A Complete Guide to Nursing: Understanding the Various Roles and Certifications

Nursing is a vocation to which the majority of nurses feel called. A combination of compassion, desire to care, medical knowledge and clinical skills is the blueprint for a highly desirable nurse.  A caregiver of this caliber is exactly the kind of staff member healthcare organizations seek.

There are different types of nursing degrees and certifications that are required depending on your career goals. Some certifications take a few months and advanced degrees take years. The skills you acquire range from the clinical fundamentals to advanced specialized practice, including nurse practitioner and physician’s assistant. Your income and career growth potential correspond directly with these levels of certification and degrees. 

There are also specialized roles within your education level you may wish to pursue. Geriatrics, pediatrics, oncology, wound care and nurse-anesthetist are just a few of the more specialized areas that require specific certifications. Understanding the various roles and certifications tends to be a bit overwhelming, especially for those who are just beginning their career in nursing. Here we hope to clear up the confusion and help you get a clear view of what is necessary to become the nurse you’re called to be.

Understanding Various Nursing Roles and What They Require

In general, the various roles in nursing fall into three different ascending categories: non-degree, degree, advanced degree. Non-degree nurses include CNAs and LPNs, those nurses who complete education and certification programs but do not receive a degree. Nurses who do receive degrees do so as part of an undergraduate program and include Associate of Science in Nursing (ASN) and Bachelor of Science in Nursing (BSN). Advanced degrees fall into two categories, Masters of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP). 

There are requirements for certification that fall beneath each category, from entry level to advanced degree, and enable you to bring sought after skills to the interview table. Depending on your goals for your nursing career there may be more than a few certifications required. Here is your complete guide to the various roles and certifications in nursing.

CNA (Certified Nursing Assistant)

As a CNA you will most likely find a career in long-term care, either in a skilled nursing facility, rehabilitation center or home care. The CNA is the main contact between the patient/patient’s family and the healthcare provider and organization. Their duties involve assisting the patient with toileting, bathing and getting ready for the day. As a CNA you will also assist the patient with moving about whether getting them up out of bed or to the dining room or activities areas. If necessary the CNA assists the patient in eating as well.

As a CNA you will be instrumental in providing companionship to your patient and putting them at ease. CNA’s are trained in charting and taking vitals, and depending on the regulations  of your state, administering medication. 

If you want to pursue a CNA career here are the requirements:

  • High school diploma or equivalent (GED)
  • Completion of your state-approved CNA program
  • Pass a state exam for CNA

You can usually complete your state-approved CNA program in as little as 2-3 months, depending on your state’s requirements. You will be required to have a specific number of training hours in the classroom, lab and clinical setting. 

LPN (Licensed Practical Nurse)

An LPN (also recognized as an LVN, or Licensed vocational nurse) provides patient care and, as the central point of contact between the healthcare team and the patient, communicates and advocates for their patients needs as well as keeping the family in the loop. Physical care is a bit more advanced for LPNs than CNAs. They are skilled in inserting catheters and starting  IVs, monitoring vital signs, administering meds and treatments, tending to basic care tasks and collaborating with the care team for patient care plans. 

Both CNAs and LPNs duties will vary depending on state regulations and protocols in place within the healthcare organization. 

Requirements to become an LPN:

  • High school diploma or equivalent (GED) 
  • Successful completion of a state approved practical nursing program
  • Passing a state licensing exam for practical nursing (NCLEX-PN)

The program to become an LPN typically takes a year and, in many cases, offers schedules that complement the typical working person.

RN (Registered Nurse)

A registered nurse is the role most often associated with the term “nurse.” RNs are prevalent and a necessary part of patient care in hospitals, clinics, doctors offices and many other healthcare organizations. The RN has a broad range of skills and duties. They collaborate with doctors and are an instrumental part of determining patient care plans. RNs administer patients’ medication and treatment and often oversee CNAs and LPNs in an administrative role.

RNs are also instrumental in triage, assessing patients and collecting information such as health history and any pertinent symptoms. Because they are skilled and practiced in clinical care the RN is often called upon as a multitasker. 

In order to become an RN you must earn a degree, either an associate degree or a bachelor degree. Upon graduation from your nursing program you will need to pass the NCLEX-RN exam for licensure in your state. There are some essential differences in your degree options for RN. They are:

ASN

An associate degree nursing program takes fewer years to complete than the bachelor/four year degree. In recent years this degree has become more popular and gets you out into your nursing career much faster.  Many times you may decide to advance your degree to BSN or beyond with a bridge program for ASNs. Some healthcare organizations require their ASNs to complete a BSN/RN program within a certain amount of time as a condition of employment. This is because studies show a better patient outcome when the RN has a BSN degree. 

BSN

A bachelor of science in nursing will certainly open up more opportunities for you than the ASN but it takes longer to obtain the degree. Typically you will complete a 4+ year program at a nursing school in a university setting. Once you complete your program you’ll likely be required to spend time in immersive training, also known as practicum. You’ll work under the supervision of an experienced nurse and learn hands-on skills in real time. 

APRN (Advanced Practice Registered Nurse)

The APRN is a leadership role known also as an NP.. As an APRN you’ll direct the course of your patient care plan, overseeing the RNs who are implementing the plan. The role of APRN most often requires an advanced degree such as a masters of science I nursing. Then a specialized course of study including nurse anesthetist, nurse midwife, nurse practitioner and clinical nursing specialist. 

As an NP you perform all of the duties of an RN but have the skills to diagnose illnesses and provide treatment, manage care and prescribe certain medications and also provide more detailed and advanced interventions. You are also well-attuned to public health issues. APRNs have advanced degrees that affords them more opportunities. APRNs work in private practice and community health as well as hospital and clinical settings and long-term care. 

The requirements for APRNs:

  • A minimum of one year practicing as an RN
  • Completion of an MSN program
  • Passing a certification exam from an accredited national organization

DNP (Doctor of Nursing Practice)

The title of doctor of nursing is one of the highest levels of nursing you can obtain. Its useful in opening doors to a wide variety of nursing roles. With a DNP you can become directly involved in public health, help steer healthcare policy, advise on healthcare information systems and become involved in leadership in several healthcare organizational nursing roles. 

The DNP is someone who is vastly experienced in healthcare as a nurse and is creative when it comes to problem solving. The DNP program is open to those with a BSN or MSN. As a DNP your doctorate will cover one of two specialties, family nurse practitioner or nursing executive. You will be required to have at least one year of nursing practice as a BSN-RN. A degree as an ASN is not eligible to move on to a doctorate program. 

Specialized Nursing Roles and Certifications

Nursing roles at each level offer some type of certification. You may find this a part of your job and the study and cost of certification covered by your employer or you may wish to obtain certification yourself in order to attain certain career goals. Here are some of the in-demand specialized certifications you may find helpful in all nursing roles.

CNA

  • Certified Alzheimer’s Care: a specialized certification which focuses on the care of Alzheimer’s and dementia patients.
  • Wound Care: You acquire the skills necessary to address the care of patients with wounds, including pressure wounds, common in patients in long term care.
  • CNA II: This advanced CNA certification equips the CNA to provide care for patients with chronic and stable conditions.
  • Hospice and Palliative Care: Equips the CNA to provide care to hospice patients and their families.
  • Medication Certification: In some states this is a required certification before CNAs may administer certain medications.

LPN

  • IV Therapy: Certification for skills relating to IV management
  • Pediatric Advanced Life Support: ability to recognize pediatric distress and resuscitate and stabilize infants and children.
  • Advanced Cardiac Life Support: Certifies your ability to recognize a cardiac event and administer life-saving intervention.
  • Basic Life Support: Certifies your ability to perform CPR and administer automated external defibrillator (AED)
  • Wound Care: Recognize wounds and administer treatment.
  • Hemodialysis Certification: Certifies ability to care for those undergoing dialysis. 
  • Developmental Disabilities Care: Specific skills required when caring for those with developmental disabilities.
  • Gerontology: Provide care specifically related to the aging population
  • Long Term Care: Ability to provide specific care required for long-term and homebound patients. 

RN

  • Holistic Nursing Certification: For RNs who wish to approach patient care with equal focus on body, mind and spirit.
  • Nurse Executive Certification: an excellent certification for RNs who wish to pursue leadership nursing roles. This certification is only open to those with a BSN.
  • Nursing Informatics Certification: A certification that brings together nursing and IT.  

APRN

  • Family Nurse Practitioner: As mentioned above this is specific to your education as a NP. This certification is currently in high demand.
  • Adult Gerontology Primary Care: Certification proving your extensive knowledge in conditions directly related to the senior population.
  • Nurse Anesthetist Certification: This is one of the highest paying nursing roles for those with advanced degrees in nursing. Even if anesthesia was your focus in your advanced degree courses you must maintain certification due to the ever-changing technology surrounding nursing roles in anesthesia. 

Understanding Various Roles and Realizing Your Career Goals

Realizing your career goals as a nurse is possible when you take the right steps. Understanding the various roles and certifications helps you move forward whether you obtain  a CNA or LPN certification or undergraduate or advanced degree. Becoming the nurse you’re called to be is a lifelong journey and one that offers rewards beyond measure.

For more information on various nursing roles and staff positions available to you please contact BOS Medical Staffing. 

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