After earning your RN license, the most common next step is a Bachelor of Science in Nursing (BSN), followed by graduate degrees that open the door to advanced practice, leadership, and specialty roles. The path you choose depends on whether you want to stay in direct patient care, move into leadership, teach, or shift into a field like health informatics. Each option has a different timeline, salary ceiling, and day-to-day reality.
BSN: The First Step for Most RNs
If you entered nursing through an associate degree (ADN) or diploma program, a BSN is the natural next move. RN-to-BSN programs typically take about two years and are widely available online, making them manageable while you work full time. Many hospitals now prefer or require a BSN for hiring and promotion, so this degree has become less of an optional upgrade and more of a baseline expectation.
The BSN curriculum adds coursework in research, public health, leadership, and evidence-based practice. It doesn’t change your license or scope of practice, but it qualifies you for roles like charge nurse, case manager, or community health nurse, and it’s the prerequisite for every graduate program in nursing.
Master’s Degree (MSN)
An MSN is where nursing careers start to branch significantly. Programs usually take 18 months to three years depending on whether you attend full or part time and whether you already hold a BSN. If you have an ADN, RN-to-MSN bridge programs let you skip the standalone BSN by folding those requirements into a single, streamlined program. Admission is competitive: you’ll need a solid GPA, specific prerequisite courses, an active RN license, and often a few years of clinical experience.
At the master’s level, you choose a track. The most popular clinical tracks lead to Advanced Practice Registered Nurse (APRN) roles, but non-clinical tracks in education, administration, and informatics are also available. Your choice here shapes the rest of your career, so it’s worth understanding what each path actually looks like.
The Four Advanced Practice Roles
APRNs are nurses with graduate education and national certification who can assess, diagnose, and treat patients. There are four recognized APRN roles, each with a distinct scope.
Nurse Practitioner (NP) is the most common. NPs provide primary, acute, and specialty care across the lifespan. Within the NP title, you pick a population focus: family (FNP), psychiatric/mental health (PMHNP), adult-gerontology primary or acute care, pediatric primary or acute care, women’s health, neonatal, or emergency care. Family and psychiatric mental health are currently the highest-demand specialties. Some programs offer dual tracks, like combined pediatric and family NP certification.
Certified Registered Nurse Anesthetist (CRNA) delivers anesthesia and pain management services. This is the highest-paying nursing role by a wide margin, with a median salary of $223,210 per year. As of January 2022, every student entering a CRNA program must enroll in a doctoral program rather than a master’s, making this the first APRN role to fully require a doctorate for entry.
Certified Nurse-Midwife (CNM) provides primary care, gynecological services, and reproductive health care including prenatal, birth, and postpartum management. The median salary for nurse midwives is $128,790.
Clinical Nurse Specialist (CNS) works differently from the other three. CNSs focus on improving care at the systems level: driving practice changes across a unit or organization, mentoring bedside nurses, and ensuring evidence-based protocols are in place. They also provide direct patient care, but their role blends clinical expertise with organizational influence.
Doctoral Degrees: DNP vs. PhD
Nursing has two doctoral tracks, and they lead to very different careers.
The Doctor of Nursing Practice (DNP) is a clinical and leadership doctorate. Programs focus on translating research into practice, organizational leadership, and advanced clinical skills. If you already have an MSN, a DNP typically takes one to two years full time (or four-plus years part time). If you hold a BSN and want to go straight to a doctorate, BSN-to-DNP programs take three to four years and include clinical preparation for APRN certification in specialties like family NP, midwifery, or acute care NP.
The DNP is increasingly becoming the expected entry-level degree for advanced practice. The National Organization of Nurse Practitioner Faculties called for the DNP to be required for all new NPs by 2025, and CRNA programs have already made this shift. Whether or not every program enforces this timeline, the trend is clear: doctoral preparation is becoming the standard.
DNP graduates land in roles like nurse practitioner, chief nursing officer, director of advanced practice, health system education leadership, and consulting. The “Executive DNP” track specifically prepares nurses for C-suite positions.
The PhD in Nursing is a research doctorate. You’ll design and conduct original studies to generate new knowledge in nursing science. A PhD does not provide clinical certification. PhD-prepared nurses typically work in academia training the next generation of nurses, lead research at universities or health systems, shape healthcare policy, or consult for organizations that need research-backed expertise. If you love asking questions more than answering them at the bedside, this is the path.
Non-Clinical Paths After RN
Not every next step involves seeing patients. Several growing fields let you use your nursing knowledge in entirely different ways.
Nursing Informatics sits at the intersection of nursing, data, and technology. Informatics nurses design and optimize the electronic health records and clinical systems that other nurses use every day. To earn the Nursing Informatics Board Certified (NI-BC) credential, you need a BSN or higher, at least two years of RN experience, 30 hours of continuing education in informatics, and a minimum of 2,000 hours of informatics practice in the last three years. An alternative path accepts 1,000 practice hours combined with 12 semester hours of graduate-level informatics coursework.
Nurse Education puts you in front of nursing students rather than patients. The Certified Nurse Educator (CNE) credential from the National League for Nursing requires a master’s or doctoral degree in nursing. If your graduate degree emphasized nursing education, that’s sufficient. If your degree focused on a different nursing specialty, you’ll need either a post-master’s certificate in nursing education, nine or more graduate-level credits in education courses (curriculum development, instructional design, adult learning principles, assessment), or at least two years of teaching experience in a nursing program within the past five years.
Nurse Administration and Leadership roles like nurse manager, director of nursing, or vice president of patient services typically require an MSN with a focus on leadership or health systems management. Some nurses in these roles pursue an MBA or a Master of Health Administration alongside or instead of the MSN.
How Salary Changes With Each Step
The financial picture shifts substantially as you advance. The median annual salary for registered nurses is $93,600. Nurse practitioners earn a median of $129,210, and nurse midwives are close behind at $128,790. CRNAs sit at the top with a median of $223,210. That’s more than double the staff RN salary.
Leadership and informatics roles vary more widely depending on the organization and region, but an MSN or DNP consistently opens the door to six-figure positions that a BSN alone won’t reach. The investment in time and tuition is real, but the salary jump from RN to any advanced role is significant and begins immediately after you start practicing in the new role.
Choosing Your Path
The right next step depends on where you are now and what kind of work energizes you. If you have an ADN and want to keep your options open, start with a BSN. If you already know you want to diagnose and treat patients independently, aim for an NP or CRNA program. If you’re drawn to teaching, research, or systems-level work, look at CNE certification, a PhD, or an informatics specialty.
Bridge programs make it possible to skip intermediate degrees. An RN-to-MSN program lets ADN nurses bypass the standalone BSN. A BSN-to-DNP program lets you earn a doctorate without stopping at the master’s level. These accelerated options save time, though they demand a heavier course load. Consider whether you want flexibility to change direction at each stage or whether you’re committed enough to a specific role to take the fastest route there.