How to Become a Registered Nurse
A career as a registered nurse offers flexibility, stability, and excitement. Although demanding at times, nursing can also be a rewarding occupation. The steps to become a registered nurse involve education, testing, and licensing. Once these are complete, nurses have a lot of options. Below, we’ll detail the steps to follow, how long it takes to become a nurse, and where to start.
Become a Registered Nurse in 6 Steps
Registered nurses hold lives in their hands and each step on a nurse’s path prepares them for that eventuality. Education gives the knowledge needed to care for the sick and prevent disease. State licensing tells nursing employers they have hired competent professionals, and specialty certifications highlight experts in their field.
2
Graduate With an ADN or a BSN Degree
Both a two-year ADN and a four-year BSN degree bestow the title of registered nurse, or RN. However, the two paths have some important differences. For example, some states and employers require RNs to hold a bachelor’s degree. Keep reading and we’ll dig into the details ahead.
3
Pass the NCLEX-RN Licensing Examination
Prospective nurses can take the National Council Licensure Examination–RN (NCLEX-RN) in any state and its results apply nationwide. Once a passing grade is confirmed, nurses may apply for a state license.
4
Acquire a State License
Each state has different license application requirements and nurses applying for an RN license can find their state’s application process at the National Council of State Boards of Nursing.
5
Apply for Registered Nursing Jobs
Once a new RN has a valid license, they may apply for any nursing job in the state of their licensure. If an RN wishes to work in a new state, they must apply for a license in that state. Some states have a “compact” agreement in which one state’s license may be used in other states.
6
Earn Registered Nurse Specialty Certification
Once a nurse has gained some experience in a specialty, they may apply for further certification beyond their degree and license. To achieve certification, nurses must prove varying amounts of experience and pass an exam. Specialty certification offers improved salaries and more desirability to employers.
Schooling Requirements for Registered Nurses
Registered nurse schooling can be completed on a few different paths, however, all nursing programs have some similar admission requirements:
Similarly, all nursing programs teach the same basic skills: fundamental concepts of nursing, pharmacology, physiology, pathophysiology, nutrition, and growth and development. While faster programs may focus on the basics, all programs teach future nurses how to provide nursing care to many patient groups.
The nursing landscape is changing, and more and more employers are looking for nurses with a bachelor’s degree. In fact, a survey by the American Association of Colleges of Nursing found that over 70% of healthcare employers want new nursing hires to hold a BSN. The National Academy of Medicine announced a goal in 2010 for 80% of RNs to hold a BSN degree by the year 2020. By 2020, at least 65% of nurses held BSN degrees, but in 2023, the National Nursing Workforce Survey reported that number rose above 70%.
Associate Degree in Nursing — ADN
An Associate Degree in Nursing, or ADN, is the quickest option to become a registered nurse with no previous university education. ADN degrees can take 18 months to two years to complete and may require some prerequisites before an application can be accepted.
Time to Complete
18 months to 2 years
Clinical Hours
190 to 900*
Pros
- Earn an RN degree in less than two years
- Less competitive than a BSN
- Lower cost than a BSN
Cons
- May limit job opportunities compared to a BSN
- Must obtain a BSN before pursuing an advanced practice nursing degree
Nurses with an ADN may not have their first choice of positions and may receive lower pay than an RN with a BSN. However, the nursing shortage ensures a large pool of work for nurses with ADNs.
*Varies depending on institution
Sources: Central New Mexico Community College, Teaching and Learning in Nursing
Bachelor of Science in Nursing — BSN
A Bachelor of Science in Nursing gives future nurses a more well-rounded education experience than an ADN. Typically done over four years, the BSN curriculum covers the basics of nursing care and how the body works, but also teaches more specialized critical thinking skills.
Clinical Hours
160 to 750*
Pros
- More likely to pass NCLEX on first attempt (82.32% with a BSN vs. 77.91% with an ADN)
- Easier to find work in highly specialized environments like gerontology or neonatology
- Higher salary than an ADN
Cons
- Takes longer to complete
- More competitive than an ADN
- More expensive than an ADN
A BSN prepares future nurses to handle a high level of care. Where an ADN focuses on preparing future nurses quickly for clinical situations, a BSN adds higher-level concepts like evidence-based practice, community health nursing, statistics used in research, nursing management and leadership, health informatics and analysis, healthcare ethics, and nutrition.
*Varies depending on institution
Sources: Forbes Advisor, Teaching and Learning in Nursing, National Council of State Boards of Nursing
RN-to-BSN Degree
A working registered nurse with an ADN degree can earn their BSN through an RN-to-BSN bridge program. Many employers offer incentives to do this, and some partially cover the cost of tuition. Besides the general application requirements for all degrees, RN-to-BSN candidates must show they graduated from an accredited ADN program, hold a current RN license, and pass a criminal background check. Many programs also require their students to work as a nurse while earning their degree.
Time to Complete
9 months to 2 years
Clinical Hours
Typically none required*
Pros
- Can continue to work while getting degree
- Expense may be covered by employer
- Possible salary increase upon graduation
Cons
- May take longer than a traditional BSN if applicants must work concurrently
This degree bridge adds on all the pieces of a nursing education that the BSN offers and the ADN does not. Some programs require a capstone experience, like a community project. RN-to-BSN coursework may include concepts like critical thinking, leadership, management, clinical reasoning, and statistical analysis.
*Varies depending on institution
Sources: Illinois State University, Chamberlain University, University of Cincinnati, University of Bridgeport
Accelerated Bachelor of Science in Nursing — ABSN
For aspiring nurses who have a bachelor’s degree in another area, an Accelerated Bachelor of Science in Nursing (ABSN) can be earned more quickly than a traditional BSN. Many BSN prerequisites have been completed while earning another degree, and so may be excluded from the ABSN curriculum.
Accelerated nursing programs must be completed on a full-time schedule and typically involve full days of classes and clinicals.
Time to Complete
11 to 18 months
Clinical Hours
160 to 750*
Pros
- Fastest option to earn a BSN
- More likely to pass NCLEX on first attempt (82.32% with a BSN vs. 77.91% with an ADN)
- Easier to find work in highly specialized environments like gerontology or neonatology
- Higher salary than an ADN
Cons
- Most students are unable to work during this program
- More competitive than an ADN
- More expensive than an ADN
Accelerated nursing students must possess strong internal motivation and an exceptional work ethic. In fact, according to the American Association of Colleges of Nursing (AACN), “Employers report that these graduates are more mature, possess strong clinical skills, and are quick studies on the job.”
*Varies depending on institution
Source: AACN
Registered Nurse Licensing
Once a new nursing graduate has their degree in hand, the next step is licensure. To become a licensed and practicing nurse in any state, graduates must pass the state licensing exam (the NCLEX-RN) and apply for a state license.
NCLEX-RN
The National Council Licensure Examination–RN (NCLEX-RN) is a computer-based exam with 85 to 150 questions. The exam takes anywhere from an hour to a maximum of five hours. Questions fall into four basic categories:
- Safe and Effective Care Environment
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
Once completed, the state board of nursing sends test results within six weeks, usually by email. In the time leading up to the NCLEX-RN, it’s important for graduates to study practice questions to ensure a passing grade, and many students take NCLEX prep courses to increase their likelihood of success.
Registered Nurse State License Application and Renewal
Each state in the U.S. has a unique registered nurse licensing application process. The state board of nursing will want to see proof of an NCLEX passing result and a diploma from an accredited nursing program. Most states require criminal background checks and fingerprinting, and some may want to see university transcripts.
After initial licensure, RNs must renew their license every two years in most states. Each state has varying requirements on continuing education and other documentation needed for renewal. The National Council of State Boards of Nursing offers a plethora of information on registered nurse licensing requirements by state.
Specialty Certification
Registered nurses can earn specialty certification once they have some experience in a specific field of medicine. A licensed registered nurse automatically earns the letters “RN” after their name, but additional certification can add to those letters and demonstrate expert knowledge in a specialty. RNs may view specialties offered by the American Nurses Credentialing Center.
Where Registered Nurses Work
Registered nurses can find employment in a wide variety of settings. One positive aspect of a nursing career lies in the vast sea of work options. Nurses can work in busy trauma centers, in their local elementary schools, or from home, to name a few. It’s also easy to pivot to a new specialty as a registered nurse. Below, we’ve listed some nursing employment categories and opportunities.
Acute Care
RNs in acute care have to work well in a fast-paced environment and think on their feet. These roles may offer higher pay because of the acuity of the patient load. Acute care nurses can find employment in:
- Emergency rooms
- Hospital units
- Intensive care units (ICUs)
- Pediatric intensive care units (PICUs)
- Neonatal intensive care units (NICUs)
- Telemetry units
- Non-elective medical air transport (flight nurse)
Long-Term Care
Long-term care nurses treat patients with chronic illness or who are recovering from a severe injury. They may work in:
- Skilled nursing facilities (SNFs)
- Nursing homes
- Rehabilitation centers
- Assisted living
- Adult day care
Home Care and Hospice
Home health and hospice nurses visit patients at home. Whether they need IV antibiotics, wound care, or pain management, home care and hospice nurses must be able to work with a high level of autonomy.
Outpatient Care
Outpatient care roles can vary widely. These nurses may see patients before and after surgery, in urgent-care settings, or during a primary care visit. The medical situations outpatient nurses face may not be as acute as in other settings, and they often take on some coordination and case-management responsibilities for their patients. Outpatient care nurses can work in:
- Primary care offices
- Specialist offices
- Urgent care
- Dialysis
- Same-day surgery
- Dental offices
- Optometry offices
- Schools
Non-Clinical Roles
Some nurses choose to leave the bedside in favor of a non-clinical role. These nurses may work in:
FAQs: How to Become a Registered Nurse
1. What education is needed to become a registered nurse?
Candidates must earn a nursing degree from an accredited college or university to become registered nurses. They may pursue a 2-year Associate Degree in Nursing (ADN) or a 4-year Bachelor of Science in Nursing (BSN). An Accelerated BSN (ABSN) can be done in as little as 11 months, but requires a previous degree.
2. How many years does it take to become a registered nurse?
Depending on which degree a prospective nurse pursues, a nursing degree may take anywhere from a year to four years when done full-time.
3. What are the steps to become an RN?
To become an RN, aspiring nurses must apply to and graduate from an accredited nursing school, pass the NCLEX-RN, and apply for and receive a nursing license in their state.
4. Is nursing school hard?
Nursing school requires focus and determination. Courses such as pharmacology, anatomy, and physiology are fast-paced and challenging, but many professors seek to help their students succeed.
5. How many times can I take the NCLEX?
The NCLEX can be taken eight times per year, with 45 days between exams.
