Nursing career path: three licenses, three different decisions

Nursing is not one job. It is a set of licensed roles with different training lengths, different medians and different projected trajectories, and the decision most people are actually making is which of them to aim at rather than whether to nurse at all.

Here is the federal picture, on May 2024 median wages and 2024 to 2034 projections. We are not adjusting the wages to a current year, because no federal source publishes that adjustment.

Two things about that table are worth stating plainly. It is a ladder in the sense that each rung is normally entered from the one below, and it is not a ladder in the sense that time served moves you up. Each step is a separate programme, a separate cost and a separate licence.

The third row is a group figure covering three distinct occupations with their own separate BLS profiles. Nurse practitioners in particular carry their own projection, and quoting the group growth rate as though it were the nurse practitioner rate is a common error worth avoiding. If a specific figure matters to your decision, read the individual profile rather than the group one.

What BLS does not publish

There is no BLS breakdown of registered nurse pay by degree. The $93,600 median covers registered nurses as an occupation, whether they entered through an associate degree, a bachelor’s, or a diploma programme.

So anyone showing you a table of what an ADN earns against a BSN is not drawing on federal data. Employer preferences and requirements are a real consideration, and some employers do prefer or require a bachelor’s for particular roles, but that is a question for specific employers in your area rather than something the national statistics answer.

Reading the ladder as a sequence of costs

Each rung has a different shape of commitment, and the wage difference is compensation for that rather than a reward for ambition.

The LPN route is a postsecondary non-degree programme, so it is the fastest way to a licence and a wage above the $49,500 all-occupations median. It is also a terminal licence in its own right: becoming an RN afterwards means a further programme rather than a top-up, even where bridge programmes shorten it.

The RN route is the largest step in absolute wage terms, from $62,340 to $93,600 at the median, and it opens the setting where about 59 percent of the occupation works. It is also the prerequisite for everything above it.

The advanced practice routes require a master’s degree at minimum and are entered after RN licensure, which means they are a second major programme undertaken by someone already working. That is the practical reason people study while employed, and it is the subject of our note on working while in nursing school.

None of these steps happens automatically with time served. Planning the sequence, and knowing which employers help fund which stage, is the part that repays attention early rather than at the point of application.

The hospital concentration, and what it implies

About 59 percent of registered nurses work in hospitals, which shapes the job in ways a wage figure does not capture. Hospitals run continuously, so shift work, nights, weekends and holidays are ordinary rather than exceptional, and that is worth weighing before the training rather than after it.

The remaining share works in other settings, which is why the occupation is more varied than the hospital image suggests. If shift work is the binding constraint on your household, that variety is the part of the picture to investigate.

Entry-level roles in the same buildings, and what they do and do not lead to, are covered in our note on hospital jobs with no experience. How nursing pay sits against healthcare generally is in the medical pay range.

Questions readers actually ask

Does a BSN pay more than an ADN?

BLS does not publish registered nurse pay by degree, so there is no federal figure to quote. The $93,600 median covers the occupation regardless of entry route. Some employers prefer or require a bachelor’s for particular positions, which is a question to ask employers in your area rather than one the national data settles.

Is LPN a good way in?

It is the shortest licensed route, with a May 2024 median of $62,340, which is above the all-occupations median of $49,500. Whether it is a step toward registered nursing or a destination is a personal decision. It is a separate licence, not a partial completion of the RN one.

How much do nurse practitioners earn?

The BLS group covering nurse anesthetists, nurse midwives and nurse practitioners had a median of $132,050 in May 2024. That is a group figure across three occupations, and nurse practitioners have their own profile with their own median and projection. Read that page rather than applying the group number to the individual role.

Is nursing growing quickly?

Registered nursing is projected to grow 5 percent from 2024 to 2034, against 3 percent for all occupations. That is modest as a percentage, but the occupation is very large and openings also arise from replacement needs. Growth rate alone understates the hiring in an established field of this size.

Written by

Keith Guirao

Founder & Editor, ConsumersWeek

18+ years in consumer marketing and lead generation across insurance, personal finance, and home services. ConsumersWeek explains how these products are priced and sold so you can evaluate them with the same information the industry has.

About the editorLinkedIn