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As I learn more about the art of nursing care, and then relate that knowledge to the people in my life, I have seen a significant deficit in their overall knowledge of nursing titles and education.  I was definitely part of that group until I began researching in earnest how to become a nurse midwife.  In an effort to clear up a bit of the confusion, I am writing this post.  The list below is not exhaustive, but a good introduction.  If you come across additional tiles that you want to know more about, or feel are needed on this list, feel free to write me a message and I will edit the post as needed.  So, without further adieu, here is an introduction to nursing titles.

Nurses Aide or CNA (certified nursing assistant): no formal class room education is necessary, though some people take a course.  Many organizations offer these courses, including the Red Cross.  A test for certification is required to carry the title.  This person is in charge of many of the simple and physical tasks that encompass patient care.  These include turning patients in bed to avoid pressure ulcers, changing linens, taking vitals and daily weights, and feeding.  Nurses aids are not responsible for decision-making, and require a level of supervision.

LPN (licensed practical nurse): A LPN has approximately one year of nursing education.  They represent the next step above a nurses aide, and can supervise a nurses aide.  An LPN can do most of the cares for a patient, but is not trained, or authorized to perform assessments.  More education means more pay, and more opportunities for employment.  A LPN always works under the supervision of an RN, physician, or both.  Their work tends to be physical, and stays focused on bedside cares.

Registered Nurse (RN): An RN has a minimum of a 2 year degree.  They have a combination of lecture and clinical preparation, and have authority over both nurse aides and LPNs.  RNs can focus their practice to specialize, and earn certificates in areas of specialty.  There is currently a push to reduce the number of associate prepared RNs and increase the number of bachelor prepared RNs.  RNs do everything from bedside cares to supervisory roles.  An RN takes the NCLEX exam (it’s the same test nation wide) to get licensed by the state that they practice in.

BSN RN: This is the level of education I am currently working on.  A BSN (bachelors of science in nursing) RN has four years of education, and typically three of those are heavily focused on nursing curriculum.  The clinical hours are longer and more diverse than the two-year RNs, and more focused on theory, research, and leadership than the two-year as well.  BSNs take the same NCLEX exam and the Associates prepared RNs.  Holding a bachelors puts a nurse in position for graduate school, management positions, and higher pay.  One reason that the push for more BSNs exists is to try to cultivate more nursing educators.  To educate nurses, you must be a minimum of a BSN, but graduate level is prefered.  Therefore, if most of our nurses continue to be associate RNs, we will have no one to teach the next generation.  It is common for a two-year RN to complete a BSN part-time, as four-year programs are highly competitive, expensive, and time-consuming.

MSN (masters of science in nursing):  A master level prepared nurse is becoming more rare.  Many nursing specialties are transitioning to doctoral level programs, leaving fewer MSN graduates.  However, as this switch is happening right now, nurses who specialized up until the past few years hold this level of education.  Many people who are currently earning this degree are obtaining it as a “pre-licensure” student.  They already held a bachelor’s degree in science, and decided to change careers.  These students are often in fast paced and intense nursing program, and are groomed for nurse supervisory positions.  They are competent in bedside cares, but generally have a different focus.  In the case of a few nurses I know, they tried repeatedly to enter a four-year undergrad degree, but could not get in due to the limited admission.  They finished a biology focused undergrad, and continued straight on to the pre-licensure MSN program.  These nurses are highly educated.

DNP (doctor of nursing practice): This is a newer classification of education for nurses.  As I said in the MSN, specialty of focused education is being elevated to this level.  DNPs are focused on patient care, and the title is often followed by an additional letters for the specialty they have earned, such as NP (nurse practitioner) CNM (certified nurse midwife) and so on.  It can take three to four years to earn this degree and is accompanied by a focused and intensive practicum in addition to the classroom credits.  As time goes on, you will see more DNPs and fewer MSNs.  MSN nurses and DNPs are able to work as faculty on a nursing staff to train the next generation of nurses.

PhD:  Yes, nurses can hold a PhD!  These nurses focus on research instead of patient care.  Some practice, but many focus on teaching, research, and advancement of both the nursing profession as well as health care knowledge.  It takes several steps to obtain this degree.

PHN: This is a public health nurse, a specialty that requires additional education.  There is very little “bedside” nursing in this field.  PHNs focus on the needs of the population as a whole, and find ways to improve the overall health by preventing illness in the first place.  I am very interested in this field.

CNM (certified nurse midwife):  This is my ultimate goal.  I will earn a DNP to become a certified nurse midwife.  To learn more about them, see my resources page and check the links.  In my opinion, every healthy woman should see a CNM over an OB, but I do have some pretty strong opinions on this subject…

There are so many more classifications and specialties, but I am going to list only one more.  I chose this one because I didn’t know what it was until recently, and I see the letters listed by my professors’ names all the time.  In case you were wondering too, here you go.

FAAN:  You should be excited if your instructor or care providing nurse have these letters following their title!  It stands for “Fellow of the American Academy of Nursing”.  This person has been recognized to have made “significant contributions to the nursing profession”.  FAAN was established by the ANA (american nursing association) in 1966 by its house of delegates.

In conclusion, there are many different levels of education that accompany the title of “nurse”.  Along with those are very diverse skill sets, and responsibilities.  We need good people to be filling this title at all levels of education, and I am excited to be entering such a diverse and dedicated group of people.

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