Becoming a nurse requires completing an approved nursing program and passing a national licensing exam. The full timeline ranges from about two years for an entry-level associate degree to four years for a bachelor’s degree, with faster options available for career changers. Here’s what each step looks like.
Choose Your Degree Path
There are two main degrees that qualify you to become a registered nurse (RN): an Associate Degree in Nursing (ADN) and a Bachelor of Science in Nursing (BSN). Both allow you to sit for the same licensing exam, but they differ in time, cost, and career flexibility.
An ADN is a two-year program typically offered at community colleges. Some schools offer accelerated versions you can finish in about 18 months. It covers the core clinical training you need to start working as an RN, and it’s the most affordable entry point into the profession.
A BSN is a four-year undergraduate program at a college or university. It includes everything in an ADN plus deeper coursework in leadership, public health, and research. Many hospitals now prefer or require a BSN when hiring, and nurses with a BSN tend to earn higher salaries. If you’re weighing cost against long-term options, keep in mind that many nurses start with an ADN and later complete an RN-to-BSN bridge program while working.
Complete Your Prerequisites
Before you can start a nursing program, you’ll need to finish a set of prerequisite courses. The exact list varies by school, but most programs require a core group of science and general education classes. A typical set includes:
- Anatomy and Physiology I and II (with lab)
- Chemistry (with lab)
- Microbiology (with lab)
- Statistics
- Developmental psychology or human growth and development
- Nutrition (at some schools)
These courses must be taken at accredited schools, and most programs accept online versions as long as any lab component is included. Science prerequisites often have a shelf life of five years, meaning you may need to retake them if too much time has passed. Competitive programs typically look for a minimum GPA of 3.0, with a C or higher in each science course.
Get Through Clinical Rotations
Nursing school isn’t just classroom work. A large portion of your training happens in clinical rotations, where you care for real patients in supervised settings. The number of clinical hours you need depends on your state’s board of nursing, and each state sets its own requirements.
Rotations cycle you through different healthcare environments so you gain broad experience before specializing. Common settings include medical-surgical units, pediatrics, labor and delivery, mental health facilities, long-term care, and community health clinics. These rotations are where you learn to start IVs, administer medications, assess patients, and communicate with care teams. They’re widely considered the most challenging and most valuable part of nursing school.
Pass the NCLEX-RN
After graduating from your nursing program, you need to pass the NCLEX-RN to earn your license. This is a computerized adaptive test, meaning the difficulty of each question adjusts based on how you answered the previous one. You’ll answer anywhere from 75 to 145 questions, and the exam ends once the computer has enough data to determine whether you’ve met the passing standard.
The test covers four broad areas: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity (which includes pharmacology and basic patient care). Registration with Pearson VUE, the company that administers the exam, costs $200. Your state board application fee is separate and varies, but expect roughly $100 to $150 on top of the testing fee.
LPN: A Faster Entry Point
If you want to start working in nursing as quickly as possible, becoming a Licensed Practical Nurse (LPN) is another option. LPN programs typically take about one year and are offered at community colleges and vocational schools. After completing the program, you take the NCLEX-PN (a separate exam from the RN version).
LPNs provide direct patient care, including taking vital signs, administering certain medications, and providing education to patients and families. The key difference is scope: LPNs work under the supervision of an RN and cannot independently perform comprehensive assessments, formulate nursing diagnoses, or create care plans. They carry out interventions designed by the RN and report back on how patients are responding. Many LPNs later pursue an LPN-to-RN bridge program to expand their scope and earning potential.
Options for Career Changers
If you already have a bachelor’s degree in another field, you don’t need to start from scratch. Accelerated BSN (ABSN) programs are designed specifically for second-degree students and compress the full nursing curriculum into 12 to 18 months of intensive study. These programs are fast and demanding, often running year-round with full-time schedules.
Admission requirements are straightforward: you need a bachelor’s degree from an accredited institution, a GPA of 3.0 or higher, and completion of the same science prerequisites required for traditional programs. Loyola University Chicago’s ABSN, as one example, requires 33 credit hours of prerequisites, including chemistry, anatomy and physiology, microbiology, statistics, and developmental psychology. Most programs accept applications on a rolling basis, so you can start planning around your prerequisite timeline rather than a single annual deadline.
Advancing to Nurse Practitioner
Once you’re working as an RN with a BSN, you can pursue advanced practice roles. Becoming a nurse practitioner (NP) requires completing a graduate program at the master’s or doctoral level, then passing a national board certification exam specific to your chosen population focus (such as family medicine, pediatrics, or psychiatric care). NPs can diagnose conditions, prescribe medications, and in many states practice independently without physician oversight.
The path is rigorous. NP programs combine advanced coursework in pathophysiology and pharmacology with clinical rotations, and admission requires an active RN license and BSN. After graduation, the national certification exam verifies both general advanced practice knowledge and specialty competencies. This certification is also required for state licensure and insurance credentialing.
Licensing Across State Lines
Nursing licenses are issued by individual states, but a system called the Nurse Licensure Compact (NLC) allows nurses to practice across state lines without obtaining a new license in each state. Currently, 43 states participate in the compact. If you live in a compact state and meet its requirements, your multistate license lets you work in any other participating state, which is especially useful for travel nursing or telehealth roles.
Salary and Job Outlook
The median annual salary for registered nurses was $93,600 as of May 2024, according to the Bureau of Labor Statistics. Employment is projected to grow 5 percent from 2024 to 2034, faster than the average for all occupations. That steady demand is driven by an aging population and ongoing retirements within the nursing workforce. Salaries vary significantly by state, specialty, and experience level, with nurse practitioners, travel nurses, and those in high-cost metro areas earning well above the median.