Becoming a nurse requires a nursing degree, a passing score on the national licensing exam (NCLEX-RN), and a state-issued license. The full process takes two to four years depending on the degree path you choose, plus several months for testing and licensure paperwork. Here’s what each step looks like.
Choose Between a Two-Year and Four-Year Degree
Two degree paths qualify you to become a registered nurse. 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 allow you to sit for the licensing exam and work as an RN.
The differences show up after graduation. BSN holders earn more on average, roughly $92,000 per year compared to $75,000 for ADN holders, according to Payscale data from mid-2023. Many hospitals prefer or require a BSN, and it’s a must if you ever want to pursue a graduate degree in nursing. BSN graduates also pass the licensing exam at a slightly higher rate: 82.3% on the first attempt versus 77.9% for ADN graduates.
If cost or time is a barrier, starting with an ADN and completing an RN-to-BSN bridge program later is a common and practical route. Many employers even offer tuition assistance for this.
Complete Prerequisite Courses
Before you start core nursing classes, you’ll need to complete a set of prerequisite courses. These are the same whether you’re applying to a community college or university program, though the exact course names and grade requirements vary by school. Most programs expect a B or higher in these prerequisites. A typical list includes:
- Anatomy and Physiology: A two-course sequence covering the structure and function of the human body.
- Microbiology: One course on bacteria, viruses, and infection, sometimes with a required lab component.
- Chemistry: Either a general chemistry sequence with labs or a single allied health chemistry course with a lab.
- Introductory Biology: One lecture course covering foundational biology concepts.
- Statistics: One semester of statistics, which can often be taken through a math, psychology, or social sciences department.
- English Composition: One or two writing courses depending on your placement level.
- Human Nutrition: One course covering nutritional science as it relates to health.
- Lifespan Development: One course on physical, emotional, and cognitive development from birth through death.
These prerequisites alone can take two to three semesters to finish, so many students begin them before formally entering a nursing program. Completing them with strong grades also makes you more competitive during the application process, since most programs admit more applicants than they have seats for.
Pass a Nursing Entrance Exam
Most nursing programs require you to take a standardized entrance exam as part of your application. The two most common are the TEAS (Test of Essential Academic Skills) and the HESI A2 (Admission Assessment). Your school will tell you which one it uses.
The HESI A2 covers reading comprehension, vocabulary and general knowledge, biology, and anatomy and physiology. Some versions also test math, chemistry, and physics. Each program sets its own minimum score for admission, and competitive programs may require scores well above the minimum. Study guides specific to each exam are widely available, and taking a practice test before the real one is well worth your time.
Complete Clinical Training
Nursing school isn’t just classroom work. A significant portion of your program involves supervised clinical rotations in hospitals, clinics, long-term care facilities, and other healthcare settings. During clinicals, you’ll practice skills like administering medication, inserting IVs, assessing patients, and documenting care, all under the guidance of an instructor or experienced nurse.
The number of clinical hours you need varies by state, as each state’s board of nursing sets its own requirements. Expect to spend several hundred hours in clinical settings before you graduate. These rotations happen throughout your program, not just at the end, and they rotate you through different specialties like pediatrics, maternity, mental health, and medical-surgical nursing. This exposure helps you figure out what area of nursing interests you most.
Pass the NCLEX-RN
After graduating from your nursing program, you must pass the National Council Licensure Examination, known as the NCLEX-RN. This is the single exam that determines whether you can practice as a registered nurse anywhere in the United States. You can’t skip it or substitute anything else for it.
To sit for the exam, you submit an application to your state’s board of nursing, provide your official transcripts, and pay the application fees. If you graduated from a nursing program in your state, your school may send transcripts directly to the board on your behalf. Out-of-state graduates typically need to arrange electronic transcript delivery through a service like Parchment or the National Student Clearinghouse.
The NCLEX-RN uses computerized adaptive testing, meaning the difficulty of questions adjusts based on your performance. The exam tests clinical judgment, patient safety, and your ability to prioritize care in realistic scenarios. Most nursing programs build NCLEX preparation into their final semester, and many graduates also use third-party review courses.
Get Your State License
Passing the NCLEX-RN doesn’t automatically make you licensed. You also need to apply for licensure through the board of nursing in the state where you plan to work. This process includes a background check, and certain criminal convictions can affect your eligibility.
Convictions involving assault, abuse, theft, fraud, or sex offenses are considered substantially related to a nurse’s ability to practice safely and can result in denial or discipline of a license. You’re required to disclose all convictions on your application, including those that were expunged, set aside, or occurred during military service. Failing to disclose a conviction is itself grounds for disciplinary action. If you have a criminal record and are considering nursing, contact your state board early in the process to understand how it may affect your path.
One major advantage for nurses is the Nurse Licensure Compact. Currently, 43 states and jurisdictions participate in this agreement, which allows you to hold a single multistate license and practice in any compact state without applying for a separate license. If you live in a compact state, this gives you significant flexibility to work across state lines or pick up travel nursing assignments.
Skills That Matter Beyond the Classroom
Degrees and exams get you licensed, but the day-to-day reality of nursing demands a specific set of personal strengths. You’ll need physical stamina for 12-hour shifts spent mostly on your feet. You’ll need emotional resilience, because you’ll care for people on the worst days of their lives. Communication skills matter enormously: you’ll explain complex medical information to frightened patients, advocate for them with physicians, and coordinate with a team that may include dozens of people.
Critical thinking is the skill nursing programs test most heavily, and for good reason. Nurses constantly make judgment calls about which patient needs attention first, whether a change in vital signs is concerning, and when to escalate a situation. Attention to detail protects patients from medication errors and missed symptoms. These aren’t soft skills in nursing. They’re the core of the job.
How Long the Full Process Takes
If you go the ADN route and already have your prerequisites done, you could be a licensed nurse in roughly two and a half years, accounting for the program itself plus time for the NCLEX and licensure processing. Starting from scratch with no college credits, a BSN typically takes four years, sometimes five if prerequisites aren’t built into the program’s schedule.
For people who already hold a bachelor’s degree in another field, accelerated BSN programs compress the nursing curriculum into 12 to 18 months. These programs are intense, often running year-round with no summer breaks, but they’re one of the fastest paths to becoming an RN if you already have a college education behind you.