Nursing Ranks and Levels

Nursing Ranks and Levels

Nursing Ranks & Levels

Nursing is widely considered as an art and a science. Nurses uses both artistic and scientific aspect of care in their professional practice. Whether you are interested in becoming a nurse, or you already have a nursing degree, it is essential to understand the nursing 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.

Now a days, there are many opportunities for studying nursing in different levels, such as regular courses and accelerated courses. Nursing education starts with diploma and end in doctorate degree. You can become a nurse in a step by step fashion for diploma to ADN to BSN and so on. Or you can study ND from BSN to ND straight in an accelerated 5 years course.

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.


Chief Nursing Officer (CNO)

At the very top of the nursing hierarchy within a healthcare system is the Chief Nursing Officer (CNO). This position requires overseeing and communicating with nursing departments about business matters, best nursing practices, and nursing issues. This position ensures that a hospital’s nursing operations are efficient.

In addition to good nursing knowledge and experience, a CNO commonly has a Master’s of Science in Nursing (MSN) or higher degree with a focus on business administration.

Doctor of Nursing Practice (DNP)

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.

A DNP commonly work as educator, leader, manager, health policy maker and other high level jobs. The DNP education requires three to six years of study.

Advanced Practice Registered Nurse (APRN)

Nurses who earn their Master of Science in Nursing (MSN) can become advanced practice registered nurses (APRNs). These nurses have many options when it comes to career choices. An APRN is a master’s degree prepared RN with a post-master’s certificate, or a DNP in one of the role of Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, and Certified Nurse-Midwife.

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.

Masters of Science in Nursing (MSN)

This master’s program allows nurses to specialize in a specified area such as research or advanced clinical training. Obtaining an MSN helps nurses increase their earning potential and advance their careers away from the bedside. Nurses with an MSN work in advanced nursing roles with increased responsibility. To obtain an MSN, nurses must first obtain an RN and Bachelor of Nursing (BSN) degree.

Those with master degree in nursing often work as care coordinator, nurse educator, nurse leader or manager.

Nursing Director

A nursing director, also known as a unit manager, works directly with patients and staff within the healthcare setting and handles various administration and management duties within respective nursing units. They are registered nurses with a minimum education of an MSN.

Bachelors of Science in Nursing (BSN)

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.

Both ADN and BSN graduates must pass the NCLEX-RN examination to become licensed to work as an RN.

Associates Degree in Nursing (ADN)

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. 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.

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.

Licensed Practical Nurse (LPN) / Licensed Vocational Nurse (LVN)

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.

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.

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.

For more information about different nursing education and accreditation programs refer to ANA website.

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