The roles registered nurses (RNs) play in keeping communities healthy and safe have never been more vital than they are today. In May 2020, the U.S. had nearly 3 million RNs, with an estimated 276,800 new jobs for RNs expected between 2020 and 2030, according to data from the U.S. Bureau of Labor Statistics (BLS). Nursing is the largest health care profession and one of the largest professions in all industries. For 20 years in a row, the Gallup Poll has named nursing the most honest and ethical profession.
However, there continues to be a serious shortage of nursing representation on the boards of hospitals and health systems and in leading community health efforts. To capitalize on the rising need for nurses with advanced degrees, RNs should investigate the potential advanced nursing career paths available, and what it takes to pursue each one. Prospective nursing students should consider what type of nursing education best serves them and their career goals and how earning an advanced degree in nursing can benefit them.
Nursing Career Advancement
Today’s complex health care environment requires leaders at every level of nursing — from nurse managers at clinical bedsides to chief nursing officers in administrative boardrooms — to work together to meet the profession’s challenges. Nurse leaders are not limited to working in hospitals; they also work in scientific, technological, and academic environments. They play critical roles as liaisons between businesses, governments, and community organizations to ensure the most up-to-date and accurate policies and practices are employed by health care providers.
Statistics from the BLS show that the more nurses learn, the more they earn, as higher education leads to more advanced and higher-paying positions. However, more than one pathway is available to nurses interested in those roles. Once individuals have determined the nursing career path they would like to follow, they must consider how they want to earn an advanced degree, what relevant certifications they wish to pursue and what leadership roles are available to them.
Earning an Advanced Nursing Degree
Nursing education programs include one-year training programs for becoming a licensed practical nurse (LPN) or licensed vocational nurse (LVN), two-year associate degree programs, three-year diploma in nursing programs, and four-year bachelor’s degree programs for becoming an RN.
Beyond the bachelor’s degree in nursing are two types of postgraduate nursing career paths:
- Advanced practice nurse: The APN category includes nurse practitioner (NP), nurse educator, nurse anesthetist, nurse midwife, and nurse administrator.
- Researcher: Nurse researchers have typically earned a doctorate in nursing to qualify for their positions.
Obtaining an Advanced Nursing Certification
Various professional and certification bodies issue dozens of nursing and medical certifications, but the two largest organizations offering advanced nursing certifications are the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP).
- ANCC certifications include family nurse practitioner-board certified (FNP-BC), adult-gerontology primary care nurse practitioner-board certified (AGPCNP-BC) and psychiatric-mental health nurse practitioner-board certified (PMHNP-BC).
- AANP certifications include family nurse practitioner (FNP), adult-gerontology nurse practitioner (AGNP) and emergency nurse practitioner (ENP).
In addition, the American Association of Critical-Care Nurses (AACN) issues certification for acute care nurse practitioners (adult-gerontology), and the Oncology Nursing Certification Corporation offers the advanced oncology certified nurse practitioner (AOCNP) certification.
Pursuing Leadership Roles in Nursing
Two of the most important aspects of nurses’ progress toward their nursing goals are their role in mentoring and educating new nurses and their input and influence in shaping local and national health policy. Preparing to apply for a nurse leadership position starts by determining the qualifications for the job and understanding all the responsibilities and duties.
- Nurse leaders must be able to anticipate and prevent conflict when possible and know techniques for mitigating conflicts when they arise.
- Nurse leaders need first-rate writing and speaking skills and should be adept at presenting medical information clearly, concisely, and completely.
- Nurse leaders must commit to their own long-term success in terms of keeping abreast of developments in their field and learning useful new skills.
- Nurse leaders must be committed to the short- and long-term success of their employees, departments, and organizations.
The SMART Goal Nursing Model
SMART is a goal-setting technique that can help nurse leaders set specific, measurable goals that they can attain in a realistic, timely manner. Nurses should write their goals in their own words, and the goals should reflect the ideals and achievements they prize. They should structure the goals so they can measure their progress toward achieving them.
- Specific: State the goal clearly, such as by writing, “I want to qualify for a nurse manager position.”
- Measurable: Set identifiable mileposts on the path to achieving the goal, such as gaining experience managing a team or project.
- Attainable: Find an achievement that’s within reach, such as qualifying for a nursing position with budget responsibilities, rather than setting a goal of becoming a hospital CEO.
- Relevant: Set a goal that resonates with one’s values and reasons for pursuing a career as a nurse leader.
- Timebound: Set a deadline for achieving the goal and place the interim steps on a timeline to monitor progress toward the goal.
Different Types of Nursing Degrees
Each type of nursing degree qualifies nurses for specific roles and duties. Each degree can also serve as a stepping-stone on a nursing career path that culminates in a leadership position in a health care setting, whether at a hospital or clinic; a public health role; or management or top administrative position with a health care provider or other organization.
The professional degree that most RN employers require is a Bachelor of Science in Nursing (BSN), although RNs may also hold an Associate Degree in Nursing (ADN), an Associate of Science in Nursing (ASN), or a diploma from an approved nursing program. The BLS notes that far more BSN, ADN, and ASN degree programs exist than diploma programs.
All the undergraduate programs include supervised clinical experience as well as courses in anatomy, physiology, microbiology, and various social and behavioral sciences. Their goal is to prepare students to pass their states’ licensing examinations for RNs as well as to teach the skills and experience nurses need to thrive in their careers.
Bachelor of Science in Nursing
In addition to the science topics listed above, the curriculum of BSN degree programs includes courses in physical and social sciences, communication, critical thinking, and leadership. In the past, a bachelor’s degree in nursing was considered the minimum education requirement to qualify for nurse administrator positions as well as for work as a nursing researcher, consultant or teacher. However, a growing number of employers now consider a master’s degree in nursing to be a prerequisite to qualify for nurse manager roles.
To receive a state-issued nursing license, RNs must graduate from an approved nursing program and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
Many hospitals and other health care providers now require that candidates for entry-level RN positions have a bachelor’s degree. RN-to-BSN programs allow RNs with an associate degree or diploma to earn their bachelor’s degree. Holding a BSN degree qualifies RNs for work in specialties such as genetics and public health. RNs are also able to take on more responsibilities for treating and diagnosing patients in clinical settings.
Master of Science in Nursing
A Master of Science in Nursing (MSN) degree is the minimum education requirement for clinical nurse specialists (CNS), most of whom also have at least one year of experience working as RNs. For nurses aspiring to leadership roles in their profession, most employers now consider an MSN degree or higher to be a prerequisite to qualify for nurse manager and administrator positions. These include assistant clinical nurse manager, charge nurse, or head nurse at the lowest level of management, as well as senior-level positions, such as assistant director or director of nursing, vice president of nursing, and chief nursing officer (CNO).
The curriculum of an MSN degree program expands on the science and clinical subjects that undergraduate nursing programs cover and includes courses in health services administration, leadership skills, negotiation, health planning and development, marketing, consulting, policy development, and quality assurance. Master’s degrees are the minimum educational requirement for advanced practice RNs (APRNs) working in specific areas of primary and specialty care, although a doctoral degree may qualify them for a wider range of nurse leadership positions.
Doctor of Nursing Practice
The BLS points out that many APRNs choose to earn a Doctor of Nursing Practice (DNP) to boost their training and experience in preparation for leadership roles in health care settings. The DNP curriculum typically includes courses in advanced health assessments, pathophysiology, pharmacology and other topics related to each NP specialty.
The following are among the other nursing leadership positions that nurses with a DNP degree may qualify for:
- Nurse educator: In addition to preparing new nurses for the profession, nurse educators promote innovation in clinical practice. They combine their clinical experience and nursing expertise with strong communication skills and cultural competency.
- Nurse administrator: Nurse administrators manage and lead work groups, departments, and facilities that provide clinical services. They influence and execute health policy, tapping their knowledge of and experience with nursing administrative procedures.
- Director of Nursing: Nursing directors are charged with managing the day-to-day functions of nursing departments and entire health care facilities in collaboration with other health care professionals. They serve as liaisons between medical teams and other departments within the organization, and they represent nursing departments to parties outside the health care setting.
DNP vs. Ph.D.
Nurses who wish to pursue a doctorate in nursing must choose between a DNP and a Ph.D. When comparing career paths, it’s critical to understand how each advanced degree focuses on different strengths, geared to different careers. For those considering a DNP vs. a Ph.D., the differences between the two degrees can be categorized into five areas, according to the American Association of Colleges of Nursing (AACN):
- Program of study: The DNP degree prepares nurse leaders to apply the results of research in areas of nursing practice. A Ph.D. in nursing emphasizes research at the highest level of nursing science.
- Students: DNP graduates focus on improving patient care outcomes and population health. Ph.D. holders develop new nursing knowledge that furthers nursing science.
- Program faculty: DNP faculty members have expertise in practice areas and working with patient populations. Faculty members in Ph.D. programs have expertise in research and experience with research funding and related areas.
- Resources: DNP students rely on mentors and the opportunity to gain firsthand experience in a range of clinical settings. Ph.D. students also rely on mentors as well as access to medical information, research technology, and dissertation support.
- Program assessment and evaluation: The goal of DNPs is to contribute directly to health care practice and policy. Ph.D.s develop new knowledge that improves health care delivery.
Focus of Ph.D. in Nursing Degree
Nurses who earn a Ph.D. lead through their nursing research with health care innovations and novel approaches to improving health care quality on an individual and population basis. The AACN points out that the number of nurses with a Ph.D. has remained constant despite the increase in nursing doctorate programs being offered. This has led to a shortage of qualified nurse educators at a time of growing need for research on treating chronic illnesses.
The research topics that Ph.D. candidates investigate have expanded in recent years from clinical areas, such as diabetes, cancer, and mental health, to technologies and techniques for improving the treatment of chronic illnesses. In many cases, the research seeks to improve patients’ quality of life by minimizing the negative effects of treatments.
To be accepted to a nursing Ph.D. program, candidates must have an RN license and a suitable Graduate Record Examination (GRE) score. They typically submit their college transcripts along with a letter of recommendation and an essay. Most nursing Ph.D. programs require the equivalent of three to five years of full-time study.
Focus of DNP Degree
Nurses who wish to pursue various leadership roles in the profession will gain a broad range of skills and experience by graduating from a DNP program. The curriculum of a DNP program prepares nurse leaders for roles and duties that are beyond those for which RNs usually train.
- Investigate the impact of modern health issues on health policy.
- Assess and report on program outcomes in health care settings.
- Study the distribution of diseases in communities and populations.
- Examine the legal, social, ethical, financial, and technological aspects of modern evidence-based nursing practice.
The AACN explains that the DNP degree is becoming the standard education requirement to qualify for many specialty APRN positions. The majority of nursing schools that offer APRN programs now have post-master’s DNP programs. Areas in which DNP degree holders may pursue careers include forensics, case management, military nursing, nursing administration, nursing informatics, and genetics. They also work as entrepreneurs, public health policymakers, consultants, and nursing department directors.
The requirements for pursuing a DNP degree may include letters of recommendation, an in-person or a remote interview, a 3.0 GPA, a declaration of professional goals and a minimum score on the GRE. Along with course requirements, the programs entail at least 500 clinical hours. Degree tracks cover clinical and executive preparation and usually require from two to six years to complete for students who don’t already have an MSN degree.
Advancement Opportunities for Nurses with a DNP Degree
The growing demand for NPs and other APRNs creates diverse nursing career paths for nurses looking to qualify for leadership roles in health care. The BLS forecasts that the number of jobs for NPs, nurse anesthetists and nurse midwives will increase by 45% between 2020 and 2030, which is much faster than the projected average job growth for all occupations.
Several factors contribute to the growing demand for DNP degree holders:
- Greater emphasis on preventive care
- The health care demands of an aging population
- Medical advances that convert formerly deadly diseases into manageable chronic conditions
- Changes in state laws that allow APRNs to perform a wider range of medical procedures and other health care services
Consider four advancement opportunities for nurses with a DNP degree.
Health Policy Analyst
Health policy analysts research topics related to the impact of existing and prospective government policies on health care providers and the health care industry. Government agencies, nonprofit organizations, and community groups employ health policy analysts.
- Typical duties: Health policy analysts gather data related to health care policies or supervise others collecting the data. These analysts apply advanced data analytics techniques to convert the data into actionable intelligence that policymakers can use to inform their health care decisions.
- Essential skills: The position typically requires a graduate degree in public health, public policy, or a similar field. Analysts must have strong research and communication skills for preparing reports and making presentations to executives, administrators, and the public.
- Median annual salary: PayScale estimates that the median annual salary of health policy analysts is about $64,000 as of June 2022. The median salary of starting health policy analysts is around $53,000 annually, and analysts with more than 20 years of experience have a median salary of about $81,000 annually.
Nurse educators are charged with preparing the next generation of nurses and nurse leaders. They contribute to the design of nursing curricula and analyze the effectiveness of nursing education programs. Nurse educators work in classrooms and a range of clinical settings, including clinics, hospitals, and nursing homes.
- Typical duties: Among the skills that nurse educators teach are how to administer medication and change dressings. They serve as coaches and mentors for nursing students throughout their education, and they instruct working nurses and other health care workers in training sessions. Nurse educators may conduct research and participate in professional nursing organizations.
- Essential skills: Nurse educators must possess strong communication and interpersonal skills when working with groups of students and in one-on-one teaching situations. They bring their practical nursing experience to bear as they instruct students in hands-on nursing skills.
- Median annual salary: The median annual salary of nurse educators is about $78,000, according to July 2022 data from PayScale. The median salary of starting nurse educators is approximately $71,000 annually, and nurse educators with more than 20 years of experience have a median annual salary of about $87,000.
Advanced Clinical Educator
Advanced clinical educators share practical knowledge about nursing in clinical settings with nursing professionals who work in specialized fields. These educators work in classrooms and healthcare settings and interact with nurses, clinicians in training, public health care workers and patients.
- Typical duties: Advanced clinical educators need to be good communicators in group settings and one-on-one teaching situations. They differ from nurse educators in that they focus on specialized instruction for working nurses and other health care professionals, as well as those in training.
- Essential skills: Advanced clinical educators must be licensed health care professionals who possess specialized clinical knowledge about their areas of instruction. They often work with seasoned professionals who are keeping their skills and knowledge up to date.
- Median annual salary: PayScale estimates that the median annual salary of clinical educators was about $78,000 as of July 2022. The median salary of starting clinical educators is about $69,000 annually, and clinical educators with 20 or more years of experience have a median salary of approximately $89,000 annually.
Chief Nursing Officer
CNOs are responsible for the operation of all nursing activities in a health care institution. They ensure the organization’s nursing care complies with all standards and regulations and that patients receive quality care. CNOs work with health care professionals, officials in business and government, community groups, and the public.
- Typical duties: A primary duty of CNOs is ensuring sufficient staffing of nursing units across shifts and workdays. They participate in developing contingency plans for a range of emergencies and are also responsible for the organization’s nursing budget, including purchasing supplies and equipment.
- Essential skills: Serving as a CNO requires practical nursing skills; management and administrative skills; and political skills for dealing with policymakers, community groups, and patients.
- Median annual salary: PayScale estimates that the median annual salary of CNOs is about $134,000 as of June 2022. The median salary of starting CNOs is about $124,000 annually, and those with 20 or more years of experience have a median salary of approximately $149,000 annually.
Discover a Satisfying Career in Health Care
Few professions are more vital to their communities than nurses. Effective nursing requires skilled, trained, dedicated nurse leaders who ensure positive patient outcomes and quality patient care while promoting the careers of their nursing colleagues. As the health care industry faces continuing nurse shortages, nurse leaders will be increasingly in demand to teach, mentor, and manage the next generation of nurses.
Nursing programs such as Duquesne University’s online Doctor of Nursing Practice program teach nurse leaders the skills and expertise needed to qualify for leadership positions and chart a successful nursing career path. This program provides students with the opportunity to reap the benefits of high-quality nursing education while enjoying the convenience of online learning, allowing students to advance their careers without uprooting their lives.
Learn more about how the online DNP program can help nurses pursue their professional goals.
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