Nursing career options and specializations


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HomeNursing overview

Introduction to nursing

Although nursing is a well-paying, in-demand position, the people who go into this field usually do so for altruistic reasons. They enjoy helping people overcome illnesses or injuries and have often had a caring personality since childhood. Although everyone who pursues a career in nursing is a unique individual, the field tends to attract people with similar values and skills.

Who is an ideal nursing candidate?

People who value relationships with coworkers, patients, and patients’ family members are likely to find satisfaction working as a nurse. However, nurses work in high pressure environments with rapidly changing priorities. Some find this stressful and develop caregiver burnout. Nurses who learn to separate their personal feelings from the job are best able to serve patients and preserve their own health.

Nurses typically value community, service, and the opportunity to work as part of a larger support team.


Nurses typically value community, service, and the opportunity to work as part of a larger support team. They value cooperation and support from both co-workers and management, holding each to exacting standards. Nurses can sometimes feel a sense of personal betrayal when managers do not stand behind them against criticism or unreasonable demands from others.

Ideal skills and personal attributes in nursing

Attention to detail is one of the most important attributes a nurse can possess. Patients rely on nurses to give them the right medication, provide important updates to their doctors, and keep them comfortable. Nurses who fail to be accurate and thorough in their work can literally put patients in a life-or-death situation. Double checking their work and asking for clarification are some of the ways nurses prioritize patients’ safety.

The ability to cooperate with a patient’s care team and put that person’s care ahead of personal ego or ambition is critical for success in this field. Patients do not want to deal with a nurse who is in a chronically bad mood or who does not give their all to the job, and neither do a nurse’s coworkers. The ability to remain upbeat and friendly regardless of the situation is also key.

A keen sense of ethics and personal integrity are additional attributes nurses should possess, since the job puts both skills to the test.


A keen sense of ethics and personal integrity are additional attributes nurses should possess, since the job puts both skills to the test. For example, a patient may ask their nurse not to repeat certain details about their medical condition to family members. Nurses in this situation need to honor that request regardless of how much pressure the patient’s family members apply.

Nurses also need to be honest about their knowledge and skills, such as admitting when they have little understanding of a patient’s diagnosis. This profession can also put nurses in ethical dilemmas, such as deciding which patient to treat first. Fortunately, nursing school teaches future nurses how to triage patients based on who presents the greatest need.

People considering a career in nursing should expect to be on their feet most of the time. They also need to be prepared to face stress and criticism regularly. People are rarely on their best behavior when they do not feel well, especially those dealing with significant anxiety or pain. Nurses need to be able to deal with patients’ mistreatment without allowing it to affect the quality of care they provide.

Qualities of people who enjoy nursing

Nursing typically attracts more extroverted than introverted people, which can make the social aspects of the job easier for them. Common examples of social interactions include teaching patients how to care for themselves at home, communicating with patients about their symptoms, and discussing patient care with other nurses, doctors, and family members. Effective communication skills are also essential when helping patients. People with extroverted personalities tend to thrive on the constant social contact integral to nursing.

Nurses often have an inborn sense of curiosity and the drive to investigate until they arrive at solutions. For example, a nurse practitioner treating a patient with diabetes who is not responding to any of the usual medications to reduce blood sugar may take it upon themselves to search for alternatives. That sense of urgency, coupled with a solutions-oriented personality, serves nurses well.

Nursing pathways

Nursing offers multiple opportunities, from providing basic care as a nursing assistant to conducting in-depth research at the Ph.D. level. A common strategy among new nurses is to earn the minimum educational credential and then accept an entry-level healthcare position.

Taking this approach allows them to work for a while to see if nursing is indeed a good fit. Thanks to the flexibility of most nursing schedules, it is usually possible for nurses to continue working while they return to school to earn more advanced credentials. Combining work with school is definitely manageable, especially when students choose to complete most of their program online.

Certified nursing assistant (CNA)

A certified nursing assistant provides basic patient care, which includes helping patients with activities of daily living. They rarely provide any direct medical care because of their limited training. Approximately 78% of CNAs work in hospitals. Like nurses, CNAs spend most of a shift on their feet.

Total employment


Projected growth (2018-2028)


Degree required

High school diploma or GED

Here is a list of the various common duties a CNA can expect to perform:

  • assist patients with eating or drinking
  • record the daily amount of food and drink a patient consumes and outputs of urine and fecal matter (if required), with significant changes reported to the supervising doctor or nurse
  • reposition or turn patients who are bedridden to prevent bedsores and blood clots
  • assist patients with using the bathroom, dressing, bathing, exercising, and other activities of daily living
  • ensure that patients take daily prescribed medication and nutritional supplements
  • make sure patients receive appropriate daily menu items by reviewing their food allergies, dietary restrictions, and personal preferences
  • observe and document patient behavior and report any concerning changes to the supervising doctor or nurse
  • respond to patients who summon the CNA using their call light
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Most states require nursing assistants to complete an approved course and pass an exam before becoming an official certified nursing assistant. Their name is listed on the state’s registry of CNAs upon passing the exam. Although CNAs do not need a license, their name must appear on the state registry before they can accept their first position.

CNA training courses are typically short, with the typical program lasting 6 weeks or less. Many long-term care homes offer training as part of an employment offer. People interested in becoming a CNA may also be able to find a low-cost course through their local Red Cross.

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Licensed practical nurse or licensed vocational nurse (LPN, LVN)

A licensed practical nurse (LPN) or licensed vocational nurse (LVN) provides basic medical care to patients under the direct supervision of a registered nurse (RN).

Total employment


Projected growth (2018-2028)


Degree required

Postsecondary nondegree

Examples of common duties performed by someone in this position include:

  • observe and record patient behavior and medical conditions, report worsening symptoms or an unexpected reaction to medication to the supervising RN
  • work as an essential part of patient healthcare teams to assess their needs and provide the most appropriate interventions
  • record patient vital signs, including weight, height, blood pressure, body temperature, respiration, and pulse
  • respond to patients who have pressed the call light.
  • supervise CNAs
  • completion of basic patient care tasks, such as treating bedsores, setting up a catheterization, changing wound dressing, and obtaining body temperature.

LPNs may also complete some of the following duties, depending on the level of education they have received:

  • reinforce instructions given by a registered nurse regarding how a patient should be cared for at home by family members
  • answer basic questions from patients and family members about the patient’s medical condition
  • feed and care for infants
  • collect blood, urine, or other types of body fluid for laboratory samples and deliver them to the appropriate person for processing
  • feed patients who cannot feed themselves due to an illness or injury.
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LPNs and LVNs must complete an accredited post-secondary education program. Most community and technical colleges offer these programs, which generally take a year to complete. Before practical nursing students can accept employment, they must pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN). Some practical nurses choose to earn certification in a specialty area, such as intravenous (IV) therapy.

With minimal education requirements to complete, CNAs can begin working within a few months and LPNs or LVNs can accept their first nursing position less than a year after starting their training. Those who decide to pursue education as a registered nurse (RN) may be able to transfer credits earned in a career training program to a 2- or 4-year degree.

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Registered nurses

Registered nurses work under the supervision of the patient’s physician to coordinate and deliver their care. They are often the first point of contact for family members, and they are instrumental in providing patients with instruction on managing their injury or health concerns at home.

Total employment


Projected growth (2018-2028)


Degree required

Associates or bachelor’s

  • supervising LPNs, CNAs, and other healthcare personnel with fewer credentials
  • consulting with other members of a patient’s care team and coordinating duties
  • helping patients prepare for medical tests or surgery
  • adjusting treatment plans based on how the patient responded to previous interventions
  • monitoring patients’ diet, physical activity, and medication schedules
  • taking vital signs and administering medication
  • helping doctors and testing technicians perform diagnostic tests
  • helping perform diagnostic tests such as MRIs or blood tests
  • monitoring and operating several types of medical equipment, e.g. heart rate monitors
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RNs must complete a minimum of an associate degree in nursing (ADN), although healthcare employers are increasingly requiring a bachelor’s degree for entry level RN vacancies. After earning their degree, nursing students must pass the NCLEX-RN exam before they can start working. Depending on the employer and position offered, they may also need certification in basic life support or cardiopulmonary resuscitation (CPR). Nursing students can expect to study anatomy, microbiology, physiology, and social and behavioral science in addition to accruing hours under clinical supervision.

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Transition programs

Current nurses who have an associate degree and would like to earn a bachelor’s degree should look for schools that offer accredited RN to BSN (bachelor of science in nursing) transition programs. The average timeframe to complete a transition program is 1 to 2 years. Transition programs focus on teaching students additional skills and do not spend a lot of time on general nursing education.

Not only are RNs with a bachelor’s degree in much higher demand, but they can also expect to earn a significantly higher salary. According to the American Association of Colleges of Nursing, nurses with a 4-year degree earn an average of $15,000 more per year than nurses with a 2-year degree. Nurses who want to specialize in a specific treatment area or transition to mostly academic research need to earn advanced nursing credentials first.

Advanced nursing

Nurses who want to practice advanced medicine or focus on a specialty area need a master’s degree and additional credentials. There are various RN to MSN education programs which cater to working RNs. Exam requirements and certifications vary by state and specialty. The most common specialties among healthcare professionals with the Advanced Practice Registered Nurse (APRN) credential are nurse practitioner, nurse anesthetist, nurse midwife, and clinical nurse specialist.

  • Median salary: $118K

    Nurse practitioners (NPs) diagnose and treat chronic or acute illness, either independently or as a member of a healthcare team. Many NPs focus on nutrition and lifestyle choices to help patients avoid disease. These professionals can diagnose and treat disease, prescribe medication, and interpret diagnostic testing. Depending on the state, NPs are beginning to replace physicians in primary care settings.

    RNs who want to become a nurse practitioner need an active nursing license and complete a graduate degree program accredited by a national agency like the Accreditation Commission for Education in Nursing. NPs also need to pass a certification exam accredited by the Accreditation Board of Specialty Nursing Certification and the National Commission for Certifying Agencies.

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  • Median salary: $161K

    Nurses in this role administer anesthesia to patients about to have surgery. They also monitor patients’ vital signs while under anesthesia and supervise their recovery. Nurse anesthetists may work with doctors, dentists, surgeons, or anesthesiologists. According to the American Association of Nurse Anesthetists (AANA), healthcare providers in this role need the following qualifications before they can practice:

    Some nurse anesthetists choose to earn certification in a specialty area, such as chronic pain management. Private physicians hire the most nurse anesthetists, followed by hospitals and outpatient care centers.

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  • Median salary: $98K

    Some people have the mistaken belief that nurse midwives only work with pregnant women. The reality is that these specialty nurses work with female patients starting in their adolescent years and care for them past menopause. Some specific duties of nurse midwives include:

    • caring for newborns
    • offering gynecological and family planning services
    • providing pre-conception care
    • caring for women in postpartum recovery
    • treating male partners with a sexually transmitted disease
    • supporting women in labor

    Nurse midwives can prescribe medication and diagnose and treat disease. Like many advanced practice nurses, nurse midwives tend to focus on wellness and preventive medicine more than treating existing health conditions. After earning a graduate degree, nurse midwives are required to pass an exam administered by the American Midwifery Certification Board. The board also recommends that people interested in training for this career enroll in a school accredited by the Accreditation Commission for Midwifery Education.

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  • Median salary: $92K

    Clinical nurse specialists have advanced training that allows them to diagnose, treat, and manage patients on an ongoing basis. These nurses provide direct bedside care, implement evidence-based interventions, and help drive organizational change.

    Licensing requirements and laws regarding how clinical nurse specialists can practice vary by state. Clinical nurse specialists who choose to earn certification pursue a specialty area based on the top healthcare needs of the population they serve. Common examples include geriatrics, pediatrics, and neonatal intensive care.

    People interested in training for this career can learn more about the education and experience requirements of their state at the National Association of Clinical Nurse Specialists.

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Additional specializations

Below are brief explanations of 6 other types of advanced nursing practice available to nurses aiming to expand their practice:

Travel nurse

These nurses complete temporary nursing assignments in areas that have the greatest need. For example, a travel nurse may temporarily relocate to an area recently affected by a natural disaster.

Pediatric nurse

These specialty nurses work exclusively with patients from birth up to age 18. Pediatric nurses work in a wide range of settings and are responsible for teaching patients and their families about caring for health conditions at home.

Obstetrics and gynecology nurse

OB-GYN nurses care for women throughout the duration of their pregnancy while also assisting them with sexual wellness and reproductive health. These types of nurses also support women during childbirth.

Labor and delivery nurse

Labor and delivery nurses remain with pregnant women throughout labor, delivery, and the postpartum period. These nurses act as a go-between for new mothers and the rest of the medical staff. They spend more time with pregnant women and women in labor than any other type of nurse.

Neonatal and intensive care nurses

Neonatal nurses care for healthy newborns, moderately ill or premature babies, and those requiring extensive medical intervention.

Hospice nurse

Nurses with this specialty training work exclusively with patients who are dying or have a terminal illness. Rather than provide life-saving care, the main duty of hospice nurses is to keep their patients as comfortable as possible during their last days or weeks of life.



People and healthcare facilities cannot get by without nurses, which means people studying to receive nursing credentials should never have to worry about being out of a job. The high demand for nurses increases the starting wage employers are willing to pay. Nursing students can feel confident that they will receive an excellent return on investment when they work in this career.

Nurses play an instrumental role in helping patients recover from injury or illness, making them an essential member of any healthcare team. If you are drawn to the medical field and want to make a direct impact in patients’ health, nursing could be the field for you.

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 U.S.

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

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

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