Alternative Careers in Nursing

Osmosis Team
Published on May 16, 2022. Updated on May 16, 2022.

Nursing is a complex and evolving profession that offers endless career opportunities. Depending on location, skills or interests, as well as financial capabilities and experiences, obtaining a nursing degree can lead to many opportunities in different healthcare settings.

In this article, we break down the different career paths for nursing, from basic to higher-level degrees, as well as a general description of different careers outside of the traditional hospital or acute care settings.

Traditional Nursing Career Paths

To start with, aspiring RNs in the USA must complete a BSN, ADN, or nursing diploma program, and in order to practice, graduates must then pass the National Council Licensure Examination (NCLEX®-RN). Depending on state and institution requirements, certification in basic and advanced cardiac life support may also be required in order to practice nursing. Basic career paths in nursing include direct patient care, nursing management, or nursing research/informatics.

Direct patient care includes inpatient or outpatient management of acute or chronic conditions. Although the majority of nurses work in hospitals to provide holistic patient care, many work in ambulatory or residential care settings. In general, the minimum education required is an associate degree in nursing (ADN) while some hospitals require their nurses to hold a bachelor’s degree (BSN).

Osmosis illustration of a nurse caring for a patient in a hospital bed.

Nursing management involves taking on more leadership and managerial responsibilities to strengthen nursing care standards and policies with a focus on patient safety and dignity. The minimum education required is an associate degree in nursing (ADN) while some hospitals require their nurses to hold a bachelor’s degree (BSN) or master's degree focusing on nursing administration (MSN).

Nursing research and informatics contribute to the improvement of healthcare delivery and patient safety through evidence-based nursing. The minimum education required is an associate degree in nursing (ADN) while some hospitals require their nurses to hold a bachelor’s degree (BSN). Pursuing a career in nursing informatics would require a master’s degree in nursing focusing on informatics (MSN).

Common Higher Level Degree Paths in Nursing

As nurses acquire more education, skills, and experiences, the more they become eligible for additional opportunities and wages. Nursing professionals who earn a master’s degree (MSN) or doctoral degree (DNP) in nursing qualify for multiple advanced practice roles such as nurse practitioner (NP), certified registered nurse anesthetist (CRNA), nurse midwife, clinical nurse specialist (CNS), and nurse educator.

A nurse practitioner is an advanced practice registered nurse who provides primary, acute, or specialty care to patients including ordering, performing, and interpreting diagnostic and laboratory tests, diagnosing and treating acute and chronic conditions, prescribing medications and other treatments, and managing patients' overall care, as well as providing counseling and health education. A master's or doctoral degree program and advanced clinical training are required to become an NP as well as pass a certification exam for their specialty.

An RN with at least 1-year experience in critical care (ICU or ER) may opt to pursue a career as a certified registered nurse anesthetist (CRNA). CRNAs are advanced practice nurses that provide all aspects of anesthesia care in every healthcare setting. Minimum requirements to become a CRNA also include a master’s degree from a nurse anesthesia educational program and passing the National Certification Examination (NCE) from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Nurse-midwives are advanced practice registered nurses who provide care during the antepartum, intrapartum, delivery, and postpartum period. Both aspiring certified nurse-midwives (CNMs), if with BSN, or certified midwives (CM) if without a BSN, must complete an accredited midwifery program and pass the national certification examination administered by the American Midwifery Certification Board (AMCB).

Clinical nurse specialists are leaders in healthcare with advanced education and training in a specialized area. They provide expertise in clinical practice, research, education, and management. Aspiring CNS should pass the NCLEX-RN, hold a master’s or doctoral degree in nursing, and acquire an advanced practice certification offered by the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses Certification Corporation (AACN).

A nurse educator educates and assesses nursing students’ competencies and knowledge in the healthcare setting, either in the classroom or in the clinical setting. Depending on the educational setting, clinical or staff nurse educators minimally require a bachelor’s degree in nursing (BSN). Higher education settings teaching bachelor’s or master’s degree in nursing would require either a master’s degree in nursing focusing on education (MSN), or doctoral degree such as PhD, DNP, EdD.

Osmosis illustration of a Nurse educator teaching a group of nursing students in a classroom.

Less Traditional Nursing Careers

Nursing is a multi-faceted skillset and the possibilities for nurses go beyond bedside nursing or hospital employment. While most nurses find careers in hospitals, many nurses pursue opportunities and career growth in less traditional non-hospital settings. The following are common possible career paths for nursing outside the hospital:

School Nurse 

  1. The role of a school nurse is focused on maintaining and promoting the health of students, faculty, and staff in a school environment. Some responsibilities of a school nurse include health screenings, medication administration as well as care of chronic health conditions.

  2. Education required: BSN

Primary Care Office Nurse

  1. A primary care office nurse works in the physician’s clinic, handling basic office duties as well as seeing patients and delivering basic nursing care. Responsibilities may also include telephone triage, assessment and documentation, chronic illness case management, hospital transition management, delegated care for episodic illness, health coaching, and medication reconciliation.

  2. Education required: RN, BSN

Home Health Care Nurse

  1. Home health care nurses provide one-on-one care for patients such as elderly, critically ill, disabled, or recovering from surgery, injury or accident, in their homes. A home health care nurse may assist in pain management, dressing changes, assessments, and managing patient care.

  2. Education required: RN, BSN

Nurse Case Manager 

  1. Home health care nurses provide care for clients with chronic illnesses through coordination of patient care by advocating for them and getting them the services and education they need. Nurse case managers work as a liaison between the healthcare provider and the patient/patient family members in order to manage long-term illnesses.

  2. Education required: RN or BSN

Public Health Nurse

  1. A public health nurse focuses on ensuring the overall health and safety of communities, preventing disease, and reducing health risks through evidence-based care and health education.

  2. Education required: RN or BSN

Legal Nurse Consultant

  1. Legal nurse consultants (LNCs) are registered nurses who work with attorneys and other professionals in the legal field and provide expertise in the analysis and evaluation of clinical issues in a variety of settings.

  2. Education required: RN

Clinical Research Nurse

  1. Clinical research nurses combine holistic patient care with the world of clinical research protocols, governance and management. Clinical research nurses focus on providing care to research participants in different fields of study such as medication safety as well as interventions for nursing-driven patient protocols.

  2. Education required: It varies, BSN, MSN, NP, DNP, PhD.

Osmosis illustration of a nursing student with a thought bubble of a group of different careers.

Flight Nurse

  1. Flight nurses are highly trained registered nurses who provide medical care to patients with urgent or life-threatening conditions in transit to medical facilities aboard an aircraft. Flight nurses may be required to provide and assist with emergency medical care ranging from first aid treatment to advanced cardiac life support and resuscitation.

  2. Education required: RN, preferably having experience working in an emergency or intensive care unit (ICU) setting.

Nurse Informaticist

  1. Nurse informaticists work to combine nursing science, information management science, and computer science to manage and process nursing data, information, and knowledge to deliver quality care to the public.

  2. Education required: BSN or MSN in nursing informatics.

Forensic Nurse

  1. A forensic nurse provides care to victims of violence and abuse while demonstrating competence in conducting a thorough medical forensic examination and providing expert courtroom testimony. Forensic nurses work in a variety of fields, including sexual assault (as Sexual Assault Nurse Examiners or SANEs), domestic violence, elder abuse, and child maltreatment, death investigation, corrections, and in the wake of mass disasters.

  2. Education required: BSN or MSN, sometimes requires special certification as a SANE nurse.

Nursing Recruitment

  1. Nurse recruiters work to fill nursing positions within various healthcare settings. Nurse recruiters assist with screening, interviewing, and evaluating nursing applicants as well as marketing open nursing positions.

  2. Education required: RN or BSN

Correctional Facility Nurse 

  1. Correctional facility nurses provide care to inmates in public and private correctional facilities, including juvenile detention centers, jails, prisons, and state and federal holding facilities. Many of the tasks correctional facility nurses may perform are similar to nurses in the acute care setting, such as medication administration, health promotion, and assisting with medical treatments.

  2. Education required: RN

Nurse at sea

  1. Nurses at sea provide basic first aid, administer medications, and occasionally provide care for emergent or trauma injuries as well as triage and educate about medical concerns to passengers and crew in ships, yachts, or boats.

  2. Education required: RN, ACLS certification, experience in emergency or acute care setting

Infusion Nurse

  1. An infusion nurse is a registered nurse who specializes in administering medications and fluids through an intravenous (IV) line, central line, or venous access port in the hospital, outpatient clinic, or homecare setting as well as educating patients and family members who are caring for infusions at home.

  2. Education required: RN or BSN


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