When Melissa Kessler— one of EdAssist’s academic coaches— first started working in nursing education, advancement was typically limited to just three specialties. It could be limited even more by what programs your local school offered.

While these specialties are still the most commonly pursued today, the rise of online education that no longer limits adult learners by geography alone has made a variety of MSN programs more accessible to nurses than ever before.

In this post, we’re going to talk about when you may want to consider advancing your career with an MSN and what different career options (including clinical and non-clinical roles!) are waiting for you on the other side.

Understanding your options: The big picture

You think you’re ready for the next step in your nursing career, but aren’t quite sure what direction to choose.

There are three main career tracks available with an MSN, in order of the least patient contact to the most: Administrative roles, clinical leader roles, and advanced practice nursing roles. Let’s discuss each of these options more closely.

Administrative roles

In administrative roles, you may still work in a hospital setting but the roles are largely non-clinical and require little (if any) bedside nursing.

MSN majors focused on administrative work can prepare you for the following careers:

• Nurse executive in administration
• Informatics
• Research
• Case management

These degrees typically require around 36 hours and little or no clinical requirements, making fully online programs an option.

If you’re looking for more business skills you could consider a dual degree program.  You can complete your MSN along with a Master of Business Administration (MBA) or Master of Healthcare Administration (MHA). Be aware that this will require significantly more credits, averaging about 55 credits.

Clinical leaders roles

Clinical leader roles allow you to remain engaged in patient care at a leadership level. This will have less direct patient contact compared to APRNs, but you’ll be more involved with patients or bedside nursing than you would be in most administrative roles.

Examples of potential roles include:

• Clinical nurse leader
• Patient safety and quality
• Nurse education
• Public health

Many MSN degree programs that lead to clinical leadership roles typically require around 36 credits. While some specialties include clinical components, these usually involve fewer than 150 hours. You can find fully online options, and if clinical requirements exist, they are often in the form of a capstone project, which can often be completed at your current workplace.

Advanced practice nursing roles

Advanced practice degrees are a great fit for those who love bedside nursing and want to work directly with patients.

Advance practice degrees can allow you to work in roles such as:

• Nurse practitioner
• CRNA
• Midwifery
• Clinical nurse specialist

APRN programs typically require at least 45 credits and 600 clinical hours. Most also require at least one trip to campus for a skill evaluation and experience working as a registered nurse in your desired specialty.

The Doctorate in Nurse Anesthesia (CRNA) is an outlier requiring full time attendance, generally on campus.  It is typically a 3 year program requiring nearly 2500 clinical hours for completion.

Degrees for administrative and clinical leader careers

There are a number of degrees that can help you pursue roles in both administrative and clinical leadership roles. Let’s review each and the types of career paths they can facilitate.

Education

If you enjoy teaching your colleagues new skills, nursing education might be your perfect fit— especially since there’s a current nursing educator shortage.

An MSN in Education prepares you for careers as a nurse educator in associate and baccalaureate nursing programs, as well as education positions in healthcare delivery systems. You'll help teach, build, and grow curriculum for students at colleges and universities, often working in simulation and leading clinical courses.

Most programs are about 36 credits, and many online programs don't require campus visits, though a capstone may be required. You can also obtain nurse educator certification through the National League for Nursing.

Where you can teach with an MSN depends on the program level. Many ADN programs welcome MSN-prepared educators for coursework and clinical precepting. With BSN programs, you could work in clinical and adjunct positions, but tenured faculty positions typically require a doctorate degree.

Patient Safety and Quality

If terms like "nosocomial infection" or "patient fall" make you want to jump into action, patient safety and quality might be your calling. This career path is designed for nurses who want to take leadership roles in improving patient care by reducing negative outcomes, ineffective treatments, and care plan variations.

You'll learn to analyze, manage, and improve healthcare systems, policies, processes, and services. The goal is identifying, developing, and implementing quality and safety interventions that improve patient outcomes.

Career opportunities include quality and patient safety coordinator, director of risk and quality, director of nursing, and patient safety officer.

Johns Hopkins University, Grand Canyon University, and Southern New Hampshire University offer this specialty, with credit hours varying from 36 at Grand Canyon to 48 at Hopkins.

Public health, population health, and community health

Interested in the bigger picture of healthcare? Public health, population health, and community majors focus on monitoring health trends, analyzing risk factors, and educating communities about health disparities.

This specialty may appeal to nurses interested in education since you'll have opportunities to implement community-based programs that positively impact health outcomes. The curriculum includes some informatics (great if you're having trouble choosing a specialty!), needs assessment, data analysis, program development, implementation, and evaluation. Leadership skills are also a key focus.

Graduates find employment in state and federal agencies, academic health centers, school health programs, global health initiatives, and as leaders in community-based, non-profit, and advocacy agencies.

Many programs allow you to specialize in vulnerable populations like geriatrics, infants, those experiencing poverty, or people with chronic illnesses.

Liberty University, University of Kansas, and Jacksonville State University offer online programs requiring 36-39 credits. A practicum or capstone is typically required.

Clinical nurse leader (CNL)

As a clinical nurse leader, you'll analyze healthcare systems and implement improvements to enhance patient outcomes. Your focus includes providing and managing direct care to patients, individuals, families, and communities. The AACN defines CNLs as specialists in care coordination, transitions of care, risk assessment and outcomes measurement, quality improvement, and team leadership.

The clinical nurse leader is a relatively new role in nursing, first being recognized in 2004. There are now over 100 MSN-CNL programs nationwide, with colleges continuing to add programs as they recognize the need.

CNLs work in various healthcare settings beyond just hospitals, including large medical groups, home care agencies, and outpatient clinics all benefit from this type of care manager.

Programs typically require 36 credit hours and include a practicum, so clinical hours are required.

University of South Alabama, Central Methodist University, and Western Governors University offer CNL programs.

Advanced practice registered nurse degrees

Advanced practice registered nurses, as previously discussed, have the most significant patient contact. This is also the highest level of licensure for nurses, and has four different certification options:

• Nurse practitioner
• CRNA
• Clinical nurse specialist
• Nurse midwife

Nurse practitioner overview program

Nurse practitioner programs tend to require around 45 semester credits, with 600-700 clinical hours. After completing your academic program, you will be required to pass a credentialing exam.

Specialties may include:

• Family nurse practitioner (FNP): Popular amongst APRNs, this generalist specialty focuses in family practice, internal medicine, women’s health, pediatrics, mental health, and gerontology.
• Adult gerontology acute care NP (AGACNP): Perfect for continuing your hospital career working with the adult population. Requires two years of Emergency, ICU, or Med-Surg experience.
• Adult gerontology primary care NP (AGPCNP): Provides primary care services to adults with acute and chronic illnesses in ambulatory care settings such as clinics, physician offices, home health, and rehabilitation settings.
• Pediatric specialties: Multiple options for child-focused care including Pediatric acute care (hospital-based) and pediatric primary care (outpatient). Dual programs available for certification in both.
• Women's health NP (WHNP): Provides care for women from puberty through adulthood including primary, gynecologic, and obstetric services. Ideal for those with labor and delivery, post-partum, or gynecology clinical experience.
• Psychiatric mental health NP: High-demand specialty providing psychiatric services across the lifespan from children to geriatric patients. Practice settings range from private practice to community health to inpatient care.

There are also postgraduate nurse practitioner certificates, which allow you to obtain an additional specialty. These certificate programs typically average around 25 credits and require about 500 clinical hours.

Certified Registered Nurse Anesthetist (CRNA)

If you're looking for the highest-paid APRN specialty, this is it. Certified Registered Nurse Anesthetists provide anesthetics to patients during surgical, diagnostic, and obstetric procedures. They're the sole anesthesia providers in many rural hospitals and serve as the main anesthesia providers for the U.S. Armed Forces.

This specialty comes with the most rigorous requirements of all APRN programs. You'll need ICU experience and must commit to a doctorate degree that is a full-time, three-year program that's either on-campus or hybrid. CRNAs accumulate nearly 2,500 clinical hours in their program.  A national certification exam is then required to practice.

Clinical nurse specialist (CNS)

Clinical Nurse Specialists provide leadership within their chosen discipline, focusing on patients, nursing practice, and organizational needs. This role blends teaching, care, and management in a unique way that sets it apart from other APRN positions.

CNSs are designed to identify gaps in healthcare delivery and implement interventions to improve care. They support bedside nurses and act as catalysts for change within healthcare organizations. You can specialize by age groups (like gerontology or pediatrics), practice setting (home health, critical care, rehabilitation), or focus on specific diseases or problems across age groups (such as diabetes or pain management).

The key difference between a CNS and a nurse practitioner: CNSs don't have prescribing authority and typically aren't providing direct patient care. Your specific role will be defined by the population you work with, your work setting, specialty focus, and the type of care you deliver.

Certified nurse midwife (CNM)

If you're interested in women's health, becoming a Certified Nurse Midwife might be your calling. CNMs focus on labor and birth, gynecologic care, and newborn care for women from adolescence through their senior years.

Your responsibilities would include annual women's health visits, family planning, gynecological services, and comprehensive care during pregnancy, childbirth, and postpartum. You can work in women's health and obstetrics practices, family practice clinics, or inpatient settings.

Most programs require at least one year of clinical experience post-BSN, with many requiring specific labor and delivery experience. The University of Cincinnati offers a 57-credit online program requiring 784 clinical hours with just two onsite visits.

Graduates are eligible to sit for the American Midwifery Certification Board (AMCB) exam to become certified.

Choosing the advanced degree program that’s right for you

When you’re choosing which MSN or other degree program is best to advance your nursing career, there are a few things to keep in mind.

Getting clinical hours

When it comes to getting the clinical hours you need to complete your degree, there are a few things to keep in mind:

• Your school can likely provide you a list of preceptors in your area.
• You can reach out to your facility’s education department.
• You can also request the school certify someone at your facility if they’ve acted as a preceptor before.

Oftentimes, a combination of these three tactics can help you get the number of clinical hours you need to meet your program’s requirements.

Job market considerations

When choosing your MSN specialty track, it’s also helpful to think about the current job market.

Which positions are currently in-demand? Increasingly, hospital systems are encouraging prospective nurse practitioners to consider specialties outside of an FNP focus. It’s worth noting, of course, that a versatile FNP program can complement your clinical experience and help you find a position suited for your interests.

If you have years of cardiac experience, for example, and want to work with children and adults, the FNP option might be a fit for you. Or, if you want to work in dermatology, an FNP is also a great choice— just make sure you do some clinical hours in a dermatology practice.

You also should consider which may require you to relocate? If you choose to get a degree in a specific type of research, for example, you may need to relocate to an organization that’s working on clinical trials.

Finally, it’s important to determine if you want to remain with your current employer. They may outsource informatics work to a third-party, meaning they wouldn’t have jobs available to hire you for. Or, if you’re considering becoming a nurse educator, it’s worth nothing if their education department is small with no signs of any full-time team members leaving soon.

The MSN vs. Doctorate debate

If you have specific career goals in mind, it may be a good idea to determine if you want to start with an MSN or go directly to a doctorate degree.

Currently, there is an ongoing debate about whether nurse practitioners (NPs) should be required to earn a Doctor of Nursing Practice (DNP) degree. While the American Association of Colleges of Nursing (AACN) and the National Organization of Nurse Practitioner Faculties (NONPF) have recommended transitioning all NP programs to the doctoral level by 2025, this is not yet a universal requirement for licensure.

Many programs still offer MSN pathways, though the trend is shifting toward doctoral preparation.

In contrast, Certified Registered Nurse Anesthetists (CRNAs) are required to earn a doctoral degree to enter the profession starting in 2025. Master's-level CRNA programs are no longer accepting new students, and all new CRNAs must graduate from a doctoral program such as the DNP or DNAP. However, CRNAs who were certified before this change will be grandfathered in and can continue practicing without returning to school.

So, if you’re planning to become a nurse practitioner or CRNA, it’s worth considering whether you’d prefer to complete a doctoral degree now—especially if you don’t anticipate wanting to return to school later in your career.

Determining which specialty is right for you

When choosing between the specialties, asking yourself these questions can be helpful:

• What am I most interested in?
• Do I love patient care and want to advance your skills?
• Are you interested in teaching others?
• Do you want to have an impact on hospital or practice management?
• What kind of work-life balance and work schedule do I want?

If you want to continue working directly in bedside nursing, you may want to consider an APRN program. And if you’d rather focus on creating safe environments for patients behind the scenes, a clinical leadership role in patient safety and quality may be a better fit.

And there’s good news: If you choose to become an APRN and ten years down the road you want to work in a different role, there are always post-master’s certificates that can help you change your specialty. There’s also the option to get a doctorate degree.

When in doubt, you can book a consultation with EdAssist’s academic coaches. They can help you review your goals, your current education, and your situation to determine which degree program is best for you.