialties, such as geriatric or pediatric care.
Advancement potential—Once you become a nursing instructor, you may have additional opportunities to advance your career. After you spend several years working in your position, you may be able to achieve tenure, which is a goal for many post-secondary instructors. You can also pursue the department head position for your school's nursing department. And if you wanted to expand your career outside of the field of education, then you can go after positions as an advanced practice nurse (APRN), or you could pursue nursing management or department head jobs within medical facilities.
Salary range—Nursing instructors who are new to the field can expect to make a starting salary of about $41,490. As you gain experience and take on a larger course load, you could make up to $112,680 a year or higher. And, although the national average salary for this occupation is $73,150, there are states that pay much higher wages. The top-paying states are California, New Jersey, New York, Massachusetts, and Delaware. The average annual salaries in those states range from $86,350 to $99,250.*
Total projected job openings—Just like all other nurses, nursing instructors are expected to retire in large numbers in the coming years. Additionally, more schools are ramping up their nursing programs in order to meet the country's demand for more nursing professionals. So, that will likely result in the hiring of more nursing instructors. There could be over 25,000 nursing instructor positions available during the decade from 2014 to 2024.** And it is estimated that more than 13,000 of those positions will be new jobs; the remainder will be created due to the need for replacement workers.***
Your Next Step
Decide which nursing fields you're interested in. Which ones spark your interest? Start exploring the best nursing schools that fit your goals. Whether it's online, accelerated, or part-time, there are plenty of options that can help you get to where you want to be. The career you're after is waiting for you. It's up to you to take the next step!
* Bureau of Labor Statistics, U.S. Department of Labor, Occupational Employment Statistics, website last visited on September 13, 2016.
** Bureau of Labor Statistics, U.S. Department of Labor, Employment Projections, website last visited on January 27, 2017.
*** Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016-17 Edition, website last visited on September 13, 2016.