If you have been working as a registered nurse for a while, you might be thinking about steps that you can take to advance your nursing career. Nursing is a vast and expanding field, and it offers increasing scope for specialization in terms of particular areas of practice such as pediatric care, gerontology, mental health, midwifery, and more. Here are some ways you can advance your career in the nursing field.
What counts as nursing?
Hopefully, if you have been working as a registered nurse, you have a good idea of what nursing is! It’s worth pointing out. However, that nursing is a much wider field than most people give it credit for. The American Nurses Association defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations”. It could be said, therefore, that nursing is not so much a single healthcare profession, but rather a specific professional approach to the provision of healthcare and health education, which values holistic approaches towards the promotion of health and wellbeing at all levels of society.
What can a nurse specialize in?
There are many different ‘levels’ of nursing which indicate different levels of training and specialization. Even as a registered nurse, you can specialize in certain fields of practice such as infection control, quality control, and case management. Your options for specialization are particularly high if you hold a Bachelor’s Degree in Nursing rather than just an Associate’s Degree.
If you are willing to go back to university and gain a graduate-level degree (a master’s or a doctorate), you can become an Advanced Practice Registered Nurse. This is an ‘umbrella term’ which comprises of nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists.
Both nurse practitioners and clinical nurse specialists provide primary and secondary care, including diagnosing, treating, and managing conditions. Clinical nurse specialists also often work in the realm of research or education. If you become a clinical nurse specialist or a nurse practitioner, you will be asked to choose an area of specialization, which can be based on a segment of the population—such as geriatric or pediatric care—or on a particular clinical area such as cancer treatment or mental illness.
Nurse midwife training is essentially a way for registered nurses to make the transition to becoming midwives. Just like direct-entry midwives, you will care for pregnant, birthing, and post-partum patients and their babies both in hospital maternity wards and in out-of-hospital settings such as birth centers, care homes, and even private homes if the patient decides to have a home birth.
A nurse anesthetist is someone who has experience of working as a registered nurse and has then gained a graduate degree specializing in providing anesthesia to patients in a variety of settings. By contrast, an anesthesiologist is a doctor who also specializes in the field of anesthesia. Depending on your state, as a nurse anesthetist, you may be able to work independently, or you may be required to practice under the supervision of a qualified anesthesiologist.
What education options are available to you?
Having determined what you would like your next career step to be, you need to figure out how to get there. If you want to become a nurse practitioner, a clinical nurse specialist, a nurse-midwife, or a nurse anesthetist, you will need to complete a graduate program in nursing—either a master’s degree or a doctoral program, though all nurse anesthetists will be required to hold a doctorate before sitting their licensure exams from 2025. This doesn’t necessarily mean that you have to ‘go back to college’ in the traditional way; many universities, such as the Wilkes Passan School of Nursing, will allow you to complete your classes and assignments remotely and attend clinical experience placements in a healthcare setting close to your home. Studying for a graduate nursing degree is hard work, but it can also be done flexibly alongside your existing employment or other commitments.
If you would like to remain a registered nurse but specialize in a particular clinical area or gain new skills to become an assistant nurse manager or similar, you can take several certifications offered by the American Nurses Credentialing Center. These include certifications in ambulatory care, gerontology, medical-surgical nursing, nurse executive education, and many more. Different professional associations for healthcare workers also offer their own certifications; for instance, through the American Board of Neuroscience Nursing, a registered nurse can study to become a Certified Neuroscience Registered Nurse or a Stroke Certified Registered Nurse.
Nursing-adjacent career paths
When you are thinking about how to advance your nursing career, don’t forget that there are many opportunities open to qualified nurses which go beyond working in healthcare settings. One of the least talked about but possibly most intriguing of these options is for you to become a Legal Nurse Consultant. Legal Nurse Consultants are certified nurses who work with a legal team to review and assess the medical evidence presented in legal cases. As part of this work, you may be asked to participate in client interviews, act as an expert witness, conduct medical literature searches, educate attorneys and their clients on medical terminology, and a lot more besides.
If you like teaching and learning, you could also consider becoming a nurse educator and teaching on nursing programs and in teaching hospitals. In order to become a nurse educator, you will need a graduate degree in nursing, with most employers requiring a doctorate rather than just a master’s degree. You will also need to stay up to date with nursing practices, legal requirements, and more, which is one of the reasons why many nurse educators continue practicing as nurses in addition to taking on teaching responsibilities. Nurse educators also carry out research and may need to meet some publishing requirements, making this role suitable for those who like staying busy and are excellent at organizing their time!
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