Education for Registered Nurses

Whether you’ve been working as a registered nurse for decades or you’re considering pursuing your first degree, the education system for nursing is a confusing one. Here are answers common questions related to nursing education, which will hopefully help you decipher which path is best for you.

Which degrees are most common for RNs?

When you pursue a nursing degree, there are several options:

  • Associate’s degree or diploma in nursing
  • Bachelor’s degree
  • Master’s degree
  • PhD

About 45 percent of registered nurses have a bachelor’s degree, according to a 2018 survey by the U.S. Department of Health and Human Services. The next most-common degrees for RNs are at the associate’s (29.6 percent) and graduate levels (19.3 percent). The least common is a diploma of nursing (6.4 percent).

To give yourself the best career prospects possible, you may want to consider earning another degree, especially if you have anything that precedes a bachelor’s.

What are the pros and cons of pursuing more education?

The cons usually relate to time and money, which you will have to suss out for yourself. But if you’re currently working, your employer may help you pay for your program. In fact, some health systems require nurses to earn a bachelor’s before getting hired or after a few years of employment, says Robert Rosseter, chief communications officer at the American Association of Colleges of Nursing (AACN).

Benefits of a Bachelor of Science in Nursing

More job opportunities. More employers are requiring registered nurses to have a bachelor’s degree to get hired, Rosseter says.

Higher pay. The average RN with associate’s degree earns $70,820 a year, according to NursingProcess.org. On the other hand, RNs with BSNs make around $80,000, according to Wolters Kluwer’s 2018 nursing salary report.

Better patient outcomes. Research links the higher the number of bachelor’s-prepared nurses in hospitals to lower patient mortality rates.

Pro tip: If you’re on the fence, talk to a nurse who’s gone from an associate’s or diploma to a bachelor’s. “It will give you an idea of whether it’s possible given your workload and life situation,” Rosseter advises. “Lots of nurses say it’s changed their perspective and broadened their possibilities. Many people think, ‘Oh my gosh I could never,’ but that conversation could open up your eyes.”

How to go from an associate’s or diploma to a bachelor’s

There are hundreds of accredited programs that can earn you a BSN. If you’re starting from scratch, then this will take about three to four years. If you’ve already passed the NCLEX and are working as a nurse, you could to finish in two if you’re enrolled full-time. The AACN has a list of accredited schools offering the RN to BSN track.

Benefits of a Master of Science in Nursing

Becoming an APRN. Many nurses who pursue master’s degrees become advanced practice registered nurses. There are four types of APRNs: nurse practitioners, clinical nurse specialists, certified nurse midwives and certified registered nurse anesthetists.

Developing an expertise. Many nurses choose to pursue a master’s degree in nursing and continue to work as an RN. These programs usually focus on areas outside clinical practice, such as public health, administration or informatics.

More leadership opportunities. In addition to separating you from the majority of nurses, who are bachelor’s prepared, you will learn management skills, which will make you more qualified for leadership roles.

Increased pay. The average annual salary for a nurse with a graduate degree is $95,805, according to HHS. This is roughly $15,000 to $25,000 more a year than what associate’s- or bachelor’s-prepared nurses earn.

How to earn a Master of Science in Nursing

There are more than 200 accredited programs that accept students with ASNs and graduate them with MSNs, according to Rosseter. BSN to MSN programs are even more common, and they usually take about two years to complete. Some MSN programs require several years of working experience.

If you plan to work as an APRN, look for an accredited program that also aligns with your interests. Some employers only accept people with degrees from such schools, and if your program isn’t accredited, you may not be able to pursue APRN certification.

Pro tip: If you’re already a practicing nurse, then an online program may be the easiest option for you. When deciding, just make sure it’s accredited and that it suits your learning style. You also may need to set up your own clinical hours, if you’re want to become an APRN.

Benefits of a Doctorate of Nursing Practice

Practicing at the highest level for nurses. These programs are designed to make you a leader in your field. They empower you to excel in organizational leadership, health policy implementation, direct patient care and more.

No “going back to school.” Nursing bodies, including the AACN and the American Nurses Credentialing Center (ANCC), are working to make the DNP the minimum educational requirement for APRNs. While some MSN-prepared APRNs will be grandfathered in, this may not apply to everyone.

Better salary, more opportunities for advancement. This is the case if you choose to pursue more education, no matter your end-degree. The DNP in particular emphasizes scholarship, research and innovation, and practice improvement.

How to earn a Doctorate of Nursing Practice

To improve your job prospects, you should find an accredited program with the path you need, whether it’s MSN to DNP or BSN to DNP. The former will take less time, but you can usually expect to graduate within three to six years. Rosseter says there are about 300 DNP programs in the U.S.

If you are already a practicing as an APRN, consider choosing an accredited program where you can focus on a different patient population. If you are not, make sure you have the necessary educational requirements (in terms of coursework and certification) to become an APRN in your desired area.

Pro tip: The process for practicing as an APRN varies by state. You should seek national certification, but the state chooses which certifications by which agencies it will accept. Three states don’t require certification (California, New York and Kansas), but it’s likely your employer will. So it’s best to take the certification exam as soon as you can after you graduate. Look up your state’s licensure requirements.

Benefits of a PhD for nurses

Obtaining the highest level of education for nurses. Like a DNP, a PhD is at the doctoral level. Becoming a doctor as a nurse challenges existing, reductive notions about what nurses are capable of.

Becoming a teacher. A higher percentage of PhD-prepared nurses, versus DNPs, go on to teach, Rosseter says.

Becoming a leader in research. Many nurses who pursue PhDs do so because they’re more interested in research than clinical practice. Another popular career option for PhD nurses is health systems leadership.

How to earn a PhD in nursing

The most common programs for earning a PhD as a nurse are: BSN to PhD, MSN to PhD and dual DNP/PhD. If you aren’t an APRN and want to become one, the DNP/PhD option (or just a DNP) makes the most sense.

PhD programs aren’t usually accredited because they’re individualized to the institution, Rosseter says, which makes choosing the right program even more important. While some topics, such as research methods, will be included in most if not all, make sure the coursework covers the areas you want to study.

Pro tip: Look up the faculty at the school or program and see what primary research areas are. If they don’t align with yours, you may want to find a different school.

What should you look for in a nursing educational program?

  • Coursework. Make sure it aligns with your interests. If you are pursuing APRN certification, make sure the school has a program for your desired track.
  • Certification/licensure pass rates. This information may not be available online, so contact the school and ask to see this data.
  • Graduate exit surveys. These will show how students felt about the school and include info on job placement and earnings after graduation.
  • Professors. If you are pursuing a post-graduate degree, the school should have professors with research backgrounds in your interest areas.
  • Cost. Make sure it’s within your budget.

What certification is required to become an APRN?

Becoming an APRN requires specialized knowledge in a certain patient population focus areas, which you will study during your educational program. To be come one, you should seek certification by one of two accredited organizations — either the National Commission for Certifying Agencies or the Accreditation Board for Specialty Nursing Certification — in one of the following areas:

  • Family/individual across lifespan
  • Adult-gerontology
  • Neonatal
  • Pediatrics
  • Women’s health/gender related
  • Psychiatric-mental health

Some states do not require certification for licensure, but most do. Even if your state does not require certification, your employer likely will. What’s more, these tests are designed for recent graduates, so if you move states and need certification, the test will be more challenging the longer you’ve been out of school.

Certifications for APRNs are issued by five different bodies. Per the American Association of Nurse Practitioners, these include:

American Academy of Nurse Practitioners National Certification Board (AANPCB)

  • Family Nurse Practitioner Certification (FNP)
  • Adult-Gerontology Primary Care Nurse Practitioner Certification (A-GNP)
  • Emergency Nurse Practitioner Certification (ENP)

American Nurses Credentialing Center (ANCC)

  • Adult Nurse Practitioner Certification (ANP-BC)
  • Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC)
  • Adult-Gerontology Primary Care Nurse Practitioner Certification (AGPCNP-BC)
  • Adult Psychiatric-Mental Health Nurse Practitioner Certification (PMHNP-BC)
  • Advanced Diabetes Management Certification (ADM-BC)
  • Emergency Nurse Practitioner Certification (ENP-BC)
  • Family Nurse Practitioner Certification (FNP-BC)
  • Gerontological Nurse Practitioner Certification (GNP-BC)
  • Pediatric Primary Care Nurse Practitioner Certification (PPCNP-BC)
  • Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC)
  • School Nurse Practitioner Certification (SNP-BC)

American Association of Critical-Care Nurses (AACN)

  • Acute Care Nurse Practitioner Certification Adult-Gerontology (ACNPC-AG)
  • Acute Care Nurse Practitioner (ACNPC)

Pediatric Nursing Certification Board (PNCB)

  • Primary Care Certified Pediatric Nurse Practitioner (CPNP-PC)
  • Acute Care Certified Pediatric Nurse Practitioner (CPNP-AC)

National Certification Corporation (NCC)

  • Neonatal Nurse Practitioner Certification (NNP-BC)
  • Women’s Health Care Nurse Practitioner Certification (WHNP-BC)

Nursing salaries depending on educational level

ADN or ASN: These nurses earn an average of $70,820 a year, according to NursingProcess.org.

BSN: RNs with BSNs make around $80,000, according to Wolters Kluwer’s 2018 nursing salary report.

MSN: According to PayScale, the average nurse with an MSN earns $93,000 a year. That said, pay for MSN-prepared APRNs varies widely based on profession. CRNAs earn an average of $161,076 a year, followed by CNMs at $102,115, NPs at $99,962 and clinical nurse specialists at $95,773.

Doctorate: Many DNPs can earn more than MSNs, but it depends on your profession and specialty. According to 2018 data from the Bureau of Labor Statistics, nurses with doctorates earn around $125,000 year.

Should you pursue specialty certification?

Separate from degrees is the nursing specialty certification system. Its overarching goal is to promote lifelong learning, and pursuing specialty certification can lead to professional advancement.

What is specialty certification?

These are exams that test your clinical knowledge and skills for a certain population — or validate your expertise in topic that doesn’t relate to bedside nursing, such as informatics or professional development. Many agencies provide certifications, including the ANCC and professional, specialty organizations, like the HIV/AIDS Nursing Certification Board.

How long certifications last varies, but it’s usually a few years. The renewal process depends on the certification, as well. Certifications are transportable, so if your employer pays for yours, it doesn’t disappear if you switch jobs.

How is it different from licensure?

Simply put, you don’t always need a specialty certification to work as a registered nurse. But if you are administering direct patient care, you usually need a nursing license and/or APRN certification, depending on your profession and state.

That said, whether you’re specialty-certified could affect your employment. More and more hospitals have benchmarks numbers of specialty-certified nurses they are trying to meet.

What are the most useful certifications?

The answer to this question depends on your practice area. If there are multiple options that make sense for you, contact the agencies administering them to ask for advice. For a comprehensive list of available specialty certifications from accredited agencies, visit the American Board of Nursing Specialties.

The ANCC’s most common specialty certifications include: med-surgical, psychiatric-mental health and gerontological nursing.

How much do certifications cost?

This answer also depends on the certification you’re pursuing. Taking the test usually costs a few hundred dollars, but some professional organizations offer discounts to members. For non-ANA members, the ANCC certifications cost $395.

How does it affect salary?

This, too, depends on your specialty and where you work. But generally speaking, specialty certification will increase your earning potential and prospects for promotion.

What are the basics of continuing education for RNs?

Many states require registered nurses to complete a certain number of continuing education units to renew their license. The same goes for agencies that administer specialty certification. Depending on where you practice and your specialty, you may have to complete a certain number of hours on a certain topic, and the rest you can choose based on your interests. To avoid any challenges relating to the validity of your CEUs, it’s best to use ANCC-approved continuing education providers.

Check with your state’s board of nursing and specialty-certification organization for CEU requirements.

For more information about CEUs, visit Florence Health’s guide to free and low-cost resources and how to stay organized with CEUs.