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Levels of Nursing

There are four basic tiers of nursing. The lowest tier is composed by the Certified Nursing Assistant (CNA) and performs only the most basic services. The next tier is made up of the Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) they attend to many of the tasks commonly associated with nursing such as starting IV’s, planning patient care, giving some injections and other basic nursing tasks. The LPN and LVN must take orders from higher level nurses and cannot directly fulfill doctor’s orders. The tier that defines the nursing practice is that of the Registered Nurse (RN). The RN can do every task the lower tiers can do plus they can take orders from doctors, assist doctors in complicated tasks and give orders to CNA’s, LPN’s and LVN’s. The final level of nursing is the Advanced Practical Registered Nurse (APRN) which is a specialist level of RN nursing and usually requires additional study or certification above and beyond that required of an RN. They can be specialists in Anesthesia, be a nurse midwife or other forms of specialized nursing.

The most basic level is the Certified Nursing Assistant who provides very basic services such as monitoring vitals, attending to patient’s personal care, assisting patients with basic tasks such as eating, assisting nurses in tasks, Administering medicines and attending to basic room cleaning type tasks. You can usually become a CNA with minimal training via a certificate program.

The level of the Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) is when the duties classically attributed to nurses begin to really come into focus. LPN and LVN’s cannot take orders from doctors and must receive their instructions from a RN. They can however perform tasks beyond what the CNA is able to do such as giving certain injections, beginning Intravenous drips, assisting in the delivery rooms of hospitals along with basic newborn care such as checking vitals and bathing. The LPN and LVN will also be required to perform CPR on some occasions. You will need a nursing diploma to become a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) and this takes one year at a college to earn in most cases.

The Registered Nurse (RN) is the backbone of nursing and is the level at which the profession is truly defined. Work in tandem with doctors the RN is able to provide a variety of high skill services such as: giving patients almost any necessary injection, operating most basic medical equipment, giving patients most medications, creating care plans for patients, acting as a nursing authority and delegating tasks or signing off on other nurses work and assisting doctors in surgical situations. The Registered Nurse has a tremendous amount of responsibility and is able to perform a wide variety of tasks. The RN position requires a minimum of a two year associate’s degree. Increasingly however, hospitals are looking for RN candidates with either a great deal of experience or a Bachelor’s degree in Nursing.

The Advanced Practical Registered Nurse (APRN) is essentially an RN that has continued their training or education until they develop highly specialized nursing skills. Some examples of APRN’s are: Psychiatric-Mental Health Nurses (PMHNs), Certified Nurse Midwife (CNM), Nurse Practitioner (NP), Certified Nurse Specialist (CNS). In order to attain these titles you will need to have a full four year Bachelor’s degree in Nursing and have gone on to take graduate level course work in your nursing specialty. Certain titles such as Nurse Practitioner (NP) often require a Master’s degree in Nursing or sometimes post-graduate nursing studies.
There are many levels of nursing and each one fulfills an important part of the overall healthcare system. You will want to explore each level until you find one that resonates with you as being the ideal balance of skills and process for your particular temperament and personality. You can learn more about the supply of nurses at various levels through this report through the Department of Health and Human Services.