Crystal Gustafson
Crystal Gustafson
December 18, 2019 - 5 min read

Moving Up the Ranks from CNA to LPN to RN

Many nurses start their healthcare careers by first becoming a CNA, or Certified Nursing Assistant. Working can be a CNA is a rewarding career path, as well as a valuable stepping stone to advancement in a nursing career.

Maybe you’re already working and want to know what comes after your CNA or maybe you’re curious about what the next level of nursing after a CNA is — but no matter what your career goals are, we have the information you need to know about moving from a CNA to RN.

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Certified Nursing Assistant (CNA)

If you think of a nursing career in levels, you can think of a CNA as the first “level.” Like the name suggests, a CNA is a nursing assistant and they assist with the day-to-day duties of nursing care.

CNAs learn professional skills such as workplace communication, teamwork, diversity skills, and gain a foundation of healthcare clinical skills that support nursing care.

Some of the typical duties of a CNA include:

  • helping patients with their activities of daily living (ADL’s) like eating, grooming, toileting, bathing, and getting dressed
  • assisting with interpersonal care, such as visiting with patients or participating in facility activities in a long-term care setting
  • monitoring intake and output
  • checking blood sugars and vital signs
  • helping nurses with certain tasks such as dressing changes and repositioning

To become a CNA, you must get certified through a CNA course before becoming licensed, which usually takes around 4-8 weeks. You must also pass a competency test. The specifics of CNA courses vary from state to state, but as a general guide, the Red Cross lists the following requirements to become a CNA:

  • A high school diploma or GED
  • Background check
  • TB test

CNAs differ from Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) in the scope of their practice, what they are responsible for, and the type of clinical care they are able to perform.

For instance, CNAs cannot do assessments or hand out medications, and they are not responsible for the overall monitoring of a patient’s status, labwork, care plan, or orders. They also do not communicate with the healthcare team, such as the physician or nutritionist.

CNAs can work in hospitals, mental health facilities and nursing homes. According to the National Bureau of Labor and Statistics (BLS), the average pay for a CNA is $13.72 per hour or $28,530 a year. Working nights and weekends can give you a pay differential of much as $5 an hour. Also, because there is high demand for CNAs, overtime is often an option.

According to the BLS, the projected job market growth for CNAs is 9%, faster than average growth for all occupations. The need for CNAs is only predicted to increase, as the baby boomer population ages and will need more nursing care.

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Licensed Practical Nurse (LPN)

Licensed Practical Nurses (LPNs) have more responsibility than a CNA, but not as much as an RN. LPNs have to work under the supervision of an RN, and unlike RNs, typically can’t specialize in any clinical area. As an LPN, your options for work will be more limited to long-term care facilities or general medical-surgical areas. Only RNs can work speciality units such as pediatrics, labor and delivery, or NICU.

Every state has its own rules for what type of medications LPNs can administer. Some states, for instance, will not allow LPNs to administer IV medications or certain medications, like narcotics. LPNs may also not be able to perform autonomous care for a patient like an RN can, so an LPN won’t be able to do an assessment and nursing care plan.

LPNs can work in hospitals, nursing homes, home health, clinics, and schools, just like an RN, but unlike an RN, LPNs do not hold management positions. LPNs usually only work at the bedside, so there is little opportunity for growth or advancement in non-clinical roles.

As an LPN, job duties usually include:

  • all of the job duties of a CNA
  • passing out medications
  • dressing changes
  • inserting catheters and IVs and other nursing duties
  • notifying the RN of any abnormalities in a patient’s body system

If you are already a CNA and would like to move from a CNA to an LPN, programs to become an LPN usually take about one year to complete. The average pay for an LPN is $22.23 per hour or $46,240 a year according to the BLS.

Many CNAs choose to become an LPN while pursuing their RN or BSN so they can continue to work and make a higher income. The BLS notes that the job outlook for LPNs is 11%, faster than other occupations.

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Registered Nurse (RN)

Becoming a Registered Nurse (RN) requires more time and education than both a CNA and an LPN. RN programs are a minimum of 2 years, however, bachelor degrees are becoming required in some hospital settings, so some programs can take four to five years to complete on a full-time basis.

RNs can specialize in any area, from surgical to dermatology to mental health care to private practice, and have more opportunity for career mobility than LPNs. RNs can work in a multitude of settings including hospitals, nursing homes, home health, community health, clinics, aesthetics, management, and education. Earning your BSN concurrently with your RN will also provide more advancement capabilities.

An RN must be able to perform all of the job duties of a CNA and LPN, but is also ultimately responsible for actively assessing, monitoring, and implementing care for patients. Unlike LPNs, RNs assume full responsibility of all aspects of patient care. An RN’s tasks on the job include:

  • critical thinking skills
  • planning a patient’s care based on their diagnosis
  • implementing and carrying out nursing care plans assessments, and any resulting follow-up interventions
  • patient education
  • competence with highly technical equipment, such as ventilators and balloon pumps
  • physician collaboration
  • communication with healthcare team members, including patient family members

According to the BLS, the job outlook for RNs is a projected growth of 11%, which is similar to LPNs. RNs, however, earn an average of $34.48 per hour, or $71,730 per year, which is significantly more than LPNs.

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Expand your career opportunities

Depending on where you are in your life and what you are looking for in a career, any of these professions in the nursing field can serve you — and of course, your patients.

If you decide to start your healthcare career as a CNA, there are many options available for you to advance your profession. For instance, you could go from a CNA to an LPN. Or, you could choose to take the CNA to LPN to RN route. And finally, you could make the decision to go directly from CNA to RN.

Becoming an RN will give you the most freedom to choose what indof career you want, from clinical specializations, higher pay, increased flexibility, and more opportunities for growth and new experiences, such as travel nursing.

No matter what position you currently have in the nursing field, however, remember that you are serving a vital role for your patients. In the healthcare field, there is room for everyone to explore their passions and make a difference, from CNA to LPN to RN and beyond.

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