A registered nurse (RN) is a licensed healthcare professional who provides direct patient care, coordinates treatment across medical teams, and educates patients about managing their health. It is one of the largest healthcare occupations in the United States, with a median annual salary of $93,600 as of May 2024.
What RNs Do Day to Day
The core of a registered nurse’s job is assessing patients and responding to what they find. That starts with physical exams, reviewing medical histories, recording symptoms, and documenting observations about a patient’s condition. From there, nurses administer medications, assist with diagnostic tests, operate medical equipment, and monitor how patients respond to treatment over time.
But the role goes well beyond carrying out orders from a physician. RNs help create and update care plans that guide a patient’s treatment. They educate patients and family members about diagnoses, medications, and what to expect during recovery. They also serve as the connective tissue between different providers, making sure the physician, physical therapist, pharmacist, and social worker are all working from the same information. In many settings, RNs also oversee licensed practical nurses (LPNs) who share in bedside care.
What makes nursing distinct from other clinical roles is the sheer amount of time spent with the patient. A doctor may visit a hospital patient once or twice a day. The nurse is there for the full shift, catching subtle changes in condition, adjusting care in real time, and acting as the patient’s advocate when something doesn’t look right.
Where Registered Nurses Work
Most people picture RNs in hospital settings, and hospitals do employ the largest share. Within a hospital, though, nurses specialize across very different units: emergency departments, intensive care, labor and delivery, surgery, oncology, pediatrics, and psychiatric wards. Each of these environments demands different skills and carries a different pace. An ER nurse triages patients under pressure, while an oncology nurse may spend months building relationships with the same patients through long treatment cycles.
Outside the hospital, the range is equally broad. Outpatient clinics, urgent care centers, physician offices, home health agencies, schools, nursing homes, rehabilitation facilities, and public health departments all employ RNs. Outpatient and home health nursing has grown steadily as more procedures and chronic disease management have shifted away from inpatient settings. Some nurses work in drug rehabilitation centers or birthing centers. Others work for insurance companies reviewing claims, for corporations managing employee wellness programs, or in clinical research coordinating trials.
The Team Around the Nurse
Nursing is fundamentally collaborative. RNs work alongside physicians, surgeons, respiratory therapists, physical therapists, social workers, pharmacists, and other nurses every shift. The quality of that teamwork directly affects patient safety. Clear internal communication and mutual respect across disciplines reduce the risk of medical errors caused by misunderstandings, missed handoffs, or conflicting instructions.
In practice, this looks like participating in daily rounds, calling physicians with status updates, coordinating discharge plans with social workers, and flagging medication interactions with pharmacists. Nurses often function as the hub of the care team because they have the most continuous contact with the patient and the most complete picture of how someone is actually doing.
Education and Licensing Requirements
Becoming a registered nurse requires completing an approved nursing program. That can be either a two-year associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN). Both paths qualify graduates to sit for the NCLEX-RN, the national licensing exam required in every U.S. state. Many hospitals, particularly larger medical centers, prefer or require a BSN, and many ADN-prepared nurses go on to complete a bachelor’s degree while working.
After graduation, the process works like this: your program director submits proof of your graduation to the state board of nursing, you register with the testing company (Pearson VUE, which costs $200), and you receive authorization to test. Some states, like Texas, also require a separate jurisprudence exam covering state nursing laws before you can schedule the NCLEX. Results come back within 24 to 48 hours. You also need to complete a criminal background check, including fingerprinting, as part of the application.
Once licensed, many nurses pursue specialty certifications in areas like critical care, emergency nursing, pediatrics, or nurse midwifery. Advanced practice roles, such as nurse practitioner or nurse anesthetist, require a master’s or doctoral degree and carry their own separate licensing requirements.
Salary and Job Outlook
The Bureau of Labor Statistics reports a median annual wage of $93,600 for registered nurses as of May 2024. That median means half of RNs earn more and half earn less. Pay varies significantly by geography, specialty, and experience. Nurses in metropolitan areas and high-cost states typically earn more, while those in rural regions earn less but may face lower living costs.
Employment is projected to grow 5 percent from 2024 to 2034, faster than average across all occupations. That growth is driven by an aging population that needs more healthcare services and by a wave of retirements among nurses already in the workforce.
The Nursing Shortage and What It Means
The demand for nurses is outpacing the supply, and that gap is projected to persist for at least the next decade. Federal projections from the Bureau of Health Workforce estimate an 8 percent shortage of RNs nationally by 2028, narrowing slightly to a 3 percent shortage (roughly 109,000 positions) by 2038. The shortage is not evenly distributed. Rural areas face significantly steeper deficits than cities: by 2028, nonmetropolitan areas are projected to be short by 24 percent compared to just 5 percent in metro areas.
Some states face especially acute gaps. California, North Carolina, and Georgia are each projected to have RN shortages of 20 percent or higher by 2038. Michigan, Washington, and Maryland follow closely behind. For nurses entering the profession, this means strong job security and, in many markets, negotiating leverage on salary and working conditions. For patients, it means longer wait times and heavier workloads for the nurses caring for them, which is one of the profession’s most pressing challenges.
The shortage is even more severe among LPNs, who work under RN supervision. Nationally, the LPN supply is projected to meet only 70 percent of demand by 2038, which in turn increases the responsibilities that fall on registered nurses in settings like nursing homes and home health agencies.