Pathways ForwardCurricula · Hands-On Healthcare · Butte & Silver Bow County
Nursing: the Butte Path
Nursing is the largest field on this list and has the most ways in. A teenager can start as a nursing assistant, and each rung pays for the next: LPN, then registered nurse, then nurse practitioner, nurse-midwife or nurse anesthetist. The RN is where nursing becomes a family income in Silver Bow County.
Why this field is on the list · as of September 2026
The RN clears only the one-child bar. Registered nurses earn a median of $85,280 here, and the 25th percentile is $80,210. A new graduate usually starts near the lower figure and climbs with experience, night shifts and specialty work.
The lower rungs are stepping stones. A nursing assistant ($40,900) or LPN ($62,210) will not carry a family alone, but both put a young person at a real bedside and pay for the next rung.
AI exposure is low. AI drafts chart notes and flags drug interactions. It does not turn a patient, start an IV, or notice that a quiet patient is getting worse.
Watch for: Montana belongs to the Nurse Licensure Compact, so a Montana multistate license lets a nurse work for patients in the other compact states. Check nursecompact.com before taking an out-of-state job.
01 · The ladderFrom nursing assistant to advanced practice
Each rung is a license of its own, and each one counts toward the next.
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Nursing assistant (CNA)
At least 75 hours (the federal minimum). Minimum age: Set by each program; ask (often 16 or 18).
Where: Highlands College of Montana Tech (ask about the next class) and local care homes that train their own aides.
Montana median $40,900 · 25th percentile $38,040 · stepping stone
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Licensed practical nurse
About a year of training, then the NCLEX-PN exam and a license from the Montana Board of Nursing.
Where: Highlands College of Montana Tech (ask whether a practical-nursing program is running).
Montana median $62,210 · 25th percentile $58,130 · stepping stone
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Registered nurse
A two-year associate degree (ADN) or a four-year bachelor’s (BSN), then the NCLEX-RN exam. Many hospitals prefer the BSN, and ADN nurses can finish one while working.
Where: Montana Tech in Butte (associate and bachelor’s degrees in nursing).
Montana median $85,280 · 25th percentile $80,210 · clears only the one-child bar
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Advanced practice: NP, nurse-midwife, nurse anesthetist
Graduate school after RN experience: a nurse practitioner or nurse-midwife degree, or a nurse anesthesia doctorate after ICU work.
Where: Montana State University’s Mark and Robyn Jones College of Nursing (DNP, including family nurse practitioner). Montana has no nurse-midwifery or nurse anesthesia program, so those mean a distance or out-of-state program.
Montana median $137,210 · 25th percentile $123,260 · clears the three-child bar
02 · BranchesWhere the work leads
The hospital bedside
Medical-surgical, ICU, emergency, labor and delivery, and pediatrics. Rotations and first jobs are at St. James Healthcare in Butte.
Schedule: Three 12-hour shifts a week is normal, with nights and weekends early in a career.
Hospice and home health
Visiting patients at home, including the dying. The work is slower and deeply personal, and it rewards an experienced nurse.
Schedule: Daytime visits, with some on-call.
Clinics and schools
Doctor’s offices, school nursing and public health. Pay is lower than the hospital, and the hours are set.
Schedule: Weekday hours.
Advanced practice
Nurse practitioners run clinics and see patients on their own license; nurse-midwives deliver babies; nurse anesthetists give anesthesia for surgery. BLS publishes no local nurse-midwife figure; the field is small.
Schedule: Clinic hours, with call for midwives.
Remote and virtual nursing
Some RNs now work from a screen. A virtual nurse watches hospital patients by camera and handles admissions, discharge teaching and paperwork for the bedside team. Others answer a telephone triage line, watch remote-monitoring data sent from patients’ homes, or do case management and utilization review. Nearly every employer asks for two to five years at the bedside first, often in medical-surgical nursing. Pay averages about $38.50 an hour, or roughly $75,000 to $100,000 a year full-time, and most earn about $28 to $43 an hour. Full-time, that is near or above the Silver Bow County one-child bar ($81,200); part-time, it is a strong second income.
Montana belongs to the Nurse Licensure Compact, so a Montana multistate license lets a nurse work for patients in the other compact states. Check nursecompact.com before taking an out-of-state job.
Schedule: Often part-time (0.6 or 0.9 of full-time) at set hours. The job needs a quiet room, reliable internet, and hours when no one else needs the nurse’s attention.
03 · For the familyThe schedule, for a father and for a mother
- For the one who carries the income. An RN clears only the one-child bar here, and more with nights, overtime or a specialty. Advanced practice adds to that.
- For a mother at home. Per-diem RN shifts, hospice visits and school nursing can be skilled work on hours she sets. Twelve-hour shifts mean only a few days a week away.
- Keep the license current. Keep the RN license active with the Montana Board of Nursing through the years at home, even by working a few shifts a year.
- Remote work, later. Remote nursing can fit a mother at home, but only after the bedside years. Work two to five years in a hospital first, keep the license active through the years at home, and move to part-time remote work later. Employers hire remote nurses for the judgment they built at the bedside, so a lapsed license or experience that is many years old closes this door.
04 · The home-school yearsWhat to add to the core path
Grades 9–10
- Everything in the shared core, with full-year biology and chemistry with labs
- Volunteer at a care home or hospice
Grades 11–12
- Earn the nursing-assistant certificate and work part-time
- Anatomy & physiology and microbiology through One-Two-Free dual enrollment
- Take the TEAS or other nursing-school entrance test
After high school
- Apply to an ADN or BSN program, working as a CNA or LPN meanwhile
- After two to five years at the bedside, consider graduate school
Tie to the Verification Track
Before every medication, a nurse checks the right patient, drug, dose, route and time. Some doses need a second nurse. A nurse compares what the monitor and the chart say with the patient in the bed. The Verification Track trains that habit.
05 · SourcesWhere these facts come from
Checked 2026-09-26
- Wages: U.S. Bureau of Labor Statistics, OEWS May 2025, the state of Montana (BLS publishes no Butte metro area). bls.gov/oes
- Income bars: MIT Living Wage Calculator, Silver Bow County. livingwage.mit.edu/counties/30093
- Montana Board of Nursing: licensing and approved programs
- Virtual nursing roles and requirements: Providence postings via LinkedIn and Salary.com
- Virtual nurse pay: ZipRecruiter
- Compact member states: nursecompact.com
- Montana Tech and Highlands College: mtech.edu; Montana State University nursing: montana.edu/nursing; Great Falls College MSU: gfcmsu.edu
- University of Montana (Skaggs School of Pharmacy, physical therapy, speech-language pathology): umt.edu; Rocky Mountain College: rocky.edu; Rocky Vista University: rvu.edu; WICHE: wiche.edu
- Montana licensing boards (nursing, medical examiners, pharmacy, alternative health care): boards.bsd.dli.mt.gov