The field of nursing has dozens of different specialties that students can pursue once they have met the basic educational requirements to become registered nurses or licensed practical nurses. With additional education and training, nurses may move on to become certified nurse midwives, nurse practitioners and nurse educators, or they work in different areas of hospitals, such as geriatrics, labor and delivery, emergency room, obstetrics and many other nursing specialties.
Specialty Nursing Careers
Demand for nurses has been strong in recent years due to the increased amount of health care need in the U.S., according to the Bureau of Labor Statistics. A common education path would be to start out as a registered nurse (bachelor's degree), and others may consider becoming a licensed practical or licensed vocational nurse (associate degree). No matter what your degree level, you may choose to specialize in a certain area of health care, such as:
- Addiction: This type of nurse helps people who are overcoming addictions.
- Cardiovascular: This specialty is all about the heart.
- Critical Care: This work involves critical injuries in intensive-care units.
- Genetics: These nurses specialize in genetic disorders, such as cystic fibrosis.
- Neonatology: This involves the care of newborn babies.
- Nephrology: This requires knowledge of kidney-related health issues.
- Rehabilitation: These nurses help patients with disabilities.
Specialty nurses typically need years of intensive training and education. In some cases, your specialty may require even more education beyond a bachelor's degree. nurse practitioners and nurse midwives usually have completed master's degree, and sometimes doctorate-level education, the BLS reports.
Nursing Education Coursework and Skills
It doesn't take years to get started in the profession, though. Some nurses choose to get their start in the field by working as licensed practical nurses or licensed vocational nurses. LVNs and LPNs typically complete yearlong educational programs at nursing trade schools or community colleges and pass state licensing tests. Some LVNs choose to further their education by completing associate's or bachelor's degrees in nursing and becoming registered nurses.
Coursework for nursing education programs varies between classes in theory and practice. Coursework at nursing trade schools can include:
- Basic and advanced nursing theory and research
- Organization, delivery and health care policy
- Anatomy and physiology
- Nursing assessment
- Nursing leadership
Nurse education programs vary by institution and degree conferred -- usually a diploma or associate's and bachelor's degrees.
Becoming a Nurse: Expert Q&A
To learn more about what it takes to become a nurse, we spoke with Dr. Marilyn Smith-Stoner, who has been a nursing educator, researcher and clinical expert in end of life care and the use of technology in education for many years. She has taught at all levels of nursing education and lives and works in Southern California.
Dr. Marilyn Smith-Stoner is a nursing educator, researcher and clinical expert in end of life care.
RWM: What is the educational path needed to become a RN?
Dr. Smith-Stoner: The earlier a person starts planning to become a nurse, the better. High school students with high GPAs increasingly have a distinct advantage through special programs that guarantee admission to a state university in the major of the student's choice. They usually still have to pay tuition and complete the college prerequisite work, but the cherished spot in the nursing program is waiting for them once the prerequisites are completed. This is a significant advantage as many states have capped the number of students entering popular majors such as nursing. Your high school guidance counselor can provide information on this process.
A second way to enter a nursing program is to enroll in a community college. They are generally more accessible as there are more programs and the entry level requirements, such as GPA are not a strict. The length of time to complete an associate degree is 2-3 years. Community colleges issue associate degrees; however, this is changing. Many states now allow community colleges to award bachelor's degrees upon completion of additional courses. This means a student may obtain an associate degree at a community college and then complete the additional coursework for a bachelor's degree at the same campus.
A third way is to enter through a for-profit college. These colleges have more open admission policies and are becoming increasingly common. For an associate degree, the length of time to complete the degree is 2-3 years. For a bachelor's degree, it takes 4 years. The major advantage of these colleges is the convenience of having all the courses available in one place. The disadvantage is the higher cost.
RWM: How long does it take to complete education for this job?
Dr. Smith-Stoner: A bachelor's degree in nursing is the most desired and often required entry level degree. However, many facilities will hire a nurse with an associate degree if they are in school to obtain a bachelor's degree. Although both associate and baccalaureate degree nurses take the same NCLEX exam, extensive research has shown that patients cared for by nurses with a bachelor's degree have better health outcomes.
The determination of which program to apply for is based on your GPA, budget and the accreditation of the school. Nursing schools in the United States are accredited by The Commission on Collegiate Nursing Education (CCNE) or National League for Nursing Commission for Nursing Education Accreditation (CNEA). Another important factor is to consider the pass rate for the nursing licensing examination called the& NCLEX, which are published online for each state.
Additional requirements for a nursing school application may include letters of recommendation, personal statements and an assessment examination called the Test of Essential Academic Skills (TEAS). This is a non-nursing test of basic knowledge. Each sets the passing score and number of times an applicant can repeat the assessment.
RWM: Why would you encourage someone to pursue this career?
Dr. Smith-Stoner: Nursing will remain a high demand career for many years. Two of the most significant reasons are the high number of aging adults in general and, in particular, the high number of current nurses who are at retirement age… However, since the Affordable Care Act, the places that nurses are working is changing. High demand areas of nursing include mental health and community care. Positions in acute care hospitals are declining,
RWM: Do you have any advice for people starting out in this career?
Dr. Smith-Stoner: If you are considering starting out in nursing, here are some tips for your personal success plan. First, develop excellent study habits. Nursing students have to balance a lot of competing courses and life demands. Second, be cautious in personal choices you make. Nursing school requires a criminal background check upon acceptance. Drunk driving convictions, fraud or any charges related to abuse may disqualify you from entry. Third, prepare financially by setting a budget up and become aware of how much you spend a month. Nursing students have a lot of extra expenses and not anticipating the cost is a leading cause of dropping out of school. These include uniforms, insurance, transportation, books, equipment and the cost of required additional independent testing. These costs can add up to thousands of dollars over the time you are in the program. You can find out about these costs by attending informational sessions at the schools you are considering.
RWM: Are there any certifications or additional courses you recommend?
Dr. Smith-Stoner: Since the job market is very competitive, especially for graduates of associate degree programs, there are additional certifications and skills that can significantly increase the chances of employment. Speaking another language is a highly sought after skill. Most students will also take Advanced Cardiac Life Support (ACLS), and an EKG interpretation course.
RWM: What other tips do you have for improving job prospects when starting out?
Dr. Smith-Stoner: Your professional presentation is very important. Every day you are in clinicals, you are essentially in a job interview. Nurses and administrators notice first how students present themselves and then how they perform. Plan your time effectively and be on time for all courses. If you are considering a tattoo, put it somewhere that clothes will cover it up. Keep your nails, hair, clothes and shoes clean and neat. You don't have to cut your hair, but you will need to keep it out of your face. There are no fancy nails in nursing school, they are a health hazard. All of the grooming requirements are in place because of infection control and patient safety standards.
Developing a comprehensive plan that includes excellent study skills, responsible behavior, financial planning and professional behavior are the basis of being admitted to nursing school and being successful in the profession of nursing.
Nursing Salaries and Career Outlook
LVNs and LPNs are usually the lowest-paid nurses because they require the least amount of schooling, the BLS reports. Still, LPNs can move up in their education. For example, with their more advanced education, registered nurses tend to command higher wages. Below you can see a chart with the various levels of nursing, with recent salary and job growth data nationwide:
|Career||Total Employment||Annual Mean Wage||Projected 2012-2022 Growth|
|Licensed Practical and Licensed Vocational Nurses||697250||44030||16.3|
Growth for nurses of all types is expected to be highest in the country's most densely populated states, but nurses are in high demand in rural parts of the county as well, the BLS reports. Demand is driven primarily by increased need for health care services.
Nurses are the backbone of hospitals and physicians offices. Their scope of work varies by their education and the licenses they hold. Students interested in this growing field can get their careers started by enrolling at nurse vocational, trade and technical schools.
- Bureau of Labor Statistics, Occupational Outlook Handbook, http://www.bls.gov/ooh/healthcare/
- RN to BSN Curriculum, Jacksonville University School of Nursing, Accessed July 24, 2014, http://www.jacksonvilleu.com/programs/bachelors-degree/rn-to-bsn-online/curriculum/
- Interview with Dr. Marilyn Smith-Stoner, nursing educator and researcher, July 2016