Starting At the Bottom
You might want to start as a nurse's assistant and work your way up the ranks from the inside, taking the nursing programs offered at your hospital. There's nothing wrong with that; it'll get you the social and political connections you need to be at the top of the totem pole by the time you get there. But it does take an awfully long time, and you might find you get upset when people from the outside -- the ones who went to nursing school -- get hired to be your superiors despite your experience and connections.
On the other hand, you can get started quickly -- getting a Certified Nursing Assistant diploma only takes three months, and that's if you don't take the accelerated course. And once you have your CNA, you can walk into almost any hospital, nursing home, or other major medical institution and have at least a ground-level job.
Starting In the Middle
You might want to skip the startup and jump straight in as a Licensed Practical Nurse. It's nice to jump into a position that pays in the middle five digits up front, there's no doubt about that. Of course, to get there you'll have to take 2-3 years of nursing education. Some hyper-accelerated courses (usually online) might allow you to get your LPN in only nine months, but only if you're extraordinarily motivated and dedicated.
The upside is starting in a position that involves a little less gruntwork and a lot more autonomy than being a CNA. The pay and benefits are significantly better, and the opportunities for moving into a specialization (which pay even more) are abundant.
Starting At The Top
Of course, you could go for the full 4-6 year nursing school experience and start working as a Registered Nurse right at the get-go. There's a lot of demand for RNs in the US, and they command some surprising salaries. Of course, they also owe quite a bit of school debt for that nursing education, so a significant portion of those funds are going to pay back those loans.
On the plus side, an RN is a leader in her workplace. Only an RN has any significant potential to move up to administration and take a command position, but even those that don't generally end up in specialist slots that draw in a very decent salary.
In the end, there are significant benefits and drawbacks to each plan -- and none of them is 'right'. You can start with in-house nursing programs or go to six years of nursing school; in the end, there are good reasons to do either. Figure out which one works with your priorities, and once you choose a plan, commit to it. That's the best way to start a career in nursing!
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