Nursing – degrees, programs and career options

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HomeNursing overview

What nurses do

Nurses work in a variety of roles from providing public health education to performing diagnoses and treatments. Care and compassion are key traits associated with nursing and highlight the close connection nurses have to their patients. Their work involves a focus on patient wellbeing and the application of skilled work from a diverse knowledge-base. The scientific process of nursing involves assessment, diagnosis, planning, implementation, and evaluation. This standard is replicated across all types of nursing.

Nursing is a diverse profession that combines specialized practical work and critical thinking. Careers in nursing are an essential part of public health and are at the forefront of transformations taking place in societies across the globe.

The field of nursing is varied and provides opportunity for ongoing professional development and specialization. An important consideration in nursing is what type of qualifications you require and what type of nurse you aim to become. The healthcare sector is a growing field and nurses continue to be in demand. Technological advances and an aging population are factors that have a direct impact on the growth of nursing as a career.

One of the appealing aspects of nursing is that there is so much opportunity to specialize. Nurses have the option of ongoing professional development and many advanced courses may be online or have online components.

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Types of nursing

There are 3 main types of nursing that have their own roles and specializations. The multiple entry points to nursing provide flexibility in choosing the type of study best suited to your needs.

Registered Nurse (RN)

Registered Nurses are the foundation of the nursing profession. They perform physical exams, administer medicines, and provide health promotion at various levels. An important part of their work is co-ordination and collaboration with other healthcare professionals. To qualify as an RN, you are required to complete a nursing course, either diploma, associate’s degree, or bachelor’s degree. As of 2019, the average annual salary for an RN is $65,000.

Advanced Practice Registered Nurse (APRN)

Advanced Practice Registered Nurses provide primary care and often specialize in a patient population. Their work can be involved with the care of children, women’s health, or the elderly. APRNs can also subspecialize to provide acute care in areas such as dermatology, oncology, and a variety of chronic conditions. Specialized roles for APRNs can include midwifery, anesthetics, and both physical and mental health issues. APRNs typically hold at least a master’s degree in addition to the training and accreditation required for RNs. As of 2019 the average annual salary for an APRN is $96,000.

Licensed Practical Nurse (LPN)

Licensed Practical Nurses provide support and typically work under a RN, APRN, or Medical Doctor. They help the core health team by providing basic and routine care. Their work involves checking vital signs, dressing wounds and changing bandages, and ensuring the wellbeing and comfort of patients. LPNs require vocational training of approximately 12 months. As of 2019 the average annual salary for an LPN is $45,000.

Pathways in nursing profession

Licensure

To become a nurse you will be required to train and then be licensed to practice. The standardized National Council Licensure Examination (NCLEX) is the licensing required in the USA and Australia. Licensure is the final step in becoming a RN or LPN and the examination is usually sat via a computer mediated test. Sitting the NCLEX will cost approximately $200 and tests are available all year round.

Certification

In addition to licensure, certification is a way to validate your specialization in nursing. The ANCC (American Nurses Credentialling Center) provides certification which certifies your expertise, qualifications, and history of practice. Certificates are normally valid for 5 years and come at an average cost of $395 or $295 for ANCC members. These certificates cover an array of niche areas including gerontology, ambulatory, psychiatric and mental health specializations.

Education

One of the primary goals of a nursing qualification is to prepare you for sitting your license exam. There are a variety of undergraduate and postgraduate courses that can develop your career in nursing. Most diploma and degree courses will involve practicums and internships, as part of practical nursing practice in order to qualify, with a minimum number of required hours. These hours will often make up part of your credit total and will vary depending on which degree or course of study you follow.

Undergraduate

Diploma in nursing

A diploma in nursing is typically provided by a hospital-based nursing school. They are between 1 and 3 years in length and on completion provide eligibility for licensure. While previously the main path to nursing, these programs are now few. Some schools offering diplomas require non-nursing prerequisite courses, but the majority are self-contained.
Diploma courses will generally have an emphasis on clinical practice. They will include foundations in lifespan nursing, psychology, pharmacology, and patient care. You will also be able to use a diploma in nursing to gain admission to bachelor’s degree nursing programs. A diploma will often be accepted as fulfillment of a portion of a bachelor’s degree credit, typically reducing a 4-year course to 3 or 2 years depending on its structure.

The pre-requisites for a diploma in nursing are typically a high school diploma or GED. Good grades in biology, math, and sciences are valued in admissions, though thresholds for GPAs vary. If you are an international student, English will also be a pre-requisite. Courses vary, but often require IELTS/TOEFL at a minimum score between 5 and 6, or TOEFL internet-based test (iBT) with an overall score of 80.

On average, fees for full-time one-year campus study for a diploma in nursing will cost approximately $7000. There are few online options as these courses are practical in nature.

Careers for qualifying RNs with a diploma in nursing include: aged care nurse, palliative care nurse, mental health nurse.

Associate’s degree in nursing (ADN)

An Associate Degree in Nursing involves 2 years of training. These courses are often offered by community colleges and nursing schools. These are popular courses and provide a direct pathway to RN licensure or to a BSN. Essentially skill-based, the ADN also often includes liberal arts components such as anatomy, anthropology, and microbiology. Clinical practice is aimed at orienting you to working with patients. Essential technical nursing skills are taught which include bed-care, nursing terminology, math for administering medicine, and catheters.

The prerequisites for an ADN can be broad. Typically, you are required to have a high school GPA of 2.5 or higher, or at least 12 college credits with a GPA of 2.0 or higher. High school biology and chemistry are generally required, and competency in math. Some courses will have entry exams in math and may require additional prerequisites such as a police check. The benefit of an ADN is that it will qualify you for admission to bachelor’s degree nursing programs and may be transferable to account for one third to half of your degree credits.

The fees of an ADN are typically lower than those of a BSN. At a state institution they can cost around $3000 a year to $20,000 a year at private institutions and universities. The shorter study length is also a consideration in the costing. Additional expenses of books, health insurance, and lab work may also be included.

Some schools offer online ADN and pre-nursing degrees with fees at community colleges being around $8000 calculated on a credit hour basis. Accreditation varies and some courses may be only partially fulfilled online.

Careers for qualifying RNs with an ADN include: school nurse, nurse at doctor’s surgery, hospital nurses.

Bachelor’s of science in nursing (BSN)

A bachelor’s of science in nursing is designed to prepare you for the full scope of nursing in the contemporary healthcare environment. These courses are typically 4 years in duration and offered by nursing schools and university hospitals. There are a large variety of these courses available and many offer specializations such as community nursing, family nursing, midwifery, and mental health. While the content of courses differ, they will generally include the technical skills of nursing and components in theory, research, statistics, and nutrition.

There are also additional models of BSN for students with existing qualifications that only require 2 years of study. The RN-BSN is designed for those who have completed their ADN and have become a licensed RN. The Accelerated BSN is designed for those who have achieved a Bachelor’s degree, or have some existing nursing qualification from another country.

There are many online options for RN-BSN courses which provide flexible learning and scheduling. Prices for these courses vary between state and private institutions. On average you can expect fees of $15,000 to $40,000 depending on the school.

There are various requirements for admission to a BSN program. Admission directly from high school will on average require your completion of 16 high school academic units, a GPA of 3.00 or higher, and a composition SAT score of 1100. Some schools have more competitive programs and require a higher GPA or the completion of pre-admission nursing courses. A diploma in nursing can also provide access to BSN courses. If you are an international applicant, there will also be additional English language entry requirements such as IELTS/TOEFL.

Fees can range between $40,000 to $100,000 a year in private institutions and large universities. In state colleges, fees can be much lower between $3000 and $15,000 a year with possible reductions if you are studying in your home state.

Careers for qualifying RNs with a BSN in nursing include: nurse midwife, nurse anesthetist, hospital roles, nursing homes and health centers amongst many others.

Other degrees and switching careers

As there are a variety of degrees on offer, there are also various way to qualify. You might already have a degree in psychology, or biology and want to use this on your path to qualify as a RN. There are now many options to help you achieve this with accelerated degrees and admissions that take into consideration anything from a GED to a completed bachelor’s degree. There is no standard route to RN status when switching career, so you will want to consider where and how you want to study and then pursue the options available at different institutions.

Postgraduate

You may consider graduate courses in nursing if you wish to extend your expertise and develop your career in a niche area. These courses may enable you to specialize in a clinical area, work in leadership roles, or to focus on research and advanced patient care. There are also focused graduate courses to qualify for specific roles such as Nurse Educator or Nurse Midwifery.

Master’s degree (MSN)

The MSN has a focus on advanced patient care and nursing practice. These courses provide a variety of specializations and can be offered by university nursing schools. Many of these courses are available as online study and will be 1 to 2 years in length. An MSN will be composed of credits and some courses will give you options to complete these in a flexible time frame. Some MSN courses, like the Masters of Science in Nursing and Anesthesia, do involve extensive clinical practice and are not offered online.

Key components of an MSN will include advanced nursing theory, evidence-based research, ethics, and end-of-life care. Specialized MSN concentrations include nurse leadership, nurse practitioner, midwife, endocrinology, cardiology, anesthesia, and case management.
Some MSN courses can also be combined into joint degrees like business administration MSN/MBA, or health administration MSN/MHA.

Fees for MSN courses can range between $30,000 to more than $60,000 and many courses are calculated on a credit by hour basis. Public universities and online courses are often more affordable. Scholarships, subsidies, and support from employers are also sometimes an option to help cover MSN fees.

Careers for qualifying RNs with a MSN in nursing include: nurse practitioner roles in specialty areas like psychiatrics, gerontology, forensic, pediatric, and many others.

Doctor of Philosophy (Ph.D.)

Ph.D.s in nursing provide high level professional focus on research and healthcare administration. These can be campus based or online courses with a duration of 3-5 years of study. Essentially a Ph.D. will be research focused with an aim to producing nursing researchers and scholars.

Fees for Ph.D.s on average will be between $30,000 and $70,000 a year. Fellowships and grants are a competitive but appealing way to finance a Ph.D. If you are successful in obtaining funding, it may also include an obligation to teach or provide teaching assistance to faculty members.

Doctor of nursing practice (DNP)

The DNP is an option if you are becoming an expert in practice. Unlike the Ph.D. it is not research focused and aims to further professionalize practice for leadership positions.

Fees for DNP study are in a range between $30,000 and $70,000 a year. Financial aid and support from employers are some options to help with costings. Many DNP graduates will achieve leadership positions that earn upwards of $135,000 a year.

Careers for qualifying RNs with a Ph.D. in nursing include: managerial, research, and academic roles. These might include work as a professor, medical scientist, or medical health services manager.

Accreditation

Accreditation ensures courses are academically benchmarked and approved for public health safety. In the United States there are 2 different bodies that provide accreditation for nursing courses. The 2 accreditation groups are the ACEN (Accreditation Commission for Education in Nursing) and the CCNE (Commission on Collegiate Nursing Education). The main difference between the 2 bodies is that the CCNE only accredits bachelor and master’s level degree programs, while the ACEN provides accreditation for all levels of nursing from practical based courses to doctorate level.

Scholarships and financial aid

Due to the demand for nurses, there are many organizations that offer some form of financial support to nursing students. Some of these are focused on specializations, and range from a few thousand dollars, to tens of thousands of dollars over a number of years. Some of these awards require professional membership in the organizations that administer them. Deadlines vary. A small selection of these funds are listed below.

A Nurse I Am Film and Scholarship

Offers an annual $2,000 scholarship to student nurses at any level who are already enrolled and have begun their coursework. Their application process opens every year starting in the month of February.

The After College-AACN Scholarship

Fund is available to students who are pursuing BSN, MSN, or a Ph.D. in nursing. It awards one scholarship each quarter to a sum of $2,500. Eligibility is confined to enrolled students at an AACN accredited program.

American Holistic Nurses Association Research Grant

Offers an award of $5,000 to AHNA members involved in research on holistic nursing. The award is aimed at doctoral students and requires a detailed research proposal as part of the application.

The American Cancer Society’s Doctoral Scholarship

Scholarship in Cancer Nursing is for doctoral candidates in the field of cancer nursing research, education, administration, or clinical practice. A first award is made for up to 2 years with the possibility of a 2-year renewal. The award is a $15,000 stipend per year. Applicants are required to have an MSN and be pursuing a Ph.D.

The American Nurses Association administers the Ethnic/Racial Minority Doctoral Fellowships

Is for minority registered nurses. This award is open to applicants pursuing a Ph.D. in, or closely connected to, Psychiatric/Mental Health Nursing. In most cases, applicants will hold a master’s degree in Psychiatric/Mental Health Nursing or a closely related field. The award amount varies and the duration of the award can be between 3-5 years.

The AAC (American Addiction Centers)

aims to help those caring for others. They provide 3 scholarships to a total of $10,000 for students in the fields of behavioral health, counseling, psychology, social work, nursing, or related sciences. Open to applicants who are undergraduate or graduate students. Eligibility requires students to be enrolled in a program with a focus on counselling, psychology, social work or mental health and substance abuse issues.

Careers in nursing

Nursing is a broad field and can lead to work in various settings such as:

Here nurses work within specific communities to provide treatment and education to local populations. Public health issues such as obesity, smoking cessation, planned parenthood, substance abuse, and mental health are common roles. Community health nurses have an average pay scale between $38,000 – $81,000 per year depending on experience and qualifications.

Our typical ideas of nursing relate to the work that takes place in hospitals. Nurses are involved with a range of front-line care in monitoring the conditions of patients, administering medicine and rehabilitation, and supporting medical procedures from dressing wounds to assisting in surgery. In hospital settings, nurses on average will earn between $48,000 – $89,000 per year.

Working as a nurse for the elderly is attainable with a practical nursing qualification or for a range of qualified licensed nurses. This work involves daily care for residents in terms of basic hygiene and well-being. Work can also include administering medicine, physical exercise, attending to illness, and palliative care. Hourly wages for nursing staff at elderly homes can be $21 for practical nurses to around $28 for registered nurses.

In the private health care sector there are a range of roles for nurses. These might include everyday nursing care that would be performed in a health center or hospital. It may also include surgical nursing for cosmetic surgery, drug rehabilitation, fertility, or dermatology. Whatever the role may be, private clinics prioritize patient care. The work setting is often smaller scale with both fewer staff and patients, and more time for close working contact and support for patients. Average wage for nurses working in clinics is around $65,000 per year.

The role of a school nurse is focused on supporting the day-to-day health needs of students and staff. School nurses are part of the school community and provide front-line support to students with injuries and medical conditions. The set and sociable hours make this an appealing job to many nurses with young families and school age children themselves. On average a school nurse can expect to earn $50,000 a year.

Clinical research nurses are involved with enhancing and developing patient care. They can be involved in developing protocols for treatments for new infectious diseases, cancer drugs, or disaster scenarios. Part of this work revolves around collecting data but, similarly analyzing findings and developing new treatments. Research nurses will often have graduate degrees and can expect to earn between $57,000 and $97,000 a year.

Many nurses feel at some stage they would like to go back to where it all began and share their knowledge. Of course, nurses need to learn from other nurses and nurse educators perform this role. They can teach at nursing schools, community colleges, and large research universities. Their work can be diverse, developing curriculum and appraising students, or teaching specialized classes on a niche like pediatrics, or psychology. A mid-career educator will on average earn $75,000 a year.

Nursing administration involves a variety of work that can evolve into high tier managerial roles. At the lower level there are positions of charge nurses who will manage a hospital ward or clinic and oversee the staff on duty and their rosters. At a higher level the director of nursing will be responsible for nursing programs and patient care across a hospital or health care organization. Chief nursing officers hold high level positions overseeing recruitment, budgeting and synchronization with physicians and surgeons. A charge nurse will have an average salary between $53,000 and $96,000 a year, while a chief nursing officer will be paid between $92,000 and $213,000 a year.

There are numerous sites online which provide further information and guidance to a career in nursing. Some provide information on how to seek funding and financial aid, others provide tips on different types of schools.

Accreditation Commission for Education in Nursing
This is the site for the main body that provides accreditation for all levels of nursing programs across the USA.

Commission on Collegiate Nursing Education
The site for national accreditation for degree level nursing courses in the USA.

National Council Licensure Examination
Website for the national licensure for RN qualification. Provides information on preparation and organization for examination.