The ADN Career Ladder

Currently working as an RN and interested in moving up the ranks? The ADN career ladder can take one of several paths. Some hospitals have a formalized career ladder that allows nurses to progress from level to level through some combination of education, experience, and accomplishment. These levels may replace a number of traditional job titles. At Sarasota Memorial Health Care System, for example, registered nurses are classified as Levels 1 – 4. How long it takes to get to Level 4 depends partly on education. An ADN nurse needs at least twenty years’ experience to get there; a nurse who earns a BSN along the way can get there with as few as ten years’ experience. Education and experience are not the sole determining factors; in order to move up the career ladder at Sarasota, nurses must earn national certification in their specialty, complete required contact hours, and do committee work or qualifying projects.

In some settings, advancement is less formalized. Nurses may apply for various positions and roles and compete with one another on merit. Success can mean a significant salary increase. In some cases, many factors are considered – the final decision is at the discretion of the manager. Other positions, though, require a higher degree. Magnet hospitals face quotas with regard to the education level of nurse managers. The following is a look at educational options and the careers they can lead to.

BSN Completion

Degree completion programs may be termed RN to BSN or ADN to BSN. They follow curriculum guidelines put forth by the American Association of Colleges of Nursing. Courses in the nursing major teach advanced health assessment, evidence-based practice, population level health, informatics, and leadership. There are generally a few general studies requirements as well. Programs may require classes in critical thinking, composition, statistics, and/or cultural competency. There are often a few electives.

The BSN is the minimum degree for nurse managers in many settings. When hiring for case manager positions, employers often want to see a BSN as well as experience. The BSN is often preferred for new hires on the floor as well; this depends on geographic location and hiring philosophy as well as on current economy. The AACN has reported that higher degrees are an asset during economic downturns.

Some ADN nurses see the BSN more as a step stone than a final destination. Once a nurse has a baccalaureate, she’s only one program away from a doctorate – and licensing as a nurse practitioner.


Some RNs choose to go straight from an ADN to a master’s. There are a number of RN to MSN programs that will accept students who currently hold an associate’s; some allow the candidate to earn a BSN en route to a master’s. At the master’s level, nurses have more opportunities to specialize. Many advanced practice nursing programs have transitioned from master’s level to doctorate level (motivated by a strong call to action on the part of the AACN and other organizations like the Institute of Medicine). There are, however, some that are still offered at the master’s level.

Other nurses pursue MSNs to prepare for administrative or coordinative roles. Nurses can choose to specialize in diverse areas, from infection prevention to organizational leadership. (Some premier hospitals do prefer master’s level candidates for higher level nursing management positions.) Another popular specialization is informatics. Nurses become technological experts; some serve as liaisons and educators while others participate in software development. Clinical nurse leader is a relatively new master’s degree program. It prepares nurses to be care coordinators and horizontal leaders. Certification as a CNL is sought by some employers.