Your Nursing Career Ladder

A nursing career is an ongoing and continual project of self-discovery, skill mastery, and professional and personal development. A nurse can choose to get comfortable in a niche and drill down into everything that that area of specialization has to offer; she can also choose to diversify her career trajectory and branch in novel directions when the time is right. It is an individual journey.

There Is More Than One Ladder

Those with myopic vision might only see one ladder to nursing success: a med/surg job right out of school, followed by a clinical pathway that encompasses what seems to be the best course for the achievement of clinical expertise. This particular ladder may feel perfectly amenable to some nurses, and wholly stifling to others. For some, the traditional nursing career path may feel like a veritable professional straightjacket.

Some nurses choose to pursue paths that are less “nursey” (e.g.: psych nursing, nursing education, research), areas that do not necessarily require hard clinical skills. Not every nurse will fit in the med/surg mold, and some will chart a course that differs greatly from that of their nursing school peers.

Particular nurses may enter school with a vision of their career path, only to be distracted from their well regarded plans by a newly discovered passion or interest. A nursing student sure of her desire to work in the emergency department in preparation for becoming a flight nurse changes her mind when she has her first hospice assignment. Another student had no previous desire to work in a hospital setting but then falls head over heels in love with peri-operative nursing.

There is no one-size-fits-all nursing career ladder; a nursing career can be idiosyncratic and differentiated from the normal ways of moving forward as a professional nurse.

The Pressure to Conform

There can be great pressure to conform in both nursing school and the profession itself. The gold standard of a med/surg job right out of school is not always attainable, and some novice nurses are crestfallen when they cannot fulfill what they have been told is an absolutely essential right of passage in order to become a “real” nurse. The reality could not be further from the truth.

Conformity to what some say is the common nursing career path may be perfectly acceptable for some; in fact, there are many nurses who absolutely thrive making such choices, easily finding their niche and their comfort zone along that trajectory. This is as it should be.

For others, a career outside of the clinical/hospital nursing box is what calls them; educators, researchers, nurse entrepreneurs, and nurses who open businesses and leverage their skills in novel ways. Coming from another career, nurses can combine a previous MBA with a BSN, or marry a former career as a social worker with that of a nurse care manager in the outpatient setting.

Nurses have so much to choose from, and the straight and narrow path cannot work for everyone.

Build Your Own Ladder

Nurses, you can build your own ladder by creating your own definition of what it means to be a successful nursing professional. Earning your BSN may feel right, and once that goal is achieved, an unusual path may open in the field of functional medicine, holistic health, or perhaps a path to becoming an acupuncturist. This career ladder is yours to create; you are not beholden to use one that was constructed for you.

Seeking another degree should be a means to an end, not something that you pursue because you’ve been told you “should”. Yes, many doors may be closed to you without a BSN, so by all means earn that BSN if it will take you where you need to go. In fact, a PhD or MSN may be absolutely essential to fulfill your heart’s desire as a nurse; or perhaps not.

Construct a satisfying nursing career based on due diligence, prudent research, career savvy, and a dose of inspiration and intuition. Consider the advice and counsel of others, but remember to also listen deeply to your own desires and aspirations. Whether you follow a tried and true nursing career path, or a path that’s innovative and revolutionary, the choice is yours. Build your own career ladder, and enjoy the climb.

About Keith

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Keith Carlson is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, speaker, author, and popular career columnist.

With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s two podcasts, RNFM Radio and The Nurse Keith Show, offer inspiration and practical support to nurses seeking to create meaningful, satisfying lives and careers.

Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. Keith can be found on many social media platforms, as well as at