June 6, 2022
By: Sarah Jividen RN, BSN
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.
Levels of Nursing Credentials (Ranked From Lowest to Highest)
1. Certified Nursing Assistant (CNA)
A certified nursing assistant, orCNA, 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.
- 4-12 week program
- CNA certification exam
- Earn a state license
- $30,290 per year, $14.56 per hour per BLS
- 8% growth per BLS
>> Click to See the Top 10 Online RN to BSN Programs
2. Licensed Practical Nurse (LPN) / Licensed Vocational Nurse (LVN)
LVNs and LPNsare 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.
- 1-year program
- NCLEX-PN licensing exam
- Earn a state license
- $48,070 per year, $23.11 per hour per BLS
- 9% growth per BLS
3. Registered Nurse (RN)
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.
- Associate Degree in Nursing (ADN)
- 2-3 year program
- Bachelor of Science in Nursing (BSN)
- 4-year program
- $77,600 per year, $37.31 per hour per BLS
- 9% growth per BLS
4. Advanced Practice Registered Nurse (APRN)
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:
- Nurse Practitioner
- Clinical Nurse Specialist
- Certified Registered Nurse Anesthetist
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.
- Master of Science in Nursing (MSN)
- 2-3 year post-graduate program
- APRN roles must also complete in-person clinical hours and pass a certification exam in the area of specialization
- Doctor of Nursing Practice (DNP)
- 3-4 year post-graduate program
- Requires capstone DNP project
- Nurse Practitioner (NP)- $120,680
- Clinical Nurse Leader (CNL) - $104,107
- Clinical Nurse Specialist (CNS) - $106,407
- Certified Registered Nurse Anesthetist (CRNA) - $195,610
- Certified Nurse Midwife (CNM) - $112,830
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5. Non-Clinical Advanced Nursing Specialties
Nurses can increase their earning potential and advance their careers away from the bedside by pursuing a non-clinical advanced nursing career.
- Nursing Director
- Nursing Educator $77,440
- Nurse Administrator -$101,340
- Nurse Manager
- Healthcare Administrator
- Nursing Informatics - $79,720
- Research Nurse - $99,372
Levels of Nursing Degrees (Ranked from Lowest to Highest)
1. RN Diploma
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.
2. Associates Degree in Nursing (ADN)
AnADN is a 2-year degreeand 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.
3. Bachelors Of Science in Nursing (BSN)
ABSN is a 4-year nursing degreefor 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.
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4. Master's of Science in Nursing (MSN)
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.
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5. Doctor Of Nursing Practice (DNP)
ADoctorate 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:
- Organizational leadership
- Nurse management
- State and national health policy
- Health informatics
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.
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Opportunities for Career Advancement in Nursing
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.
Nursing Levels FAQs
What are the different levels of nurses?
- The levels of nurses range from diploma-prepared and vocational nurses, to LPNs to RNs to advanced practice registered nurses (APRNs) to a doctor of nursing (DNP).
What is the highest level of nurse?
- The highest level of clinical nursing is an advanced practice registered nurse (APRN), which is a nurse-midwife, nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist. RNs may also pursue a doctorate in nursing (DNP), but a DNP is an educational degree, not necessarily a clinical advancement.
What comes first, RN or BSN?
- It’s possible to pursue both your RN and BSN at the same time through a Bachelor’s degree nursing program. However, you can also take an associate’s degree level program in nursing (ADN) first to receive your RN license, then pursue your Bachelor's later.
What degree is higher than an RN?
- Being an RN refers to having a license as a Registered Nurse. It is not a degree, but is instead a license granted after passing a state board exam (the NCLEX). You can become eligible to take the NCLEX to become an RN by enrolling in an associate’s degree program in nursing (ADN) or a Bachelor’s of Science in Nursing program (BSN).
Who is higher, RN or LPN?
- An RN has more responsibility than an LPN. An LPN has some clinical practice limits, such as not being able to push IV medication.
What are the 3 levels of nursing? ›
- Nursing assistant (CNA) Nursing assistants also go by the title of nursing aides or CNAs (Certified Nursing Assistants). ...
- Licensed practical nurse (LPN) ...
- Registered nurse (RN) ...
- Advanced practice registered nurses (APRNs)
Benner (1984) also detailed the acquisition of nursing expertise and proposed five possible expertise levels: novice, advanced beginner, competent, proficient, and expert. Nurses at the novice stage are still in nursing school.What does Level 2 mean in nursing? ›
Registered Nurse Level 2 means a Registered Nurse, appointed as such, and whose input into more complex care needs provides support and direction to Registered Nurses and/or other personnel.
The levels of nurses range from diploma-prepared and vocational nurses, to LPNs to RNs to advanced practice registered nurses (APRNs) to a doctor of nursing (DNP).What is lowest level nurse? ›
As the name suggests, CNAs assist nurses with patient admittance and vitals. It is the lowest-level credential related to the nursing field and the quickest point of entry.What is a level 1 nurse? ›
In the UK, a Level 1 nurse is a nurse who has completed a three-year programme of education leading to a nursing qualification/academic qualification (a degree or diploma). For midwifery, you will need to hold a qualification capable of leading to registration as a midwife in the country of which you have trained.What is RN II and RN III? ›
RN is just starting; RN1 skilled nurse with some years under their belt; RN2 = Nurse Supervisor; RN3 = ADON & RN4 = DON.What is the highest nurse level? ›
The highest level of nursing education is the doctoral level. Positions that require doctoral nursing degrees include certain types of advanced practice registered nurses (APRNs), as well as leadership positions such as chief nursing officer or director of nursing.What is Level 7 in nursing? ›
Caring for patients with a wide range of health conditions. Equivalent to master's degree. for apprenticeship training.What are the four phases of nurse? ›
Hildegarde Peplau describes four sequential phases of a nurse-client relationship, each characterized by specific tasks and interpersonal skills: preinteraction; orientation; working; and termination.
What is a Level 3 RN? ›
Registered Nurse Level 3 means a Registered Nurse who may be referred to as: Clinical Nurse Consultant or Nurse Manager or Staff Development Nurse. A registered Nurse Level 3 shall be appointed to Clinical, Management or Staff Development stream.What does a Level 4 nurse mean? ›
Registered Nurse Level 4 means a Registered Nurse in their fourth year of service, who meets the requirements of a Registered Nurse Level 3, and has completed 960 hours with a minimum of twelve (12) months clinical experience at the Registered Nurse Level 3.
(l) "Registered nurse - level 4" shall mean a registered nurse who may be referred to as an assistant director of nursing - clinical, assistant director of nursing - management, assistant director of nursing - education, assistant director of nursing - clinical/management/education.What are basic level registered nurses roles? ›
The Role of a Registered Nurse
RNs assess and identify patients' needs, then implement and monitor the patient's medical plan and treatment. They also ensure that patient care is conducted according to the policies and standards of their employer, whether that is a hospital or another facility.
A certified nurse (CN) provides general patient care and works under registered nurses, while a registered nurse (RN) provides a higher level of patient care and coordination and works under a doctor.What is an entry level nurse called? ›
Licensed Vocational/Practical Nurse (LVN/LPN)
LVN/LPNs are entry-level nurses. It can take one to two years to complete the program, depending on the school. Vocational schools and colleges may offer LVN/LPN programs.
Senior Lifestyle classifies its levels of care under six different options for senior care services: Independent Living, Assisted Living, Memory Care, Skilled Nursing, Affordable Housing, and Short-Term Care.What level is a qualified nurse? ›
A Nursing associate qualification is a Level 5 qualification (the same level as an HND), one level lower than a degree/degree apprenticeship. It can be used as a step-up to getting a degree.What is nurse 1 and nurse 2? ›
Typically these positions are based on what is known as a "clinical ladder". Nurse I may have less than 12-16 months experience, Nurse II may have 2 years experience, Nurse III may have 3+ years experience. Clinical ladders can also include things like shared governance and research projects.What does a nurse III do? ›
Handles various health programs; 2. Develops program plans; 3. Monitors and evaluates the implementation of health programs and projects; 4. Provides technical assistance to LGUs and other partner organizations relevant to program implementation and evaluation; 5.
What is a Level 9 nurse? ›
Band 9 Consultant Level Nurse
Band 9 nursing posts are for the most senior members of NHS management who help shape high level decision making. Nurses at this level are experts within their field that help to educate others.
Registered nurses need a bachelor's degree in nursing, to pass the National Council Licensure Examination (NCLEX), and to obtain a state licensure to get started in the medical field. Nurse practitioners, on the other hand, must have earned a master's degree in nursing (MSN) or higher.What nurse is lower than an RN? ›
A licensed practical nurse (LPN), also known as a licensed vocational nurse (LVN) in some states, works under the supervision of doctors and registered nurses. The duties of an LPN include taking vitals, collecting samples, administering medications, and ensuring patient comfort.What is a level 8 nurse? ›
Band 8 – Modern Matron or Chief Nurse.Is a nursing degree level 8? ›
Foundation Programmes (Level 8) include:
Critical care nursing.
Giving care, advice and support to sick, injured or disabled people. Qualification level 6. Equivalent to degree. Typical duration 48 months.What are the 4 domains of nursing? ›
The four principal domains of nursing—person, environment, health, and nursing—are the building blocks for all philosophies of nurs- ing. As you are learning about these ideas, you are also learning that many nurses develop nursing theories or models. Think about it . . .What are the 4 P's in nursing care? ›
- Pain (Is it controlled?)
- Personal Needs (Does the patient need hydration or nutrition, the restroom, etc.?)
- Position (Is the patient comfortable?)
- Placement (Are personal items and the call light within reach?
Primary, secondary and tertiary prevention.What is the difference between registered nurse 1 and 2? ›
I assume RN I is an entry level position here in the U.S., You may need 1 year experience, you may need no experience (depends on the facility). RN II and III are more experienced positions.
What is the difference between clinical nurse 1 and 2? ›
This is an entry level position for a nurse with limited experience. The Clinical Nurse I is distinguished from the Clinical Nurse II in that the latter is expected to have more professional experience in a healthcare setting including Public Health and Mental Health.What is the highest rank of a nurse? ›
Chief Nursing Officer (CNO)
Chief nursing officers are nursing administrators who work within the leadership team of a healthcare organization. They are considered the highest level of nursing leadership.
Understanding the Hierarchy of Nursing. Chief Nursing Officer (CNO): The CNO, sometimes referred to as the chief nursing executive (CNE), is at the top of the pyramid. This position usually works under the CEO of the hospital or agency and has administrative and supervisory roles.What does RN Level 1 mean? ›
Registered nurse (RN1)
There are usually several nursing specialisations within the RN1 nursing level, such as cardiac nursing and critical care nursing. Their responsibilities may vary depending on their specialisation, but most registered nurses can perform complex nursing procedures.
Giving care, advice and support to sick, injured or disabled people. Qualification level 6. Equivalent to degree. Typical duration 48 months.Which is higher rank LPN or RN? ›
RNs Have More Responsibilities & Can Provide Higher Levels of Patient Care. RNs have a broader scope of practice and require considerably more education to earn licensure. RNs can also work independently in most areas. LPNs, however, must work under a physician or an RN's supervision.What are the 4 levels of care in nursing? ›
Routine home care, general inpatient care, continuous home care, respite.What are the 4 levels of health care? ›
Doctors usually refer to four different levels of care: primary care, secondary care, tertiary care, and quaternary care.What is the order of nursing credentials? ›
List the highest education degree first, for example, Michael Anderson, PhD, MSN. In most cases, one degree is enough, but if your second degree is in another relevant field, you may choose to list it. For example, a nurse executive might choose Nancy Gordon, MBA, MSN, RN.What is the chain of command in nursing? ›
A chain of command is an authoritative structure used to resolve administrative, clinical, or other patient (or worker) safety issues using an established process for healthcare workers to present a concern through the lines of authority until a resolution is reached.