Are you currently studying to become a nurse or interested in the field? These frequently asked nursing questions may help you along your education or career path.
Q: What are the different types of nurses?
A: Practicing nurses generally fall into one of four, broad categories: advanced practice registered nurses (APRNs), registered nurses (RNs), licensed practical nurses (LPNs), and nurse aides (NAs). While all four groups of nursing careers are directly involved with patient care, field mastery and levels of responsibility vary according to titles.
Q: What do nurse aides do? What are the education requirements for nurse aides?
A: Nurse aides usually work under the direction of a supervising RN. They perform caretaking tasks like bathing patients or changing bed clothes. Nurse aides may also be called on to record temperatures or blood pressure readings, to assist patients with eating and walking, or to facilitate the movement of beds and other medical equipment.
Nurse aide certification requirements differ by state. Some medical facilities, like hospitals and nursing homes, provide their own, state-approved nurse aide training. Facilities often provide free training for their employees. Some community colleges and vocational schools also offer state-approved, nurse aide training. Nurse aide education must be completed through an in-person program and not online.
Q: What do licensed practical nurses do? And what are the education requirements for LPNs?
A: LPNs are sometimes referred to as LVNs, or licensed vocational nurses. LPNs and LVNs provide specialized levels of nursing. They take patients’ vital signs and dress wounds. LPNs and LVNs also assist physicians with patient exams, and often council patients on proper care after an injury or medical procedure. In some states, LPNs are authorized to administer medication.
Most LPN programs are about a year long. They include both classroom study and supervised clinical practice, which involves direct patient care. Classroom study covers basic nursing subjects, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics nursing, pharmacology, nutrition, and first aid. Clinical practice usually takes place in a hospital, but some LPN students work in other types of health care facilities. Students are not paid for work they perform during their clinical training.
The LPN program you attend must be approved by your state’s board of nursing (which can sometimes be found in the State Office of Health and Human services). If you are unsure of a specific program, contact your state office, and ask for a list of approved, practical nursing programs. You cannot complete an LPN program online.
Before you can claim your LPN license, you’ll have to pass the National Council Licensure Examination or NCLEX-PN. The exam is administered by the National Council of State Boards of Nursing. It’s a computer-based test that covers four main categories: safe and effective care environments, health promotion and maintenance, psychosocial integrity, and physiological integrity. You should contact your state’s board of nursing for test eligibility requirements.
Q: What do registered nurses do?
A: RNs assume varying responsibilities, depending on where they work and, if applicable, their specialty. Some nurses work in hospitals and emergency rooms. Other nurses work in doctor’s offices, residential facilities or rehabilitation clinics. Some nurses serve a specific patient population, like premature babies or the elderly. Other nurses specialize in medical conditions such as cancer, or in specific body systems like respiratory nurses, who focus on patients with lung problems.
Q: What are the education requirements for RNs?
A: There are three major routes by which students can earn an RN license: diploma programs, associate’s degree programs, and bachelor’s degree programs.
Students who complete associate’s degree nursing programs are known as ADNs because they have an associate’s degree in nursing. If their program is state-approved, students can qualify to take the NCLEX-RN exam. If they pass, they can become registered nurses.
Similarly, students who complete bachelors in nursing programs are known as BSNs because they have a bachelor’s of science degree in nursing. If their degree program is state-approved, they can qualify to take the NCLEX-RN exam. If they pass, they can become registered nurses. BSN programs are longer, and include more general education courses than ADN programs, but the extra course work is often preferred by employers.
Nursing students can also attend hospital-based, diploma programs that lead to RN certification. These programs provide neither an associate’s nor bachelor’s degree. They may be shorter and less expensive than either of the above options. With that being said, they are less common, and therefore harder to find. There are also clear drawbacks to forgoing an associate’s or bachelor’s degree, including limited employment opportunities.
Q: Who are advanced practice registered nurses (APRNs)?
A: Advanced practice registered nurses are RNs who have completed additional study and training (master’s degrees and/or doctorates) in order to provide advanced levels of patient care. The National Council of State Boards of Nursing (NCSBN) recognizes four categories of APRNs: certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP).
Q: What are the education requirements for APRNs?
A: Currently, each state creates its own rules about APRN education requirements, entry level qualifications, recognized roles, and career titles. The NCSBN is working to standardize these state requirements, and to create consistent benchmarks for the certification, accreditation, education, and licensure of all APRNs.
Q: Who are clinical nurse specialists (CNSs)?
A: According to the National Association of Clinical Nurse Specialists, CNS practices “integrate nursing practices with medical diagnosis and treatment of disease, injury and disability.” In other words, clinical nurse specialists don’t just provide patient care, they also inform treatment plans, advise nursing staffs, and adjust healthcare delivery systems.
Clinical nurse specialists can focus their training on a specific patient population (e.g. women or children), a specific setting (e.g. home health or emergency room), a specific medical specialty (e.g. oncology or HIV/AIDS) or a specific type of care (e.g. critical care or rehabilitation.)
Q: Who are certified registered nurse anesthetists (CRNAs)?
A: According to the American Association of Nurse Anesthetists (AANA), CRNAs are nurses who oversee “patients’ anesthesia needs before, during, and after surgery or the delivery of a baby.” CRNAs perform physical assessments and preparatory procedures. They also administer anesthesia, monitor pain management and airway management, and observe postoperative recovery.
In order to become a certified registered nurse anesthetist (CRNA) one must: graduate from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), and pass the certification examination administered by the Council on Certification of Nurse Anesthetists.
Q: Who are certified nurse midwives (CNMs)?
A: Nurse midwives improve the health of pregnant women and newborns by educating patients, providing prenatal and postpartum care, and assisting with labor and delivery procedures. CNMs may be particularly concerned with reducing the risk factors that are associated with pregnancy complications, including high or low birth weight, cesarean births and preterm deliveries.
Certified nurse midwives must graduate from an ACNM ACME accredited program, and they must complete the national certification exam offered by the American Midwifery Certification Board (AMCB), in order to become certified.
Q: What’s the difference between a certified nurse midwife and a certified midwife?
A: Certified nurse midwives are registered nurses. In addition to completing a state-approved nursing program, they have completed a midwifery degree that is certified by the American College of Nurse-Midwives (ACNM.) CNMs have the legal authority to practice in every state, and their nursing credential may improve their employment options. CNMs often work in hospitals, clinics, or in their own private practices. They can also be hired to oversee at-home births.
Only three states (NY, NJ and RI) recognize the title of “certified midwife.” Certified midwives have also completed a degree program that is certified by the American College of Nurse-Midwives (ACNM), but they may lack comprehensive nursing education.
Q: Do I have to be a registered nurse and/or certified by the ACNM in order to work as a midwife?
A: Not necessarily. Some midwives are known as “direct-entry” midwives. They enter the profession without studying nursing, and in some cases, without completing an advanced degree in midwifery.
Direct-entry midwives are usually credentialed by the North American Registry of Midwives (NARM). They can earn their credentials by completing established midwifery degree programs or by undergoing an evaluation process that looks for equivalent knowledge gained through experience. Midwives credentialed through NARM must also pass a certification exam.
Direct-entry midwives can hold different titles, depending on how they were trained and what their state laws require. Some are called licensed midwives; some are called certified professional midwives (CPMs); others are called lay midwives.
If you are not already a nurse, and you are interested in direct-entry midwifery, you should check your state’s guidelines to determine what kind of educational program or credentialing you will need. Bear in mind, direct-entry midwives may encounter more professional limitations than those who are ACNM-certified. States may limit the types of pregnancies direct-entry midwives can facilitate, the kinds of medications and procedures they can administer, the settings in which they can practice, and the level of autonomy they can legally assume.
Q: Who are certified nurse practitioners (CNPs)?
A: According to the U.S. Bureau of Labor Statistics, “nurse practitioners serve as primary and specialty care providers, providing a blend of nursing and healthcare services to patients and families.”  The most common specialty areas for nurse practitioners are family practice, adult practice, women's health, pediatrics, acute care, and geriatrics. However, there are a variety of other specialties that nurse practitioners can choose, including neonatology and mental health.
Q: Who are clinical nurse leaders (CNLs)?
A: Clinical nurse leaders are advanced practice generalists. This distinguishes them from APRNs, including nurse practitioners and clinical nurse specialists, who focus their nursing education on a defined area of practice.
According to the American Association of Colleges of Nursing,“the CNL puts evidence-based practice into action to ensure that patients benefit from the latest innovations in care delivery. The CNL collects and evaluates patient outcomes, assesses cohort risk, and has the decision-making authority to change care plans when necessary. This clinician functions as part of an inter-professional team by communicating, planning, and implementing care directly with other healthcare professionals, including physicians, pharmacists, social workers, clinical nurse specialists, and nurse practitioners. The CNL role is not one of administration or management.” 
Q: Are “clinical” nurse leadership degrees the same as master’s-level nursing degrees in management or administration?
A: No. Clinical nurse leadership is a specific and newly emerging role. The “clinical nurse leader” title was developed by the American Association of Colleges of Nursing (AACN) along with other leaders from the field. CNLs are charged with providing point-of-contact care in complex medical situations. They are responsible for health outcomes, not organizational outcomes, which means they are not system managers or administrators.
Accredited, clinical nurse leadership degree programs qualify graduates to sit for the CNL certification exam. Some accredited CNL degrees are available online.
By contrast, MSN degrees in general leadership, management, or nursing administration are designed for nurses who wish to study healthcare policy, finance, and executive decision making that pertains to the organization of health care departments/facilities.
Q: I’m an LPN. Can I earn my LPN-to-RN or LPN-to-BSN online?
A: Yes. When looking for an LPN-to-BSN bridge program (or for any RN program), you should be careful to select one that is either approved by your state board of nursing, or accredited by the National League for Nursing Accrediting Commission (NLNAC). The NLNAC maintains national standards and criteria for nursing education programs. If your RN/BSN program is not approved by your state or the NLNAC, you will probably not qualify to sit for the NCLEX-RN exam.
Q: I’m an RN, but I earned my nursing license through a diploma program or an associate’s degree program. Can I complete an RN-to-BSN program online?
A: Yes. There are many online, RN-to-BSN programs available. More importantly, many of them are accredited by the National League for Nursing Accrediting Commission (NLNAC).
In the current job market, nursing employment and promotion opportunities are often reserved for candidates with bachelor’s degrees. RN-to-BSN programs allow students to continue working while completing online coursework and locally-based clinical requirements.
Q: Can I complete an RN-to-MSN program online?
A: Yes. If you are an RN (even if you earned it through an ADN or diploma program), you can qualify for a master’s level nursing program. However, you may be required to take certain general electives before starting your degree, and the college may only admit students with an acceptable undergraduate G.P.A.
Q: I don’t have any nursing experience. Can I earn my RN or BSN online?
A: No. Online nursing degrees are designed for students who are already registered nurses (RNs), and who wish to supplement their nursing credential with a bachelor’s degree in nursing (BSN) or a master’s degree in nursing (MSN).
If you have no nursing experience or nursing education at all, you need to start your training at an in-person program, offered though a hospital, a community college, or traditional college. You don’t have to complete a bachelor’s degree to become a registered nurse (although more employers do prefer to hire nurses with 4-year degrees). Additionally, you can qualify for certification as an LPN or an RN with just an associate’s degree, and in some cases, through an even shorter diploma program.
Q: I don’t have any nursing experience. Are there any online, health-related degrees available to new students?
A: Yes. Healthcare is a vast and growing field. People tend to think that all medical professionals are either doctors or nurses. In reality, there’s a sector full of people who help patients and administer healthcare, and many of them never studied nursing or advanced medicine.
Online degrees help to prepare medical assistants, medical billers and coders, healthcare administrators, and even some types of counselors.
Q: I want to pursue an online master’s degree in nursing. What’s the difference between an MSN, an MS and an MBA in nursing?
A: Many colleges now offer online master’s degrees for registered nurses. Master’s level nursing programs differ a great deal, depending on which types of nurses and nursing professionals they prepare. Online master’s degrees can prepare graduates to become certified nurse midwives, clinical nurse leaders, nurse educators, healthcare executives, nurse practitioners – in areas like adult health or family practice – and more.
RNs interested in continuing their clinical careers should look for master’s degrees that emphasize clinical study and clinical titles. If you have a specific clinical title in mind, it’s a good idea to contact enrollment advisors from the programs you’re considering, and ask if those programs will prepare you for any necessary licensing or certification exams.
RNs who hope to step back from direct patient care, and instead focus on health policy, medical informatics or organizational issues, should look for master’s degrees that emphasize management and administration. Studies estimate that thousands of lives are lost each year – not to mention billions of dollars – due to medical oversights and preventable delivery errors. With this in mind, more health executives are recognizing the need for management-trained nurses at every level of their organizations.
Q: What is the DNP nursing degree?
A: The DNP (doctor of nursing practice) is a doctorate level degree for practicing nurses. DNP students study specialized issues in advanced practice nursing. You may be aware that some colleges previously offered the ND (doctor of nursing) degree, but all ND programs have since transitioned into DNP programs.
Until very recently, advanced practice nurses were educated as far as the master’s level, with MSN degrees being the standard for nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. Nursing organizations and industry experts now believe these professionals should benefit from a doctoral degree. Moving forward, more and more advanced practice nurses will be required to obtain the DNP.
Q: What’s the difference between a Ph.D. in nursing and a DNP?
A: DNP degrees are doctorates for practicing professionals. Generally, they’re designed for nurses who will continue to work in clinical practice roles, as opposed to academic or research roles. With that being said, some DNP graduates go on to become nurse educators or researchers, and some Ph.D. graduates do pursue direct care roles.
Students who complete nursing Ph.D. programs are considered nursing scientists. Their degrees include extensive course work in theory, statistics and research methodology. Ph.D. nursing students must also complete a lengthy dissertation, or an academic paper, that puts forth original scholarship on some aspect of nursing science.
Contrarily, DNP students spend more time on applied nursing studies and clinical experiences at hospitals or clinics. DNP programs involve “immersion sessions” and supervised internships. Individual programs allow students to hone their knowledge in specialized areas of advanced practice. DNP programs also build students’ competencies based on a variety of entry-points. For example, students who enter DNP programs with BSN degrees usually need more preparation and course credits than those who enter with MSN degrees.
Q: Can I earn my DNP online?
A: Yes. Accredited, online DNP degrees are available in a variety of advanced practice specialties. However, students should be aware that significant, in-person time commitments are usually involved – either at the college campus, at an internship site, or both.
Q: I want to teach nursing. Do I need a master’s degree, a Ph.D. or a DNP?
A: It depends. The requirements for nurse educators vary, according to the hiring institution and the nursing level being taught. For non-tenure track positions, like adjunct or instructor, colleges and universities usually require at least a master’s degree. MSN-credentialed nurse educators can often teach ADN, LPN and BSN students.
More permanent faculty members such as associate or assistant professors, are usually expected to hold an earned doctorate, though some schools will provisionally hire tenure-track candidates in the process of completing a Ph.D. And although there may be some exceptions to these guidelines – especially now, when nurse educators are in such high demand – your long-term career options can only benefit from an advanced degree in nursing education, since higher credentials allow you to teach more courses.
In clinical settings (as opposed to colleges), nurse educators may be hired with just a BSN and some practical nursing experience. BSN nurses may be qualified to teach in RN diploma programs or certain LPN programs. But again, more and more facilities are looking for a master’s degree, at minimum.
If you don’t have a master’s degree, you can opt to pursue an MSN with a focus on education, or you can complete a BSN-to-DNP program or a BSN-to-Ph.D. program. There are advantages and disadvantages to all three routes. MSN nurse educator programs are usually shorter and less intense than doctorate level programs. On the downside, academic teaching options may be limited by the lack of a terminal degree. Ph.D. and DNP degrees improve job opportunities and command greater salaries, but they also involve residential colloquia and immersion sessions that may be unappealing to students with very hectic lives.
In terms of the DNP versus the Ph.D., see the above section for the differences between these two degrees. You may be concerned that by committing to a DNP (versus a Ph.D. in nursing education) you are limiting your career options to direct care roles. But this isn’t necessarily true. According to AACN data, “doctoral students who teach are just as likely to have a DNP as a PhD. This indicates that graduates of both types of doctoral programs are finding teaching positions.”
Q: Do I need to be a Certified Nurse Educator (CNE) in order to teach nursing?
A: No. In fact, you won’t be eligible to sit for the CNE exam until you have at least two years of fulltime employment, in an academic faculty role. With that said, CNE certification is a recognized indicator of expertise and professionalism. The standards defined by the NLN’s CNE program are good benchmarks for your teaching career and also good guidelines to follow when selecting a master’s or doctoral degree in nursing education. For example, the NLN recommends nine or more credit hours of graduate-level education courses, including: Curriculum Development and Evaluation; Instructional Design; Principles of Adult Learning; Assessment/Measurement & Evaluation; Principles of Teaching and Learning and Instructional Technology.
| 1 nacns.org/html/cns-faqs1.php | 2 aana.com/forpatients/Documents/crnas_aana.pdf | 3 bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm | 4 aacn.nche.edu/cnl/cnc/what-is-cnl-certification