How to become a nurse

The U.S. Bureau of Labor Statistics expects that employment for registered nurses will grow 6% each year between 2022 and 2032, with roughly 193,100 job openings projected each year during that decade.

“There is such a huge nursing shortage,” says Peggy Maddox, acting co-chair of George Mason University’s School of Nursing. “You can depend on going pretty much anywhere in the United States and not having difficulty getting a job as a registered nurse.”

So, how does someone enter the nursing profession? Read on to find out.

How to become a nurse 

Becoming a nurse can be a rewarding career move. No workday is the same, and nurses often feel a sense of satisfaction about helping other people. Here’s how to start your journey to becoming a nurse.

1. Understand the difference between a registered nurse and a licensed practical nurse  

While the titles registered nurse (RN) and licensed practical nurse (LPN) may sound similar, they’re very different in terms of educational paths, salary ranges, and the job tasks that are expected of them. In general, LPNs are responsible for the comfort of a patient and providing basic nursing care. In addition to those tasks, RNs administer treatments, medication, and offer educational advice.

LPNs must complete an accredited practical nursing program, which takes about a year to finish in most cases and may be taken at a technical or community college. RNs have a variety of educational options available to them (detailed in the next section), which are more involved.

Generally speaking, LPNs work in doctors’ offices, long-term care or outpatient facilities. RNs usually work in high-acuity settings, like hospitals.

LPNs can rise to supervisory positions after gaining work experience or may undergo additional education to become an RN, nurse practitioner, or pursue roles in academia, clinical education, and research. RNs usually start as staff nurses but can move into management positions through work experience and additional education.

“A lot of it really depends on where you see yourself in nursing, what you want to do, and what your background is,” says Cathy Wilson, director of admissions at the Johns Hopkins University School of Nursing.

In 2023, the U.S. Bureau of Labor Statistics reported that LPNs had a median annual wage of $59,730, while RNs had median annual pay of $86,070.

2. Earn a degree 

Those contemplating a career in nursing must consider different educational pathways that lead to different job outcomes.

A practical nursing program allows you to become an LPN. Offered at community and vocational colleges, this program generally takes about a year and grants graduates a practical nursing certification. It also allows students to take the National Council Licensure Examination (NCLEX-PN), which leads to licensure as a practical nurse.

The most common ways to become an RN are by earning an associates degree, a bachelor’s of science in nursing, or attending an accelerated nursing program.

An associates degree in nursing is the quickest and least expensive pathway to become an RN. This degree gives students core knowledge and clinical skills in the field. This degree usually requires two to three years of coursework. Upon competition, graduates can take the national licensure exam (NCLEX-RN).

“It’s a good place to start, especially if finances are a concern. It’s good foundational knowledge and it’s a building block for future degrees, if that is something that you want to do,” Wilson says. “Many employers will be OK with that level of degree, but others will be looking for a BSN.”

With a bachelor’s of science in nursing, or BSN, students undergo three or four years of coursework that includes education in liberal arts, nursing specific courses, and clinical education before taking NCLEX. Nurses with a BSN have a better chance of employment than those with an associates degree, and often earn higher salaries and have more workplace responsibilities.

An accelerated nursing program is geared toward those who already have a bachelor’s degree in another field of study. Relevant coursework from a prior degree can count towards an accelerated nursing program. This type of program allows people to earn their BSN in 12 to 16 months.

A master’s of science in nursing can allow people to improve their general knowledge and skills in nursing, and learn about broader topics like education and leadership. It’s common for MSN programs to specialize in a certain area, like anesthesia, midwifery, or becoming a nurse practitioner.

Most MSN programs require students to hold a BSN before applying. This highly customizable program may be offered online, as well as on a full-time or part-time basis. It’s recommended that MSN applicants have a specific career goal in mind when they decide to pursue this degree.

“The key is to make sure that, with any of those routes that you choose, that it is a program that is accredited and recognized in the state that you’re going to be seeking licensure,” Wilson says. 

3. Get a license 

All nurses must pass an NCLEX exam to obtain a nursing license in the United States. Past that, licensing requirements can vary. Laws concerning each state’s rules and regulations for nursing can be found on the website for the National Council of State Boards of Nursing.

Some states have slightly different requirements. California, for example, has separate course requirements for education about child and elder abuse, whereas that information is baked into nursing program requirements in Virginia. New York requires specified coursework and training in infection control and barrier precautions.

Forty-one states and two territories are part of the Nurse Licensure Compact, an agreement that allows nurses the ability to have one multi-state license that lets them practice in participating states.

4. Land a job 

There are many ways for nurses to seek employment. Students may be connected to potential employers through clinical practicum experiences in their nursing programs. Many hospitals, clinics, and nursing homes have “learn and earn” arrangements where students can gain practical experience while collecting a paycheck.

Nursing schools often help their graduates connect with employers, as do nursing organizations like the National Student Nurses’ Association, job boards, and organizations that specialize in an area of practice, like the Oncology Nursing Society.

Making connections with people in the medical field is paramount.

“Networking is as important in nursing as it is in every other field,” says Maddox, who’s also a professor and chair of the department of health administration and policy at GMU and co-director of GMU’s Center for Health Workforce. “Truly knowing individuals and being known by an agency or an organization in which you want to work is always helpful.”

5. Specialize 

There are many different types of RN specializations.

An addiction nurse works in hospitals, outpatient care facilities, and recovery centers. These nurses screen for signs of substance abuse disorders, implement treatment plans, offer support during recovery, and administer medications to prevent relapse and manage withdrawal.

A cardiovascular nurse administers direct support to patients who are facing chronic or acute heart conditions. They may assess heart health using vascular monitoring, stress tests and electrocardiograms.

A critical care/ICU nurse works with critically ill patients in an intensive care unit. Usually, these patients are rapidly deteriorating because of an illness or are coming out of surgery and require around-the-clock observation.

A gastroenterology nurse helps patients who are experiencing stomach, esophagus, or bowel issues. These nurses may assist with colonoscopies and endoscopies, and treat conditions like abdominal injuries, inflammatory bowel disease, ulcers, or cancer.

A medical-surgical nurse provides care for patients with many medical challenges, including acutely ill patients experiencing chronic illnesses, complications, and comorbidities. They often handle heavy caseloads.

A neonatal nurse specializes in caring for infants who are born with life-threatening or chronic issues, or who were born prematurely.

An occupational health nurse may work in a corporate setting and endeavor to minimize workplace injuries, as well as administer workers’ compensation and family medical leave. They may also offer counseling for psychosocial needs, substance abuse and other work- or health-related concerns.

A public health nurse aims to prevent illness, injury, and disability for entire population groups. Instead of waiting for patients to come to them with an illness, these nurses go into communities to prevent disease and improve a population’s health. 

6. Pursue additional education 

If you’re already a nurse but want to move up the ladder or into a specialized field, additional schooling may be in order. This may include pursuing an MSN, a master’s of public health, or a doctor of nursing practice degree. The latter is designed for nurses and focuses on leadership, clinical practice, and applying research to improve patient care. There are also nursing Ph.D. programs that focus on research instead of clinical practice.

When contemplating further education in nursing, it’s important to consider how this additional schooling will help you achieve your career goals.

“They need to be sure that they’re picking the right career path for them,” Wilson says. 

The takeaway 

Nursing is a rewarding, well paying, and in-demand field. Different education paths can yield different employment results, but it’s always possible to get more training to change your career trajectory.

“There is a great need for nurses everywhere,” Wilson says. “It’s such a wonderful, versatile career choice, and there are so many different employment opportunities out there.”