Most healthcare organizations are based on hierarchical systems. That means that each person is ranked within the healthcare organization based on their own particular skill sets or abilities. Even within professions, such as nursing, a hierarchy exists. This hierarchy is determined by the positions themselves and also by levels of education and experience. State licensing requirements also establish assignments based on abilities, training and expertise and scope of practice. For example, the nursing profession has its own hierarchy. This is based on level of training and experience. Certified nursing assistants (CNAs) report to nurses.The nurse may be a licensed practical nurse (LPN) or a registered nurse (RN). The LPN has approximately 18 months training, whereas an RN has to two to four years of training. An LPN often reports directly to an RN. Within the RN's, there is also a hierarchy. Registered nurses may either hold an Associates Degree in Nursing (ADN) or a Bachelor
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