The Nursing Career Ladder: How to Advance in the Nursing Field

Career advancement is one of the principal topics of discussion in nursing, both for aspiring nurses and currently working professionals.

It is no secret that climbing the nursing career ladder can be difficult and that professional stagnation is among the leading causes of dissatisfaction in the field. Having a clear picture of the trajectory of your career is essential for motivating learners, attracting prospective candidates, and helping the industry combat the ongoing nursing shortage.

That is why we will provide an overview of the nursing career ladder and the paths you may consider for your future nursing career.

What is a nursing career ladder

What Is the Nursing Career Ladder?

A nursing career ladder is a structured professional development program designed to help nurses advance their careers by developing their clinical skills, education, and leadership abilities. Employers are usually expected to create such programs and pathways for career growth. However, career advancement is often relegated to nurses, so every professional is left to explore the practice opportunities.

The three pillars of the nursing career ladder are learning how to be a better nurse, continuing education, and accessing leadership opportunities.

Levels of the nursing career ladder

The Levels of a Nursing Career Ladder and Steps to Advancement

Below, you will find the five levels of a nursing career ladder. While these can describe the trajectory of many nursing careers, your advancement process may differ as it will depend on your willingness to devote your time to education and personal aspirations in the nursing field. However, it is worth exploring all facets of a career in nursing as well as all the options for continuing to develop and become a better professional.

1. Certified Nursing Assistant (CNA)

A Certified Nursing Assistant (CNA) is an entry-level role tasked with providing basic patient care, such as assisting patients with daily activities, monitoring vital signs, and ensuring their comfort. CNAs usually work under the supervision of nurses or physicians.

Although it is an entry-level position that only requires between 4 and 12 weeks of preparation, the CNA role can allow you to start specializing in an area of practice (such as geriatrics, pediatrics, hospice care, or acute care) early on while performing more straightforward tasks under supervision.

The restrictive set of duties and responsibilities may discourage many entry-level nurses who may choose to become LPNs or RNs from the get-go. However, the valuable practical experience gained by CNAs can be the cornerstone of a more successful career later on. You can read more about the advantages and disadvantages of this entry-level position in our CNA vs. LPN comparison. CNAs can advance their career by pursuing further education to become LPNs or RNs.

2. Licensed Practical Nurse (LPN)

Licensed Practical Nurses are frontline nurses who provide hands-on patient care, administer medications, assist with wound care, and support Registered Nurses and physicians in various healthcare settings. Similar to other entry-level positions, they perform a broad range of tasks but can also specialize in areas such as IV therapy, pediatrics, geriatrics, home care, and so on.

The standard duration of the educational program to become an LPN is 12 to 16 months and includes theoretical classes and supervised field experience sessions. Starting your career as an LPN can be a good balance between your initial commitment and your potential to learn and advance your career later on. If you want to start your nursing career as an LPN, you can enroll in the PN Diploma Program at Nightingale College, a hybrid learning option that combines online instruction with supervised on-ground field experiences (SOFEs) to deliver quality education in the most accessible way. You can also complete the program and go on to take the NCLEX-PN in just 12 months.

As their next step on the career ladder, LPNs will either enroll in a full-time 4-year Bachelor of Science in Nursing (BSN) program or an LPN to RN intermediary track. Either way, becoming a Registered Nurse is the next natural step for all LPNs wishing to advance their careers. You can find out why from our LPN vs. RN comparison article.

If you wish to advance your career in the shortest and most accessible way, without sacrificing the quality of the education you receive, enroll in the LPN-to-ASN Program at Nithingale College and advance to the level of an RN in just 16 months.

3. Registered Nurse (RN)

Registered Nurses represent the backbone of the current nursing industry, making up the largest segment of nursing professionals. Their tasks can include assessing patient conditions, developing care plans, administering medications, and collaborating with healthcare teams to ensure quality patient outcomes. Still, the list of duties and responsibilities varies depending on their work environment and specialization.

You can become a Registered Nurse by earning an Associate Degree in Nursing (ADN), equivalent associate degrees (such as the Associate of Science in Nursing and Associate of Applied Science in Nursing), or getting a BSN. The differences in outcome for these options are numerous. Getting a BSN takes longer (3-to-4 years) but comes with more job options, better salaries, and various benefits. ADN-level RNs spend less time in school and can start practicing sooner. However, all RNs will eventually need to reach the BSN level, as it is slowly becoming an industry standard and the preference of more and more employers.

You can learn more about why you should get a BSN as an RN.

You can receive high-quality training to pass the NCLEX-RN via the BSN Program at Nightingale College. This hybrid concept-based educational option combines online instruction with on-ground practice, allowing you to earn your degree in less than 3 years.

If you have decided to get your bachelor’s later on in your career, you can enroll in our RN-to-BSN Program, a fully online educational option that allows you to advance your education with maximum flexibility and accessibility.

Explore our academic program and enroll in the one that is best for you.

Apart from the educational requirements and the subsequent NCLEX-RN exam, becoming an RN has no other professional prerequisites. This means you can start your career directly as an RN,without working as an LPN or CNA beforehand. However, whether you do so depends on your resources, availability, and expectations from your work.

4. Advanced Practice Registered Nurse (APRN)

Advanced Practice Registered Nurse is an umbrella term for roles such as Nurse Practitioners (NPs), Certified Nurse Midwives (CNMs), Family Nurse Practitioners (FNPs), Nurse Educators and Instructors (NEs/NIs), Clinical Nurse Specialists (CNS), Psychiatric Mental Health Nurse Practitioners (PMHNPs), and so on.

The one commonality is that they generally have to earn a Master of Science in Nursing (MSN) to practice. While getting this degree is the next step on the career ladder, both from a professional point of view and judging by MSN salaries, the type of specialization you pursue at this point will dictate the direction of your career. Thus, before you start studying, you should learn how to pick your nursing specialty if you have not done so before.

For instance, at Nightingale College, you can choose from three MSN-level educational routes:

MSN FNP – Recommended for aspiring Family Nurse Practitioners who wish to work closely with patients, families, and diverse communities.
MSN Ed – Recommended for learners who wish to advance to faculty or educational roles in the nursing field, including that of a Nurse Educator/Instructor.
MSN PMHNP – Recommended for learners who wish to become Psychiatric Mental Health Nurse Practitioners and help patients with psychiatric or mental health conditions.

All MSN programs will combine theoretical instruction, supervised on-ground field experience, and in-person seminars to prepare students for their chosen specialty. The programs provided by Nightingale College combine online classes with in-person activities to ensure maximum accessibility without losing the necessary quality of teaching, allowing you to advance your education and career in just 24 months.

Explore the academic programs at Nightingale College!

5. Doctor of Nursing Practice (DNP) & PhD in Nursing

Earning a doctorate in nursing represents the highest level of professional advancement and the endpoint of the nursing career ladder, at least from an educational point of view.

Advancing your education to the highest degree will also provide different professional opportunities. There are generally two options for nurses looking to earn their doctorate – earning a Doctor of Nursing Practice (DNP), which focuses on clinical practice, leadership, and improvements for the healthcare system, or a Doctor of Philosophy in Nursing (PhD-N), which centers on nursing research, education, and advancement of healthcare science. Consequently, a DNP will allow you to take on executive roles in various healthcare organizations, lead policy changes in the field, and improve patient care practices. Comparatively, getting your PhD in nursing opens the way to contributing to nursing education, conducting research, and developing evidence-based solutions for the healthcare industry.

The prerequisites for advancing to the doctoral level include having a Master of Science in Nursing, or in some cases a Bachelor of Science in Nursing, owning an active nursing license (as a Registered Nurse or Nurse Practitioner), and having clinical experience (it depends on the program, but usually, one to two years of experience are required). The learning period also varies from one program to another and depends on your prior level of education. Earning a DNP can take around three to four years of full-time learning, with more extended periods being necessary if you enroll in a BSN-to-DNP program (usually four to six years). PhD in Nursing programs can take three to five years, with additional time for dissertation research.

You can learn more about how long nursing school will take depending on your career objectives.

Your activities during the doctoral program will differ depending on your chosen route. DNP students require over 1,000 clinical hours of practice, while PhD learners deal more with independent research and dissertation work.

Once you receive your doctoral degree, you can hold various positions, from leadership roles (such as Directors in Nursing) to jobs in healthcare administration, advanced clinical practice, academia, research institutions, or policy development. These positions include some of the best-paid nursing jobs in the industry. Additionally, as nursing technology and practice advance, more and more occupations increase their academic requirements. This was the case for Certified Nurse Anesthetists, a role that was previously accessible to MSN-level nurses but which, as of 2025, requires a doctoral degree.

Growth throught specialization and certification

Enhancing Your Career with Specializations and Certifications

The nursing career ladder does not simply boil down to linear advancement that hinges on academic advancement. Many nurses choose to remain at a certain level of education and instead specialize in various fields of practice.

Specialization is most popular among Registered Nurses, Advanced Practice Registered Nurses, and Nurse Practitioners, who can attain a certain degree of workplace autonomy. They can specialize in various areas:

Another option, which is available for nurses at all levels of education, is to earn certifications for various tasks and expand their scope of practice within their work environment. These include certifications for tasks such as therapeutic communication, IV therapy, basic life support, long term care, or wound care.

Learn more about the most important nursing certifications you should have.

How to advance on the nursing career ladder

Strategies for Career Advancement

Now that you have an overview of the directions that your career may take, depending on your expectations and abilities, you must learn the essential tips and tricks for climbing the nursing career ladder.

Working toward a certain professional level is not as straightforward as the overview may make it seem. Often, employers do not provide the resources to attain the prerequisites for reaching your career goals according to your potential. For this reason, you will need to know how to pursue your desired career, where to find support groups for growth, and how to find the opportunities that are right for you.

Build a Strong Resume in Your Area of Interest

Building up your resume in an area that you are passionate about will ensure that you accumulate the necessary experience in the healthcare settings that interest you the most. If you are only starting out as a nurse, you can also spend a period of time exploring various roles via shadowing more advanced professionals or completing instructional programs.

Once you accumulate experience and build up a strong resume, you can more effectively advance to your desired role while also having perfected the necessary skills to perform in your future career.

Join Professional Associations and Groups

Networking is as important in nursing as it is in any other profession, as it can give you a clear direction for your formation and career, and it may even ease your climb up the nursing career ladder. More than knowing about new opportunities, the people you interact with can guide you and instruct you in relation to how you should pursue your development.

Some promising avenues for networking include professional associations, specialty-focused groups, and educational institutions. For instance, at Nightingale College, beyond the academic programs, faculty staff can help you advance your career via academic coaching, among other material support.

Look into Mentorship Opportunities

Mentorship is another effective way of orienting your career development and climbing the nursing career ladder without the risk of increased levels of stress or burnout. An experienced nurse mentor can provide insights into career growth, leadership development, and work-life balance, both from a professional and personal perspective.

Luckily, you often will not need to look for a mentor figure, as many healthcare employers offer formal mentorship programs in order to help their newer staff in their professional journeys.

Search for Leadership Opportunities in Nursing

Leadership and management roles can be both an aspirational career path for many nurses, but they can also provide valuable insight for professionals at the start of their journeys. Occupying such positions, even temporarily, can prepare you for having more responsibilities in a clinical environment or any other nursing-related workplace while also training you in one essential trait – working collaboratively with various types of nurses with different levels of preparation. Essentially, leadership and management positions can provide a valuable perspective over your current place of employment while also allowing you to explore other avenues.

Balance Career Growth with Work-Life

Professional advancement is a normal desire that often appears when you start being bored with your nursing role or feel frustrated by your career’s stagnation. In the worst of scenarios, seeing little development in your career path can lead you to hating nursing overall. However, a constant pressure to evolve and search for ways to advance up the nursing career ladder can be just as detrimental to your professional life and job satisfaction.

An appropriate balance between going up the nursing career ladder and taking your time to consolidate your knowledge and understanding of each step on your way is key for growing steadily without sacrificing on your wellbeing.

Why Is the Nursing Career Ladder Important?

Having a nursing career ladder and pursuing it provides much-needed support and direction, at the individual level, and the necessary framework for tackling some of the most pressing issues facing the industry, including personnel shortages, high staff turnover, burnout, and widespread job dissatisfaction.

Studies indicate that career development strongly correlates to job satisfaction in the industry, which recently plummeted from 80-85% over the past decade to 64% in 2023[1].

Providing career advancement opportunities can result in a more satisfied workforce, better quality of care and patient outcomes, and an increase in personnel retention. Additionally, considering that job satisfaction is lowest among newer nurses or professionals with entry-level certificates and that nurses with under one year of experience face the highest rates of burnout and turnover, providing a nursing career ladder can also be a targeted method of relieving one of the main contributors to the national nursing shortage.

Despite the importance of the nursing career ladder and its potential impact on the health of the healthcare industry, nurses often lack the necessary guidance and support for exploring their career options, as well as advancing their education and practice. That is why we will provide an overview of the levels of a nursing career and how you can advance along.

Why is the nursing career ladder important

Take Your Next Step Up the Nursing Career Ladder With Us

Learning is a central part of career advancement, and advancing your education in the most accessible way, via programs that accommodate working while studying, is quickly becoming a must in the academic field.

At Nightingale College, we provide academic programs for all steps of the nursing career ladder while also ensuring that aspiring learners from all walks of life can enroll, study, and achieve their maximum potential.

All of our programs combine online instruction with various types of necessary in-person activities, such as seminars or supervised on-ground field experiences (SOFEs), which you can complete in one of the many SOFE locations that we have partnered with to ensure maximum accessibility.

We also know that excellence in the field of nursing also requires material support, which we provide to our learners through various types of tuition and financial aid meant to promote success and ensure that non-traditional students from historically underserved and underrepresented communities can access quality education. If you want to know how Nightingale College aims to help aspiring nurses reach their goals, learn more from our learner experience page.

Explore the academic programs and take your next step up the nursing career ladder!

FAQs on the Nursing Career Ladder

What Is the Nursing Career Ladder?

The nursing career ladder is a structured professional structured program meant to bolster professional advancement and skill development, and overall career growth, in an organized manner. Whether it is developed by employers or pursued independently by nurses, a nursing career ladder is essential for personal satisfaction with the nursing profession and for the improvement of the industry as a whole.

How Can an RN Advance in Their Career?

Registered Nurses (RNs) can advance their careers by gaining clinical experience, earning advanced certifications, pursuing higher education (such as a BSN, MSN, or DNP), specializing in a specific field, and taking on leadership roles. The highest-paying nursing roles typically require advanced degrees and include Nurse Anesthetists (CRNAs), Nurse Practitioners (NPs), and Nurse Educators, among others.

While nurses do not always need advanced degrees to specialize, many specialized roles, particularly Advanced Practice Registered Nurse (APRN) positions, require at least a Master of Science in Nursing (MSN) or higher to practice independently and earn higher salaries.

What Are the Highest-Paying Nursing Roles?

The highest-paying nursing roles typically require advanced education and specialization. Certified Registered Nurse Anesthetists (CRNAs) are among the top earners, followed by Nurse Practitioners (NPs), Nurse Midwives (CNMs), and Clinical Nurse Specialists (CNSs). Nurse executives, educators, and researchers with doctoral degrees also earn competitive salaries, especially in leadership and academic positions.

Discover the best-paying nursing jobs and what certifications they require.

While some nursing specialties can be pursued with certifications and experience, many advanced practice roles require an MSN or higher. For example, becoming a Nurse Practitioner, Nurse Anesthetist, or Clinical Nurse Specialist typically requires a graduate degree. However, RNs can specialize in areas like critical care, oncology, or pediatrics through certifications and hands-on experience without necessarily earning an advanced degree.

Do Nurses Need Advanced Degrees to Specialize?

While some nursing specialties require an advanced degree, many can be pursued through experience and certifications. RNs can specialize in areas like emergency care, oncology, or neonatal nursing by obtaining certifications. However, becoming an APRN, such as an NP or CRNA, requires a Master of Science in Nursing (MSN) or higher.