Various Fields of Nursing

 For Prospective Students

When I was in nursing school, I was going to work in a prestigious regional pediatric oncology unit. I even won a scholarship on that premise. Then I got out of school, and life happened.

I worked in long term care. I considered emergency nursing. I decided to do home care, and accidentally applied to the pediatrics office instead of the adult office. (True story!)

So now I have the pediatric part of the dream down, but I don’t work in a hospital, and none of my clients have cancer.

I have friends who do hospice nursing, a few who are in long term care, many who work in medical-surgical units, others who work in Intensive Care Units, and one adventurous soul who serves as a prehospital provider on an ambulance and is working toward becoming a flight nurse.

The multitude of opportunities is one of the amazing things about choosing a career as a nurse. To a student just starting out, that same multitude of opportunities can be overwhelming. In this article, we break down the various opportunities in nursing, and help you understand what it may be like to work in those fields.

RN, LPN, APRN…What does it mean? 

First, let’s tackle the question of the letters after a person’s name, and what they mean. 

LPN requires the least amount of education and the greatest level of supervision. A typical program is a year to a year and a half long and focuses mostly on learning hands-on skills. Like all nurses, LPNs are licensed by the State Board of Nursing, and are responsible to follow the code of ethics and stay within the scope of practice as defined in whichever state you practice. LPNs work under the supervision of an RN. 

RNs have three educational paths to licensure, which gets a little confusing. 

Diploma programs are usually two years long, with lots of practice in care settings versus classroom time. Graduates are eligible to sit for the licensure exam, but do not have a degree. Diploma programs are rare today. 

Associate degree programs are a popular alternative, often offered by community or technical colleges. These programs usually take two or three years to complete. Graduates are eligible to sit for licensure and are awarded an associate degree. 

Bachelor’s degree programs take four years and include additional classroom time focused on theory and leadership, as compared to associate degree programs. Graduates must wait until the end of the program to sit for the licensure exam, and earn a Bachelor of Science degree. BSN graduates are sought after by many employers, especially in acute care settings. 

APRN stands for advanced practice registered nurse and requires a masters or doctoral degree. Many APRN roles are rather similar to the role of a physician. 

Opportunities for LPNs 

Roles for LPNs are often considered to be rather limited because of the requirement for direct supervision by an RN. This is true in many hospital settings, where there are often limitations on what an LPN may do. However, in recent years, more facilities have been welcoming LPNs into their ranks, especially in units like Labor and Delivery and rehab. Many LPNs work in areas outside a hospital, such as hospice, home care, or long-term care. 

Opportunities for RNs (and BSNs) 

Many people choosing nursing will choose an RN program, whether diploma, associate, or bachelor’s program. RNs have the most flexibility of opportunity, with a host of subspecialties available. 

RNs can work in multiple settings, including inpatient units like medical-surgical, intensive care, pediatrics, labor and delivery, or rehab. The settings can be as intense as a busy inner-city emergency department, or as laid back as rural home care. From pediatrics to geriatrics, parish nursing to drug and alcohol rehab, wound care to IV team to international disaster relief, the opportunities and variations are practically endless. 

For those who prefer to be in a management or oversight position, there are opportunities to work in case management, or as floor supervisor (in long term care especially, but also in many other areas). If bedside nursing is more your preference, you can choose from a variety of hospital units. Or try home care, where you are responsible for only one client at a time.

 For adventure or a change of pace, there is camp nursing, disaster response, or international medical relief. Experienced nurses may choose to do travel nursing, where they spend several months in one place as temporary staff and then move on to the next assignment. 

For all positions, employers will provide an orientation period and on-the-job training for the specialty or area you choose. Continuing education is a necessary part of every nurse’s ongoing development. Once they have found an area they like, many nurses choose to pursue specialty certification and take a nationally recognized exam to demonstrate their knowledge and competence. Or, they may choose to go back to school for a masters or doctoral program, and become an Advanced Practice Registered Nurse. 

Opportunities for APRNs 

APRNs work in multiple areas. Here are some of the most popular. 

CRNA (Certified Registered Nurse Anesthetist) administers anesthesia, usually in an operating room. This is a highly skilled and well paid position. 

CNM (Certified Nurse Midwife) works with women during pregnancy and childbirth, including delivering babies. 

CNS (Clinical Nurse Specialists) hold a master’s or doctoral degree in a specialized area of nursing practice. They work at the bedside, providing specialized care for pediatrics, geriatrics, or women’s health; or in a particular setting such as critical care. They may specialize in a particular disease, like diabetes or wound care.  

Nurse Practitioners (NPs) fill a role that is often interchangeable with a physician assistant. However, in some states they are permitted to practice independently with full prescriptive authority. In many states, NPs are required to work in collaboration with a physician and have some limits on what they can prescribe. FNP (Family Nurse Practitioner) works in family practice, providing routine medical care. 

Regardless which level of education or role you choose, nursing is a rewarding and satisfying career, with an infinite number of opportunities.