How to Advance Your Nursing Career: A Guide

Registered nurses make up the bulk of healthcare. They are the ones who are at the forefront of the pandemic, and who are there for everyday care in almost every single environment. They are not, however, at the apex of their career. If you have the drive you can earn over $100,000 per year, take on responsibilities that many doctors tackle, and of course increase your work/life options substantially. 

Moving up is the only way to move forward, but with so many different positions and areas of medicine to work moving up is not as simple as many think. You don't just work to earn an MSN and suddenly have all the APRN positions available to you, you need to earn an MSN in your chosen speciality. 

Knowing what you want and what will make you happiest is the best way forward, so use this guide to help you work towards your dream job: 

How to Figure Out Your Ideal Career Path 

To find the best position for you, you will need to know what you are most interested in, what working environment suits you best, and what you personally are looking to get out of your career. With those three in mind you can narrow down the different types of nursing positions substantially, and also increase the likelihood that you will love your future job wholeheartedly. 

1. Know Your Passions 

There are numerous positions that you can work towards in nursing, and though you will need at least an MSN in all of them to qualify it is actually better to understand where you want to specialize beforehand. 

2. Shadow Other Departments 

A good way to start is to work in different departments. If you cannot get formally assigned to work there, see if you can shadow other nurses for a day or so every once in a while. Medicine is a very broad practice, and you will be surprised at how different the various departments in just one hospital are to work in. Practical experience and first-hand accounts of what it is like to work in these different departments is worth more than all the advice in the world, though you should never turn down good advice if it is offered. 

3. Take Up Your Own Personal Study 

Subscribe to nursing magazines or even read up on some medical news in your spare time. By being engaged in healthcare and its future direction you can work towards the area of medicine that you personally find most fascinating. Not only will simply reading help you understand where you should work in healthcare, it can actually make you a better nurse and job candidate in the future. 

4. Understand Yourself 

Most importantly, however, you need to understand yourself. You need to know where you are happiest, and aim to find a position that suits your working style and goals the best. Nursing is a hard job. RNs are often overworked and bear the brunt of the physical and emotional labor of healthcare. 

It is a gruelling job and you won't see the same level of reward as doctors do when you first become a nurse. The high pay and job opportunities only come to those who push through beyond their position as an RN to become an APRN. 

That is where you truly advance your nursing career. Unfortunately there is no broad spectrum option you can choose. You will want to specialize and get the right MSN and even a DNP that suits your area of medicine. 

Which is why you will need to know yourself and what you want. Be honest, and try to find an answer to these two major inquiries:

• Know the job type (or role) you want 

• Be honest about your ideal working environment 

Where Nurses Can Work 

Nurses work in a variety of settings, and in fact actually are more free in where they work than doctors. Their freedom in working environment makes it possible to not just specialize in an area of medicine that you are interested in, but in the working environment that suits you. The fast pace of a hospital may suit you when you are younger, but as you get older and want to slow down a clinic or even a school may be better suited to you. 

Hospitals 

Most nurses will work at a hospital at least once in their career. It is the best place to get experience treating and caring for the largest range of patients. It is also often where you are placed for the clinical hours you need to earn your next degree. 

Hospitals are typically fast-paced and can be hectic, but in terms of helping the most people through one of the most difficult periods of their life, it is undeniably rewarding. Every day is a new challenge, and the experience you learn here cannot be replicated elsewhere. 

Clinics 

Clinics also need nurses. Many clinics will see the same type of cases as hospitals, though the function will be different. Rather than working in an institution for care, you will be working within diagnostics. Walk-in clinics and family clinics are much easier to work in and in comparison to hospitals, can feel very laid back. You will be dealing with small emergencies and regular check-ups. 

Working in a clinic you will find you'll actually be able to recognize your patients. Small towns in particular have a very close relationship with their local town doctor and nurses, so you'll be able to settle in wonderfully. 

Education Sectors 

Another great option for nurses who want to slow down is to work in the education sector. This can either be as a practicing nurse, there to treat students and staff on site for a variety of ailments, or as an educator yourself. There is a huge shortage of nurse educators, and though the pay isn't nearly as high as for practicing nurses, the work/life balance is great. Not only do you have your set hours, you also enjoy breaks. Take summer vacation off for once, and finally have enough time to enjoy the holidays properly. 

Research 

Nurses also work in research settings. You can help develop the next cure for a disease, or be there to aid in the creation of a new treatment method. Nurses are ideal to work as researchers or even as consultants to help improve the face of healthcare. 

Offices 

You can work as a nurse recruiter, in health policy, or even in administration as a nurse. Many of these roles actually require you to have a BSN, so your qualifications won't be put to waste. Health policy in particular is a very powerful position to be in, and any administrative role will allow you to help improve the quality of life for nurses and patients alike. 

Understanding the Nurse Licensure Compact 

It can be very frustrating to work yourself into a box. For some, it's their job role that has them backed up into a corner, for others, it is the state where you live. Thankfully thanks to the Nurse Licensure Compact many participating states make it easy to move with your existing nurse license with minimal hassle. 

If you live in and receive your license in any of the NLC states when you move to another participating state you don't need to worry about renewal requirements or any additional fees. As of 2018, thanks to the new enhanced Nurse Licensure Compact (eNLC) you can also work remotely. As a NLC state nurse you can practice both in person in any of the participating states, as well as work in Telehealth from your state to any of the other NLC states. 

If your goal is to be able to travel or move to a state in the NLC group, then it is a good idea to work towards your nursing license in a participating NLC state, or at the very least in one of the states that is currently working to become an NLC state. To date, 29 states are currently in the Nurse Licensure Compact, and six more are still pending. 

Choosing Your Specialization 

There are four main types of nurses. There are Nurse Practitioners (NPs), Clinical Nurse Specialists (CNS), Nurse Midwives, and Nurse Anesthetists. NPs and CNS are huge umbrella nursing types that work in all areas of medicine from demographic specializations all the way to medical specializations. 

If you intend to work in clinical settings, you will likely be one of these four main types of nurses. Just know you will likely need to narrow it down further before choosing your degree, as formal certifications and exams are needed to apply for the various roles. 

Choosing Your Degree Type 

You have two main levels of degrees you can work towards. You can stop at your MSN and become an APRN, or you can go one step further and become a DNP. DNPs are the highest level of nursing and open you up to a variety of management-level positions. 

MSN Route 

At the very least to qualify for the APRN roles you will need an MSN level degree. MSN degrees are incredibly varied, so you need to know what type of nursing you want to get involved in beforehand. The MSN degrees for nurses who want to get involved in anesthesiology will be very different to the nurses who want to become midwives or family nurse practitioners. 

Know what your specialization is in advance, and then work to earn your MSN. 

DNP Route 

If you really want to push yourself and open up your options (and of course make it easier to demand higher wages) then the better option is to go through the DNP route. Though challenging, it is possible to obtain your MSN and DNP one after the other. There is no need to become a Nurse Practitioner in between, as you can earn that qualification after completing your MSN and DNP. 

There are a variety of DNP programs available, so when looking to choose which program is right for you aim to find the one that allows for the most support. The median salary of a DNP is $135,830 per annum, but the effort it takes to achieve a DNP cannot be stressed enough. You need a program that allows you to work on your flexible schedule, and one that helps to incorporate as much of the clinical hours within your course load as possible. 

Alternatively you can work to complete your DNP at a later date. So long as you achieve your MSN somewhere along the way, you will be eligible to apply to a DNP program and then move on to become the highest level of nurse in all categories. 

Choosing Your Institution 

It goes without saying that when you are looking at either a MSN or DNP program the institution that you choose matters. You need a lot of support because, unlike other degrees or careers, it simply isn't feasible to take time off. It is in your best interest both to support yourself and to further your career to work and learn at the same time. 

This dual workload is hard on the body and the mind. A strong support system is essential to help you through it. This means both a fair and simple way to work and study, and also officers on hand to help you with a variety of different aspects of your education. 

You will want an admissions representative, a student success coach, an online library you can access, an online writing center you can use, as well as an academic advisor and even a technology help desk. 

It takes a village to raise a highly qualified nurse, so not only do you want an institution that offers these benefits, but you will also want to make sure that you take advantage of them. 

What to Remember When Advancing Your Career 

Knowing the direction you want your career to take is a great first step, but don't try to marathon through it. It takes years to qualify for these higher level roles, and you won't do yourself any favors if you burn out before you reach the finish line. Take your time, adjust your schedules, and work with both your university and your employer to strike the right balance that will help you reach your dream job.