Nurses provide care for families, individuals, and communities in need of healthcare. Nurses play an important role in healthcare, but they don’t have the same authority as doctors. Nurses are normally under the supervision or directions of a doctor. However, some states do allow nurses to work independently in certain situations. However, no matter the situation, those in nursing differ in training, level of authority, approach to patient care, and education.
The most well-known professions in nursing include:
- Certified nursing assistant (CNA)
- Registered nurse (RN)
- Licensed practical nurse (LPN)
Although all three of these professionals work in nursing, they aren’t all the same. The initial training and continuing education requirements differ for CNAs, RNs, and LPNs.
Initial Training and Continuing Education for a CNA
A CNA doesn’t have the authority to diagnose medical conditions or make medical decisions. But a CNA does play an important role in a patient’s well-being.
If a patient needs help feeding themselves, a CNA is there to help. When a patient is unable to bathe themselves, a CNA gets the job done. A CNA does what they can to make hospitals and nursing homes more comfortable for patients.
The entry-level job of a CNA is often a stepping stone to other opportunities within the healthcare industry. It’s often a good starting point because becoming a CNA takes less time, money, and training than other healthcare positions.
Initial CNA Educational Requirements
The only requirement for entering a CNA program is to have a high school diploma or GED. But specific program requirements vary by state. In some states, a CNA is referred to as a Patient Care Assistant (PCA) or a Nurse Aide (NA).
For example, Alabama uses the term Nurse Aide. Alabama requires a NA to pass a competency evaluation program and state-approved training. Training is available from universities, colleges, healthcare training facilities, and in nursing home settings.
For example, The University of West Alabama offers the Certified Nursing Assistant Program. And the American Red Cross offers CNA training in some states.
While specific program requirements vary by state, a prospective CNA must complete an accredited program. Upon program completion, the CNA will need to complete a specific number of clinical and training hours. The number of hours required varies by state.
For example, Alabama requires a CNA to have 75 hours of training, including 16 hours of lab training and 16 hours of clinical training.
Continuing Education Hours or CEUs
A CNA must become certified to work within a healthcare setting. And to remain certified, it’s necessary to renew the certification periodically. Some states require proof of continuing education courses, or CEUs, before certification is renewed. CNA continuing education requirements vary by state.
Below is a list of 20 states and their continuing education requirements. This example illustrates how states have different requirements and why it’s important for a CNA to know their state’s specific requirements.
CNA Continuing Education Requirements by State
- Alabama – Alabama requires CNA certification renewal every 2-years. But the state doesn’t require a CNA to renew their own certification unless the CNA hasn’t worked in a 24-month period. Normally, the CNA’s employer must report the CNA’s employment status to the Alabama Nurse Aide Registry. The employer should also provide 12 hours of mandatory continuing education per-year to the CNA.
- Alaska – CNAs in Alaska must complete 12 hours of continuing education before renewing their license.
- Arizona – No CNA continuing education required.
- Arkansas – No CNA continuing education required.
- California – Forty-eight hours of in-service training is required before CNA renewal of certification. Of those 48 hours, 24 hours can come from online continuing education courses.
- Colorado – No CNA continuing education required.
- Connecticut – No CNA continuing education required.
- Delaware – Delaware requires 24 hours of continuing education before CNA renewal of certification.
- District of Columbia – Requires 24 hours of continuing education for CNA certification renewal.
- Florida – Requires 24 hours of continuing education for CNA certification renewal.
- Georgia – No CNA continuing education required.
- Hawaii – No CNA continuing education required.
- Idaho – No CNA continuing education required.
- Illinois – No CNA continuing education required.
- Indiana – No CNA continuing education required.
- Iowa – Requires 36 hours of CNA continuing education before the renewal of their certification.
- Kansas – Requires 12 hours of CNA continuing education before renewing their certification.
- Kentucky – No CNA continuing education required.
- Louisiana – No CNA continuing education required.
- Maine – No CNA continuing education required.
The most reliable way to confirm continuing education hours is to contact the local CNA governing board.
For example, a CNA in Kansas would contact the Survey, Certification, and Credentialing Commission of the Kansas Department for Aging and Disability Services. And a CNA in Florida would contact the Florida Board of Nursing.
Initial Training and Continuing Education for an RN
An RN typically assists doctors and other nurses in providing critical care to patients in settings such as hospitals, clinics, and medical offices.
However, an RN can actually work in a wide variety of settings. Home healthcare services, schools, businesses, churches, and community centers often employ RNs.
A bachelor’s degree in nursing is the most common route taken to become an RN. The Bachelor of Science in Nursing (BSN) takes 4 years to complete. During that time, the students learn about:
- The human body and other science topics
- The importance of clear communication with patients and colleagues
- The importance of teamwork with other nurses, doctors, caseworkers, pharmacists, and other healthcare workers.
- Problem-solving by evaluating, interpreting, and analyzing information.
- The importance of organization and responsibility.
Instead of a BSN, some students choose to pursue an Associate Degree in Nursing (ADN) or nursing diploma. It takes 2-years to earn an ADN from a community college or vocational school. A nursing diploma also takes 2-years to earn from an approved nursing program.
RN Continuing Education
An RN must have a license to provide medical care and assistance within certain healthcare settings legally. And after earning a license, an RN must periodically renew the license based on state requirements.
Continuing education courses are a requirement for RN license renewal in most states. And in those states, an RNs license is only renewed if the RN fulfills the course requirements. However, the exact requirements vary by state.
Below are examples of RN continuing education course requirements by state. The examples highlight how different states have different requirements.
- Alabama – Requires 24 hours of continuing education for RN license renewal. For first-time license renewal, at least 4 hours must come from courses in the Nurse Practice Act, Board functions, professional conduct, regulations, and accountability.
- Alaska – In Alaska, an RN must choose two of the following three options to renew their license: Every 2-years, an RN can accumulate a total of 30 hours of continuing education, 30 hours of nursing volunteer work or professional activities, or 320 hours of official nursing employment.
- Arizona – Continuing education isn’t required for RN license renewal.
- Arkansas – Requires 15 hours of continuing education every 2-years for RN license renewal.
- California – The state of California requires 30 hours of continuing education for RN license renewal.
- Colorado – Colorado doesn’t require continuing education for RN license renewal.
- Connecticut – Connecticut has no continuing education requirements for RN license renewal.
- Delaware – Thirty hours of continuing education is required for RN license renewal. Three of those hours must come from courses in substance abuse.
- District of Columbia – Requires 24 hours of continuing education every 2-years. Three of those hours must come from courses in HIV/AIDS. And 2 hours must come from courses on working with LGBTQ patients.
- Florida – Florida requires a total of 24 hours of yearly continuing education for RN license renewal. Before the first license renewal, two out of the 24 hours must come from courses on Prevention of Medical Errors. And a course in HIV/AIDS is a one-time, 1-hour continuing education requirement before the first renewal. For the third renewal, a Florida RN must have at least 2 hours in domestic violence courses.
- Georgia – Georgia requires 30 hours of continuing education every 2-years for RN license renewal.
- Hawaii – The state of Hawaii has several options for RN license renewal. An RN can choose to complete 30 hours of continuing education every 2-years for RN license renewal. But instead of continuing education, an RN can also choose to complete an RN refresher course or maintain national certification.
- Illinois – Twenty hours of continuing education is required every 2-years. At least one hour must come from a course in sexual harassment prevention.
- Indiana – Continuing education not required.
- Iowa – In Iowa, an RN needs 36 hours of continuing education to renew a 3-year license. But to renew a license that hasn’t been issued for at least 3-years, 24 hours of continuing education is required for license renewal.
- Kansas – RNs need 30 hours of continuing education every 2-years.
- Maine – Continuing education not required.
- Maryland – Continuing education not required.
- Massachusetts – RNs need 15 hours of continuing education every 2-years for license renewal.
- Louisiana – Louisiana bases RN continuing education hours on employment status. A full-time working RN needs 5 hours of continuing education before license renewal. An RN that works part-time needs 10 hours of continuing education before license renewal. And an RN who isn’t employed or worked less than 160 hours in a year needs 15 hours of continuing education.
An RN needs to know the specific continuing education requirements for their state. Each state has a local board or committee that oversees the nursing profession and can provide information on local course requirements.
Differences Between an RN and an LPN
An LPN provides basic nursing care and helps keep patients comfortable. And unlike an RN, an LPN isn’t authorized to offer medical advice, administer medication, or provide treatment.
It generally takes 1-year to 2-years to earn an LPN diploma or to complete an LPN certificate program. LPN training generally includes nursing coursework and hands-on clinical experience.
The license renewal requirements for an LPN depend on the state. And like with CNAs and RNs, continuing education is sometimes a requirement for LPNs.
For example, an LPN licensed in Alabama needs 24 hours of continuing education courses every 2-years. And in Georgia, the requirement is 30 hours every 2-years.
Some states, such as Arizona and Colorado, don’t require any continuing education for LPN license renewal. And other states, such as Alaska, offer LPNs a choice between continuing education and some other option.
In Alaska, an LPN can choose to complete 30 hours of continuing education in order for license renewal. The LPN can also choose 320 hours of nursing work or 30 hours of nursing activities. To renew a license, the LPN must choose two of the three options.
Finding Accredited Courses
All continuing education courses must have state approval. A CNA, RN, or LPN won’t receive credit for courses taken from a non-approved course provider.
Approved course providers must provide courses that each state considers appropriate for nursing training. And each state has its own requirements that course providers must meet.
In general, approved course providers are educational institutions or organizations with organized educational departments. There is usually an official program director, official program procedures and policies, and the appropriate instructors, resources, and facilities.
Approved continuing education course providers often include:
- Professional associations, organizations, and partnerships
- Universities, colleges, and junior colleges
- Nursing homes
- Home healthcare agencies
- Governmental agencies
Some states also allow online continuing education courses. However, even states that allow online courses sometimes limit how many hours can come from online courses.
Getting Credit for Hours Earned
Upon completion of continuing education courses, a certificate of completion is issued to each student. The certificate confirms that the student has taken and passed the required continuing education courses.
In some cases, the course provider submits proof of hours earned to the state on behalf of the student. But some states require the student to submit their own proof of hours completed.
Proof of continuing education course completion is due before the license renewal deadline. If the requirement isn’t met, then the license will lapse.
Job Outlook for the Nursing Profession
The job outlook for the nursing profession is positive. The Bureau of Labor Statistics predicts that jobs within the nursing profession will experience a higher than average growth between 2012 and 2022.
Over half a million new nursing jobs are expected. And the current 2 percent unemployment rate in the nursing field is low. However, some nursing positions are in more demand than others.
The most in-demand nursing positions include:
- Nurse midwife – A nurse-midwife is a licensed nurse who specializes in female reproductive health and childbirth. In addition to assisting with births, a nurse-midwife can perform annual exams, write prescriptions, and give medical advice.
- Clinical nurse – A clinical nurse is an RN who specializes in a specific medical area. Becoming a clinical nurse requires additional training beyond what’s received as an RN. Common clinical nurses’ areas include public and community health, pediatrics, home health, adult health, adult mental healthcare, child and adolescent mental healthcare, diabetes management, and gerontology.
- Nurse practitioner – A nurse practitioner has clinical training and is authorized to diagnose illnesses, provide health education, and treat conditions.
- Nurse anesthetist – A nurse anesthetist is a nurse who specializes in administering anesthesia for medical procedures.
The above jobs in nursing require a Master of Nursing (MSN) degree. That means after earning a bachelor’s degree, the nurse must also earn a master’s degree.
Other high-demand nursing areas don’t require extra schooling. For example, a master’s degree isn’t required for critical care nursing, dialysis nursing, nursing education, research, travel nursing, or nursing informatics.
The nursing profession’s explosive growth is attributed to the aging population and the current shortage of nurses. Also, more people are obtaining health insurance and gaining access to medical care. All of these factors combined have increased the need for nurses.
Earning a BSN
A Bachelor of Science in Nursing isn’t a requirement for becoming a CNA. But getting a BSN is a stepping stone that opens the doors to other areas of nursing.
Also, some healthcare facilities are starting to require that all nurses at least have a BSN. That means that even if a person wants to become a CNA, they’ll have a better chance of getting the job if they have a BSN instead of an associate’s degree or nursing diploma.
Nurses with a BSN also make more money than those without a BSN. Nurses with a BSN earn an average salary of $84,000 a year. But nurses with an associate’s degree or nursing diploma earn an average of $69,000 a year.
A BSN also allows a nurse to develop a better understanding of the nursing profession. Advanced training usually results in nurses who are more confident in their role than nurses without advanced training.
State-Approved BSN Programs
There are several BSN programs available. It’s important to choose an accredited program, so always research a program before enrolling.
Most local nursing commissions, registries, or boards maintain a list of state-approved nursing programs. In addition to checking locally, The Commission on Collegiate Nursing Education and The Accreditation Commission for Education in Nursing maintains a list of accredited nursing programs.
The Importance of Education for Nurses
Getting a good education is important for anyone entering the field of nursing. Not only is it important to attend a state-approved program, but continuing education is important in most states as well. Perspective nurses should take care to learn their specific state requirements for beginning a nursing career.
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