1. Pullen, Richard L. Jr. EdD, MSN, RN, CMSRN


Get the tools you need to progress along your professional journey.


Article Content

Nursing as a profession is flexible-we can begin our careers at various points of entry into practice and gradually advance through different levels until we've reached our desired career ladder destination. A variety of educational bridge programs are available to suit your aspirations as an adult learner and help you achieve your nursing dream job.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Career ladders as a form of professional development allow you to develop an individualized plan, which may include a demonstration of your expertise in evidence-based best practices as you serve in various roles within your organization. For example, you may have the career goal of moving from being a clinical nurse to a nurse director while gaining advanced knowledge through attending organization-based educational offerings; participating in local, state, and national conferences; and earning certifications and/or graduate degrees.


Land of opportunity

The U.S. Bureau of Labor Statistics projects that the employment rate for RNs, LPNs, and LVNs will grow 16% between 2014 and 2024-faster than average for other occupations. It's vital that more RNs enter the field to care for an aging patient population with increasingly complex and chronic illnesses. And more LPNs and LVNs are necessary to provide care for individuals in residential and home healthcare settings.


In addition to the need for more nurses in the clinical practice setting, there's also a demand for RNs to earn graduate degrees and specialize in areas such as teaching, administration, research, and advanced practice. The nursing faculty shortage is a major barrier limiting enrollment in nursing programs at a time when there's a critical need to educate more nurses to care for the community. RNs considering graduate studies are encouraged to explore a career in academia.

Table Career ladder ... - Click to enlarge in new windowTable Career ladder opportunities

Nursing education is changing to focus on preventive care and the management of chronic conditions. The new frequency of complex patient scenarios requires a more highly educated nursing workforce. In 2010, The Institute of Medicine Future of Nursing report recommended that RNs achieve advanced educational degrees at the baccalaureate level and higher. The American Association of Colleges of Nursing, National Organization for Associate Degree Nursing, and National League for Nursing all support academic progression for the growth of the nursing profession.


Colleges and universities are creating seamless educational pathways for RNs, LPNs, and LVNs, and accelerated tracks for all levels of nursing to achieve advanced education. Clinical specializations are numerous and include, but aren't limited to, obstetrics, pediatrics, medical-surgical, critical care, community health, long-term care, mental health, and end-of-life or hospice care (see Career ladder opportunities).


As nurses gain advanced education and experience, organizations are recognizing and rewarding these achievements through an increase in salary and career mobility that showcase the nurse's leadership, management, and teaching expertise. Many organizations have levels of recognition and status, such as RN-1, RN-2, RN-3, and RN-4. In this organizational structure, RN-4 is considered the "top" level for RNs. Similarly, a faculty member may begin his or her teaching career at a college or university with the rank of instructor; with advanced education, service, and research, the instructor may petition for promotion to assistant professor, followed by associate professor, and then full professor.



Life-long career aspirations, educational goals, and family and financial obligations are variables that adult learners face when selecting a nursing program. For example, if the primary goal is to practice as a hospital RN at the bedside, then an associate degree in nursing (ADN) or diploma in nursing may be the chosen educational pathway. If the primary goal is to be in management or earn an advanced degree, then the bachelor of science in nursing (BSN) degree may be appropriate.


Individuals may find it necessary to initially select an educational pathway that's the shortest route to graduation to earn a salary to support themselves and their families. For example, a 24-year-old single mother who's a certified nursing assistant (CNA) in a residential care facility selected an LPN program as the initial step in her career ladder. Her goal is to earn a doctor of nursing practice (DNP) degree and be an NP specializing in the care of older adults by the time she's 34.


The plan

Developing a career plan requires you to prioritize the factors that impact your personal and professional life. Don't let barriers prevent you from achieving your career goals. Life circumstances may require you to slow down the pace of achieving your plan, but stay on track, be focused, and be patient. Take care of yourself during your journey and keep envisioning the day you reach your goals. Don't forget to surround yourself with positive and encouraging people.


Here are some helpful hints as you hone your career plan:


* Clearly articulate your passions in nursing.


* Develop short- and long-term goals. Short-term goals allow you to pursue your career aspirations without being overwhelmed by the long-term goals.


* Research the school(s) that you're considering to advance your education. Check the curriculum, approval status with your state board of nursing, and status with accreditation bodies. Also, explore how the nursing program is taught. Many programs are partially or totally web-based to meet the needs of busy adult learners. For example, LPN/LVN to RN, RN to BSN, and graduate programs in nursing are common educational pathways offered online. Lastly, perform a cost analysis.


* Investigate the salary and benefits, such as health insurance, sick leave, and retirement, for the organizations that are appealing to you. Find out if there are sign-on bonuses or shift differentials. You should also check the accreditation status of the agency.


* Create a curriculum vitae (CV) that showcases your talents and experiences. It's wise to review examples of properly and thoroughly prepared CVs before you begin writing yours.


* Cultivate a professional image in the way you dress, speak, and relate to other people.


* When you arrive for an interview with a potential employer, make sure that you've done your homework. Become familiar with the mission, vision, and values of the organization. Ensure that you're well hydrated and eat a balanced meal before the interview because dehydration and hypoglycemia can increase anxiety. Be confident, even though you may be a little nervous. Smile and offer your genuine self. Speak at a pace that's conversational and remember to enunciate.


* Seek a mentor in the nursing profession to guide and encourage you. Select someone who's highly valued in the nursing community with the experiences and education necessary to provide you with direction.


* Visit with key nursing professionals who've achieved their career goals.


* Be involved in professional and community activities.


* Get back on the career ladder when life events happen. Don't be discouraged!



Dream big

Our profession needs caring and compassionate nurses who are organized and analytical, with strong communication skills. The time is now for you to make your move upward on the nursing career ladder.


consider this

Allen was 18 when he decided that he wanted a career in nursing. He enrolled in a local community college practical nursing program. Allen wanted to graduate as soon as possible to begin earning a living to help his family. Allen lived with his parents, who struggled financially. His father was disabled due to a heart condition and his mother worked as a server. His father always said that Allen would make a good nurse because he frequently helped him with his heart condition.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

The only way Allen could afford college was through a grant, which paid for his tuition, books, fees, and the three-speed bike he used to travel 5 miles to campus. When the weather started to get cold, riding his bike in freezing temperatures and snowy conditions wasn't practical or safe. A friend of Allen's parents gave him $200 to buy a used car, which had many broken parts. During the winter, Allen had to leave class and clinical every 2 hours to start the car to keep the battery charged. Allen overcame this adversity and graduated from nursing school in 1 year as an honor student. His parents were in the audience when he received his award.


Allen started his career on a medical-surgical unit while attending an ADN program to become an RN. He later became a coronary care nurse. After 10 years of practice on the coronary care unit, he decided to become an NP. Over the next 5 years, he earned a BSN, MSN, and family NP certification. As a family NP at a cardiac care physician group, Allen thought that he was finished with school until one of his friends encouraged him to apply to a DNP program at a local university. They both graduated 3 years later. Allen's parents would've been proud.


consider this

Marie was originally inspired to pursue a nursing career by her mother, who was an RN. Unfortunately, Marie's mother died of cancer right after Marie was married. Marie decided to put her career goals on hold while she raised her four children.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Marie earned the nickname "super mom" as she worked 12 hours a week at a day-care center when her children ranged in age from 11 to 16. She loved working with the children and found it especially rewarding to care for children with chronic illnesses, such as diabetes and asthma.


At age 43, when her youngest child graduated from high school, Marie decided to enroll in the BSN program at her local college and attend classes full time. She maintained her super mom nickname-most of her classmates were young enough to be her children. Marie's life experience and sense of humor were sources of strength to her younger classmates during challenging semesters.


Marie graduated in 4 years, at age 47. Although she wished that her mother were alive to see her accomplishment, Marie's husband reminded her that her mother's passion for nursing would now live on through her.


Marie began her nursing career in pediatrics and, after a few years, transferred to the pediatric ICU. Several years later, she decided to specialize in pediatric oncology. Marie is now certified to administer chemotherapy to pediatric patients and is the pediatric oncology unit director at her hospital.




American Association of Colleges of Nursing. Fact sheet: the impact of education on nursing practice.


American Association of Colleges of Nursing, Organization for Associate Degree Nursing. Envision your nursing future: taking the next step in your nursing education. American Association of Colleges of Nursing. Your nursing career: a look at the facts.


American Nurses Association, Organization for Associate Degree Nursing. Academic progression to meet the needs of the registered nurse, the health care consumer, and the U.S. health care system.


CNA The nursing ladder of success: a career ladder for nurses.


Institute of Medicine. The future of nursing: focus on education.


Kalenkoski J. Higher education for nurses: a summary of postgraduate options.


National League for Nursing. Academic progression in nursing education.


National Student Nurses' Association. NSNA...the gateway to your nursing career.


Palatnik AM. The future of nursing: leading change, advancing are we doing?,_advancing.1.aspx?WT.mc_id=HPxADx20100319xMP.


Robert Wood Johnson Foundation. The case for academic progression: why nurses should advance their education and the strategies that make this feasible.


Sullivan EJ. Becoming Influential: A Guide for Nurses. 2nd ed. Upper Saddle River, NJ: Pearson Education, Inc.; 2013.


U.S. Bureau of Labor Statistics. Occupational outlook handbook: registered nurses. https://


Wise T, Gautam B, Harris R, Casida D, Chapman R, Hammond L. Increasing the registered nursing workforce through a second-degree BSN program coaching model. Nurse Educ. 2016;41(6):299-303.