How to Become a Nurse
There are multiple ways to become a nurse in the US and the process is not as complex as it might seem. If you're interested in how to become a registered nurse (RN) in the US, you should know that you have a choice of three main nursing pathways to follow. Your decision will depend on your circumstances, including your existing commitments, financial situation and as well as your nursing career goals.
The process of becoming a nurse can take anywhere from one to four years, with one year of study allowing you entry into the profession and three to four years permitting you to work as a registered nurse with increased responsibility and a higher earning potential from the outset.
Here we'll address the much-asked question of how to become a nurse in the US, with details on nursing requirements, the types of nursing qualifications available, how many years it takes to become a nurse and the nursing careers open to you after your nursing school.
Nursing requirements in the US differ depending on the type of nurse you want to be. There are four professional titles and these are:
- certified nursing assistant (CNA)
- licensed practical nurse (LPN)
- registered nurse (RN)
- advanced practical registered nurse (APRN)
If you're interested in becoming a registered nurse and gaining the license that allows you to work as an entry-level staff nurse, you'll need to hold an associate's degree in nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree.
To become an advanced practical registered nurse (APRN) you'll also need to complete a specialized postgraduate degree in addition to the ADN or BSN. If you do not wish to study for a degree but still want to enter the nursing profession as soon as possible, you can become a CNA or become an LPN with completion of a short vocational course. These programs provide opportunities to progress into registered nursing roles with the right education and training.
If you have previously studied for a healthcare related degree and now wish to take steps to become a nurse, you can choose an accelerated baccalaureate nursing program which will take one and a half to two years to qualify for for the RN licensure exam.
State licensing for Nurses
How to become a registered nurse is not just a question of education, but also a question of gaining a US nurse license. Upon completion of your nursing degree or registered nurse (RN) training you will be eligible to sit the NCLEX-RN, which is the standardized exam issued by the National Council of State Nursing Boards and offered across the US. Only if you successfully pass this exam will you be able to gain state licensure and employment as a registered nurse (RN).
How to become a Registered Nurse
Before you think of gaining licensing however, you must first obtain the correct qualifications. To be eligible to take the RN licensure exam, you'll need to hold a two- or four-year nursing degree, a three-year nursing diploma or the relevant RN qualification. Below, we've outlined each pathway of how to become a registered nurse in detail, including information on the curriculum and process.
Certified Nursing Assistant (CNA) and Licensed Practical Nurse (LPN) programs
CNA and LPN programs are two informal routes towards becoming a registered nurse for those who do not wish to gain their qualification with lengthy study at a college or university. The CNA and LPN qualifications are vocational courses offered at technical colleges, teaching hospitals, and community colleges. They can take 75 hours (CNA) to one year (LPN) respectively, leading to a certification exam. CNA and LPN programs provide theoretical classes and practical clinical training in either a hospital or clinic. Typical areas of study include first aid, nutrition, and physiology.
These qualifications are not strictly guaranteed ways of becoming a registered nurse, but rather are the bare minimum requirements to enter into the profession. Because of this, you should keep in mind that until you undergo further on-the-job training, you'll only be able to conduct basic nursing tasks such as administering injections, preparing patients for surgery, and changing dressings. Despite this, the CNA and LPN can be quick routes into the medical field, with some employers providing further training and tuition reimbursement for dedicated workers.
If you become an LPN and are still interested in becoming a registered nurse, consider enrolling on an LPN-RN program either at your place of work or at a community college or training hospital. This will allow you to progress in the nursing profession and use the credits you earned during your LPN training and put them towards your RN coursework.
Associate's Degree in Nursing (ADN/ASN)
An associate's degree in nursing (ADN) offers a formal route into the nursing profession and takes two years to complete. Associate's degrees in nursing are offered in community colleges, hospital-based schools of nursing, or training hospitals. A select few four-year colleges also offer this degree, aiming to provide the practical and technical training needed to work as a registered nurse in a certain area.
Applicants for the ADN must hold a high school diploma or GED and meet a specified grade point average, and some schools may even require nursing experience or a CNA qualification. Accepted degree titles for RN licensure include Associate of Applied Science in Nursing (AASN), Associate Degree in Nursing (ADN) or Associate of Science in Nursing (ASN).
Although on-site practical training is often a prerequisite, some programs now offer some of theoretical modules online, meaning that studying for an associate's degree is more flexible than ever. Whether nursing classes online or on campus, an associate's degree in nursing will blend theoretical coursework with hands-on training in labs and nursing clinics, commonly covering subject areas such as anatomy, biology, nutrition, and physiology.
Due to the growing employer preference for new nurses to hold a BSN, once you complete your ADN and become a registered nurse, you might think about enrolling on a RN-BSN conversion program. The RN-BSN program can be completed while you work as a nurse, meaning you can earn and gain invaluable experience all while advancing your qualifications and earning potential. Some employers even offer tuition reimbursement programs to help staff achieve their BSN qualification.
If you are looking to work as an RN for any length of time, pursuing the RN-BSN program is a wise choice, as not only does it open you up to career progression but it also is a necessity for anyone wanting to undertake further study at master's or doctorate level in order to gain an advanced practical registered nurse (APRN) qualification.
Bachelor of Science in Nursing (BSN)
While you can also work as a registered nurse with an associate's degree, with a four-year Bachelor of Science in Nursing (BSN) degree you'll likely be hired for roles of more responsibility and therefore have a higher earning power. Also, in recent years, more and more US employers have been making the BSN a hiring requirement.
According to a 2012 nationwide survey of employers by the AACN* (American Association of Colleges of Nursing), 43% of hospitals and healthcare providers in the US now require new nurses to hold a BSN, while 78% express a preference for BSN degree holders.
The Bachelor of Science in Nursing degree is a four-year program widely offered at recognized colleges and universities, with common requirements being a high school diploma or GED and a suggested grade point average, varying on the school. The BSN curriculum incorporates both theoretical coursework and clinical practice, covering scientific courses, nursing skill based courses, and general education requirements such as liberal arts subjects.
A typical BSN degree program will provide you with a rounded knowledge of the nursing profession, across all areas of healthcare. During your first two years you'll be covering foundational units such as anatomy, biology, human growth and development, microbiology, nutrition, organic chemistry, psychology and physiology.
In your final two years there will be more freedom to specialize in your specific interests. Such as acute and chronic disease, community nursing, maternal health, mental health nursing, pediatrics, and public health. In addition to technical knowledge, you will also gain applied skills in leadership and assessment, as well as the ability to conduct your own evidence-based practice research across diverse fields such as economics, health informatics and health policy.
With this broad curriculum, the aim is to help students develop a deep understanding of the economic, cultural, political and social aspects that affect healthcare providers and their patients, giving students the practical and theoretical knowledge needed to deliver healthcare effectively in various environments.
Choosing a Nursing Program
If you are choosing a nursing program and not sure what nursing program you want to go into, a four-year BSN degree will give you a solid foundation across all possible areas, allowing you to gain a rounded knowledge of the profession with the chance to specialize later on in your studies.
Mature students, or those with work or family commitments, will often go down the route of obtaining a two-year associate's degree or diploma due to the fact that these routes offer a shorter study period and more flexibility, with many colleges offering online or evening and weekend classes.
Ambitious and driven workers who don't want to be out of work for any length of time should consider on-the- job development, by starting out as CPAs or LPNs and developing into RNs and then undertaking the RN-BSN practical training qualification.
Advanced Practical Registered Nurse - Advanced Study
After successfully completing your BSN degree or RN-BSN qualification, you may wish to undertake further study in order to become eligible for advanced practical registered nurse (APRN) roles. With a BSN you are able to apply for a Master of Science in Nursing (MSN) and/or doctorate (PhD in Nursing) programs at colleges and universities across the US.
On a one- or two- year master's degree, you are able to specialize further in an area of your choice, in topics such as administration, curriculum development, healthcare business practices, human resources, mental health, and nursing law.
PhD programs meanwhile are for students wishing to pursue upper-level careers in the nursing profession, such as chronic illness, global health, and women's health. The PhD is a research based degree requiring a dissertation, but also both MSN and PhD programs will likely have a thesis as a required part of the course.
What can you do with a nursing degree?
Once you complete your nursing degree there are an endless amount of nursing careers open to you, across a range of diverse work environments. Before you try and answer the question of "what can you do with a nursing degree?" you should first ask yourself, "where do you want to work?"
Some common examples of where qualified nurses work include correctional facilities, home-based healthcare services, hospitals, local clinics, military bases, nursing homes, physicians' offices, and schools.
Choosing from the wide selection of nursing careers will ultimately depend on you; you should think about the types of people you enjoy working with (i.e. the elderly or children), the type of environment you thrive in (i.e. in a home or a hospital), the shifts you want to work (i.e. night shifts, split shirts or normal-hour shifts) and the career progression you wish to see.
According to the Bureau of Labor Statistics, projected job growth for registered nurses is expected to increase by 19% between 2012 and 2022** (a whole 7% more than the average across all sectors which sits at 11%). This means that over the next ten years, nursing careers are likely to be more secure than ever before. In 2013 the average annual salary for a registered nurse in the US was US $68,910 (BLS figures***) but this is projected to rise as demand increases.
- * AACN, Press Release
- ** BLS, Occupational Outlook Handbook
- *** BLS, Occupational Employment Statistics
Career Satisfaction for Nurses
If you find value in serving and helping others, a career in nurse will provide high satisfaction. It is also a work environment that is non-competitive, meaning other nurses are your teammates and not trying to compete with one another in the workplace. In addition, this career can make people feel a sense of accomplishment and that their skills are put to good use.
Nurses are also in constant contact with others, so it goes without saying if a person is considering a career in nursing, they may want to consider whether they enjoy working with people or not.
If you do not have your degree in nursing yet, look at your areas job boards to see if some employers desire (or require) a bachelors in nursing or if an associates in nursing meets their need. You could get a foot in the door as a nurse in as little as two years!