Becoming a registered nurse requires completing an approved nursing program, passing a national licensing exam, 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.
Choose Between a Two-Year or Four-Year Degree
You have two main educational paths to become an RN. An Associate Degree in Nursing (ADN) is a two-year program typically offered at community colleges, with some accelerated options that finish in 18 months. A Bachelor of Science in Nursing (BSN) is a four-year program at a college or university. Both qualify you to sit for the licensing exam and work as a registered nurse.
The difference is depth. Both programs build clinical patient care skills, but a BSN adds coursework in public health, nursing ethics, pathophysiology, and microbiology. This broader training opens doors to leadership roles, hospital positions that prefer or require a bachelor’s degree, and graduate school if you want to become a nurse practitioner later. Many hospitals, especially in urban areas, have shifted toward hiring BSN-prepared nurses. If cost or time is a barrier, starting with an ADN and completing an RN-to-BSN bridge program while working is a common and practical route.
Complete Your Prerequisite Courses
Before you enter a nursing program, you’ll need to finish a set of prerequisite science and general education courses. Programs vary, but a typical list includes:
- General biology
- Human anatomy (with lab)
- Human physiology
- Elementary chemistry (with lab)
- Statistics
- Nutrition
- Human growth and development (lifespan)
- Medical microbiology
- Pathophysiology
Most programs require a C or better in each prerequisite, with a cumulative GPA of 3.0 or higher across these courses. Competitive programs may expect higher. Some schools also set expiration dates on science courses. Anatomy and physiology, for example, often must have been completed within seven years of your application deadline. If you took them longer ago, you’ll need to retake them.
You can complete prerequisites at a community college before transferring into a nursing program, which keeps costs lower. Plan on one to two semesters of prerequisite work if you’re starting from scratch, though some students spread it over a full year to manage the workload.
Pick an Accredited Program
Make sure any nursing program you apply to is accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). Accreditation matters for three practical reasons: it makes you eligible for federal financial aid, it ensures the program meets quality standards recognized by state licensing boards, and it keeps graduate school options open if you decide to pursue an advanced degree later. You can check a program’s accreditation status on the CCNE or ACEN websites before applying.
What Nursing School Looks Like
Nursing programs combine classroom learning with hands-on clinical rotations in hospitals, clinics, and other healthcare settings. Clinical hours vary by state because each state’s board of nursing sets its own requirements for the number of hours and the types of settings students must train in. Expect to spend significant time in clinical rotations during your second year (for ADN) or your junior and senior years (for BSN).
Clinicals rotate you through different specialties: medical-surgical nursing, pediatrics, obstetrics, mental health, and community health are common placements. You’ll work under the supervision of a clinical instructor and practice skills like medication administration, patient assessment, wound care, and charting. The pace is intense. Most nursing students describe the clinical years as the hardest part of the process, but also the part that makes everything click.
Pass the NCLEX-RN Exam
After graduating from your nursing program, you need to pass the National Council Licensure Examination for Registered Nurses, known as the NCLEX-RN. This is a computerized adaptive test, meaning the difficulty of each question adjusts based on how you answer the previous one. The exam tests your ability to apply nursing knowledge to patient care scenarios rather than memorize facts.
You’ll register for the exam through your state board of nursing, which sends you an authorization to test. Most graduates take the NCLEX within a few weeks to a couple of months after finishing school. The test can range from 75 to 145 questions, and you’ll typically get your results within 48 hours. First-time pass rates for graduates of accredited programs generally hover around 85 to 90 percent, though this varies by school.
Apply for Your State License
Passing the NCLEX-RN doesn’t automatically make you licensed. You still need to apply for licensure through the board of nursing in the state where you plan to work. This involves submitting your application, paying a fee, and passing a background check. Processing times vary, but most new nurses receive their license within a few weeks of passing the exam.
If you live in one of the 43 states that participate in the Nurse Licensure Compact, you can apply for a multistate license. This lets you practice in any other compact state without obtaining a separate license, which is especially useful if you live near a state border or want flexibility to pick up travel nursing assignments. If you move to a new compact state, you have 60 days to apply for licensure in that state.
Salary and Job Growth
Registered nurses earned a median annual salary of $93,600 as of May 2024, according to the Bureau of Labor Statistics. Employment is projected to grow 5 percent from 2024 to 2034, which translates to steady demand driven by an aging population and ongoing healthcare needs. Pay varies significantly by setting and location. Nurses in hospitals and specialty clinics tend to earn more than those in outpatient or long-term care facilities, and metropolitan areas generally pay higher than rural ones.
Specializing After You’re Licensed
Once you have your RN license and some experience, you can pursue specialty certifications that boost your expertise and earning potential. Most certifications require one to three years of clinical experience in the specialty area. Some of the most common paths include:
- Critical care (CCRN): requires 1,750 to 2,000 hours of direct critical care experience
- Emergency nursing (CEN): recommended two years of emergency clinical practice
- Pediatric nursing (CPN): requires 1,800 to 3,000 hours of pediatric experience
- Oncology nursing (OCN): requires 2,000 hours of oncology practice plus continuing education
- Psychiatric-mental health (PMH-RN): requires two years and 2,000 hours in psychiatric nursing
- Operating room nursing (CNOR): requires two years and 2,400 hours of perioperative experience
Certification is voluntary, not required to practice. But it signals a higher level of competence to employers and often comes with higher pay. Many nurses work in a general medical-surgical role for their first year or two, then transition into a specialty that interests them. That first year of broad experience builds the foundation that makes specialization possible.