Whether you’re in the hospital or visiting a doctor’s office, you’re going to encounter different kinds of nursing team members at Novant Health. Each role in nursing includes a unique job description and it can be confusing for patients and family to understand the different titles and duties.
What follows is a basic overview on the general categories of nursing in health care. It is important to note that many subspecialties are not covered here.
Certified nursing assistants (CNA)
A certified nursing assistant (CNA) is on the frontline of care in the health care setting, helping with a patient’s daily needs.
CNAs help with daily activities such as bathing, eating, basic assistance, walking and more. They measure patient vital signs and record them in the electronic health record. CNAs will examine their patients for any conditions or behaviors that need to be communicated to nurses and physicians. These responsibilities help ensure a patient’s needs are being addressed at all times and that all providers are kept informed.
A CNA is supervised by a registered nurse, commonly called an RN, in the unit.
In North Carolina, CNAs are required to undergo classroom and practical instruction and pass a state examination.
Licensed practical nurse (LPN)
While their duties are similar to those of a CNA, licensed practical nurses have more training and can provide more interventions, such as giving medications.
In addition to assisting patients in some daily activities, LPNs will more often participate in tests and procedures conducted by doctors or registered nurses. LPNs contribute to a patient’s care plan when appropriate and are also often hired by families in need of home care.
Both LPNs and CNAs work under the supervision of an RN in the unit.
North Carolina requires about one year of education in an LPN program and licensure with the North Carolina Board of Nursing.
Registered nurse (RN)
RNs comprise the single largest workforce at Novant Health -- 30 percent. RNs are a part of the core of nursing in American health care and are found both inside and outside hospital settings.
At Novant Health, the registered nurse serves as a leader of the health care team by establishing an authentic personalized relationship with patients and their support system. They assess, plan, implement and evaluate an individualized plan of care. They work independently as a specific discipline, but collaborate to coordinate care with many health professionals, including physicians, therapists and pharmacists.
A more experienced or specialized RN may be the head of a unit, referred to as the charge nurse. All RNs report to a nurse manager of the unit.
Today, RNs graduate with a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN). RNs often hold a specialty certification by passing a board certification exam.
Nurse practitioners (NPs) may typically work independently or in other health care settings besides hospitals to promote wellness and manage disease and injury. (In some settings they are known as an advance practice registered nurse or APRN.)
NPs are licensed to diagnose patients, prescribe medications and create a treatment plan. In North Carolina, they are required to have a supervising physician.
While NPs work closely with their supervising physician, they work autonomously to care for patients, referring them as needed to a higher level of care. NPs may report directly to a physician, a clinic administrator or other health care leader.
NPs require a Master of Science in Nursing (MSN) or completion of a doctoral program. They are required to register with the board of nursing in each state they practice. Additional training, education or licensure may be required if pursuing a specialty.
Note: Nurse practitioners are sometimes compared to physician assistants. Both are considered advanced care practitioners. Nurse practitioners are registered nurses and approach care through a holistic lens, helping patients meet wellness goals and preventing disease in addition to treating disease. Physician assistants are trained in medical schools and approach care through a medical lens, helping patients recover from illness and injury.