What's the Difference Between RN I, RN II, and RN III?

A registered nurse (RN) helping a patient
Written by
Karin Zonneveld
Reviewed by
Miranda Kay, RN
August 20, 2024
Category:

What is a level I nurse, a level II nurse, or a level III nurse? 

There are several ways to classify nurses, one of which is by levels. What are the differences between the various levels, and how does a nurse get to different levels? In this article, we’ll answer those questions and more by explaining, in detail, the levels of the clinical ladder system in nursing.

Why Categorize Nurses into RN I, RN II, RN III, and More?

The capabilities and professional expertise of a newly graduated nurse are not equal to those of an RN with five years of experience. Categorizing nurses into RN I, RN II, RN III, and more is a system used by some healthcare facilities called a clinical ladder. This tool promotes nurse satisfaction and retention, among other benefits.

What Are Clinical Ladders?

Clinical ladders are a system used to differentiate the different skill levels of nursing skills among registered nurses. They provide a pathway for career advancement and professional development for nursing professionals and consist of different levels, each with specific criteria related to skills, experience, education, and leadership abilities. As nurses meet these criteria, they can progress to higher levels.

Primarily, the clinical ladder system for registered nurses takes into consideration the following:

  • Level of education
  • Quantity of experience
  • Certifications
  • Research
  • Leadership
  • Clinical skills

The levels of a clinical ladder may be used to determine staff nurse pay scales and assigned roles within a healthcare facility or system.

Benefits of the Clinical Ladder System

Some benefits of using this system include the following:

  • Clear career paths for nurses: Overall, this system guides nurses to advance their careers while further developing their experience and skills within their jobs.
  • Pay transparency: Nursing pay is typically more transparent when using the clinical ladder system; nurses know the wages for different levels and how to reach them.
  • A better definition of roles and responsibilities: Utilizing the clinical ladder system, healthcare facilities can more easily place nurses where they belong and are needed.
  • Improve retention: A clear path to advancement, pay transparency, and clearly defined roles and responsibilities increase nursing satisfaction, which in turn increases retention.

In summary, this system offers a tool for improving patient care by empowering the nursing staff and developing their skills with incentives.

Levels of Clinical Ladders

While different healthcare facilities may classify RN levels slightly differently, each level reflects and accounts for work experience and level of education. The degree of expertise that each registered nurse has is especially reflected in each level. That is why, in this section, we will specify in an example what each level of the clinical ladder looks like.

RN I (RN 1)

This level is an entry-level position applied to newly graduated RNs.

  • Responsibilities: A registered nurse at this level is responsible for providing care while under the supervision of other healthcare staff with more experience.
  • Education: This level requires an RN diploma, the certification for the NCLEX-RN, and the license for the state where the RN lives.
  • Pay range: Nationwide, RNs earn between $63,720 and $132,680 per year. Although, $71,000 per year is common before acquiring at least five years of experience.

In general, level I registered nurses can perform all the normal duties any RN can, but they are still learning from their colleagues and their work. RN I refers to the first year of work for registered nurses. Additionally, RNs must prove they can function independently to advance to the next level.

RN II (RN 2)

RN II is one of the most common levels for nurses, with at least one year of experience as RNs.

  • Responsibilities: RNs at this level can perform more nursing interventions with minimal supervision. Equally as an RN I, they provide nursing care to patients.
  • Education: At this level, RNs are licensed and have been actively working for at least six months to one year as registered nurses, thus acquiring the necessary experience.
  • Pay range: The salary doesn't change much from an RN I to an RN II. With less than five years of experience, the typical salary is still $71,000 per year, although it may be slightly higher, depending on the setting, demand, and facility.

To be considered an RN II, nurses must demonstrate competency in providing nursing care to patients independently.

RN III (RN 3)

Overall, RN III is considered a complex level in nursing, with more responsibilities and supervision within the role.

  • Responsibilities: Nurses at this level provide orientation to new nurses (RN I and RN II). Additionally, RN III level nurses provide care for complex patients.
  • Education: Licensed RNs at this level have accumulated at least 2 to 3 years of experience working in the field.
  • Pay range: RNs in this range earn more than RN I and RN II, typically earning on average $75,000 per year or more.

Level III nurses demonstrate advanced nursing skills and can become leaders for other RNs. They differ from nurses at lower levels because of their leadership skills and experience.

RN IV (RN 4)

In general, level 4 requires more experience and education, particularly in terms of management.

  • Responsibilities: Nurses at this level have administrative and managerial responsibilities, taking care of most of the nursing team under the director of nursing.
  • Education: Similar to the previous levels, RNs need their active license, although some facilities require a BSN. Additionally, 4-5 years of experience is required for this role.
  • Pay range: Typically, RN IV or RN 4 level registered nurses earn more than previous levels. The salary range is between $75,000 to $80,000 per year.

Although it is not a requirement, level IV registered nurses often have experience as assistant managers before becoming managers themselves. This role requires more commitment and experience than RN 3.

RN V (RN 5)

In general, level V nurses are also known as nurse consultants.

  • Responsibilities: RN V nurses have broader responsibilities than RN I, RN II, RN III, and RN IV nurses. Their roles entail conducting research, providing consultation services, and evaluating nursing practices.
  • Education: To become an RN V nurse, nurses need to have a master’s or doctorate in nursing. Additionally, they might need two or more years of experience in their area of expertise.
  • Pay range: The pay range for registered nurses at this level is the highest, ranging from $86,000 to $91,000 per year, depending on the education, salary negotiation, and specialization.

Level V RNs often provide less direct nursing care than lower levels on the clinical ladder. Their capabilities and advanced education lead them to roles that focus on “the bigger picture.”

More Resources for Clinicians and Facilities

RN I, RN II, RN III, RN IV, and RN V levels are the rungs of a clinical ladder system with different experience, expertise, and pay. Above all, the main difference between levels lies in education, experience, and certifications. Furthermore, levels help healthcare facilities organize schedules, assign nurse roles and unit placement, and provide patient care.

It is important to recognize the hard work of every nurse within their profession and support their dedication to researching and growing their careers. In addition to connecting nurses and facilities through PRN jobs, Nursa provides helpful guides and informative articles for the healthcare community. Check out the Nursa blog for more nursing resources.

Sources:

Karin Zonneveld
Blog published on:
August 20, 2024

Meet Karin, a dietitian and contributing copywriter for Nursa, who is passionate about compassion in healthcare, nutrition, and raising awareness and support for people with autism.

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