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New Nurse Graduates / NCLEX-RN vs. NCLEX-PN

Now that you’ve graduated from nursing school, there’s one last obstacle between you and your dream job: the National Council Licensure Examination or NCLEX.

The NCLEX is the final step to earning your nursing license. New grads and nursing schools refer to the this as “the board exam” because every state in the US requires nurses to pass this test before applying to the state board of nursing. There are two versions of the NCLEX that are called the NCLEX-RN and the NCLEX-PN. 

The NCLEX-RN is for registered nurses and NCLEX-PN is for licensed practical nurses or licensed vocational nurses.

Let’s look closer at each test and how to prepare for this final part of your journey.

• What is the NCLEX exam?
• What is the NCLEX-RN exam?
• What is the NCLEX-PN exam?
• What are resources for test-takers?

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What is the NCLEX exam?

The NCLEX exam is a 5-hour timed, computerized adaptive test (CAT). It is designed to test the entry-level knowledge, skills, and abilities required to provide safe, effective nursing care. NCSBN updated the test design in October 2020 to improve exam efficiency.

Each exam is unique because questions adapt to the test taker. The next item will be easier when the examinee marks a question wrong. Conversely, the next will be harder when the right answer is chosen. Questions consist of multiple-choice, fill-in-the-blank, and drag-and-drop items.

After completing a nursing program, graduates must pass one version of the NCLEX (RN or PN) to obtain a nursing license.

What is the NCLEX-RN exam?

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the test nursing graduates must pass to be licensed as a Registered Nurse. It is offered by the National Council of State Boards of Nursing (NCSBN).

Educational Requirements

To take the NCLEX-RN, you must have:

• High school diploma or equivalent
• Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN)

The NCLEX-RN is more advanced and requires more education. Most ADN programs require 18-24 months, while BSN programs take 3-4 years to complete.

What is the NCLEX-PN exam?

The National Council Licensure Examination for Practical Nurses (NCLEX-PN) is the exam required to obtain a license as a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). LVNs and LPNs are equal, with different state-specific titles.  

Educational Requirements

To sit for the NCLEX-PN, you must have:

• High school diploma or equivalent
• Graduation certificate from a board-approved practical nursing program

Most practical nursing certificate programs require one year of education.

What are resources for test-takers?

Whether you’re taking the NCLEX-RN or the NCLEX-PN, you probably wonder how you should prepare. You will likely spend most of your time preparing for this final test from the last semester of nursing school to graduation. Here are a few helpful resources.

Nursing School

The first place to look for NCLEX test prep is at your nursing school campus. Most nursing programs offer help to their students. You can find practice tests, seminars on test-taking, and even free study guides. Always check with your school first!   

Online Practice Tests

Another method to prepare for the NCLEX are practice tests. The official NCLEX practice exam gives candidates two full exams similar to the real thing. If you’re looking for budget-friendly resources, many test-prep companies, like Kaplan Nursing and Union Test Prep, offer free practice tests.

Printed Study Guides

NCLEX books are great for independent study. For visual learners, printed study guides are the way to go. Nursing graduates order books in print or access digital copies on mobile devices. Most guides contain full-length tests, detailed explanations, study plans, and practice questions. 

Mobile Apps

Busy nursing graduates studying on the go should check their app stores. You can use every spare moment to prepare for the test by taking practice questions on your smartphone or tablet. NCLEX Mastery has a mobile app for study. A monthly subscription costs $20-30. 

Next Steps

Now that you’re ready to take the NCLEX-RN or the NCLEX-PN, it’s time to apply through your state nursing board. You must send proof of education with your application. When the state board approves your application, they will send an Authorization to Test (ATT), which allows you to schedule your exam appointment.

All your test preparation and hard work will finally pay off when you pass the NCLEX. Then it will be time to celebrate your achievements and start looking for that dream job! 

Nurses can find help with job searches in Incredible Health’s Nursing Career Resource Center.

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Sources

• “Computerized Adaptive Testing (CAT)”. ncsbn.org. Accessed March 22, 2022.
• “NCLEX Mastery”. nclexmastery.com. Accessed March 22, 2022.
• “NCLEX Practice Exam Commercial”. youtube.com. Accessed March 22, 2022.
• “NCLEX RN On Demand Practice Test”. kaptest.com. Accessed March 22, 2022.
• “The Accuracy of State NCLEX-RN Passing Standards for Nursing Programs.” sciencedirect.com. Accessed March 22, 2022.
• “2022 NCLEX Candidate Bulletin”. ncsbn.org. Accessed March 22, 2022.
• “Union Test Prep”. uniontestprep.com. Accessed March 22, 2022.

Nurse Types / Staff Nurse vs. Travel Nurse

Transitioning from a staff nurse to a travel nurse position can be quite an adjustment. Thanks to increases in pay and other perks, travel nursing is in more demand than ever. Some travel nurses can make $5,000 per week!

If you’re a Registered Nurse (RN) looking for new opportunities, exploring travel nursing is a great idea. You can boost your earning potential without needing additional schooling. It’s a smart way to maximize your education and experience.

Still on the fence about which career move is right for you? In this article, we explore:

• Three differences between staff and travel nursing
• Pros and cons of staff nursing
• Pros and cons of travel nursing

What are 3 differences between staff nursing and travel nursing?

There has never been a better time to be a nurse. Projections for nursing indicate a 15% growth for this healthcare profession between now and 2026. That’s much faster than the national average for all other occupations.

Travel nursing and staff nursing both use the skills you’ve acquired as a licensed RN. That’s where the similarities end. Each has its own set of pros and cons, commitment to a specific facility, and pay. Let’s take a deep dive into both for a more comprehensive review of what you can expect from each opportunity.

Benefits

If stable benefits are important to you, then staff nursing positions should be your priority. Full-time, permanent positions with healthcare employers typically come with perks such as medical insurance, 401(k)s, and other retirement plans, plus paid time off.

Benefits for travel nursing jobs can be less enticing. Some travel nurse agencies offer sick pay and 401(k)s but rarely provide paid time off. Sometimes the difference in pay can offset the loss of benefits, but not always. It’s worth weighing the pros and cons before choosing.

Commitment to a Facility

When you work as a staff nurse for a healthcare employer, you must commit fully to that position. It is permanent, leaving little wiggle room for new adventures. This can be both a pro and a con of staff nursing positions.

Choosing to work as a travel nurse offers greater flexibility. Commitments can be as short as 4 weeks or longer than 26 weeks, depending on the need. The downside to such short stints is you can always feel like the “new guy” as you bounce from one place to the next.

Pay

Without a doubt, higher pay is one of the many reasons RNs choose travel nursing jobs. Pay is significantly higher for travel nursing when you combine hourly pay, tax-free stipends for meals, and housing.

If you’re smart about negotiating, you can get free housing or a monthly stipend to put toward your room and board. Since these kinds of perks are tax-free, any money left from your housing stipend does not count toward your earnings.

But you could also end up paying for housing twice: where you work as a travel nurse and for your “tax home.”

Some travel nursing agencies eager to recruit top talent toss large sign-on bonuses into their job offers. You can expect to be tempted by bonuses ranging between $5,000 and $10,000 or higher!  

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What are the pros and cons of staff nursing?

If you’re trying to decide whether staff or travel nursing opportunities are right for your nursing career, creating a pros and cons list can help.

What are the pros and cons of travel nursing?

Just like there are pros and cons of staff nursing, travel nursing has its fair share of advantages and disadvantages. Review and add to this list of pros and cons for travel nursing to help you decide if it’s the right move for your nursing career.

What are your next steps?

Only you can decide whether staff nursing or travel nursing jobs are the right moves for your career. If you’re adventurous and interested in earning top wages, travel nursing can be a great opportunity to satisfy both. If security and seniority are more important to you, then staff nursing should be a top consideration.

Incredible Health provides RNs with career leads for staff nursing positions. Check out our jobs board to get the latest scoop on openings. Whichever path you choose, you’ll be a valuable part of the healthcare system. 

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Sources

• “Nurses Have Finally Learned What They’re Worth.” nytimes.com. Accessed March 8, 2022. 

• “Occupational Outlook Handbook-Registered Nurses.” bls.gov. Accessed March 8, 2022. 

Photo by Studio Michael França on Unsplash

Working in a doctor’s office can be a great opportunity for nurses who want a calmer environment with consistent scheduling. Nursing positions can offer you a better work-life balance than you’ll find in some other nursing environments. That’s part of the reason why there’s so much competition for these nursing roles.

In this article we explore:

• Pros and cons
• Nursing positions
• Jobs roles
• Work environment 
• A typical day on the job
• How to get hired
• Salary range for RNs

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Pros and cons

There are pros and cons to working in a doctor’s office. Before you make the switch from where you work now, make sure the work environment fits your personality and career goals.

Nursing positions

Doctors’ offices employ Licensed Practical Nurses (LPNs), Registered Nurses (RNs), and Nurse Practitioners (NPs). Each nursing position requires a different level of education and has unique responsibilities. 

An LPN can expect varying duties depending on the size and scope of the practice. Some of the most common responsibilities include:

• Documenting patient medical history
• Measuring and recording vitals (blood pressure, temperature, weight)
• Performing administrative tasks (filing medical records, setting appointments)

RNs are tasked with:

• Coordinating patient care with LPNs, technicians, and any other medical professionals 
• Completing patient exams
• Explaining lab and other rest results 
• Treating minor injuries 

Unlike an LPN, you can offer more advanced assessments and patient counseling.

As an NP, your role depends on your state of practice. Some state licensing boards allow you to provide many of the same services as a doctor, including:

• Completing patient exams
• Explaining lab results
• Treating minor injuries
• Prescribing medication

Checking with your state licensing board for the nursing scope of practice is the best guide for determining your responsibilities in this setting. Make sure you are aware of all nursing license information.

Job roles

Where you work within the nursing career ladder in a doctor’s office dictates your duties and responsibilities. You’ll have a different role as a front office nurse from those assigned to direct patient care.

As a front office nurse, you’ll mostly conduct appointment check-ins, discharges, referrals for specialists, and scheduling appointments. You’ll be tasked with answering emails and phone calls from patients and determining how to handle their questions.

If you work in the back end of the doctor’s office with direct patient care, you can record patient vitals and explain care instructions to patients.

Your exact role and duties as a doctor’s office nurse depend on your supervisor and the state of practice. Job descriptions should give you a good idea of what you can expect in the position should you be hired.

Work environment 

If you’re used to working in a hospital, switching to a doctor’s office can be quite an adjustment. The hectic pace you endured in a hospital setting doesn’t carry over to a doctor’s office. That’s one of the many perks.

When you work in a doctor’s office, you also can expect a more predictable schedule. Most doctors’ offices operate between 9 a.m. and 5 p.m., Monday through Friday. Some may open earlier or close later on certain days of the week. For the most part, you always know your routine and can plan your personal life around it.

A typical day on the job

A typical day in a doctor’s office can be boring or exciting. Depending on the practice, you might see patients with the same issues every day.

While emergencies arise, they are rare in doctors’ offices. If you like interacting with many people throughout the day in a non-emergency setting, then you have the opportunity to do so in this environment.

How to get hired

Getting hired can be competitive because some nursing professionals desire the kind of predictable, daytime hours these positions offer. That’s the first step is to have the education and experience for the nursing position advertised by a doctor’s office. 

Once you verify you meet minimum education and experience qualifications, you’ll want to craft a killer nursing cover letter and resume to get yourself noticed.

Salary range for RNs

The salary range depends on location and nursing position. Most job descriptions list the salary schedule. If they don’t, you can ask about starting salary during your interview. Most RNs at a doctor’s office make between around $78,000 depending on the position. NPs make more money because of their level of expertise. 

If you want to explore nursing salaries for doctor’s offices in your state of practice, you can use the Incredible Health Nurse Salary Estimator to get an estimate for your location and nursing specialty.

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Sources

• “State Practice Environment.” aanp.org. Accessed March 22, 2022.
• “The Average Pay for a Nurse in a Doctor’s Office.” careertrend.com. Accessed March 22, 2022. 

Nurse Types / Nurse Midwife

In the United States, nurse midwives attend approximately 8% of births. In the UK and other countries, they attend up to two-thirds of births. The need for nurse-midwives is growing in the United States. The Bureau of Labor and Statistics reports that the projected growth rate for nurse-midwives in the United States will be 40% from 2021 to 2031.

For individuals who are passionate about caring for pregnant mothers and helping with the labor process, this is the perfect role. Nurse-midwives will play an important role in healthcare for years to come. In this post we will explore the following: 

• What is a nurse midwife?
• What does a nurse midwife do?
• What are the different types of midwives?
• How do you become a nurse midwife?
• How much do nurse midwives earn?

What is a nurse-midwife?

A nurse-midwife is an advanced practice registered nurse (APRN) who provides care for women throughout the reproductive process from preconception to delivery. 

Though they specialize in the reproductive process, they are also equipped to handle primary care and other gynecological services for women as well. 

What does a nurse-midwife do?

Nurse-midwives work mostly in hospitals within the United States, but some work in community clinics, birthing clinics, or directly with the patient in their homes. 

Regardless of where they work, they have the same duties across the board. 

The primary duties of nurse-midwives include: 

• Provide reproductive assistance to women
• Assist women with gynecological issues
• Treat both men and women for sexually transmitted diseases
• Help teach new moms how to breastfeed and care for their babies 
• Provide labor and delivery support to physicians

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What are the different types of midwives?

There are five different types of midwives in practice within the United States. The majority of practicing midwives receive accreditation through the North American Registry of Midwives or the American College of Nurse-Midwives. 

Certified Nurse-Midwife

A midwife who is also trained as a registered nurse. Nurse-midwives need a Bachelor of Science in Nursing and a Master’s Degree in Midwifery. They receive certification from the American College of Nurse-Midwives. 

Certified Midwife

A person who receives training in midwifery. They must have a graduate degree in midwifery. However, they are not a nurse. Every state licenses CNMs for independent practice, while not all states license CMs. Additionally, CMs receive certification from the American College of Nurse-Midwives. 

Certified Professional Midwife

An individual who has met the certification requirements of the North American Registry of Midwives (NARM). To take the NARM exam, prospective CPMs can either take on an apprenticeship with a midwife and complete an Entry-Level Portfolio Evaluation Process or graduate from a midwifery program. 

Direct-Entry Midwife

A person who mostly performs births at home and birthing centers. They are trained in many different ways including apprenticeship, self-study, midwifery school, or a college/university program. There isn’t official national certification for direct-entry midwives. Many direct-entry midwives are self-employed. 

Lay Midwife

An individual who is unlicensed and uncertified. They are generally self-taught or undergo an apprenticeship. 

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How do you become a certified nurse-midwife?

For the purposes of this post, we are going to focus on how to become a certified nurse-midwife. The process may feel intimidating, so here’s a step-by-step guide. 

Step 1: Earn a Bachelor of Science in Nursing 

The first step toward becoming a certified nurse-midwife involves earning a Bachelor of Science in Nursing (BSN). Most people earn their degree within four years, however, there are accelerated programs available to help individuals earn them sooner. It’s important to ensure that the school is accredited by the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. 

Step 2: Become a registered nurse 

To become an RN, one must take and pass the NCLEX-RN exam. Nurses must also apply for RN licensure in their state. The qualifications for licensure vary depending on the state. Most states do require that nurses have English proficiency, sound moral character, no felony record, and sound physical/mental health. 

Step 3: Gain experience

Many graduate programs require nurses to have accumulated 1 to 2 years of experience working as registered nurses. While working as a registered nurse, it’s recommended that one find a specialization adjacent to midwifery. For example, working in the neonatal intensive care unit is a great opportunity for a prospective midwife. 

Step 4: Graduate from an accredited MSN or DNP program 

Once an RN has worked for a couple of years and gained the appropriate experience, they are ready to apply to a graduate program. One must choose a program that has a midwifery specialty. Most nursing programs require students to possess a bachelor’s degree in nursing for admittance. A master’s degree can take up to 3 years to complete, while a doctoral degree can take up to 4 years (both in addition to a BSN which can take up to 4 years). There are bridge programs that can help accelerate time spent in school:

• Bachelor of Science in Nursing (BSN) – up to 4 years
  BSN-to-MSN bridge program – about 2-3 years 

• Master of Science in Nursing (MSN) – up to 6 years
  RN-to-MSN bridge program – about 2 years

• Doctor of Nursing Practice (DNP) – up to 8 years
  BSN-to-DNP bridge program – about 3-4 years
  MSN-to-DNP bridge program – 1-2 years

Step 5: Receive certification and licensure

After graduating from an accredited MSN or DNP program, the next step is obtaining certification and licensure. The American Midwifery Certification Board provides nurses with the CNM credential. Nurses must also receive licensure from the state they live in. Each state has different requirements for licensure. 

How much do nurse midwives earn? 

Nurse midwives earnings depend on a variety of factors such as location, experience, and education. However, according to the BLS, the mean annual wage for nurse midwives is $114,210 per year. 

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