Nursing offers five main credential levels, from a practical nursing certificate that takes about a year to doctoral degrees that can span a decade of higher education. Each level opens different roles, responsibilities, and pay scales. Understanding how they stack up helps you choose the right entry point and plan a long-term career path.
Licensed Practical Nurse (LPN/LVN)
The fastest route into nursing is a Licensed Practical Nurse program. Full-time students can finish in about 12 months, or 18 months on an evening and weekend schedule. Programs include over 800 hours of hands-on clinical training in addition to classroom coursework. In California and Texas, this credential goes by Licensed Vocational Nurse (LVN) instead of LPN, but the role is the same.
LPNs provide essential patient care under the supervision of registered nurses and physicians. That means tasks like monitoring vital signs, administering certain medications, changing wound dressings, and helping patients with daily activities. LPNs work in hospitals, long-term care facilities, home health settings, and clinics. The scope of what an LPN can do varies by state, but the supervisory requirement is universal.
Diploma in Nursing
Diploma programs are the oldest form of nursing education in the United States. They typically take about two years and are offered by hospitals, technical schools, or vocational schools rather than colleges. Graduates are eligible to sit for the same licensing exam as associate degree nurses and can work as registered nurses. However, diploma programs have become increasingly rare as the field shifts toward college-based education, and some employers now prefer or require a college degree.
Associate Degree in Nursing (ADN)
An Associate Degree in Nursing is the most common entry-level college pathway to becoming a registered nurse. Most ADN programs take two years at a community college, though some accelerated tracks finish in 18 months. After graduating, you take the NCLEX-RN licensing exam and can begin working as an RN.
The ADN is popular because it’s relatively affordable, widely available, and gets you into the workforce quickly. The tradeoff is that many healthcare facilities now prefer or exclusively hire candidates with a bachelor’s degree. That trend is strong enough that New York State passed a “BSN in 10” law requiring newly licensed RNs to earn a bachelor’s or higher degree in nursing within 10 years of licensure. The first cohort affected by this law will hit their deadline at registration renewal on or after June 2030. Nurses licensed before June 18, 2020 are exempt.
Bachelor of Science in Nursing (BSN)
A BSN is a four-year undergraduate degree from a college or university. It covers everything in an ADN program plus deeper coursework in leadership, public health, research methods, and community nursing. For many employers, a BSN is now the baseline expectation when hiring registered nurses.
BSN graduates also have a slightly higher first-time pass rate on the NCLEX-RN compared to associate degree graduates. The American Association of Colleges of Nursing reports that baccalaureate program graduates consistently outperform ADN graduates on the licensing exam, though pass rates for both groups dropped by roughly four percentage points between 2020 and 2021.
If you already hold an ADN and work as an RN, bridge programs let you earn a BSN without starting over. RN-to-BSN programs are designed for nurses working full time and can be completed in as little as one year (three semesters), often entirely online. These programs focus on the additional competencies a BSN requires, like leadership clinical hours, rather than repeating foundational nursing content.
Master of Science in Nursing (MSN)
A Master of Science in Nursing opens the door to advanced clinical practice, education, and leadership. MSN programs prepare nurses for specialized roles in areas like family practice, pediatrics, mental health, and anesthesia. Graduates typically move into positions as nurse practitioners, clinical nurse specialists, nurse educators, or nurse administrators.
The financial return is meaningful. Registered nurses with an MSN earn roughly $102,263 per year on average, which is about $25,594 more than the median for all RNs and around $14,649 more than RNs holding a BSN. The gap varies by state, ranging from about $5,000 to $31,000 in additional annual earnings for MSN holders over BSN holders.
An MSN is the minimum requirement to become an Advanced Practice Registered Nurse (APRN), a category that includes nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists. APRNs earn a median salary of $129,480 per year, reflecting the expanded scope of practice these roles carry, including the ability to diagnose conditions, prescribe medications, and manage patient care independently in many states.
Doctoral Degrees: DNP and PhD
Nursing has two distinct doctoral paths, and they serve very different purposes.
The Doctor of Nursing Practice (DNP) is a practice-focused degree. It prepares nurses for the highest-level clinical and leadership positions in healthcare organizations: roles like Chief Nursing Officer, Director of Clinical Services, or nurse educator in an academic setting. DNP graduates are also positioned to lead health policy reform. Research comparing PhD and DNP nurses found that DNP holders tend to be younger and most commonly hold nurse practitioner titles or other advanced practice positions.
The PhD in Nursing is a research-focused degree. PhD holders typically work in academia or administrative roles, conducting studies that advance nursing science and shape how care is delivered. PhD-prepared nurses are on average about 10 years older than their DNP counterparts and more often hold administrative or leadership positions rather than direct clinical ones.
For nurse anesthetists specifically, the doctoral requirement is no longer optional. All students accepted into accredited nurse anesthesia programs on or after January 1, 2022 must graduate with a doctoral degree. As of January 1, 2025, every new graduate entering the profession is required to hold one. This makes nurse anesthesia the first nursing specialty to mandate doctoral-level preparation for entry into practice.
How the Levels Connect
Nursing education is designed so you can enter at almost any point and build upward. Someone who starts as an LPN can later pursue an ADN or BSN through bridge programs. An ADN-prepared RN can complete an RN-to-BSN program in a year while working, then continue to an MSN. And MSN-prepared nurses can advance to a DNP without repeating master’s-level content, since many DNP programs build directly on the MSN curriculum.
This stacking structure means your first degree doesn’t lock you in. Many nurses enter through the fastest available pathway, start earning clinical experience and a paycheck, and then advance their education over time. The key consideration at each step is what roles you want access to, since employers increasingly use degree level as a filter during hiring, and state regulations are beginning to formalize higher education requirements for ongoing licensure.