
Preparation
The three major educational paths to registered nursing - a bachelor's
of science degree in nursing (BSN), an associate degree in nursing (ADN),
and a diploma. Nurses most commonly enter the occupation by completing
an associate degree or
bachelor's degree program.
Individuals then must complete a national licensing examination in order
to obtain a nursing license. Further training or education can qualify
nurses to work in specialty areas, and may help improve advancement
opportunities.
BSN programs, offered by
colleges and universities, take about 4 years to complete. In 2006, 709
nursing programs offered degrees at the bachelor's level. ADN programs,
offered by community and junior colleges, take about 2 to 3 years to
complete. About 850 RN programs granted associate degrees. Diploma
programs, administered in hospitals, last about 3 years. Only about 70
programs offered diplomas. Generally, licensed graduates of any of the
three types of educational programs qualify for entry-level positions.
Accredited
Programs
In the United States,
there are two nursing organizations that accredit schools of nursing:
the
National
League for Nursing Accreditation Commission
(ASN, BSN, MSN) and the Commission
on Collegiate Nursing Education
(BSN, MSN). Schools may choose which organization will accredit them and
can have accreditations from both organizations. The following table
provides links to detailed lists of accredited nursing programs.
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National
League for Nursing Accreditation Commission
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Commission
on Collegiate Nursing Education
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Many
RNs with an ADN or diploma later enter bachelor's programs to prepare
for a broader scope of nursing practice. Often, they can find an
entry-level position and then take advantage of tuition reimbursement
benefits to work toward a BSN by completing an RN-to-BSN program. In
2006, there were 629 RN-to-BSN programs in the United States.
Accelerated master's degree in nursing (MSN) programs also are available
by combining 1 year of an accelerated BSN program with 2 years of
graduate study. In 2006, there were 149 RN-to-MSN programs.
Accelerated BSN programs
also are available for individuals who have a bachelor's or higher
degree in another field and who are interested in moving into nursing.
In 2006, 197 of these programs were available. Accelerated BSN programs
last 12 to 18 months and provide the fastest route to a BSN for
individuals who already hold a degree. MSN programs also are available
for individuals who hold a bachelor's or higher degree in another field.
Individuals considering
nursing should carefully weigh the advantages and disadvantages of
enrolling in a BSN or MSN program because, if they do, their advancement
opportunities usually are broader. In fact, some career paths are open
only to nurses with a bachelor's or master's degree. A bachelor's degree
often is necessary for administrative positions and is a prerequisite
for admission to graduate nursing programs in research, consulting, and
teaching, and all four advanced practice nursing specialties--clinical
nurse specialists, nurse anesthetists, nurse-midwives, and nurse
practitioners. Individuals who complete a bachelor's receive more
training in areas such as communication, leadership, and critical
thinking, all of which are becoming more important as nursing care
becomes more complex. Additionally, bachelor's degree programs offer
more clinical experience in nonhospital settings. Education beyond a
bachelor's degree can also help students looking to enter certain fields
or increase advancement opportunities. In 2006, 448 nursing schools
offered master's
degrees, 108 offered doctoral degrees, and 58 offered accelerated
BSN-to-doctoral programs.
All
four advanced practice nursing specialties require at least a master's
degree. Most programs include about 2 years of full-time study and
require a BSN degree for entry; some programs require at least 1 to 2
years of clinical experience as an RN for admission. In 2006, there were
342 master's and post-master's programs offered for nurse practitioners,
230 master's and post-master's programs for clinical nurse specialists,
106 programs for nurse anesthetists, and 39 programs for nurse-midwives.
All nursing education
programs include classroom instruction and supervised clinical
experience in hospitals and other health care facilities. Students take
courses in anatomy, physiology, microbiology, chemistry, nutrition,
psychology and other behavioral sciences, and nursing. Coursework also
includes the liberal arts for ADN and BSN students.
Supervised clinical
experience is provided in hospital departments such as pediatrics,
psychiatry, maternity, and surgery. A growing number of programs include
clinical experience in nursing care facilities, public health
departments, home health agencies, and ambulatory clinics.
Licensure
and certification
In all States, the
District of Columbia, and U.S. territories, students must graduate from
an approved nursing program and pass a national licensing examination,
known as the NCLEX-RN, in order to obtain a nursing license. Nurses may
be licensed in more than one State, either by examination or by the
endorsement of a license issued by another State. The Nurse Licensure
Compact Agreement allows a nurse who is licensed and permanently resides
in one of the member States to practice in the other member States
without obtaining additional licensure. In 2006, 20 states were members
of the Compact, while 2 more were pending membership. All States require
periodic renewal of licenses, which may require continuing education.
Certification
is common, and sometimes required, for the four advanced practice
nursing specialties -- clinical nurse specialists, nurse anesthetists,
nurse-midwives, and nurse practitioners. Upon completion of their
educational programs, most advanced practice nurses become nationally
certified in their area of specialty. Certification also is available in
specialty areas for all nurses. In some States, certification in a
specialty is required in order to practice that specialty.
Foreign-educated and
foreign-born nurses wishing to work in the United States must obtain a
work visa. To obtain the visa, nurses must undergo a federal screening
program to ensure that their education and licensure are comparable to
that of a U.S. educated nurse, that they have proficiency in written and
spoken English, and that they have passed either the Commission on
Graduates of Foreign Nursing Schools (CGFNS) Qualifying Examination or
the NCLEX-RN. CGFNS administers the VisaScreen Program. (The Commission
is an immigration-neutral, nonprofit organization that is recognized
internationally as an authority on credentials evaluation in the health
care field.) Nurses educated in Australia, Canada (except Quebec),
Ireland, New Zealand, and the United Kingdom, or foreign-born nurses who
were educated in the United States, are exempt from the language
proficiency testing. In addition to these national requirements,
foreign-born nurses must obtain state licensure in order to practice in
the United States. Each State has its own requirements for licensure.
Advancement
Some
RNs start their careers as licensed practical nurses or nursing aides,
and then go back to school to receive their RN degree. Most RNs begin as
staff nurses in hospitals, and with experience and good performance
often move to other settings or are promoted to more responsible
positions. In management, nurses can advance from assistant unit manger
or head nurse to more senior-level administrative roles of assistant
director, director, vice president, or chief nurse. Increasingly,
management-level nursing positions require a graduate or an advanced
degree in nursing or health services administration. Administrative
positions require leadership, communication and negotiation skills, and
good judgment.
Some nurses move into
the business side of health care. Their nursing expertise and experience
on a health care team equip them to manage ambulatory, acute,
home-based, and chronic care. Employers--including hospitals, insurance
companies, pharmaceutical manufacturers, and managed care organizations,
among others--need RNs for health planning and development, marketing,
consulting, policy development, and quality assurance. Other nurses work
as college and university faculty or conduct research.
Note: Some resources in this section are provided by the US Department
of Labor, Bureau of Labor Statistics.
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