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Understand the Nursing Hierarchy in Hospitals

Understand the Nursing Hierarchy in Hospitals

More than four million nurses work in the United States, constituting the bulk of healthcare team personnel. Nurse hierarchies exist across different levels, each uniquely contributing to patient health and outcomes.

Aspiring nurses rely on factors like nursing education courses, training, specialized clinical skills, and credentials to progress upward within their nursing hierarchy in hospital.

Basic Nursing Positions

Nursing’s hierarchy or nursing hierarchical structure begins with certified nurse assistants (CNAs) and licensed practical nurses (LPNs).

Certified Nurse Assistants, or CNAs

CNAs, monitor and record vital signs, such as blood pressure, temperature, and heart rate. In addition, CNAs assist patients in daily activities like bathing and eating, as well as standing or sitting when necessary. Certified nurse assistants work in hospices, hospitals, or long-term care facilities. Accredited LPN programs from community college is the first choice of every nursing students to become a CNAs.

To become a Certified Nursing Assistant (CNA), one must possess either a high-school diploma or GED and complete an accredited CNA program, typically lasting 12 weeks or less.

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Licensed Practical Nurses

LPNs perform clinical duties like changing bandages and treating wounds. LPNs work in hospices, healthcare facilities, and hospitals or clinical sites.

Becoming an LPN doesn’t require a nursing degree; however, you must complete practical prerequisite courses and pass the NCLEX-PN exam.

CNAs or LPNs may enter nursing at an entry-level, unlike vocational nurses with associate’s degrees or bachelor’s in nursing degrees. CNAs/LPNs must pass the NCLEX and obtain licensure as registered (RN) nurses in each state where they plan to clinical practice in healthcare settings. To become a licensed practical nurse, students can enroll in best nursing colleges in illinois.

Nurses with Advanced Nursing Experience

Charge Nurses

Charge nurses are experienced RNs with enough leadership skills ability to assume management responsibilities for an entire nursing department or team. As charge nurses, their primary objective is to supervise other care giver within their division and delegate responsibility accordingly, ensuring high standards of safety and quality are upheld; some may also devote part of their practice directly towards direct patient care.

Charge nurse duties encompass:

  • Supervise nursing staff
  • Manage patient admissions and discharges.
  • Coordination between doctors and administrators
  • Verify Health and Safety Compliance (OHSA)
  • Staff mentoring and training.


Advanced Practice Registered Nurses, or APRNs, possess an advanced degree that allows them to work independently and provide basic care to patients. Nurses looking to become APRNs could earn either a Master of Science in Nursing (MSN) degree or a Doctorate of Nursing Practice (DNP).

Nurses Serving in Leadership Positions

Employers of nursing staff often search for nurses with clinical experience and communication skill & critical thinking skill, along with comprehensive training. Employers seek leaders at the top of the nursing hierarchy in hospital settings with multiple leadership roles with gtraet leadership experience.

Nurse Managers

Nurse managers usually work in large evidence-based practices or hospitals, supervising a team of nurses. Most nurse manager positions require at least a master’s degree and several years of hands-on experience working within various clinical settings or departments.

  • Nurse supervisor responsibilities typically include:
  • Managing nursing department operations
  • Budgeting and evaluating nurse performance.
  • Avoiding escalated situations in patient care
  • Safety regulations and facility policies

Nursing Directors

Director of nursing: A director of nursing usually heads the nursing department in large hospitals or practices. Most directors possess either a DNP or MSN degree to demonstrate their expertise.

Nurse Directors perform various responsibilities that include:

  • Nurse recruitment and hiring: a challenge
  • He is overseeing nursing staff professional development.
  • Budgeting
  • Scheduling Nursing Shifts

Overseeing Compliance LPN Can Assist in Climbing the Nurse Hierarchy

All levels of the nursing hierarchy–nurses and nurse leaders alike–play an essential part in creating positive patient experiences.

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Nursing degrees are essential for those aspiring to advance their nursing careers. Verve College’s practical nursing program pathway, with preparation for the NCLEX-PN licensure exam, offers an accelerated route for nurse leaders seeking to make significant strides in patient care and healthcare processes.