Understanding the Different Types of Nursing Jobs and Corresponding Compliance Issues – Part One

There are many different types of nursing professions. Each different type has specific academic and licensing qualifications. There are numerous federal and state regulations that govern nursing practices generally and each type of nursing profession specifically.

We’ve previously discussed many of the different types of compliance issues that nurses need to consider. This sequence of articles (there will be two additional parts) begins with identifying the different types of nursing jobs. We’ll also discuss the different types of nursing business opportunities. We’ll then discuss some of the leading concerns that nurses (all nurses and nurses with specific specialties) need to review with an experienced healthcare lawyer. We’ll finish by explaining how a Managed Service Organization (MSO) can help address some of these compliance issues.

Here’s a recap of some of our more recent nursing profession compliance articles:

• 7 Reasons Why Nurses Lose Their License
• Nurse Entrepreneur: How to Tackle Legal Challenges of Owning a Medical Spa or other Healthcare Business
• Nurse Practitioner Telehealth Functional Medicine vs. Coaching (Laws & Legal)
• Can an ND Supervise Nurse IV Injections?
• Medical Spa Laws Detail Physician vs. Nurse Authority
• California Assembly Bill (AB)-890 and Two New Nurse Practitioner Categories
• Do California Nurses Need a Collaborating Physician?
• California’s New Scope of Practice Law for Nurse Practitioners – Part One
• California’s New Scope of Practice Law for Nurse Practitioners – Part Two
• How to Use a Management Services Organization for Profit if you’re a Doctor, Nurse, or Entrepreneur

What are the different types of nursing practices?

Some of the main types of nursing professions in California and across the country from the lowest level to the highest level (based on education and skill requirements) are the following. The degrees and job duties are listed. Most of the nursing jobs also have various licensing and credential requirements.

1. Certified Nursing Assistant (CNA). The job requires completion of a state-approved training program. The job duties include helping patients with daily living tasks, obtaining vital signs, responding to patient calls, and helping with some medical procedures.
2. Licensed Practical Nurse (LPN).  LPNs must complete a practical nursing certificate program which normally takes about a year to finish. The job duties include helping with eating, drinking, bathing, and other types of essential care; taking a patient’s blood pressure; recording vital signs; and inserting catheters.
3. Registered Nurse (RN). RNs must have an RN (Registered Nurse), BSN (Bachelor of Science in Nursing), or an ADN (Associate Degree in Nursing) diploma. The job duties include administering medicines and treatments, collaborating with other healthcare professionals, educating patients and families on diseases, and other duties.
4. Labor and Delivery. This job requires an ADN or BSN degree. Job duties include timing contractions, monitoring the vital signs of the baby and mother, administering medications, helping in the labor process, and identifying and assisting with complications.
5. Pediatrics. An ADN or BSN degree is required. The job duties include administering medications and vaccines, creating nursing care plans, helping with tests and procedures, and other tasks.
6. Neonatal ICU Nurse.  ADN or BSN degree. This nurse treats critically ill newborns, calms distressed babies, and many other newborn essential tasks.
7. Oncology nurse.  ADN or BSN degree. Jot duties include chemotherapy and administration of other medications, caring for patients after cancer surgeries, developing care plans, and performing assessments.
8. Emergency Room Registered Nurse. An ADN or BSN degree. The ER registered nurse administers medications, vaccines, and blood products. This nurse also sets broken bones; cleans and dresses wounds; aids in trauma, stroke, and cardiac arrest; and provides sexual assault care.
9. Intensive Care Unit (ICU) Registered Nurse. An ADN or BSN degree. The ICU registered nurse evaluates vital signs, administers drugs, responds to medical emergencies, cleans and bandages wounds, and performs many other job duties.
10. Surgical Registered Nurse. An ADN or BSN degree. This nurse helps in different phases of surgery. There are different types of surgical registered nurses.
11. Operating Room Registered Nurse. An ADN or BSN degree. This nurse prepares operation room equipment, monitors patients during operations, helps the surgeons during the operation, and provides “pre and post-operative patient care and education.”
12. Post-Anesthesia Care Unit (PACU) Registered Nurse. ADN or BSN degree. The job duties include “diligently monitoring patients as they come out of sedation and taking immediate action if there are any complications.”
13. Trauma Registered Nurse. The job duties include caring for patients with injuries from serious events such as car accidents or shootings, providing CPR, providing IVS and medications, and administering blood products.
14. Nurse Practitioner. A Master of Science in Nursing (MSN) is required. The job assignments vary depending on the type of NP specialty. NPs generally “prescribe medication, examine patients, order diagnostic tests, diagnose illnesses, and provide treatment.”
15. Certified Nurse Midwife (CNM). An MSN from a CNM program is necessary. CNMs “deliver babies, provide prenatal and postpartum care, perform routine check-ups for pregnant patients, perform annual exams, prescribe medications, and offer patient education.”
16. Certified Registered Nurse Anesthetist (CRNA). The education requirements are “current – MSN, DNP, or DNAP from a CRNA program. By 2025 – DNP or DNAP from a CRNA program.” Job duties include “caring for patients under anesthesia, identifying patient risks, administering anesthetic and patient medication, and educating patients and families.”
17. Clinical Nurse Specialist (CNS). This job requires an MSN from a CNS program. Job duties include helping with “evidence-based practice projects and research, education, transitional care, and assisting other nurses with patient care.”
18. Nurse Educator.  This nurse must have an MSN from a nurse educator program. The job duties include preparing lesson plans, teaching, oversight of student clinical practice, maintaining clinical competencies, and student mentoring.
19. Nurse Administrator. This nurse has an MSN with a focus on business and administration. Job tasks include management of daily nursing operations, preparing budgets, preparing staff schedules, hiring new nurses, and other tasks.
20. Clinical Nurse Leader (CNL). This job requires an MSN from a CNL program. A CNL is a patient and family advocate who coordinates and delegates patient care, provides mentoring, is an administration liaison, and educates the staff about new procedures and policies.

A few other nursing jobs include Advanced Practice Nurses (APN), Advanced Practice Registered Nurses (APRN), and Advanced Registered Nurse Practitioners (ARNPs). These jobs generally require additional education and additional clinical experience.

In California, Assembly Bill 890 was signed by Governor Gavin Newsom in 2020. The law creates two new categories of nurse practitioners – who can function “within a defined scope of practice without standardized procedures.”

• 103 NP. This category of nurse practitioner works based on the criteria set forth in Business and Profession Code Section 2837.103. “This NP works in a group setting with at least one physician and surgeon within the population focus of their National Certification.”
• 104 NP. This category of nurse practitioner works based on the criteria set forth in Business and Professions Code Section 2837.104. “This NP may work independently within the population focus of their National Certification.”

Other nursing specialties focus on gerontology, public health, informatics, mental health, rehabilitation, and other practices.

Nurses can work as contractors, employees, sole proprietors, in partnerships, as corporations, S corporations, and limited liability corporations (LLCs) – subject to certain laws and regulations – which we’ll talk about in parts two and three of our discussion.

Whether a nurse works for a hospital, a medical practice, an educator, or in some other capacity; nurses need to understand the healthcare regulations that apply to their profession. While different nursing jobs have different requirements, there are many common issues such as the need for physician supervision with limited exceptions such as 104 NPs. Whether a nurse is a seasoned professional with advanced degrees or just starting out, nurses should understand the compliance laws that affect their profession.

Nurses, especially if a nurse works independently or seeks to provide specific services under the supervision of a physician, should contact Cohen Healthcare Law Group to discuss their legal and healthcare compliance requirements. Our experienced healthcare attorneys advise nurses, doctors, and medical practices about their healthcare compliance requirements.