Registered nurses are among the largest occupational groups in the United States, according to the Bureau of Labor Statistics, and the need for these professionals is projected to grow. In addition to the more than 2.7 million RNs employed in the U.S. in 2011, another 1.4 million individuals worked as nursing aides, orderlies or attendants, while about 700,000 worked as licensed practical nurses. Added up, nursing positions employed nearly 4 million Americans in 2011.
That may sound like a large number, but according to industry sources, it's not going to be enough to meet the demand for health care in coming years. The American Association of Colleges of Nursing reports that a number of factors -- including a lack of qualified nursing school faculty, an aging U.S. population and high turnover due to burnout -- could lead to a shortage of qualified individuals to fill nursing jobs.
As a profession, nursing offers a wide range of points of entry, from certificate programs for nursing aides to graduate degrees for nurse managers or educators. Tying these various levels of nursing practice together are bridge programs, which are designed to help nurses further their education and move up the career ladder. Here's a quick overview of your nursing education options.
Licensed practical nurses, or licensed vocational nurses as they are called in some states, are entry-level nurses who have completed a certificate or associate degree program and passed a licensing exam. LPN training programs combine classroom instruction with supervised clinical experience. Because LPN degree programs require students to learn basic patient care techniques such as measuring vital signs or giving injections, they incorporate in-person study.
From a clinical perspective, the certificate and associate degree both prepare students to take the National Council License Exam for Practical Nurses, or NCLEX-PN, which is required for state licensure. While the two educational paths are largely equivalent in the workplace, some differences exist from an educational perspective. Students who earn an associate degree may be required to take general education requirements such as English or liberal arts courses. Additionally, students who complete an associate degree program may be able to transfer credits toward a bachelor's degree in nursing should they choose to continue their education. However, transfer credit policies vary from school to school, so it's best to check with specific institutions regarding their policy.
Bridge programs are designed to help practicing medical professionals, such as licensed LPNs or paramedics, earn an associate or bachelor's degree in nursing and become licensed as a registered nurse. In general, bridge programs grant students a certain number of credits toward the degree, often after students have demonstrated certain skills via testing or passed specially designed courses to move them into the general degree program, which is typically an associate degree in nursing, or ADN, but may be a bachelor's degree in some cases.
Because these bridge programs introduce students to the hands-on nursing skills performed by registered nurses, in-person clinical experience is a required component. However, some bridge programs do allow students to complete the coursework portion of the program online.
Becoming a registered nurse requires both graduating from an approved degree program and passing the NCLEX-RN licensing exam. Once students become licensed RNs, they typically have greater earning power and opportunities for advancement than LPNs, according to the BLS.
One of the unique things about registered nursing as a career is the multiple points of entry: students can graduate from an associate degree or bachelor's degree program. Hospital-based diploma programs are a third point of entry into the profession, but these are becoming increasingly rare, according to the Institute of Medicine.
While both the associate and bachelor's degree prepare students to gain licensure as a registered nurse, RNs with a bachelor of science in nursing, or BSN, may have more opportunities to advance. The BSN can also pave the way for nurses who want to earn a graduate degree and move into advanced clinical or teaching roles.
Because RN to BSN programs are built for already licensed registered nurses, they focus on expanding academic knowledge through more in-depth exposure to nursing theory. In some cases, these programs do not require clinical experience, making them available both online and on campus. Some programs that require a clinical component allow students to complete them at local facilities, while others may require travel to a school-approved facility.
At the graduate level, nurses can earn the Master of Science in nursing, or MSN degree. You must be a bachelor's-prepared registered nurse to be eligible for admission to an MSN degree program, however there are RN to MSN programs for registered nurses with an associate degree who want to complete requirements for a bachelor's and master's degree in a single program.
In many cases, MSN programs can be completed at least partially online. Although not all MSN programs require clinical experience, many do. A wide range of programs allow students who want to complete coursework requirements online to do so while also fulfilling clinical requirements at a local or campus-affiliated facility.
With a master's degree in nursing, you can seek a number of more advanced roles such as nurse manager, nurse practitioner or nurse educator, and many MSN programs offer concentrations in specific career paths.
Earning an MSN or a doctorate in nursing is a prerequisite to becoming licensed as a nurse practitioner, or NP. Nurse practitioners must meet state licensure requirements, which can vary from one state to another. Most NPs are also nationally certified in their area of practice, which can include pediatrics, family practice, women's health or acute care, among others.
The two main doctoral degrees for nurses are the Ph.D. in nursing and a doctor of nursing practice, or DNP, degree. The Ph.D. in nursing, with a more academic focus, could be a good choice for nurses who want to do research or teach nursing at the university level. The DNP, a clinical degree, trains nurses to practice at the highest levels in clinical settings.
Although currently you can become a nurse practitioner with a master's degree in nursing, the American Association of Colleges of Nursing has recommended that starting in 2015, all new NPs hold a doctorate. There is some uncertainty as to how this recommendation will be implemented, according to the NPs & PAs website. State boards of nursing set requirements for NP licensure, so students should contact the board of nursing in their state to clarify requirements.
As health care technology and practice evolves and grows, nurses are certain to face new challenges, whether it be adapting to electronic health records or gaining skills in a new treatment technique. Campus-based and online nursing degree programs can allow practicing nurses to stay current in the latest trends in the field or train to take on new responsibilities.