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Nursing is the largest healthcare profession in the United States, with more than 3.1 million registered nurses. [1] Between 2012 and 2022, employment for nurses is projected to grow by 19 percent, which is more than any other profession. [2] Nurses make up the largest component of staff in hospitals but are also able to provide care in clinic settings, patient's homes, schools, nursing homes, public health agencies, and mental health centers. In addition, nurses can be found in the military, in industry, nursing education, and do health care research. [3] Nurses in these various roles and settings can provide direct patient care and case management, but also develop and establish nursing practice and quality standards within complex healthcare systems. As each degree can provide a different level of care for patients and function in vastly different roles, it is important to differentiate between them. The levels of nursing degrees have different educational requirements, licensure, and credentialing that can vary state to state.
The education required for a Licensed Practical Nurse/Licensed Vocational Nurse is the completion of a 12-18 month program, typically at a technical college. The program focuses on task activities and prepares the nurse for the National Council Licensure Examination for Licensed Practical Nurses (NCLEX). [4] Requirements for taking the NCLEX-PN include having a high school diploma or equivalent and successful completion of an accredited practical/vocational nursing program. LPN/LVNs work in a variety of settings including hospitals, clinics, nursing homes, rehabilitation centers, schools, and individual or group homes. [5] Scope of practice for LPN/LVNs is defined by individual states, but each organization may narrow the scope of the LPN/LVN. [6]
Hospital-based Diplomas in Nursing were historically the primary form of nursing education, first appearing in the early 20th century. The number of facilities offering this degree as well as the number of nurses obtaining their education through them have declined since the 1970s due to the growth of Associate Degree in Nursing and Bachelor of Science in Nursing programs at colleges and universities, as well as increasing financial constraints on hospitals and the healthcare systems. Diploma programs were the most abundant in the 1950s and 1960s, with nearly 1,300 diploma programs active nationwide. [7] Presently, less than 10 percent of nursing degree programs are diploma programs, [8] which produce less than 6 percent of registered nurses. [9] The majority of the remaining diploma programs in the United States are concentrated in the Midwest and on the East Coast. [10] Programs for hospital diplomas are traditionally sponsored and run by hospitals in the community, as their name implies. Courses are taught proximal to and in conjunction with the hospital, where students have practical application of their skills on the units and wards in the sponsoring facility. Diploma programs typically have a strong focus on practical application of skills, with a larger percentage of time spent on the “hands-on” component of learning. Students attend classes for two to three years, at the completion of which they take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) certifying exam, a standard exam for all practicing registered nurses. Students graduate with a diploma in nursing, and passing of the NCLEX-RN allows for certification and state licensure, which permits the graduate to practice as a full registered nurse within his or her state's statutes. Coursework taken in a diploma nursing program can frequently be used for credits toward nursing degrees such as a BSN or ADN. [11]
An Associate Degree in Nursing (ADN) is the minimum educational requirement to become a registered nurse in the United States. All ADN prepared nurses are credentialed through individual state nursing boards after passing the NCLEX-RN. In order to be eligible to take the NCLEX-RN exam, candidates must have a high school diploma or its equivalent and a degree from a board of nursing approved nursing program. ADN nursing programs typically take two years to complete but courses required differ by state. [12] The standard course requirement includes anatomy, physiology, microbiology, chemistry, nutrition, psychology. [13] Background checks are also performed on all candidates prior to granting licensure. Associate degree nurses are able to work in both outpatient and inpatient settings. [14] Of the almost 3.1 million registered nurses in the United States, 36.1 percent of them have an associate degrees in nursing. [15]
Bachelor of Science in Nursing (BSN) degrees prepare nurses for a wide variety of professional roles and graduate study within nursing. It is typically acquired through a four-year program at a college or university. Baccalaureate programs include a variety of liberal arts courses and professional education and training in the nursing field. It contains additional education beyond that of an ADN that often includes physical and social sciences, communication, leadership, and critical thinking. [16] There are 674 BSN programs in the United States. BSN programs are approved by each state's individual board of nursing that allows students to sit for the NCLEX-RN examination to obtain a license as a registered nurse [17] Some states have accelerated programs called “RN-to-BSN” or “BSN completion” for registered nurses with associate degrees wanting to obtain their bachelor's degree in nursing. In 2010, the Institute of Medicine called for 80 percent of nurses in the U.S. to be baccalaureate trained by the year 2020, and this has created a push for healthcare organizations to make a BSN a hiring requirement for registered nurses and instituting education assistance programs for those with associate degrees. [18]
The Master of Science in Nursing (MSN) is an advanced degree that allows for a more specialized role in nursing. The master's prepared nurse has a wide array of careers that he or she might aspire to fill. Career paths include certified nurse practitioner (CNP), certified nurse anesthetist (CRNA), clinical nurse specialist (CNS), or Certified Nurse‐Midwife (CNM). Some other areas the MSN prepared nurse might focus are in public health, business administration or health administration. Education curriculum may vary between 18 and 24 months of full-time graduate level studies, with program length determined by the specified field. [19] The certification exams for a master's prepared nurse are dependent upon the role being pursued. For example, the CNM takes the American Midwifery Certification Board exam and nurse administrators may receive their certification from the American Nurses Credentialing Center (ANCC). Master's prepared nurses are trained in advanced assessment, counseling of patients, management, leadership, research and education. [20] They may work in both inpatient and outpatient settings as well as educational institutions, and scope of practice may vary state-by-state.
The scope of practice for a Doctor of Nursing Practice (DNP) includes assessing, diagnosing, prescribing, consulting, screening, educating, initiating referrals, and the coordination of patient care. There are numerous specialties DNPs may pursue including Acute Care Nurse Practitioner, Adult Nurse Practitioner, Adult-gerontology nurse practitioner (acute or primary care), Adult Psychiatric- Mental Health Nurse Practitioner, Family Nurse Practitioner, Gerontological Nurse Practitioner, Pediatric Nurse Practitioner (acute or primary care), and School Nurse Practitioner. [21] Specific practice guidelines can vary by state and area of practice. In order to become a DNP, one would need to obtain his or her doctorate in nursing practice. Specific program requirements vary with each program. After completing the doctorate program, one must pass the specific certification exam that corresponds to his or her specialty prior to initiating practice. In 2014, there were 3,065 DNP graduates. [22]
Nurses who hold a Doctor of Philosophy Degree in Nursing (PhD), are less about hands-on patient care and more about the abstract thinking that helps move the profession forward. A nurse with a PhD has the training needed to conduct research aimed at changing nursing science or practice. The education for a PhD in nursing includes courses in scientific research methodologies and statistics and philosophy of science. Either a BSN or MSN degree are required for entry into a PhD program. [23] Credit requirements vary by program and state and typically take anywhere from three to five years to complete. PhD programs do not have clinical practice hour requirements like DNP programs. PhD prepared nurses teach as academic faculty, conduct research, evaluate programs, hold academic and leadership positions, write books, and lead health care organizations. [24]
A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.
Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to student nurses by experienced nurses and other medical professionals who have qualified or experienced for educational tasks, traditionally in a type of professional school known as a nursing school of college of nursing. Most countries offer nurse education courses that can be relevant to general nursing or to specialized areas including mental health nursing, pediatric nursing, and post-operative nursing. Nurse education also provides post-qualification courses in specialist subjects within nursing.
A licensed practical nurse (LPN), in much of the United States and Canada, is a nurse who provides direct nursing care for people who are sick, injured, convalescent, or disabled. In the United States, LPNs work under the direction of physicians, mid-level practitioners, and may work under the direction of registered nurses depending on their jurisdiction.
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.
An advanced practice nurse (APN) is a nurse with post-graduate education and training in nursing. Nurses practicing at this level may work in either a specialist or generalist capacity. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing.
The National Council Licensure Examination (NCLEX) is a nationwide examination for the licensing of nurses in the United States, Canada, and Australia since 1982, 2015, and 2020, respectively. There are two types: the NCLEX-RN and the NCLEX-PN. After graduating from a school of nursing, one takes the NCLEX exam to receive a nursing license. A nursing license gives an individual the permission to practice nursing, granted by the state where they met the requirements.
A Diploma in Nursing or Nursing Diploma is an entry-level tertiary education nursing credential.
An Associate of Science in Nursing (ASN) is a tertiary education nursing degree which typically takes 2–3 years to complete. In the United States, this type of degree is usually awarded by community colleges or similar nursing schools. Some four-year colleges also offer this degree. Students awarded an Associate of Science in Nursing are qualified to sit for the NCLEX-RN and apply for licensure as a Registered Nurse.
The Doctor of Nursing Practice (DNP) is a professional degree in nursing in the United States of America.
Nursing credentials and certifications are the various credentials and certifications that a person must have to practice nursing legally. Nurses' postnominal letters reflect their credentials—that is, their achievements in nursing education, licensure, certification, and fellowship. The letters usually appear in the following order:
Nursing in the United States is a professional health care occupation. It is the largest such occupation, employing millions of certified professionals. As of 2023, 3,175,390 registered nurses were employed, paid a median income of $86,070.
The University of Virginia School of Nursing, established in 1901, is a school of nursing education. It has an enrollment of approximately 800 students, and is consistently rated in the top 4% of U.S. nursing schools. After the retirement of Dorrie K. Fontaine as the fifth dean of the School, two-term American Nurses Association President Pam Cipriano, a research faculty member at UVA for years, stepped in as interim dean in August 2019.
In the United States, a psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessments of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.
The University of San Francisco School of Nursing and Health Professions (SONHP) is the nursing school of the private University of San Francisco, located in San Francisco, California. First established in 1954, the school has approximately 1,300 students.
A family nurse practitioner (FNP) provides continuing and comprehensive healthcare for the individual and family across all ages, genders, diseases, and body systems. Primary care emphasizes the holistic nature of health and it is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion.
The Uniform Advantage/AACN Graduate Nursing Student Academy Scholarship is an award that acknowledges the important role nurses play in the health care system. It was developed based on a commitment to improving access to nursing students enrolled in master's and doctoral programs.
Nurses in Canada practise in a wide variety of settings, with various levels of training and experience. They provide evidence-based care and educate their patients about health and disease.
Healthcare professional credentials are credentials awarded to many healthcare practitioners as a way to standardize the level of education and ability to provide care.
A pediatric nurse practitioner (PNP) is a nurse practitioner who specializes in care for newborns, infants, toddlers, pre-schoolers, school-aged children, adolescents, and young adults. Nurse practitioners have an in-depth knowledge and experience in pediatric healthcare including well childcare, and prevention/management of common pediatric acute illnesses and chronic conditions. This care is provided to support optimal health of children within the context of their family, community, and environmental setting. In order to be a pediatric nurse practitioner one must be compassionate, resourceful, good at communicating and have good attention to detail.
Advanced practice registered nurses (APRNs) are registered nurses with graduate degrees in nursing. APRN roles include: certified nurse midwife, clinical nurse specialist, certified registered nurse anesthetist, and nurse practitioner. APRNs assess, diagnose, manage patient medical problems, order diagnostic tests, and prescribe medications. Rules, regulations, and credentialing for APRNs vary by state. This page outlines the regulatory processes for nurse practitioners in Wisconsin, including education, certification, licensing, and credentialing. Regulatory and credentialing processes are continuously changing, and the information contained on this page is current as of November 2015.
Retrieved from https://www.aanp.org/all-about-nps/np-fact-sheet.
http://www.nursing.virginia.edu/programs/phddnpcompare/
http://learn.org/articles/What_Can_I_Do_with_a_PhD_Degree_in_Nursing.html