Friday, June 21

Career progression for nurses

Participating in continuing education is essential to the professional development of nurses and necessary to deliver high-quality healthcare. Learning should enable nurses to update and renew their knowledge and skills and enhance evidence-based practice to ensure positive patient outcomes. There are benefits to continuing education, such as increased job satisfaction and personal fulfillment. There are numerous potential progression paths for nurses. Many of the skills and responsibilities in various nursing careers are similar, but each has unique elements that suit different people. Learning about the characteristics of different nursing professions can help find a career matching an individual’s particular skills, experiences, and goals. Advanced qualifications, like a master’s degree, can open up opportunities for working in leadership and specialist roles. 

Master of Science in Nursing (MSN)

The MSN prepares nurses for advanced practice and leadership roles. Clinical experience is arranged close to where students live. MSN programs usually take 2 to 4 years to complete and can be taken online. 

The MSN program typically includes studying advanced nursing practice, healthcare systems and policies, healthcare informatics, research, and nursing education. The programs have different specialized options that can prepare nurses for the career they want. Some nurses do a general MSN and then come back to do a specialty program later. Specialty advanced practice programs include:

  • Nurse practitioner.
  • Clinical nurse specialist.
  • Nurse midwife.
  • Nurse anesthetist.

Studying online can be preferable for people who work. Studying while working as a nurse can be very beneficial as learning can be directly applied to the real world. Lectures are recorded and archived, so studying can fit in with other demands. 

Upon completing an MSN program, graduates are equipped with the knowledge and skills to provide advanced patient care, participate in developing healthcare policies, and serve as leaders and educators in the nursing profession. They may also be eligible to take certification exams in their area of specialization, which can lead to professional recognition and improved job opportunities.

The MSN degree program offers different specialized options that can lead to advanced nursing roles. Numerous msn jobs allow nurses to use their qualifications to establish an interesting and challenging career. 

Case study Nurse Midwife

Jane Bradley is a nurse midwife at Women and Infants Hospital in Rhode Island. She thought she would like to work in a health-related job but was unsure which career path to take. Bradley attended DePaul University and took a Health Science degree. While she was a student, she volunteered at Community Health, a local free clinic. She also volunteered as a doula for the Chicago Doula Association. As a doula, she gave support and guidance to women in childbirth and worked closely with midwives. This experience made Bradley decide to go to midwifery school. 

She looked for a nurse-midwifery program that would accept her Health Science degree. At graduate school, she became a registered nurse after the first year and then took an MSN degree, specializing in midwifery. 

She is now working in her first job as a midwife. She works primarily with women during pregnancy and childbirth but also works in well-person care and primary care. She sees patients in an outpatient center doing pap smears, family planning, and prenatal and postpartum care. She also works in a hospital delivering babies and giving postpartum care. She works 40 hours a week, 16 hours in outpatients, and 24 hours in the hospital. 

Where she works, they practice primary midwifery, which means women have the same midwife throughout the process. Bradley likes this system and enjoys getting to know her patients and building relationships with them. She says there is a lot of joy in her job, helping babies to be born and seeing people become parents.

The biggest challenge for Bradley has been how much she has had to learn while working in a clinical job. There are times when she is faced with a clinical situation she has not seen before. However, this is happening less now she has more experience.  

Bradley stays up to date with current clinical practice. She looks up clinical information regularly on subjects like new medication. She reads journals and talks to other midwives.

Bradley likes that midwifery has the philosophy that pregnancy and childbirth are normal parts of life. Midwife means “with woman” and entails being with women for a big part of their lives. 

Continuous professional development (CPD)

CPD is essential in nursing and can be achieved in numerous ways. Nurses can study for qualifications, attend professional courses and online learning, observe others, mentor, and get practice in the workplace. 

Critical thinking skills can positively affect nursing practice and contribute to continuous improvement. Nurses can reflect on what went well or did not go well during their workday and identify areas of improvement or situations in which they should have asked for help. This allows the identification of mistakes and the establishment of new behavior patterns that may help in making better decisions. 

Practicing effective communication can improve active listening skills and the ability to communicate clearly with staff and patients. Active listening techniques can be used to gain insight into nursing performance. Asking staff open-ended questions and receiving patient feedback can give ideas for improving healthcare practice. 

Having a mentor can benefit a new nurse or those progressing careers or changing specialties. A mentor is a knowledgeable and experienced staff member who supports and guides a more junior worker. They aim to facilitate that person’s career and personal development. Mentorship in nursing has been found to improve job satisfaction and promote professional development. 

It can be beneficial to build mentoring relationships with new team members. Being a mentor can help develop leadership skills as well as assist new staff in settling into the workplace. Establishing mentoring relationships can support career development and help improve nursing skills.

It is helpful to keep updated on current trends and developments in nursing, healthcare, and medicine. Attending lectures can serve as an introduction to new advancements in the healthcare field. Workshops can be instructive on contemporary theories and methodologies in nursing and new ways of interacting with and caring for patients. Another way to learn new skills is to participate in research. Activities like these help in staying updated in the field and demonstrate a desire to keep improving in your career.

Nurses and nurse managers need leadership skills to enhance how they do their job. Leadership skills can be developed by taking more responsibility within the team and helping to organize and delegate tasks, direct team meetings, and support nurses and medical assistants in improving patient care.

Certified registered nurse anesthetist (CRNA)

When studying for the MSN, nurses can choose a specialty that will qualify them for advanced roles in nursing. 

CRNAs are advanced practice registered nurses (APRN) who work in hospital operating rooms, intensive care units, cardiac care units, or surgical facilities. They administer anesthetics and other medications. They have acquired the minimum of a master’s degree focusing on anesthesia, have completed comprehensive clinical training, and have passed an exam approved by the National Boards of Certification and Recertification of Nurse Anesthetists.

CRNAs care for patients scheduled for surgery and emergency surgeries due to trauma or other life-threatening events. They have specific duties, which include:

  • Assessing patient response to anesthesia.
  • Identifying possible risks to the patient, including allergies and overdose.
  • Administering exact dosages.
  • Educating patients during the anesthesia process.

Some CRNAs work with complete autonomy while physicians supervise others. Most surgical procedures take place from early in the morning until early evening. However, emergency surgery can occur anytime, and CRNAs can be asked to work evenings, nights, and weekends.

CRNAs need to have independent thinking with critical thinking ability, judgment, and knowledge to make the right choice for the patient at crucial times. Surgery and anesthesia also need effective teamwork, with patient safety paramount.

Before deciding to pursue a career in anesthesia, shadowing a couple of CRNAs who work in different settings is helpful. These could be a city trauma center or a small provider in a rural area serving many small communities. Another option would be to find a CRNA mentor and shadow them. Working in an ICU or other critical care setting as a registered nurse (RN) will help develop the vital skills a CRNA needs. Taking on leadership responsibilities is also good preparation for working in this role. 

Nurse practitioner (NP)

An NP is an APRN that has completed the required schooling with either an MSN or DNP and NP licensure. NPs have more authority than registered nurses and have similar responsibilities to doctors. They typically focus their care on a specific group, such as families, children, or the elderly. They work on health promotion and disease prevention in their patients. 

NPs can prescribe medication, examine patients, order diagnostic tests, diagnose illnesses, and provide treatment, much like physicians. Their experience as nurses gives them a unique approach to patient care, while their advanced studies qualify them to take on additional duties usually left to physicians. Most NPs are not supervised by physicians, although some are. 

As well as being general nurse practitioners, NPs can specialize. If they choose a specialization, they must become certified in that particular specialty area.

There are many specialties for NPs; here are some examples:

  • Acute Care Nurse Practitioner
  • Pediatric Nurse Practitioner
  • Emergency Nurse Practitioner
  • Psychiatric Nurse Practitioner
  • Oncology Nurse Practitioner

Acutec nurse practitioners (ACNPs) look after patients in acute care and hospital settings. Their focus is on caring for adults with complex diseases. They see patients when they are admitted to the hospital or after a surgical procedure or trauma. 

Emergency nurse practitioners (ENP) diagnose and manage injuries and illnesses that require urgent care. They can work with or without supervision, deciding which patients need the most immediate care, making decisions about treatment, monitoring patient conditions, and providing education and consultation.

Pediatric nurse practitioners (PNP) focus on treating children from infancy through adulthood. They see patients individually, offering care ranging from check-ups and immunizations to diagnosing illnesses and treating chronic and acute conditions. 

Psychiatric mental-health nurse practitioners (PMHNP) specialize in the mental health needs of adults, children, families, groups, and communities. They help individuals cope with different psychiatric disorders and illnesses and can also help people with substance abuse disorders.

An oncology nurse practitioner (ONP) provides comprehensive care to patients who have been diagnosed with cancer. They collaborate with other healthcare staff, including physicians, to develop treatment plans for cancer patients. 

Clinical nurse specialist (CNS)

A CNS is an APRN who works to improve outcomes regarding patients, nurses, and system-wide organizations. Like NPs, they specialize in specific patient groups. However, they focus more on educating nurses and improving patient outcomes. They provide a high level of patient care and can take on a supervisory role within a healthcare team. They are required to have an MSN with a focus on a CNS specialty, although some have a doctorate. 

They constantly address these questions:

  • How can I help the nurses at the bedside?
  • How can I help these patients?
  • How can we improve this process throughout the hospital?

Clinical nurse specialists will also perform the following activities:

  • Assist with evidence-based practice projects.
  • Assist other nurses/staff with direct patient care.
  • Assist with research.
  • Educate patients and families.
  • Conduct research as the primary investigator.
  • Teach in the community.
  • Provide transitional care.

There are numerous certifications, depending on the field being worked in. These include Adult Health, Adult-Gerontology, Pediatric, Neonatal, and Public Health. 


Continuing education and professional development are essential in nursing. Nurses can become well qualified by studying at university on courses such as the MSN. They can also ensure they learn daily at work and continuously improve their knowledge and skills. A master’s degree can offer opportunities to specialize and have a challenging and worthwhile career.