Registered nurses (RN) in California can look forward to bright professional futures. California ranks as the state with the highest number of employed RNs, and the highest average salaries in the U.S. In addition, the Bureau of Labor Statistics (BLS) projects the job growth for RNs to reach 7% between 2019-2029, faster than the national average.
However, in order to legally work as an RN in California, you first need to earn registered nursing licensure from the state. The licensure process ensures candidates meet the proper education, supervised experience, and examination requirements. While the process may seem confusing or overwhelming, this guide clearly outlines the steps you need to take to earn a California nursing license.
How to Become an RN in California
The path to pursuing nursing in California starts with education. Aspiring RNs need to earn an accredited degree to qualify for licensure, as accreditation ensures that academic programs provide students a quality education. The California Board of Registered Nursing (BRN) only considers candidates with accredited degrees.
The degree can take anywhere from 2-4 years to complete, and possibly longer for part-time students. Upon graduating, candidates must sit for the National Council Licensing Examination (NCLEX). After passing this exam, candidates may then apply for BRN licensure.
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Education Requirements in California
The path to becoming an RN begins with earning a two-year associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN). Although both allow graduates to apply for RN licensure, the American Association of Colleges of Nursing (AACN) encourages students to earn a BSN. BSN graduates enter the workforce better equipped to handle the challenges of nursing, according to the AACN.
If those programs sound too time-consuming, you might consider becoming a licensed vocational nurse (LVN). These nursing professionals do not hold the same responsibilities as RNs, and they can usually complete the required training program in one year. Sometimes LVNs work in this role for a few years before pursuing an ADN or BSN degree to prepare for an RN role later on. Licensed vocational nurse works under the supervision of a registered nurse or provider.
Finally, nurses who want more responsibility can pursue a master of science in nursing (MSN). MSN degrees prepare graduates to become nurse practitioners, who can meet with patients independently and prescribe medication. Additionally, students can pursue a MSN in other programs to become a clinical nurse specialist (CNS), clinical nurse leader (CNL), or certified nurse midwife (CNM), or enter fields like nursing informatics, healthcare policy, and public health.
Licensure Requirements in California
Candidates must complete an application and submit it 6-8 weeks before they graduate. They should ask their school to submit transcripts to the BRN, and they must undergo a fingerprint background check as part of the application process. After those steps have been completed, an Authorization to Test (ATT) will be provided prior to scheduling for the actual exam date.
After earning either an ADN or BSN, RN candidates must pass the NCLEX-RN exam, which tests a candidate’s essential knowledge of nursing. Topics include health maintenance and promotion, physiological and psychosocial integrity, and providing a safe care environment for patients. Candidates take the exam on a computer, usually at a testing center. The BRN recommends that test-takers schedule the exam shortly after they graduate instead of waiting a few months.
Candidates who do not want to wait for the results of their exam can apply for an interim permit and begin working under professional supervision.
Frequently Asked Questions
How many RNs are there in California?
About 302,777 registered nurses work in California as of May 2019, according to the Bureau of Labor Statistics (BLS). California has the largest employment numbers for RNs in the country; in fact, California has 85,000 more nurses than Texas, the state ranking second for RN employment.
How long does it take to be a RN in California?
This depends on the aspiring RN’s chosen pathway. Nurses who enroll in associate degrees can become a nurse in two years, while those who choose the BSN route can become a nurse in four years. However, some students enroll in school part time, which can extend the time it takes to become an RN.
Is there a nursing shortage in California?
Different studies offer various predictions about a possible nursing shortage in California. Some studies concluded that the state will face an alarming nursing shortage of 44,500-141,348 nurses by the year 2030. One forecast from the University of California at San Francisco, however, predicts that the supply of nurses will slightly outpace the demand in that year.
How much is a RN license in CA?
For nursing candidates who apply through the examination route, California graduates must pay $300, and out-of-state graduates need to pay $350 to apply for the exam. RN candidates applying by endorsement must pay $350. You can find more information about those fees here.
How many clinical hours are needed for RN in California?
Nursing candidates complete their clinical hours while enrolled in nursing degree programs. Each program includes its own requirements, including the number of supervised clinical hours; if the program holds accreditation, then students are sure to meet the state’s licensing expectations.
Salary and Employment for Registered Nurses in California
Over 300,000 registered nurses work in California, making it the state with the highest employment of RNs in the country, according to BLS data. Los Angeles ranked as the city with the second highest employment of registered nurses, as over 111,000 RNs work in the metro area.
Additionally, California ranks as the top paying state for registered nurses. BLS data shows that RNs in the state make an annual mean wage of $113,240 — much higher than the national mean wage of $77,460.
In fact, each of the top 10 highest paying metro areas for RNs in the U.S. are located in California. San Jose ranked as the best paying city, with registered nurses earning mean pay of about $140,740. The other metro areas on the list include: San Francisco, Santa Cruz, Salinas, Vallejo, Sacramento, Yuba City, Modesto, Stockton, and Santa Maria. Mean salaries in these areas range from about $109,000-$138,000.
Working as an RN in California
From the 1990s through approximately 2007, California experienced a severe nursing shortage, as employers were unable to fill the demand for nursing positions. Some studies predict that another nursing shortage may occur in the next ten years. Those reports predict that California could see a nursing shortage ranging from 44,500-141,348 nurses by 2030, according to two studies from 2017 by the American Journal of Medical Quality and the National Center for Health Workforce Analysis.
A more recent study from the University of California at San Francisco that the supply of nurses may actually be slightly higher than demand by 2035. However, various factors — such as migration to and from the state, population growth, or an unexpected global pandemic — could cause a small shortage instead.
Best Hospitals to Work at in California
The following hospitals come from U.S. News & World Report’s list of the best hospitals in California. When calculating these rankings, the publication uses data to consider several factors, including patient outcomes, patient experience, expert opinions, and other care-related indicators like nurse staffing and patient volume.
You can read about five of the best hospitals below.
Cedars-Sinai Medical Center
Nearly 2,400 nurses work at Cedars-Sinai, located in Los Angeles. The hospital has 886 hospital beds, and within one year admits over 50,000 patients and experiences about 91,000 emergency visits. With multiple locations around L.A., Mount Sinai treats patients for diseases and illnesses within departments such as oncology, women’s health, pediatrics, and orthopaedics.
University of California, San Francisco Medical Center
At USFC Health, the 2,500 nurses who work at the medical center help the 30,000 patients admitted to the hospital and 750,000 patients who visit each year. In fact, UCF Health holds the well-respected Magnet designation from the American Nurses Credentialing Center. The medical center operates from several speciality clinics and two children’s hospitals in San Francisco and Oakland.
Scripps La Jolla Hospitals
With locations in both San Diego and La Jolla, this hospital network operates as a $2.9 billion nonprofit medical center. The hospital now offers services at its 60 medical and surgical specialities, four emergency rooms, three urgent care centers, and a same-day, walk-in express center. About 15,000 employees work at these many locations, including nurses.
University of California Davis Medical Center
The UC Davis Medical Center, located in Sacramento, serves 33 counties and six million residents in the state. The teaching hospital experiences about one million visits and 30,000 patient admissions each year. About 1,800 nurses and nurse practitioners work at UC Davis Health. About 9% held an ADN, 71% a BSN, and 18% an MSN, according to the medical center’s 2019 nurse report. Additionally, about 57% of nurses hold a specialty certification.
MemorialCare Long Beach Medical Center
With locations in Long Beach, Laguna Hills, and Fountain Valley, MemorialCare offers services in joint replacement, weight loss surgery, imaging and radiology, and several types of care. About 4,000 RNs work at MemorialCare, and about half of them hold BSNs.
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Karen Luu, MSN, PMHNP-BC
Karen Luu is a board-certified psychiatric mental health nurse practitioner. Luu holds a master of science degree in nursing from Azusa Pacific University as well as an undergraduate degree in public health science. She has seven years of nursing experience, which includes working at the Level II Trauma Center, community hospitals, mental health urgent care, and private practice. Luu is currently working at a private practice which specializes in bipolar disorder, schizophrenia, depression, anxiety, and PTSD. She emphasizes the importance of incorporating the recovery-based model in her everyday practice.