The employment outlook for registered nurses (RNs) has never been better. Several factors contribute to the increasing demand for RNs across the U.S., including government efforts to broaden access to healthcare, rising interest in preventive care, the expansion of medical services to the growing aging population, and the need to replace RNs nearing retirement.
Nurses enjoy a high level of job satisfaction, performing well-compensated work that can make a difference in people's lives. While no nursing diploma can guarantee employment, this guide can help launch you toward a nursing career, answering common questions about how to become a registered nurse, along with licensing requirements and salary prospects.
The Benefits of an RN Career
As quality healthcare emerges as one of the nation's most important priorities, RNs can expect to see increased employment opportunities accompanied by higher-than-average salaries and attractive benefits. The Bureau of Labor Statistics (BLS) projects a 12% growth in the employment of RNs through 2028. RNs earn an average annual salary of $75,510, well above the national average of $51,960. The highest-paid RNs, who possess years of experience and BSN degrees, earn well above $100,000 a year.
The Bureau of Labor Statistics (BLS) projects a 12% growth in the employment of RNs through 2028.
Where RNs work also affects compensation. The BLS reports the most job opportunities in the metropolitan areas of New York, Los Angeles, and Chicago. California offers the highest salaries, followed by Hawaii and Washington, D.C.
As nurses must work on-call, often expected to take weekend, holiday, and night shifts, employers provide relatively generous benefits packages. Many RN positions offer childcare, education benefits, and competitive salaries.
How to Become an RN
Nursing is a highly regulated field that involves strict educational and licensing requirements. This section describes the steps that you must complete on your path to a career as an RN.
If you want to practice as an RN, you must hold a nursing diploma or associate degree at minimum. However, you must typically complete certain prerequisites either in high school or college before you can gain acceptance into these programs. These generally depend on the state you are studying in, although some standard requirements exist.
Depending on the nursing program you're entering, these may include:
- Minimum scores on the SAT or ACT
- A GPA between 2.0 and 3.25
- Three years of math subjects, including algebra II and geometry
- Three years of science subjects, including chemistry and biology
- Four years of English
- Two years in any other foreign language
Earn Your Degree
Most RNs prepare to enter the field by earning either an associate degree in nursing (ADN) or a bachelor's of science in nursing (BSN). Aspiring RNs eager to enter the field as quickly as possible without earning a college degree may choose a nursing diploma, requiring only one or two years of study in a hospital-based program.
A nursing diploma prepares you for entry-level positions, while the college-level training provided by the ADN and BSN can broaden your employment prospects. The ADN, which takes about two years to complete, prepares you for RN positions while affording the flexibility to return to school to complete the BSN. A four-year BSN degree offers more comprehensive nursing preparation, leading to more opportunities and establishing the academic foundation for graduate study.
If you already hold an ADN or nursing diploma, you can enroll in an RN-to-BSN program, which shortens the BSN by two years. A student who has earned a bachelor's in a non-nursing field may enroll in an accelerated or "second degree" BSN that allows them to transfer general education requirements. Students typically complete this degree in less than two years.
Study, Take, and Pass the NCLEX
Passing the NCLEX-RN exam, administered by the National Council of State Boards of Nursing (NCSBN) is the most important step on the path to a nursing career. This national standardized test determines your eligibility to receive an RN license. The exam consists primarily of multiple-choice questions but also includes multiple-response, fill-in-the-blank, and drag-and-drop formats. RN candidates receive up to six hours to complete the exam, not including two optional breaks.
The exam covers four specific practice areas. The first area focuses on a safe, effective care environment, addressing care management, hygiene, and infection control. The second practice area deals with health promotion and maintenance across the lifespan, prevention, and early detection. The psychosocial integrity section examines ways to promote and support the emotional, mental, and social well-being of patients.
The last section, which makes up the largest part of the exam, assesses physiological integrity. This category examines appropriate nursing care to decrease the risk of complications.
Most degree programs provide the necessary training to take the exam, but you can improve test-taking skills by taking review courses, purchasing NCLEX practice booklets, or downloading review apps.
Get Licensed as an RN in Your State
The Nurse Practice Act sets up legislation for the practice of nursing in each state and establishes state regulatory nursing boards to oversee licensing. All state boards require graduates of RN programs to take the NCLEX-RN to receive eligibility to practice. When you graduate from your program, you may apply to the NCSBN to register for the exam. After receiving an authorization to test notification, you can schedule the exam.
BSN graduates have an average passing rate of 92%, compared to 85% for ADN degree-holders. If you fail, you may retake the exam up to eight times, waiting at least 45 days between tests. Each candidate must pay a $200 fee to the NCSBN to take the exam. Because each state determines its own licensing regulations, you should always check with the state board where you intend to practice for current information about additional application fees, license renewal and transfer procedures, and application deadlines.
According to U.S. Department of Labor projections, openings for RNs will grow by about 15% through 2026. Compensation varies by experience, specialty area, and type of employer. Although earning a degree does not guarantee employment, BSN graduates generally find better employment prospects, and nurses with specialties and board certifications usually earn higher salaries.
Demand for ambulatory care nurses continues to grow. These specialists provide routine medical services to patients outside of hospital settings, often in medical practices and outpatient clinics. These RNs earn a median income of $68,320, with the highest salaries for those holding ambulatory care nurse certification available through the American Nurses Association (ANA).
As school districts across the country expand healthcare services, experienced BSN degree-holders will find employment opportunities addressing the medical needs and overall well-being of students in public and private school settings. The most sought-after school nurses hold certification from the National Association of School Nursing.
Students seeking to practice as RNs can learn more about nursing specialties, licensing, and credentials from professional associations like the ANA, or career-focused websites like Nurse.org.
Get Continuing Education and Training
Nurses need continuing education credits and advanced training for license renewal and career advancement, as well as to stay current with new developments in practice, legal changes, and technological innovations. The nursing profession continues to incorporate more options for specialization in areas such as neonatal care, emergency care, geriatrics, public health, and acute care. While specializations lead to career enhancement and higher levels of compensation, they typically require certifications and advanced degrees beyond the BSN.
For example, the BLS projects a 26% increase in the employment of nurse practitioners (NPs) through 2028. As one of the fastest-growing healthcare occupations, NPs rank among the top earners in nursing. NPs must complete at least a master's degree from an accredited program and pass a qualifying exam to acquire certification in their area of expertise.
Certifications qualify NPs to enter highly paid positions in many areas of specialized healthcare. Highly in-demand nurse anesthetists who obtain the certified registered nurse anesthetist (CRNA) credential working in surgical, obstetric, and trauma care settings can expect a median annual salary of $167,950.
What Degree Can I Get to Become an RN?
This section describes the multiple educational paths leading to RN careers. Because the supply of nurses has increased with demand, RNs with advanced training and experience can enjoy a competitive advantage in the marketplace.
Diploma in Nursing
A diploma in nursing can provide students with basic nursing knowledge and hands-on practical nursing experience in a clinical setting. A nursing diploma program typically takes 2-3 years to complete, depending on a student's enrollment status. Nursing diploma students can enroll in courses covering topics such as lifespan nursing concepts, nursing informatics, basic pharmacology and psychology, and public health. A large portion of the nursing diploma program involves direct patient care, often through hospitals or health providers with ties to the school.
A nursing diploma program prepares students to pass the NCLEX-RN, which is the basic requirement for nursing professionals throughout the U.S. and Canada. An RN license qualifies holders for several entry-level nursing positions and additional studies in the nursing field.
Since diploma programs immerse students in direct patient care, students can graduate from the program with practical nursing skills for hospital settings and other clinical environments. Additionally, completing nursing diploma programs can give learners the chance to enter the workforce sooner. Students who wish to pursue further studies can do so while already working in the field.
Associate Degree in Nursing
An associate degree in nursing (ADN) prepares students to enter the workforce after just two years of full-time enrollment. Many employers prefer nurses with associate degrees over those with just diplomas. ADN programs require students to complete a certain number of clinical hours to graduate. However, the required number of clinical hours varies between schools.
Like most associate degrees, an ADN consists of 60 credits. An ADN curriculum includes foundational nursing courses such as anatomy, microbiology, pharmacology, behavioral health, and maternal and child nursing care. In addition, an ADN program also includes general liberal arts classes like English literature, history, writing and communications, and psychology. After completing an ADN program, a student usually takes the NCLEX-RN to obtain their RN license.
An ADN prepares aspiring professionals for employment in the nursing field immediately after graduation. However, most ADN programs also provide students with an excellent foundation for further studies in nursing or a closely related field. Many universities with four-year nursing programs maintain articulation agreements with two-year colleges that help ADN graduates transition to four-year nursing programs.
Bachelor of Science in Nursing (BSN)
A bachelor of science in nursing (BSN) features 120 credits and typically takes four years of full-time enrollment to complete. However, licensed RNs with associate degrees in nursing can usually earn BSNs after just two years of full-time study. Many hospitals and other health-based organizations prefer nurses with BSN degrees. In addition to more job options, nurses with BSN degrees are also more likely to receive promotions and greater responsibilities.
Many colleges and universities now offer online RN-to-BSN programs. Nurses no longer have to stop working while pursuing their BSN degrees, since they can more easily fit online classes around their busy schedules. A typical BSN curriculum includes courses on topics such as emergency care; health assessment; nutrition; public and global health; and family, community, and population-based care.
The amount of clinical or practicum hours in an RN-to-BSN program can vary greatly between schools. Most programs require students to follow a rotation-based clinical program. Student nurses train in different departments or clinical specialty areas, such as pediatrics or obstetrics, to gain a broad understanding of the nursing field and their professional duties and responsibilities.
Master of Science in Nursing (MSN)
The nursing field consists of several different specializations, and employers seek nurses with training in specific nursing areas. A master of science in nursing degree (MSN) allows each nurse to specialize in a particular medical arena, such as anesthesiology, mental health, or acute care. Nurses can also use an MSN to develop the necessary skills to work within a specific lifespan sector, like gerontology or pediatrics. Nurses who opt to specialize in nondirect care aspects of the nursing profession, as nurse educators or clinical nurse leaders, can also benefit from earning MSNs.
RNs often qualify for RN-to-MSN programs. The length of the program depends on the type of nursing degree students possess at the start of the program, the number of credits they can transfer, and their enrollment status. RNs with associate degrees or diplomas in nursing typically complete RN-to-MSN programs in 3-4 years. RNs with non-nursing bachelor's degrees can complete their programs in 2-3 years. A student with a BSN degree typically takes two years to earn an MSN degree.
Most MSN degrees require each aspiring nurse to complete a practicum, usually comprising about 500 hours of clinical nursing experience. Regardless of a student's specialty area or the population they wish to work with, MSN students typically enroll in courses in pharmacology, healthcare policy, ethics, and advanced health assessment.
Doctorate in Nursing
There are two terminal degrees in nursing: doctor of philosophy (Ph.D.) and doctor of nursing practice (DNP). Both degrees present the holder as an expert in the nursing field and thus qualified for a variety of leadership and top administrative nursing positions. A Ph.D. in nursing prepares nurses to pursue careers in research-oriented sectors, such as academia or research organizations. A Ph.D. can take 4-6 years to complete. Ph.D. candidates often must write dissertations.
A DNP degree, on the other hand, can prepare each enrollee for the highest level of nursing practice in a clinical setting. The degree typically takes two to three years to complete. Most schools require DNP candidates to complete an evidence-based practice project.
Doctoral students can enroll in courses that focus on their specialization areas, but most programs offer classes covering common advanced nursing topics, such as health policy and advocacy, principles of epidemiology and environmental health, fundamentals of comprehensive care across the lifespan, and intellectual and conceptual foundations of nursing science.
BSN-to-DNP and Ph.D. in nursing programs usually require at least 60 credits and a minimum of 1,000 practicum hours. Some of these programs award interim MSN degrees, while others move students straight to doctoral programs as soon as they meet the requirements. A nurse with an MSN degree may take fewer classes, depending on the number of credits they can transfer to the doctoral degree. Many schools require each MSN-to-DNP or Ph.D. student to complete a minimum of 500 clinical work hours.
Online RN Degree Options
Traditionally, few distance learning programs could accommodate nursing students because of the need for hands-on job training. However, many schools now offer bachelor's and associate degrees that students can complete partly or fully online. Nevertheless, online nursing programs still require some hands-on clinical experience as well, which distance learning students can complete in their local communities.
Many schools offer fully online RN-to-BSN and RN-to-MSN programs.
Many schools offer fully online RN-to-BSN and RN-to-MSN programs. These online classrooms are primarily designed for those who already work as nurses. Some colleges also offer accelerated programs for individuals who want to finish coursework more quickly. Take note, however, that these programs generally only accept students who have healthcare experience and high GPAs.
Registered Nursing Program Accreditation
Program accreditation is an important consideration when selecting a postsecondary school. Colleges and universities must pass rigorous educational standards to receive accreditation. The government only provides financial aid for students attending accredited schools, so you must ensure that you attend a properly accredited institution to receive government-distributed loans and grants. Additionally, you can only move on to a postgraduate degree program with a degree from an accredited school.
Numerous accrediting bodies assess nursing programs across the country, and schools will readily advertise their accreditation. Accreditation can vary between schools, so make sure you check the credentials of each institution. Furthermore, you may benefit from studying with a school that has held accreditation for a long period of time. Presently, the two main nursing accrediting bodies are:
- Accreditation Commission For Education in Nursing: ACEN used to be known as NLNAC, which you may still come across in your research. The organization accredits all types of nursing programs.
- Commission on Collegiate Nursing Education: CCNE focuses specifically on master's and bachelor's programs.
Nursing schools should also prepare students for the NCLEX. However, NCLEX preparation does not necessarily mean the school has the proper accreditation. Particularly since more and more online programs have appeared, students run the real risk of studying at schools that lack accreditation. Generally, state nursing boards do not approve of or recognize unaccredited institutions. It is possible that you can still take the NCLEX, but you may struggle to keep your license due to the lower educational standards at non-accredited schools.
FAQ: Becoming a Registered Nurse
Earning a nursing degree leads to personal and professional rewards but requires hard work and a significant time commitment. You can learn more about how to become a registered nurse from the answers to these frequently asked questions.
- What prerequisites do I need to earn an RN degree?
Entry to RN positions requires at least a nursing diploma or an ADN, but to enroll in any nursing program, you usually need a high school degree with a 2.0 GPA or higher. Your transcript should show three years each of math and science courses, four years of English, and two years of foreign language. Most BSN programs also require a minimum score on the SAT or ACT.
- Are online programs available?
To meet the demand for RNs, many colleges and universities have added online options to their nursing degree programs. Several online ADN and BSN programs allow students to complete clinical experiences in their local communities. RN-to-BSN and master's degrees offer flexible distance learning programs designed especially for RNs already working in the field.
- Does an online RN degree cost less than a traditional campus-based program?
While some online programs cost the same as brick-and-mortar degrees, distance learning may offer some savings. Online students generally pay the lower tuition rate available to in-state students, regardless of their place of residence. Distance learners can save on transportation and housing but may have to pay a technology or connectivity fee for access to web-based courses.
- What will I study in an undergraduate nursing program?
An associate degree can introduce students to the foundations of nursing and includes general education courses needed to transfer to a four-year program. A bachelor of science in nursing focuses more deeply on nursing practice and requires natural and social science courses in areas like anatomy, biology, chemistry, nutrition, and psychology.
- How do I know if the nursing school I want to attend is accredited?
Most nursing programs proudly reveal their accreditation status on their websites, letting prospective students know that they adhere to professional standards for nursing education. If you cannot find information about a school's accreditation, check the listing of accredited schools at the ACEN or CCNE links provided above.
- What is the difference between an LPN/LVN program and an RN program?
Earning the LPN/LVN will cost less than an RN and usually takes only a year of study. An LPN/LVN works under the supervision of an RN and typically earns less. An RN can increase employment and salary prospects, offers a broader scope of practice opportunities, and provides a strong foundation for advanced training.
- What are the highest-paying nursing specialties?
According to Nurse.org, the top-paying nursing fields, with average salaries at $90,000 and above, include CRNAs, general NPs, gerontological NPs, pain management nurses, and psychiatric NPs. Except for pain management, these positions each require a master's and specialized certification beyond the RN degree.
- What states offer the highest salaries for RNs?
While RN salaries generally have kept pace with the cost of living, compensation varies widely by state and even by geographical areas within states. The locations with the highest RN salaries also have the highest food, housing, and transportation costs. The top states for RN salaries are California, Nevada, Alaska, Oregon, and Massachusetts.
- If I receive my license in one state, can I transfer it if I move to another state?
While each state administers its own certification procedures, the process to transfer licenses to other states has become easier through the Nursing Licensing Compact (NLC). The NLC allows a licensed nurse whose primary residence is in one of its 34 member states to practice in other member states without having to apply for a new license.
- What types of financial aid are available for students entering RN programs?
The search for financial aid begins by submitting the Free Application for Federal Student Aid (FAFSA) to help you locate federal grants, loans, and work-study opportunities. In addition to scholarships and grants (which do not have to be repaid), students should investigate their eligibility for private loans, veteran benefits, and employer-sponsored tuition remission programs.
Scholarships for Registered Nursing Students
In response to the nursing shortage, many government agencies, colleges, universities, and private organizations have established scholarships to help students finance their RN training. Many of these initiatives help support learners from underrepresented groups or those intending to pursue certain specializations. This list gives you an idea of the need-based and merit-based awards available for undergraduate and graduate education in nursing.
Who Can Apply: These scholarships provide support for undergraduate or graduate nursing students who have worked or volunteered for the American Red Cross.
What to Know: Each applicant must have completed one year of college credits in an accredited nursing program and submit an essay describing how their Red Cross experience contributes to the nursing field.
Who Can Apply: AORN awards these scholarships to undergraduates and graduates enrolled in accredited nursing programs who intend to enter the field of perioperative nursing.
What to Know: Each candidate must provide documentation of a 3.0 GPA or higher and submit a personal statement that describes their interest in the perioperative/surgical nursing specialty.
Amount: Variable; award paid as reimbursement for allowable tuition and other expenses
Who Can Apply: HRSA awards this scholarship to students enrolled in accredited professional nursing programs who intend to work in eligible facilities with a critical shortage of nurses.
What to Know: This scholarship pays for tuition and fees, books and supplies, and uniforms, and provides a monthly stipend. A recipient must fulfill a minimum of two years of service at a critical shortage facility.
Who Can Apply: A Hispanic nursing student enrolled in a two-year associate nursing program may apply for this award.
What to Know: Applicants must hold membership in NAHN for at least six months before the scholarship deadline. Each scholarship recipient must demonstrate a promise of professional contributions to the nursing profession and the potential to act as role models to other students.
Who Can Apply: This professional association awards several annual scholarships to NBNA members currently enrolled in an undergraduate or graduate nursing program.
What to Know: Each candidate must submit two letters of recommendation and provide evidence of their participation in student nursing activities and involvement in the African American community.
Working as a Registered Nurse
While over half of all RNs work in hospitals, job opportunities continue to expand in other public and private settings, such as physicians' offices and clinics, home healthcare, long-term care, schools, and government agencies.
Salaries for RNs vary considerably by employer, location, degree levels, specialties, and years of experience, but overall rank well above compensation levels for other occupations. The BLS reports a median annual wage of $71,730 for RNs. The top 10% of these nurses earn over $100,000 a year, while the lowest 10% earn less than $50,000. The highest-paid RNs work in government facilities and private and public hospitals.Learn more about registered nursing salaries and job growth