Registered Nurses The 13 Best Nursing Career Paths In 2023 & How To Advance
Nurse burnout is a serious issue that’s getting more attention. Like most nurses, you probably chose nursing altruistically to help people live better lives. However, nurses can get weary. According to Gitnux:
- 62% feel burned out
- 60% consider quitting
- Only 20% feel they are getting their needed mental support
After several years of full-time nursing, with its long shifts, overtime, and constant stress, you may start feeling like you need a change. But nurses get caught in conflicting situations. You may:
- Love nursing and want to become even more helpful
- Need more family time
- Need a better schedule and less overtime
- Have hit an earning ceiling
- Want to pursue a nursing specialty and a higher degree
- Not want more student loans
How would you resolve those conflicts and achieve a manageable work-life balance?
Most advanced degrees and certifications cost tens of thousands and take at least two years of full-time study. Even if your employer shoulders some of the cost and is considerate about scheduling, you would probably need to take out a loan.
However, there are ways to increase your earning potential as a nurse and have a more flexible schedule. You could pursue your dream of higher education if you had the right health-related income source.
We’ll explore three quick ways to upgrade your skill set and solve several conflicts while you work on gaining the best nursing specialty for you. One of the fastest upgrade strategies stands out because it’s easy to implement and solves many nursing burnout issues.
As a part or full-time Certified Health Coach, you counsel and educate people about making wiser behavior choices affecting their health issues.
You can get a health coaching job in a wellness or healthcare facility. Or you could do private counseling sessions on Zoom for up to a hundred dollars an hour, allowing you to work from anywhere and take clients nationwide. By only accepting clients in your area of nursing expertise, you immediately establish a level of trust and authority that makes your advice more valuable.
Let’s explore how to become an RN and 13 paths for RNs to advance their careers, including three quick certificates and 10 advanced degrees.
Is there a difference between a nurse and a registered nurse?
People often get confused about what a nurse is because many clinical workers provide patient care but are not registered nurses. An RN has met the required educational standards, passed the National Council Licensure Examination (NCLEX), and passed their state’s licensing exam.
Knowing the five classifications of healthcare workers who perform nursing duties will help you understand the differences. The first two work with RNs but are not RNs.
- Certified nursing assistants (CNAs) help nurses with basic patient care like bathing, using bedpans, and turning over.
- Licensed practical nurses (LPNs) can perform many nursing duties but cannot dispense medication.
- ADN RNs have an associate degree in nursing and have passed the national RN examination and state licensing test.
- BSN RNs have a bachelor of science degree in nursing (BSN) and have passed the national RN examination and state licensing test.
- Nursing practitioners (NPs) have a master of science in nursing (MSN) or a doctor of nursing practice (DNP) degree.
What are the requirements to become a registered nurse?
If you’re not an RN yet, you can choose your path to become one. Your choice will depend on your present education, how fast you need to go to work, and how far you want to take your nursing career.
Bachelor of Science Nursing
The most straightforward path is:
- Complete a four-year BSN program
- Take the National Council Licensure Examination (NCLEX) for RNs
- Pass your state board exam
An increasing number of states and employers now require a BSN to become an RN. Check your state’s requirements.
Accelerated RN programs
If you already have a bachelor’s degree in another field, you can take an accelerated RN program requiring 11 to 18 months of study, including prerequisites.
LPN to RN
If you’ve completed a one-year LPN diploma course at a community college, you can choose one of three paths to becoming an RN:
- An additional year at a community college to earn an associate degree will qualify you to become an ADN RN.
- Completing your bachelor’s degree will give you a BSN RN.
- Take a hybrid or online LPN to RN bridge program while you work. There are LPN to ADN RN and LPN to BSN RN programs available.
Be sure your choice is accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
Because of the high demand for clinical workers, many employers will help you with the cost of upgrading your skill set.
When choosing the ADN RN path, be aware that:
- You can start working as an RN much faster by upgrading from LPN to ADN RN than if you stay in school to get a BSN RN.
- You won’t make as much. There is up to a 90% difference in pay between an ADN RN and a BSN RN, depending on your location.
- ADN RNs are limited in some job functions.
You’ll definitely need a BSN if you want to:
- Become an Advanced Practice Registered Nurse (APRN) to specialize in a nursing field
- Get an MSN
- Become a DPN or a Doctor of Nursing Science (DNS)
How to become a registered nurse after high school
You have four options available when choosing how to become a registered nurse after high school.
- Enroll in a four-year BSN program at a university.
- Take a two-year associate degree RN program at a community college to get an ADN RN.
- Take a one-year LPN diploma course at a community college and take a bridge program after going to work.
- Join a two- to three-year hospital-based diploma program and get an ADN RN. You’ll get hands-on experience.
After completing the path of your choice, you’ll need to take the NCLEX exam and pass your state’s license exam. Before choosing your program, carefully consider the:
- NCLEX pass rates of graduates
- Resources the program has available to help you pass the NCLEX
What education is needed to become a registered nurse?
You can get started on the education needed to become a registered nurse with a high school diploma. For:
- A BSN RN, you’ll need four years at a university
- An ADN RN, you’ll have to complete a diploma course, an associate in science degree, or a bridge program
How many years does it take to become a registered nurse?
How long it takes to become a registered nurse depends on your chosen educational path. There are four choices for high school graduates. You can pick a:
- One year LPN diploma course, then an LPN to RN bridge program
- Two- to three-year diploma course
- Two-year associate degree program
- Four-year BSN program
Accelerated programs taking 11-18 months are available for those holding a bachelor’s degree in another discipline.
Here are some tips on how to become an RN fast:
- Take online, self-paced courses wherever possible. Be sure the credits are transferable if the courses are outside your program.
- Ask if you can challenge courses by taking an exam instead of sitting in the class.
- Ask the professor if you can submit a paper instead of doing coursework.
- Use tutors, study groups, and professors’ office hours for challenging courses like pharmacology, pathophysiology, and human anatomy.
- Find a mentor.
- Take summer classes.
There are many paths to becoming an RN, and help abounds because the need for nurses is critical. Once you become an RN, many alternative career paths will open.
Alternative career paths for nurses
With 106 specialties and many more sub-specialties, alternative career path choices for RNs can be overwhelming. We’ll look at two types of paths:
- One through three only require an easy-to-get certificate like our Certified Health Coach course.
- Four through thirteen require higher degrees.
Path 1 — Health Coach
Role and responsibilities
Counsel patients and clients to motivate behavior changes that affect health risks, chronic conditions, and disease.
Education and training required for this career path
The Health Coach Certification is available for those holding current clinical certification.
A Certificate of Completion is available for those without a certification-eligible credential.
Legalities are the reason for awarding different certificates to entrants with diverse backgrounds who complete the same coursework.
Typical work environment
You can do counseling sessions in a healthcare or wellness setting or in your private practice, which could be online.
How to advance
Add a degree in nutrition, counseling, psychology, or dietetics.
Path 2 — Pain Management Nurse
Role and responsibilities
Counsel and assist patients with managing acute or chronic pain. Consult with other healthcare professionals to develop a pain management plan for a patient.
Education and training required for this career path
- Hold an RN license
- Two years of full-time practice as an RN
- Pass the ANCC Pain Management Nursing board certification examination
Typical work environment
Your work as a pain management nurse will be unpredictable because you can be called on to help anyone suffering from pain caused by any medical condition in outpatient and inpatient settings.
How to advance
Adding a pain management Advanced Practice Registered Nurse (APRN) with an MSN enables you to diagnose patients, prescribe medication, and create treatment plans.
Path 3 — Aesthetic Nurse (AN)
Role and responsibilities
Provide cosmetic procedures that may be limited to botox, dermal fillers, and chemical peels. You can also assist plastic surgeons with procedures.
Education and training required for this career path
- Be a licensed RN, NP, PA, physician, or dentist
- Complete a short certification course
Typical work environment
It may require a personal connection to get started working as an AN. ANs generally don’t work in acute care facilities but in clinics or spas. Hours are usually 9 to 5 on weekdays. You’ll likely:
- Consult with patients
- Perform medical screenings
- Prepare patients for procedures
- Manage patient expectations
- Provide education and answer questions
How to advance
Add an APRN Aesthetics certificate with an MNS or a DNP.
Paths four through thirteen are higher-paying specialties that require an APRN certificate, which typically includes an MSN in a two-year program or a DNP in a program between 18 months and 4 years long.
In addition to your degree, you’ll need:
- The required number of clinical hours for your specialty
- To pass a national APRN certificate exam for your specialty
- To pass your state’s exam
There are four general APRN categories:
- Certified Nurse Midwives provide gynecological care throughout the reproductive cycle.
- Certified Registered Nurse Anesthetists administer anesthetics and related care.
- Clinical Nurse Specialists work with population groups to identify gaps or shortcomings in patient care.
- Nurse Practitioners treat the whole patient by diagnosing, prescribing, and creating treatment plans.
Under the broad umbrella of Nurse Practitioner are many subspecialties you can add. Let’s look at ten popular specialties.
Path 4 — Certified Nurse Midwives (CNM)
Role and responsibilities
Provide care for women from adolescence through menopause, emphasizing prenatal, birth, postpartum, and postnatal care.
Education and training required for this career path
- Have a BSN RN license
- Have at least one year of experience as an RN
- Earn a Master of Science in Nursing (MSN) or a Ph.D. in nursing
- Pass the American Midwifery Certification Board (AMCB)
- Pass your state’s license exam
If you don’t have a BSN RN, you can become a Certified Midwife (CM) by passing an AMCB exam.
Typical work environment
Successful midwifery is about building relationships. You could work in a hospital, a health clinic, a birth center, private practice, or provide home delivery. Daily work is often a mix of scheduled routine appointments and open-ended childbirths.
How to advance
You could become a team leader, ward manager, director of midwifery, or midwifery consultant.
Path 5 — Certified Registered Nurse Anesthetists
Role and responsibilities
Administer anesthetics before surgery and care for the patient’s well-being.
Education and training required for this career path
Beginning in 2025, a doctor’s degree will be required for anesthetists.
Typical work environment
Every day an anesthesiologist chooses and administers the correct drugs for surgical patients and then monitors the patient’s well-being during surgery.
How to advance
Anesthesiologists can advance into administration or teaching or take a one-year fellowship in a subspecialty like cardiac anesthesiology.
Path 6 — Cardiology Nurse Practitioner (CNP)
Role and responsibilities
Cardiology nurse practitioners administer stress tests and EKGs, prep patients for surgery, monitor patients during and after surgery, and provide cardiac health education.
Education and training required for this career path
- Hold a BSN RN
- Complete an MSN or DNS program in cardiology nursing
- Pass the American Board of Cardiovascular Medicine exam
- Pass the state license exam
Typical work environment
The work environment is changing rapidly for CNPs as robotics and telemedicine play increasingly important roles. Work is divided between treatment for existing conditions and patient education.
How to advance
You can go into administration or education or take a fellowship to specialize in:
- Adult consultative cardiology
- Ambulatory/longitudinal cardiovascular care
- Electrophysiology
- Heart failure/transplant
- Invasive and noninvasive cardiology
- Critical care cardiology
- Research and scholarly activity
Path 7 — Family Nurse Practitioner (FNP)
Role and responsibilities
FNPs perform a wide range of duties in varied settings. They can:
- Order or perform diagnostic tests
- Prescribe medications
- Develop treatment plans
- Treat acute and chronic illnesses, conditions, and injuries
Education and training required for this career path
- Hold a BSN RN license
- Complete an FNP, MSN, or DNS program
- Complete 500 clinical hours
- Pass the American Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC) exam
- Pass your state’s license exam
Typical work environment
An FNP usually starts the day doing administrative tasks and reviewing patient records to prepare to see patients for the rest of the day. Building relationships and educating patients about healthcare is a large part of FNP practice.
How to advance
FNPs can advance into administrative or educational roles or take a subspeciality in:
- Cardiac
- Critical care
- Dermatology
- Endocrine/Diabetes
- ER/trauma
- Medical-surgical
- Oncology
- Perinatal
- Postpartum
Path 8 — Orthopedic Nurse Practitioner (ONP)
Role and responsibilities
ONPs assist orthopedic surgeons and take independent responsibility for many musculoskeletal treatments, including joints, muscles, and:
- Taking X-rays
- Setting fractures
- Treating wounds
- Changing bandages
- Preparing patients for orthopedic surgery
- Providing postoperative care
Education and training required for this career path
- BSN RN license
- 2,000 hours of orthopedic work in the last three years
- Complete an MSN or DNS specializing in orthopedics
- Pass the Orthopedic Nurses Certification Board exam
- Pass your state’s license exam
Typical work environment
ONPs do far more than treat musculoskeletal issues in various settings, including hospitals and clinics. They also:
- Provide emotional support and counsel patients through initial treatments and recovery
- Help with pain management
- Treat skin problems
How to advance
There are many opportunities for ONPs to advance their careers into:
- Head nurse
- Case managers
- Directors
- Nursing instructors/educators
- Administrators
- Office managers
- Researchers
- Supervisors/coordinators
- Nurse managers
Path 9 — Oncology Nurse Practitioner (ONP)
Role and responsibilities
ONPs usually work in other specialties like adult, family, women’s, or geriatric health, providing primary, acute, or tertiary care. Their roles can include:
- Developing oncology management strategies
- Diagnoses
- Prescribing treatment and medications
- Educating
- Providing support for patients’ families
Education and training required for this career path
- BSN RN
- Complete an oncology nurse practitioner program with an MSN or DNS
- Pass the Oncology Nursing Certification Corporation exam
- Pass your state’s licensing exam
Typical work environment
ONP duties vary depending on whether they work in a doctor’s office, hospital, clinic, or in-home care. They help with all cancer stages: diagnoses, treatment, and end-of-life. Exciting advances in oncology treatment are bringing hopeful change.
How to advance
Add certifications as a:
- Pediatric hematology oncology nurse
- Breast care nurse
- Blood and marrow transplant nurse
Path 10 — Psychiatric Mental Health Nurse Practitioner (PMHNP)
Role and responsibilities
You’ll diagnose and treat people suffering from mental disorders and substance abuse problems using therapy and prescribing drugs.
Education and training required for this career path
- BSN RN
- Complete an MSN or DNS specializing in psychiatric mental health
- Get 500 clinical hours
- Pass the PMHNP-BC exam with the American Nurses Credentialing Center (ANCC)
- Pass your state’s licensing exam
Typical work environment
Work settings for PMHNPs are varied — hospitals, shelters, or any type of psychiatric facility. Daily work can be diverse and challenging as you’re called on to help people of all ages with many different conditions.
How to advance
You can add degrees or certifications in healthcare or education to become a:
- Nursing director
- Chief nursing officer
- Postsecondary nursing instructor
Path 11 — Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNPC)
Role and responsibilities
Develop and monitor multifaceted treatment plans focused on preventing complications and improving patient health. Jobs can include teaching, administrative, and research work.
Education and training required for this career path
- BSN RN license
- MSN or DNS with an AG-ACNPC focus
- Complete 500 clinical hours
- Pass the adult-gerontology acute care nurse practitioner exam by the ANCC or AACN
- Pass your state’s exam
Typical work environment
AG-ACNPCs work in various settings, including but not limited to intensive care. They diagnose, treat, and monitor age-related health issues.
How to advance
AG-ACNPCs can advance by obtaining additional certifications to teach or subspecialize in:
- Oncology
- Cardiology
- Psychiatry
Path 12 — Pediatric Nurse Practitioner (PNP)
Role and responsibilities
Care for children from birth to young adulthood, focusing on preventing and caring for pediatric acute illnesses and chronic conditions
Education and training required for this career path
- BSN RN license
- MSN or DNS in a pediatric primary care nurse practitioner program
- 500 clinical hours
- Pass the ANCC Pediatric Primary Care Nurse Practitioner exam
- Pass your state’s license exam
Typical work environment
Pediatric Nurse Practitioners can work in various settings to see inpatients or outpatients. Private practice work is becoming more common. PNPs report that being a part of children’s lives as they progress into adulthood is particularly rewarding.
How to advance
Take advanced certification to teach or subspecialize in:
- Oncology
- Cardiology
- Mental health
Path 13 — Dermatology Certified Nurse Practitioner (DCNP)
Role and responsibilities
Assess, diagnose, and treat hair, skin, and nail dermatological issues like burns, dermatitis, psoriasis, eczema, and virus, fungi, or bacterial infections.
Education and training required for this career path
- BSN RN license
- MSN or DNS with a dermatology focus
- Pass the Dermatology Nursing Certification Board (DNCB) exam
- Pass your state’s license exam
Typical work environment
DCNPs usually work normal business hours with few emergency calls in clinics and private dermatology practices. You may also work in:
- Hospital burn units
- Medical spas
- Vocational schools or colleges
- Plastic surgeons’ offices
How to advance
Gain additional certifications to teach or subspecialize in:
- Pediatric Dermatology
- Cosmetic Dermatology
- Surgical dermatology
Rapid career advances are possible for RNs
While most career advancement paths for RNs require multiple years of expensive education, there are a few faster, less costly choices that enable you to earn more money and enjoy better working hours. These paths can provide income to obtain advanced degrees without taking out loans. You can also gain time for family life.
Suppose you can’t see yourself pursuing a master’s or doctorate just yet but need more money without working more overtime. In that case, we recommend getting one of the few certifications you can obtain quickly and inexpensively — like our Certified Health Coach course.
National Society of Health Coaches
