Nursing is a challenging and rewarding career, and students who choose this career path are likely to find they’ll have a variety of job options to choose from. For example, some nurses work in hospitals, physicians’ offices, or in long-term care facilities, while others choose to work in fields such as public health or travel nursing.
There are many benefits associated with pursuing a nursing career. The U.S. Bureau of Labor Statistics (BLS) projects that employment of RNs will grow by 12% between 2018 and 2028, which is much faster than the average growth projected for all occupations. This uptick in demand is linked to three key factors: the increased healthcare needs of an aging population, the baby boomer nurse retirement wave, and the ongoing nursing shortage.
Individuals who choose a career in nursing may also have significant advancement opportunities. For example, nurses who start their careers by completing an entry-level educational program can pursue a Bachelor of Science in Nursing (BSN) degree, which often leads to higher salaries and increased autonomy. BSN-holders can go on to pursue master’s and doctoral degrees, which can help them advance to management and nurse practitioner roles.
Earnings opportunities are also significant. The BLS reports that as of May 2019, RNs had a median annual wage of $73,300. Salaries in the top 10% of the range had annual earnings of more than $111,220, though these salaries may vary depending on experience, education level, place of work, and other factors.
The field of nursing is vast. Whether candidates want to work at a small, private practice or in a large teaching hospital, there is one thing that all aspiring nurses have in common: To be eligible to pursue jobs in this field, candidates must meet minimum nursing prerequisites.
The following paragraphs will discuss the various pathways toward becoming a nurse, along with educational and licensing requirements, where applicable.
How to Become a Nurse
Individuals who want to start their nursing career quickly can become certified nursing assistants (CNAs) in four to 12 weeks. Upon completion of a CNA program, nursing assistants are permitted to perform basic tasks, such as checking and recording patients’ vital signs and creating and maintaining
patient records. Nurses who want to become licensed practical nurses (LPNs)/licensed vocational nurses (LVNs) must complete a certificate or diploma program, which typically takes one year. However, students who want to work as registered nurses (RNs) will need additional training, and there are several steps that aspiring RNs must take to become eligible to pursue jobs in this field. In addition to completing educational requirements, students must pass a standardized licensing exam. It should be noted that some states require that nurses participate in continuing education coursework.
Basic Nursing Educational Requirements
There are three educational pathways to becoming a registered nurse. Educational options include completion of a diploma in nursing, an associate degree in nursing, or a bachelor’s in nursing program.
- Diploma in Nursing
A nursing diploma is the minimum educational requirement to pursue entry-level jobs in this field. This is a hospital-based program that can often be completed in two to three years, depending on the institution where it’s being offered. Nurse diploma programs should be accredited by state nursing boards, and may also be accredited through the National League for Nursing.
- Associate Degree in Nursing (ADN)
Associate degree in nursing programs are typically offered by community colleges. Most programs can be completed in two to three years, and they blend classwork with hands-on training. The primary difference between an ADN and a diploma in nursing is that ADN programs are offered by colleges and diploma programs are hospital-based. Students enrolled in an ADN program must also complete general education coursework in subjects such as math, English, and social sciences. Nurse diploma programs, on the other hand, do not require general education study.
- Bachelor of Science in Nursing (BSN)
A Bachelor of Science in Nursing program is a four-year program that’s offered by numerous colleges and universities. Nurses who have completed a BSN degree often have better job prospects than applicants who have a nursing diploma or ADN. They also tend to earn higher salaries. For example, data from PayScale indicates that as of July 2020, RNs had a median annual salary of around $65,000, while the median annual salary for holders of a BSN degree was $84,200.
Nursing Licensing Requirements
Students who have completed a nursing diploma, ADN, or BSN must pass a licensing exam before they can work as a registered nurse. The National Council Licensure Examination (NCLEX-RN) determines whether aspiring nurses have the knowledge they’ll need to safely practice entry-level nursing tasks.
The NCLEX-RN is a computerized, pass-fail test that includes 75 to 265 questions. (The variance stems from the NCLEX’s use of computerized adaptive testing technology, which chooses questions based on the test-taker’s performance on previous questions.) Although most questions are in a multiple-choice format, fill-in-the-blank and drag-and-drop questions may be included. Individuals who want to register for the NCLEX must start by contacting their local nursing regulatory body (NRB) to request a licensure/registration application. After the application is submitted, RN candidates will receive an authorization to test (ATT). Candidates cannot register for the NCLEX until they receive their ATT.
Testing is available throughout the year. According to the National Council of State Boards of Nursing (NCSBN), first-time test-takers will be offered an appointment within 30 days of their request to schedule an exam. Scheduling can be done online or by phone.
Although unofficial test results may be available online as soon as two business days after the exam, official test results are not sent out until approximately six weeks after the exam. Candidates who need to retake the NCLEX must wait a minimum of 45 days before scheduling their next test date. Although NCSBN policies do not cap lifetime retakes, the organization states that test takers may not sit for the exam more than eight times in a single year, and some states may have additional restrictions.
Continuing Your Nursing Education
Once students have passed the NCLEX exam, they may be required to participate in continuing education (CE) to keep their RN license current. Most states require RNs to participate in 12 to 30 hours of CE every two years. However, RNs should know that CE requirements vary from state to state. For example, CE is not required in Arizona, Colorado, and Connecticut; however, California, Illinois, and the District of Columbia have individualized CE mandates. Individual state requirements can be found on the AAACEUs website.
Prerequisites for BSN Nursing Programs
The prerequisites for BSN nursing programs vary depending on the type of program a student is interested in. For example, straightforward Bachelor of Science in Nursing program requirements are similar to other types of four-year bachelor’s degree programs. Candidates must submit an application and provide high school or associate degree transcripts that reflect an applicants’ cumulative GPA. Minimum GPA requirements may vary based on the school an applicant is applying to.
However, students who have completed a bachelor’s degree in a non-nursing discipline can choose an accelerated BSN nursing program. According to the American Association of Colleges of Nursing, accelerated baccalaureate programs can often be completed in 11 to 18 months. Graduates from both types of programs are eligible to take the NCLEX-RN and pursue licensure as a registered nurse.
A third type of baccalaureate degree option is an RN to BSN program. An RN to BSN program allows nurses who have an active RN license to advance their education while continuing to work. Nursing prerequisites for this type of study track including licensing and admissions requirements, as noted below.
Individuals who want to enroll in an RN to BSN program must have a current (nonexpired) nursing license. Those who need to renew an expired license will need to contact their local nursing regulatory body to ask about the reactivation process. Although this process varies from state to state, applicants often need to retake the NCLEX and complete continuing education courses.
According to the National Council of State Boards of Nursing, the purpose of a professional license is to demonstrate that an RN has met minimal qualifications and competencies. Individuals who have been licensed by the state board of nursing have shown they’ve met predetermined standards.
While the exact BSN admissions process typically varies from school to school, requirements are often similar. In addition to standards for an applicant’s minimum college or high school GPA, other requirements may include submitting official transcripts from prior colleges/universities, providing references and a CV or resume, and completing an application essay.
Nursing Skills That BSN Programs Focus On
Completing an education and passing the NCLEX are important milestones on the path toward becoming a registered nurse. However, professionals who work in this field must also develop various other hard and soft skills. Nursing is both challenging and rewarding, and it takes a lot more than medical knowledge to be successful. Consequently, aspiring nurses will be well served by developing and fine-tuning the following capabilities:
Individual and Family Assessment Capabilities
All RNs must develop health assessment capabilities. In addition to evaluating patients’ health problems, assessment skills help nurses design and carry out care plans. Registered nurses who have completed a nursing diploma or associate degree in nursing often find that completing additional education, such as an RN to BSN program, can help improve their assessment proficiencies.
Some patients are more difficult than others, but all deserve compassionate care. Nurses must understand that patients may be feeling scared or vulnerable. There are three key reasons why RNs must engage patients with kindness:
- Showing kindness can help reduce patients’ fears and anxieties.
- Engaging patients with kindness can improve the nurse-patient relationship.
- Patients who believe their healthcare provider is looking out for their best interests are more likely to adhere to treatment plans. Patients who adhere to treatment plans tend to have better outcomes.
In the nursing profession, compassion is an essential component of providing high-quality care. Nurses who develop their interpersonal skills and can empathize with their patients’ fear, pain, and suffering can help patients feel more comfortable. Compassionate care can also help improve patients’ outcomes.
Nurses must be able to detect small, subtle changes in their patients’ health. For example, if a patient reports they’ve experienced an abrupt change in their personality that isn’t linked to a major life event, it could be a sign of an underlying health problem, such as a thyroid disorder, low blood sugar, or a developing neurological disorder such as Alzheimer’s disease. Strong observational skills help nurses understand when to involve a patient’s primary care provider.
Critical thinking is an essential nursing skill, as deciphering a patient’s health problems is akin to solving a complex puzzle. Although RNs are not responsible for diagnosing patients’ health problems, they must know how to prioritize decisions that can help save lives. For example, if a nurse knows a patient has recently been prescribed blood pressure medication and discovers the patient is experiencing adverse side effects, the nurse’s critical-thinking skills can help prevent serious issues. In this example, critical-thinking skills may lead the nurse to hold the patient’s next dose and contact the patient’s doctor.
Nurses must be able to communicate with patients and their families in a clear and concise manner. This often involves relaying complex medical information in nontechnical terms. Strong communication skills in nursing involve not only providing information to others but also listening carefully and receiving information.
Prerequisites for Nursing and Nursing Licensing Requirements
Aspiring RNs should know that there are multiple prerequisites for nursing and nurse licensing. The first nursing prerequisite involves graduating from high school or obtaining a GED, as this is the first step toward gaining acceptance to an entry-level nursing program.
Students with a high school diploma or GED certificate are eligible to apply to entry-level RN nursing programs, such as diploma in nursing, ADN, or BSN programs. Prior to taking the NCLEX-RN, students must provide verification of graduation, or eligibility for graduation, from an approved RN prelicensure program. Although students who have graduated from an accredited licensed practical nurse (LPN)/licensed vocational nurse (LVN) program may also take the NCLEX, they are not eligible to take the NCLEX-RN to become a registered nurse. Instead, LPN/ LVN candidates may take the NCLEX-PN (practical nurse) test to obtain licensure.
Upon passing this exam, LPNs/LVNs will become eligible to work in a variety of settings, such as residential care facilities, in-home healthcare organizations, and physicians’ offices. Professionals who work as LPNs/ LVNs report directly to RNs and physicians and are permitted to perform basic patient care functions. LPNs/LVNs who wish to advance to RN roles must complete additional education and pass the NCLEX-RN exam.
Other Requirements and Information
Passing the NCLEX is an important step toward becoming a licensed nurse. However, licensing requirements vary from state to state. For example, Missouri, New Jersey, and North Carolina require that nurse candidates pass a criminal background check before their initial licensure. Other states, such as California, require nurses to pass a background check before transferring a license from another state.
Resource Guide for Nurse Licensing
- NCLEX Registration and Authorization to Test — Information on how to prepare for the NCLEX test from the NCSBN.
- NCLEX-PN and the NCLEX-RN — Information on the practical nurse and registered nurse exams from the Houston Chronicle.
- Nursing Continuing Education Requirements by State — Information from the AACEUs on continuing education for nurses.
- Nursing License, Verification and Renewal Information — Information from American Mobile Healthcare on licensure and renewal.
- NCLEX Test Preparation Study Guide — Tips on how to pass the NCLEX from Education Corner.
Develop the Skills and Tools You’ll Need to Advance Your Nursing Career
The path toward a career in nursing starts with education. Aspiring nurses can choose from multiple educational options that require varying amounts of time in the classroom. LPN/LVN programs can be completed in as few as 12 months, but nursing diploma and associate degree in nursing programs take longer. Although bachelor’s degree programs take the longest, with students graduating on average in four years, BSN degree-holders tend to enjoy more autonomy and higher salaries than individuals who graduated from less rigorous programs. BSN-holders who want to pursue upper-level management careers and nurse practitioner roles can go on to pursue master’s and doctoral degrees.
Future nurses must decide which educational track best aligns with their goals. If you’re wondering how to become a nurse, take some time to do additional research and explore nursing prerequisites. This will help ensure you find the program that’s right for you.