Becoming a registered nurse (RN) requires completing a nursing degree, passing a national licensing exam called the NCLEX-RN, and applying for a state license. The entire process takes two to four years depending on the degree path you choose. Here’s what each step looks like in practice.
Choose Between Two Degree Paths
You have two main options for your nursing education: an Associate Degree in Nursing (ADN), which takes about two years, or a Bachelor of Science in Nursing (BSN), which takes four. Both qualify you to sit for the same licensing exam and work as an RN. The difference comes down to time, cost, and long-term career flexibility.
An ADN at a public school typically costs $24,000 to $40,000 in tuition. A full-time BSN runs significantly more, anywhere from $90,000 to over $200,000 when you factor in four years of tuition, fees, and living expenses. Private institutions charge even higher rates on both tracks. Many nurses start with an ADN to enter the workforce faster, then complete an RN-to-BSN bridge program online for $20,000 to $80,000 while they’re already earning a paycheck.
The BSN is increasingly preferred by hospitals, especially large medical centers and those pursuing Magnet recognition. If you’re aiming for management, education, or advanced practice roles down the road, you’ll eventually need one. But for getting hired as a new RN at many community hospitals, clinics, and long-term care facilities, an ADN is a fully valid starting point.
Complete Prerequisites Before You Apply
Nursing programs don’t start with nursing courses. You’ll need to complete a set of prerequisite classes first, and most programs are competitive enough that your grades in these courses heavily influence whether you’re accepted. Common prerequisites include Biology, Chemistry, Anatomy and Physiology I and II, Microbiology, and general education courses like English composition, psychology, and statistics. Some programs require a minimum grade of B- or higher in each science prerequisite.
If you’re applying to an ADN program, you can usually knock out prerequisites at a community college in one to two semesters. BSN applicants often complete them during their first two years of university alongside other general education requirements. Either way, plan on science courses being the gatekeepers. Strong performance in anatomy and microbiology signals to admissions committees that you can handle the rigor of the clinical program.
What to Expect in Nursing School
Once you’re admitted, nursing coursework covers four core content areas: medical-surgical nursing, maternal and child health, pediatrics, and mental health nursing. The classroom portion is only half the picture. Clinical rotations, where you work directly with patients in hospitals, clinics, and other healthcare settings, make up a substantial portion of your training. A common structure is one hour of classroom instruction for every three hours of related clinical experience.
During clinicals, you’ll rotate through different specialties: caring for post-surgical patients one semester, assisting in labor and delivery the next, then spending time on a psychiatric unit. These rotations happen under the supervision of clinical instructors and staff nurses. They’re physically and emotionally demanding, often requiring 10- to 12-hour shifts that mirror real nursing schedules. This is where most students figure out which area of nursing they want to pursue after graduation.
If You Already Have a Bachelor’s Degree
Career changers with a non-nursing bachelor’s degree have an accelerated option. Accelerated BSN (ABSN) programs condense the nursing curriculum into roughly 16 months across four consecutive semesters. These programs are intense, essentially full-time and then some, with little room for outside work. You’ll still need to complete nursing-specific prerequisites before starting, so budget an extra semester or two of prep if you haven’t taken courses like anatomy or microbiology.
Pass the NCLEX-RN Exam
After graduation, the next hurdle is the NCLEX-RN, the national licensing exam administered by computerized adaptive testing. The computer tailors questions to your ability level in real time. Every time you answer a question, the system recalculates its estimate of your competence and adjusts the difficulty of the next question accordingly.
You’ll answer a minimum of 85 questions and a maximum of 150 within a five-hour window (including breaks). The exam stops when the computer is 95% certain your ability is either clearly above or clearly below the passing standard. Finishing at 85 questions isn’t necessarily good or bad news. It simply means the computer gathered enough data to make a confident decision early.
The exam covers everything from pharmacology and patient safety to prioritization and clinical judgment. Most nursing programs build NCLEX prep into the final semester, and many graduates also use third-party review courses and practice question banks in the weeks before testing.
Apply for Your State License
Passing the NCLEX-RN doesn’t automatically make you licensed. You need to apply through your state’s Board of Nursing, which involves submitting an application with fees, registering with the testing vendor (Pearson VUE), and completing a criminal background check. Most states require electronic fingerprinting, which gets screened against both state and national criminal history databases.
Once your application materials are complete, a specialist reviews everything and confirms your eligibility. If anything is missing or needs clarification, expect some back-and-forth that can add days or weeks. After you pass the NCLEX-RN, your initial license notification typically arrives within 7 to 10 days. Some states participate in the Nurse Licensure Compact (NLC), which allows you to practice in multiple member states under a single license, a major convenience if you live near a state border or want to travel nurse later on.
Keep Your License Active
An RN license isn’t a one-time achievement. Every state requires ongoing continuing education for renewal, though the specifics vary. In North Carolina, for example, nurses renew every two years and must meet one of several competence options: completing 30 contact hours of continuing education, earning 15 contact hours plus logging 640 hours of active practice, obtaining national certification, or completing post-licensure academic coursework, among others. If you don’t meet the requirements by your renewal date, your license goes to inactive status until you catch up.
States conduct random audits, so you need to keep documentation of any continuing education you complete. Most nurses satisfy these requirements through online courses, employer-sponsored training, and professional conferences. It’s a manageable commitment once you build it into your routine, but it can catch you off guard if you ignore renewal deadlines.
What RNs Earn
The median salary for registered nurses is $75,330 per year, or about $36 per hour. Nurses at the lower end of the pay scale (10th percentile) earn around $53,410, while those at the top (90th percentile) bring in over $116,000. Your actual starting salary depends heavily on geography, facility type, and whether you hold an ADN or BSN. Urban hospitals and states with higher costs of living generally pay more. Specialty areas like critical care, emergency, and operating room nursing also tend to command higher wages once you gain experience.
New graduates typically start closer to the 25th percentile, around $61,630 annually, and see meaningful pay increases within the first few years as they gain clinical confidence and take on more complex patient assignments. Overtime, shift differentials for nights and weekends, and sign-on bonuses can significantly boost your take-home pay, especially in regions with nursing shortages.