The Different Levels of Nursing in a Hospital

Explore career opportunities as a nursing professional in a hospital

Asian nurse at a desk

The nursing profession is unique because it not only offers many different levels and nursing roles but also provides different educational pathways and career development opportunities. One of the primary settings for the nursing profession is the hospital. The importance of nursing in a hospital setting cannot be overstated, as nurses are integral to the delivery of high-quality healthcare services, serving as the backbone of patient care. Their diverse skills, expertise, and compassionate care significantly contribute to patient outcomes and overall hospital efficiency.

Nursing in hospitals encompasses a wide range of educational levels, responsibilities, and clinical skills. In this article, we will explore the various levels of nursing, their educational pathways, and distinct responsibilities, highlighting the unique contributions of each role. Furthermore, we will discuss the impact of nursing on patient outcomes, hospital efficiency, and overall healthcare quality. By understanding the integral role of nursing in hospitals, we can foster an appreciation for the profession and recognize the significance of investing in nursing education, staffing, and professional development.

Certified Nursing Assistant (CNA)

What is a Certified Nursing Assistant?

Certified Nursing Assistants (CNAs) is an entry-level but crucial role in hospitals. CNAs provide essential support and care to patients under the supervision of registered nurses (RNs) and other healthcare professionals. CNAs are an integral part of the nursing team and contribute to the overall well-being and comfort of patients.

What Does a Certified Nursing Assistant Do in a Hospital?

CNAs often spend significant time with patients, building rapport and establishing trust, which can positively impact patients’ emotional well-being. Generally, their responsibilities are focused on the following:

Assisting with Activities of Daily Living (ADLs)
CNAs help patients with activities such as bathing, dressing, toileting, eating, and mobility. They ensure that patients maintain their personal hygiene and have a safe and comfortable environment.

Vital Sign Monitoring
CNAs are responsible for measuring and recording vital signs, including temperature, blood pressure, pulse rate, and respiratory rate. These measurements help the healthcare team assess patients’ overall health status and detect any changes or abnormalities.

Collecting and Documenting Patient Information
CNAs document patients’ observations, such as food intake, fluid output, and changes in behavior or condition. Accurate documentation is crucial for effective communication between healthcare professionals and ensures continuity of care.

Assisting with Mobility and Transfers
CNAs assist patients in moving, positioning, and transferring from beds to chairs or other locations. They use proper techniques and equipment to ensure patient safety and prevent injuries.

Providing Comfort and Emotional Support
CNAs offer emotional support to patients by actively listening to their concerns, providing reassurance, and offering companionship. They understand the importance of empathy and compassion in creating a healing environment.

The Importance of CNAs in a Hospital

As detailed above, CNAs play a vital role in meeting the basic care needs of patients. Their assistance helps maintain patients’ dignity, independence, and overall well-being. CNAs work closely with other nursing professionals, such as RNs and LPNs, as part of a collaborative healthcare team. They communicate patient observations, concerns, and changes in condition to the nursing staff, enabling timely interventions and appropriate care. CNAs often provide valuable insights into patients’ daily routines, preferences, and behavior, which can assist in developing comprehensive care plans.

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Educational Requirements to Become a CNA

The educational requirements to become a Certified Nursing Assistant (CNA) can vary depending on the state and the specific healthcare facility. However, most healthcare facilities require candidates to have the following education and training:

  • High school diploma or an equivalent General Educational Development (GED) certificate.
  • State-approved CNA training programs are typically offered by community colleges, vocational schools, or healthcare institutions and include both classroom instruction and hands-on clinical experience. The duration of the program can range from a few weeks to several months.
  • CNAs must pass a competency evaluation, which typically consists of a written exam and a skills demonstration. The written exam assesses the candidate’s understanding of nursing concepts, while the skills demonstration evaluates their ability to perform essential CNA duties.
  • State certification involves submitting an application, paying a fee, and meeting any additional state-specific criteria, such as criminal background checks or fingerprinting.

Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)

Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) play a crucial role in a hospital setting, providing direct patient care and supporting the overall functioning of the healthcare team. The only difference between LVNs and LPNs is where they live. In most states, vocational nurses are called LPNs while California and Texas use the term Licensed Vocational Nurse. As licensed healthcare professionals, LPNs/LVNs have a distinct scope of practice that encompasses various responsibilities within the nursing field but both work under the supervision of registered nurses (RNs) and physicians.

What Does a Licensed Practical Nurse Do in a Hospital?

The scope of practice for LPNs/LVNs may vary slightly depending on the state regulations, but generally, their responsibilities include:

Patient Comfort and Support
LPNs/LVNs provide comfort and emotional support to patients. They assist with activities of daily living (ADLs), such as bathing, dressing, and grooming, and ensure patients’ overall comfort and well-being.

Medication Administration
LPNs/LVNs are responsible for administering medications to patients, including oral medications, injections, intravenous (IV) medications, and intramuscular (IM) medications.

Wound Care and Dressing Changes
LPNs/LVNs perform wound care and dressing changes for patients with various types of wounds, such as surgical incisions, pressure ulcers, or burns.

Basic Medical Procedures
LPNs/LVNs are trained to perform basic medical procedures under the direction of RNs or physicians. This may include collecting and analyzing patient specimens, such as blood or urine samples, and performing basic laboratory tests.

Monitoring Patient Health
LPNs/LVNs monitor and record patient’s vital signs, such as blood pressure, heart rate, respiratory rate, and temperature. They observe and report any significant changes in patient’s conditions to the RNs or physicians.

The Importance of LPNs/LVNs in a Hospital

LPNs/LVNs are an important link between a patient, their family and their healthcare team. They play a vital role in providing direct patient care, they contribute to maintaining patients’ safety and well-being by administering medications accurately, monitoring vital signs, and providing necessary treatments. LPNs/LVNs often have significant interaction with patients, offering comfort, reassurance, and education, which can positively impact the patient experience and contribute to improved outcomes.

Educational Requirements to Become an LPN/LVN

To become a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN), individuals must meet specific educational requirements. While the specific requirements can vary by state, the following are the general educational steps:

  • Get a High School Diploma or equivalent, such as a General Educational Development (GED) certificate.
  • Attend a state-approved training program, typically offered by vocational schools, community colleges, or technical institutes and consist of both classroom instruction and clinical hands-on training. They can usually be completed within 1-2 years.
  • Take the licensing examination is the next step upon completion of the training program. The National Council Licensure Examination for Practical Nurses (NCLEX-PN) is a standardized exam that assesses the candidate’s competency to practice safely and effectively as an entry-level LPN or LVN.
  • Take the final step for state licensure by passing the NCLEX-PN exam. Requirements typically include submitting an application, providing proof of education and exam completion, and paying the necessary fees. Some states may also require background checks or fingerprinting.

Registered Nurse (RN)

Registered Nurses (RNs) hold a pivotal role in a hospital setting, encompassing a wide range of responsibilities and making significant contributions to patient care, coordination, and advocacy. They serve as leaders within the nursing profession and collaborate closely with other healthcare professionals to ensure the delivery of safe, effective, and holistic care.

What Does a Registered Nurse Do in a Hospital?

RNs assume multifaceted responsibilities that are essential to the provision of comprehensive patient care. Their roles and responsibilities include:

Patient Assessment
RNs perform thorough assessments of patients’ physical, psychological, and social conditions. They collect data, interpret findings, and identify actual or potential health issues.

Care Planning
RNs develop individualized care plans in collaboration with the healthcare team. These plans address patients’ unique needs, establish goals, and guide interventions to promote optimal health outcomes.

Medication Administration
RNs are responsible for administering medications, including oral, intravenous, intramuscular, and other routes. They ensure accurate dosing, monitor patients for potential adverse reactions, and provide education on medication management.

Treatment and Procedure Performance
RNs perform various treatments and procedures, such as wound care, IV therapy, catheter insertion, and specimen collection. They maintain infection control measures, follow evidence-based practices, and monitor patients’ responses.

Patient and Family Education
RNs play a crucial role in educating patients and their families about health conditions, treatment plans, and self-care practices. They provide clear instructions, promote health literacy, and address any concerns or questions.

Collaboration with Healthcare Professionals
RNs collaborate with physicians, nurse practitioners, therapists, pharmacists, and other healthcare professionals to ensure coordinated and holistic care. They communicate patient information, contribute to interprofessional discussions, and participate in care conferences.

Coordinating Patient Care and Advocacy
RNs serve as central figures in care coordination, facilitating communication between patients, families, and the healthcare team. RNs collaborate with various disciplines to ensure the seamless integration of services, continuity of care, and appropriate referrals.

Group of smiling healthcare professionals in an exam room

The Importance of Registered Nurses in a Hospital

Registered Nurses (RNs) are essential healthcare professionals in a hospital setting. With their extensive education, diverse responsibilities, and critical thinking skills, RNs contribute significantly to patient assessment, care planning, medication administration, and treatment performance. RNs serve as the primary point of contact for patients and families, addressing their concerns, clarifying information, and promoting shared decision-making. They also act as patient advocates, advocating for quality care, patient safety, and culturally equitable services.

Educational Requirements to Become a Registered Nurse

Becoming an RN requires a combination of education and licensure. The educational pathway typically includes:

  • High School Diploma or equivalent, such as a General Educational Development (GED) certificate.
  • Attend a nursing program, which can be either a diploma program offered by hospitals, an associate degree in nursing (ADN) program, or a Bachelor of Science in Nursing (BSN) program.
  • Develop skills in various areas by incorporating hands-on clinical training, such as medical-surgical nursing, pediatrics, obstetrics, and mental health.
  • Pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to obtain a nursing license.
  • State Licensure is the final step for graduates who successfully pass the NCLEX-PN exam. Requirements typically include submitting an application, providing proof of education and exam completion, and paying the necessary fees.

To get started on the path to becoming a nurse, explore the BSN Program at Eagle Gate College and learn more about how to become a registered nurse.

Educational Requirements to Obtain a Bachelor of Science in Nursing (BSN)

Let’s take a closer look at the educational pathway for obtaining a Bachelor of Science in Nursing (BSN), which is the most foundational and common path for individuals aspiring to become registered nurses (RNs) and pursue a career in nursing.

Enrollment in a BSN Program at an accredited college or university is the first step to attaining a BSN degree. BSN programs are typically four years in duration, although there are accelerated programs available for individuals who already hold a bachelor’s degree in another field. These programs also provide both theoretical classroom instruction and clinical hands-on experience and allow students to choose a specialization. Students are exposed to professional development opportunities, which may include workshops, seminars, conferences, and involvement in student nursing organizations. Upon completion of a BSN program, candidates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Lastly, graduates can attain licensure to practice as a Registered Nurse.

After completing a BSN program and obtaining RN licensure, individuals can choose to enter the workforce as a registered nurse or pursue advanced education and specialization in areas such as advanced practice nursing, nursing administration, research, or education. Let’s now look at what an advanced nursing education entails.

Advanced Practice Registered Nurse (APRN)

Advanced Practice Registered Nurse (APRN) is a term used to describe a category of highly educated and specialized nurses who have obtained advanced clinical training and skills beyond the basic level of registered nursing. They play a critical role in delivering advanced healthcare services, working both independently and collaboratively with other healthcare professionals. Only RNs with a Master of Science in Nursing (MSN) or a Doctorate of Nursing Practice (DNP) in one of these four roles are considered APNs: they include Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Registered Nurse Anesthetists (CRNAs) and Certified Nurse-Midwives (CNMs).

Two medical workers in a consultation

What Does an Advanced Practice Registered Nurse (APRN) Do in a Hospital?

APRNs assume multifaceted and specialized responsibilities that are advanced in the provisioning of patient care. Their roles and responsibilities include:

Nurse Practitioners (NPs)
NPs are primary care providers who assess, diagnose, and treat a wide range of acute and chronic conditions. They can order and interpret diagnostic tests, prescribe medications, provide preventive care, manage chronic diseases, and educate patients on health promotion and disease prevention.

Clinical Nurse Specialists (CNSs)
CNSs are experts in a specialized area of nursing practice, such as pediatrics, geriatrics, oncology, or psychiatric-mental health. They provide direct patient care, conduct research, develop evidence-based care plans, provide education and consultation to healthcare teams, and advocate for quality improvement in their specialty area.

Certified Registered Nurse Anesthetists (CRNAs)
CRNAs are specialized nurses who administer anesthesia and provide anesthesia-related care for surgical procedures, labor and delivery, and pain management. They work closely with surgeons, anesthesiologists, and other healthcare professionals to ensure safe anesthesia administration and manage patients’ pain during and after procedures.

Certified Nurse-Midwives (CNMs)
CNMs provide comprehensive healthcare to women, including prenatal care, labor and delivery assistance, postpartum care, and gynecological services. They emphasize a holistic approach, focusing on the physical, emotional, and social well-being of women throughout their lifespan.

APRNs possess advanced clinical skills and autonomy in their practice. Depending on their specialty and state regulations, APRNs may have the authority to perform tasks such as:

  • Conducting comprehensive patient assessments and physical examinations.
  • Diagnosing and treating common acute and chronic conditions.
  • Prescribing medications, including controlled substances, within their scope of practice.
  • Ordering and interpreting diagnostic tests.
  • Performing minor procedures and interventions.
  • Managing and coordinating patient care independently or in collaboration with physicians and other healthcare professionals.
  • Providing patient education and counseling on disease management, lifestyle modifications, and health promotion.

The Importance of APRNs in a Hospital

APRNs are in high demand due to their advanced skills and ability to provide quality, cost-effective care. They play a crucial role in addressing the growing healthcare needs of the population, improving access to care, and filling gaps in healthcare services, especially in underserved areas. APRNs contribute to patient care in hospitals by providing timely and comprehensive assessments, managing complex conditions, and collaborating with interdisciplinary teams to ensure continuity of care. Additionally, APRNs play a vital role in care coordination, working collaboratively with interdisciplinary teams to ensure seamless transitions of care and continuity and advocating for their patients’ rights, needs, and preferences within the healthcare system. Their involvement in research and innovation helps hospitals stay at the forefront of healthcare advancements and improves the overall quality of care provided.

Educational Requirements to Become an APRN

Traditionally, students start APN degree programs after getting a BSN degree and clinical experience. Ideally, candidates for these programs have several years of experience in their specialty area before starting the program. APN degrees are offered online and on-campus and require 2-4 years of study. Let’s take a look at the educational pathway for APRNs:

  • Get a Bachelor of Science in Nursing (BSN) degree, a four-year undergraduate program that provides a solid foundation in nursing theory, clinical practice, and healthcare sciences.
  • Obtain a registered nurse (RN) license by passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
  • Pursue advanced education at the master’s or doctoral level in a chosen specialty. These programs typically require 2-3 years of study, including advanced coursework and clinical rotations.
  • Obtain national certification in the specialty area through an accrediting body
  • Obtain state licensure as an APRN. The specific requirements for certification and licensure vary by state and specialty.

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Nurse Manager or Nurse Supervisor

Nurse managers/supervisors play a vital role in the hospital setting as they are responsible for overseeing nursing units or departments, managing nursing staff, ensuring quality patient care, and handling administrative tasks. Their role is essential in maintaining a well-functioning nursing department and promoting positive patient outcomes.

What Does a Nurse Manager or Nurse Supervisor Do in a Hospital?

Leadership and Administration
Nurse managers/supervisors provide leadership and direction to the nursing staff. They develop and implement policies and procedures, ensure compliance with regulatory standards and guidelines, and manage resources such as staffing, budgeting, and equipment procurement.

Staff Management
Nurse managers/supervisors are responsible for the recruitment, hiring, and retention of nursing staff. They assign work schedules, evaluate performance, provide feedback, and facilitate professional development opportunities for the nursing team.

Quality Patient Care
Nurse managers/supervisors are accountable for ensuring the delivery of high-quality patient care within their units or departments. They monitor patient outcomes, review patient satisfaction data, and implement strategies to improve the quality and safety of care.

Communication and Collaboration
Nurse managers/supervisors play a crucial role in promoting effective communication and collaboration within the nursing team and with other departments in the hospital. They facilitate regular team meetings, promote open lines of communication, and encourage interdisciplinary collaboration.

Conflict Resolution and Support
Nurse managers/supervisors are responsible for handling conflicts or issues that arise within the nursing department. They provide support and guidance to nursing staff, address concerns, and resolve conflicts in a fair and constructive manner. They serve as advocates for the nursing team, ensuring their voices are heard and their needs are addressed.

The Importance of Nurse Manager or Nurse Supervisor in a Hospital

The importance of nurse managers/supervisors in the hospital setting cannot be overstated. Their leadership and management skills are crucial for maintaining efficient operations, fostering a positive work environment, and ensuring the provision of safe and high-quality patient care. They contribute to the overall success of the nursing department by promoting effective communication, collaboration, and teamwork among the nursing staff.

Educational Requirements to Become a Nurse Manager or Nurse Supervisor

The educational requirements to become a nurse manager or nurse supervisor typically include the following steps:

  • Obtain either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both degrees provide the necessary foundation in nursing knowledge and skills. However, having a BSN is becoming increasingly preferred for management positions due to its broader education in leadership, management, and critical thinking.
  • Gain several years of clinical experience to ensure a solid understanding of nursing practice, patient care, and clinical workflows.
  • Pursuing advanced education beyond a BSN can enhance career prospects for nurse manager or supervisor positions, but it is not mandatory. Some individuals choose to pursue a Master of Science in Nursing (MSN) degree with a specialization in nursing leadership, administration, or management.
  • Get certifications through the Nurse Executive, Advanced (NEA-BC) credential, offered by the American Nurses Credentialing Center (ANCC). Obtaining certification demonstrates expertise in nursing leadership and management, and it can enhance career opportunities and professional credibility.

It’s important to note that the specific educational requirements for nurse manager or supervisor positions can vary depending on the organization, level of management, and the preferences of the hiring institution.

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Nurse Educator

Nurse educators play a vital role in the hospital environment by serving as educators, mentors, and facilitators of learning for nursing students, new graduates, and practicing nurses. They contribute to the development of competent and knowledgeable nursing professionals.

What Does a Nurse Educator Do in a Hospital?

Teaching and Mentoring
Nurse educators are responsible for designing, developing, and delivering educational programs and courses for nursing students and healthcare professionals.

Curriculum Development
Nurse educators participate in the development and evaluation of nursing curricula. They ensure that the curriculum aligns with current standards of nursing practice, integrates evidence-based knowledge, and reflects the evolving healthcare landscape.

Clinical Facilitation
Nurse educators coordinate and facilitate clinical experiences for nursing students and new graduates. They collaborate with clinical preceptors and healthcare facilities to ensure that students receive appropriate clinical placements and opportunities to apply their knowledge and skills in real-world settings.

Mentorship and Support
Nurse educators serve as mentors and provide guidance and support to nursing students, new graduates, and practicing nurses. They offer career advice, promote professional development opportunities, and assist in navigating the challenges of the nursing profession.

Professional Development
Nurse educators themselves engage in ongoing professional development to stay abreast of advancements in nursing practice, education, and technology. They participate in conferences, workshops, and scholarly activities to expand their knowledge and skills.

Research and Scholarship
Nurse educators may be involved in nursing research and scholarship activities. They may conduct research studies, contribute to academic publications, or engage in quality improvement initiatives.

The Importance of Nurse Educators in a Hospital

The role of nurse educators is crucial in promoting the continuous learning and advancement of nursing practice in the hospital environment. They shape the next generation of nurses, support the professional development of current nurses, and ensure that nursing education and practice align with current standards and best practices. Nurse educators foster a culture of lifelong learning and contribute to the delivery of safe, effective, and patient-centered care.

Educational Requirements to Become a Nurse Educator

To become a nurse educator, individuals typically need to meet certain educational requirements, which include the following steps:

  • Obtain either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both degrees provide a foundation in nursing knowledge and skills, however, having a BSN is becoming increasingly preferred for nurse educator positions.
  • Gain practical experience as an RN for several years to develop a strong understanding of nursing practice, patient care, and clinical skills.
  • Pursue advanced education beyond a nursing degree, such as a Master of Science in Nursing (MSN) degree with a specialization in nursing education. The MSN program provides in-depth knowledge and skills in educational theory, curriculum development, teaching methodologies, and assessment strategies.
  • Some institutions or states may require nurse educators to obtain teaching certification or licensure. This may involve completing specific coursework or passing an examination to demonstrate competency in teaching and educational practices.
  • While not always required, obtaining a doctoral degree in nursing, such as a Doctor of Nursing Practice (DNP) or a Doctor of Philosophy (Ph.D.) in Nursing, can enhance career opportunities and provide a deeper understanding of nursing education and research.

Additionally, nurse educators may also engage in professional development activities, such as attending conferences, workshops, and seminars focused on nursing education. These opportunities allow nurse educators to stay updated on current trends, teaching methodologies, and advances in healthcare.

Business man with a young nurse

The Benefits of Interdisciplinary Collaboration in Healthcare

Interdisciplinary collaboration in hospitals is of significant importance as it brings together healthcare professionals from various disciplines to work together in providing holistic and comprehensive patient care. Nurses play a pivotal role in these interdisciplinary healthcare teams, actively collaborating with physicians, surgeons, pharmacists, therapists, and other healthcare professionals.

Nurses have a unique perspective on patient care. They possess a holistic view of patients’ physical, emotional, and psychosocial needs. Through interdisciplinary collaboration, nurses contribute their expertise and collaborate with other professionals to develop comprehensive care plans that address all aspects of a patient’s well-being. They work closely with other healthcare professionals to ensure smooth transitions of care, efficient utilization of resources, and timely interventions. Nurses also provide valuable insights based on their close and continuous patient interactions, ensuring that important information is shared accurately and in a timely manner. Collaborative efforts reduce the likelihood of errors, enhance patient safety, and promote positive patient experiences throughout the healthcare journey. This interdisciplinary approach also supports continuity of care, as different professionals contribute to different stages of a patient’s journey, ensuring a seamless and well-coordinated healthcare experience.

The Importance of Professional Development and Advancement in Nursing

Ongoing professional development is of utmost importance for nurses in a hospital setting. It allows nurses to stay current with advancements in healthcare, expand their knowledge and skills, and provide the highest quality of care to patients.

Nurses have the opportunity to pursue additional certifications and specialty training in various areas of nursing, which validates their specialized knowledge and expertise in specific fields, such as critical care, oncology, pediatrics, or geriatrics. Advanced degrees can provide opportunities for roles in nursing education, research, or advanced practice nursing. In addition, it encourages nurses to embrace evidence-based practice (EBP). Lastly, professional development opportunities not only enhance clinical knowledge and skills but also foster personal and professional growth. Nurses who engage in ongoing learning experiences gain confidence in their abilities, become more adaptable to change and develop critical thinking and problem-solving skills. These qualities contribute to overall professional growth, job satisfaction, and a sense of fulfillment in the nursing profession.

Get Started by Exploring the Various Levels in the Nursing Profession

This article showcased how the nursing profession in hospitals encompasses a range of roles and responsibilities. CNAs, LPNs/LVNs, RNs, APRNs, and nurse educators each contribute uniquely to the delivery of comprehensive and quality patient care. Nurses today command a high degree of respect and often a high degree of autonomy, enjoying increasingly collaborative relationships with physicians and other professionals in the healthcare industry.

The recent global health pandemic made it absolutely clear just how much nurses’ unwavering dedication, expertise, and invaluable contributions make a significant impact on patient outcomes and the overall functioning of the healthcare system. Their commitment to the well-being of patients is truly commendable, and they deserve our utmost gratitude and support.

For those individuals, explore all the opportunities the nursing profession has to offer by learning more about different types of hospital nursing jobs available to aspiring nurses.