Nursing Pathways in Education and the Workforce

Published May 2025

Overview

Understanding the postgraduation pathways for nurses can lead to more informed decisions for those concerned with nursing education and the nursing labor market. This research describes Utah’s postgraduation labor market and continuing education pathways for postsecondary award holders from a nursing major. This project focuses on pathways after earning an initial nursing award from a public postsecondary institution in Utah. The pathways for advanced practice nurses are beyond the scope of this work. This research shows postgraduation wage, employment, and educational dynamics for different initial degrees. Finally, this research addresses early exit from the nursing industry. By demonstrating what happens for nurses postgraduation, this research will allow interested parties to make informed decisions regarding policy, advocacy, and career choices regardless of initial nursing award.

This study covers Certified Nurse Assistants (CNA), Licensed Practical Nurses (LPN), Associate Degree Registered Nurses (ADN), and Bachelor’s Degree Registered Nurses (BSN). The education requirements differ for each type of nursing award, and those differences influence labor market and continuing educational pathways.

The population of interest is all graduates from nursing fields from public technical colleges and degree-granting institutions in Utah between 2011 and 2020. This data came from the Utah System of Higher Education (USHE). The Utah Data Research Center’s (UDRC) matching algorithm matched the nursing program graduates with the Utah Department of Workforce Services (DWS) unemployment insurance (UI) wage data. The USHE data contain major, defined by the Classification of Instructional Program (CIP), award level, defined by the Integrated Postsecondary Education Data System (IPEDS), completion date, gender, race or ethnicity, age, and, when appropriate, re-enrollment date or semester. DWS UI data contain wages, the year and quarter of earned wages, the employer name, and the North American Industry Classification System (NAICS) code.

Summary of Findings

Finding 1: Graduates of programs that require NCLEX certification are more likely to gain at least one additional nursing credential.


Finding 2: Successively higher nursing awards are associated with better labor market outcomes.


Finding 3: The industry of first employment varies based on award type. CNAs are more likely to first work in Nursing and Residential Care whereas those with other nursing awards are more likely to be employed by the hospital industry.


Finding 4: Demographics vary by nursing level. CNAs are on average younger and from a more ethnically diverse background than the other award levels.


View Glossary of Terms

Detailed Findings

Finding 1: Graduates of programs that require NCLEX certification are more likely to gain at least one additional nursing credential.

Only 6% of CNAs
finished the full
education ladder.

Roughly half of the
LPNs (52%) and ADNs
(50%) finished the full education ladder.

  • LPN and ADN graduates have the shortest time to re-enrollment with a median of one quarter to return to school. BSN graduates took the longest to return to school, with the median returner waiting about five quarters before enrolling in another program.
  • Approximately 12% of those who earned an initial BSN award from 2011 to 2017 completed at least one graduate degree in nursing by 2020.
  • CNAs had the most who earned a final degree outside of nursing, eight times more than BSNs, four times more than LPNs, and close to 3.5 times more than ADNs.
Figure 1: The movement of nursing students in education and workforce pathways after the initial award

Finding 2: Successively higher nursing awards are associated with better labor market outcomes.

An additional award
is worth approximately
five years of experience
when comparing wages.

  • The median number of quarters to employment was longest for LPNs at four quarters and shortest for BSNs at one quarter.
  • The average CNA in this study had an annual wage of about $20,375 versus $43,019 for the average LPN.
  • Only 51% of CNAs are employed in the nursing industry during the seven years after graduation compared to over 90% of LPNs, ADNs, and BSNs.
Figure 2.1: Median Nurse Wage by Years of Experience and Award Level
Figure 2.2: Time to first nursing employment for those who did not have nursing jobs before graduation

Finding 3: The industry of first employment varies based on award type. CNAs are more likely to first work in Nursing and Residential Care whereas those with other nursing awards are more likely to be employed by the hospital industry.

CNAs enter the Nursing
and Residential Care
industry at almost
twice the rate of
LPNs and ADNs.

CNAs enter the Nursing
and Residential Care
industry at more
than four times
the rate of BSNs.

  • 50% of CNA graduates are first employed by Nursing and Residential Care versus 12% for BSNs.
  • Only 16% of CNA graduates are first employed by Hospitals versus 46% of LPNs, 48% of ADNs, and 53% of BSNs.
  • 7% of CNAs begin their nursing career in Social Assistance, but this drops to 2% for LPNs and ADNs and 1% for BSNs.
Figure 3: Distribution of First Nursing Industry by Award Level

Finding 4: Demographics vary by nursing level. CNAs are on average younger and from a more ethnically diverse background than the other award levels.

The proportion of
nurses who are
white is the greatest
for LPNs (87%).

The proportion of
nurses who are
white is the lowest
for CNAs (73%).

  • CNAs have the lowest median age at 19 years old, and BSNs have the highest at 29 years old.
  • About 83% of CNAs and 85% of LPNs identify as women whereas only 81% of ADNs and 80% of BSNs identify as such.
Figure 4: Demographics vary by nursing level

Limitations

  • Only USHE students are included in this study. Graduates who went to out-of-state or private institutions like Brigham Young University or Westminster University are not included. Some of these private institutions have BSN bridge programs or graduate programs that are exclusive to their institution that may be of interest to nurses in specific specialties. If a student received an initial award at USHE institutions, but they received a subsequent award elsewhere, then the study would not reflect the additional award. Thus, the number of graduates represents a lower bound to the number of nursing graduates in Utah.
  • This study does not include licensure data, only graduation from a program. It was assumed that any nursing award earner employed in the nursing industry was a nurse, but there was no concrete evidence that this was the case. Previous studies have not quantified what percentage of graduates pass the licensure exam; therefore, it is impossible to provide a reasonable estimate for this work.
  • The wage records only contain information for those employed by Utah firms that pay into the Unemployment Insurance system. When individuals find employment outside of Utah, there is no way to distinguish this from those who stop working but stay in Utah. Previous studies were also unable to estimate the out-of-state migration for nurses as these studies also used Utah specific data. In this research, it is impossible to contextualize how many of those who left nursing only left nursing in Utah.
  • NAICS classifies hospital systems attached to universities as Education Services. Therefore, nurses who are employed by a hospital associated with the University of Utah may be classified as working in the education sector when their day-to-day work is most similar to nurses in an independent hospital system. UDRC data does not contain further details to divide nursing educators from nurses practicing in university associated hospitals. For these reasons, the number of graduates with initial employment in Education Services may not give a full picture of the type of work these nurses perform or the setting in which they practice.

Conclusion

There are distinct differences in the postgraduation pathways for nurses depending on the initial award level. These differences appear to correlate with robust institutional guidelines and support in the context of additional education. In the case of labor market outcomes, these differences are related to award level. BSNs had the best labor market outcomes, while CNAs had the worst. LPNs and ADNs had similarly good educational outcomes, while CNAs had poor educational outcomes after their initial degree.

Full Report

Learn more about Nursing Pathways in Education and the Workforce

This report investigates nursing pathways in education and the workforce through comprehensive research on Utah's postgraduation labor market and educational outcomes for nurses. The study focuses on Certified Nurse Assistants (CNAs), Licensed Practical Nurses (LPNs), Associate Degree Registered Nurses (ADNs), and Bachelor’s Degree Registered Nurses (BSNs) who graduated from public institutions between 2011 and 2020. By analyzing wage data, employment trends, and continuing education opportunities, the research highlights how different nursing awards influence career trajectories. These insights inform decisions on nursing education, workforce policy, and advocacy, supporting better outcomes in the profession.

Report cover

Glossary

References

Institute of Medicine (US). (2011). The Future of Nursing: Leading Change, Advancing Health. National Academic Press.

Rao, G., & Knold, M. (2021). Utahns who work multiple jobs at the same time Insights on multiple jobholders’ earnings, industries and trends over time. Department of Workforce Services. https://jobs.utah.gov/wi/pubs/reports/mjh/index.html

U.S. Bureau of Labor Statistics. (2022, September 8). Registered Nurses: Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-2

U.S. Bureau of Labor Statistics. (2023a, April 2). Nursing Assistants and Orderlies: Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/nursing-assistants.htm

U.S. Bureau of Labor Statistics. (2023b, May 10). Licensed Practical and Licensed Vocational Nurses: Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm

Utah Department of Workforce Services. (2020). A Labor Study of Registered Nurses in Utah.

Utah Department of Workforce Services. (2023). Annual Income and Wages by County. https://jobs.utah.gov/wi/data/library/wages/annualprofilewages.html

Utah Medical Education Council. (2015). Nursing Education in Utah: A Summary of Utah’s Nurse Training Program Capacity 2007—2014.

Utah Medical Education Council. (2022). Supply of Nurses in Utah: The 2022 Survey Utah’s Registered Nurses.

Utah Nursing Assistant Registry. (n.d.). Retrieved August 22, 2023, from https://utahcnaregistry.com/approved-training-programs

Project
Team

Wei Li
Alicia Mcintire

Senior Research Scientist
(Report Author)

Wei Li
Wei Li

Senior Data Scientist-
Data Narratives