Becoming a registered nurse (RN) takes between two and four years depending on the degree path you choose, and every path ends at the same destination: passing the NCLEX-RN licensing exam. The process breaks down into three main stages: completing an approved nursing program, passing the national exam, and obtaining your state license. Here’s how each stage works and what to expect along the way.
Choose Your Degree Path
Two degrees qualify you to sit for the NCLEX-RN: an Associate Degree in Nursing (ADN) and a Bachelor of Science in Nursing (BSN). Both produce licensed RNs, but they differ in time, cost, and long-term career flexibility.
An ADN is a two-year program typically offered at community colleges, with tuition ranging from $6,000 to $20,000. Some schools offer accelerated versions you can finish in 18 months. This is the fastest and most affordable route to becoming an RN, and it’s a strong option if you want to start working quickly.
A BSN is a four-year undergraduate program at a college or university, with tuition ranging from $40,000 to over $200,000 depending on the school. The extra two years cover leadership, public health, research methods, and community nursing. Many hospitals, especially large medical centers and those pursuing Magnet designation, prefer or require a BSN. If you’re aiming for management, education, or an eventual nurse practitioner role, a BSN is the more direct path.
Both degrees include the same core nursing content and clinical training. The difference is that a BSN gives you broader preparation and more doors open from day one. If you start with an ADN, RN-to-BSN bridge programs let you complete the bachelor’s degree later, often online while you’re working.
Complete Your Prerequisites
Before you start taking nursing courses, you’ll need to finish a set of prerequisite classes. Programs vary, but the core science requirements are consistent across most schools: two semesters of anatomy and physiology, general chemistry with a lab component, microbiology, nutrition, and statistics. On the social science side, expect introductory psychology, developmental psychology (covering the full lifespan), and often a sociology course.
BSN programs layer on additional general education requirements like rhetoric or composition, arts courses, and sometimes a world language. At the University of Iowa, for example, BSN students need four years of one world language at the high school level or equivalent college coursework, plus courses in international issues and cultural perspectives.
Prerequisites matter more than many applicants realize. Nursing programs are competitive, and your GPA in science courses often carries extra weight. Most programs require a C or better in every prerequisite, but competitive applicants typically have much higher grades than that. If you’re planning to apply, treat anatomy, physiology, and microbiology as the courses that will make or break your application.
Accelerated and Bridge Programs
If you already have a bachelor’s degree in another field, an accelerated BSN (ABSN) program lets you earn your nursing degree in roughly 15 months of intensive, full-time study. These programs compress the same clinical and classroom content into four consecutive semesters. You’ll still need to complete science prerequisites beforehand (anatomy, physiology, chemistry with lab, microbiology, nutrition, statistics, and developmental psychology), and most schools require those courses to have been taken within the last ten years.
If you’re already a Licensed Practical Nurse (LPN), bridge programs let you build on your existing training. An LPN-to-BSN program runs about six semesters. You’ll need a current LPN license, and most programs set a higher bar for science GPA, often a 3.0 in science courses. Your LPN coursework and clinical experience count toward credits, so you’re not starting from scratch.
What Clinical Training Looks Like
Nursing isn’t a degree you can earn entirely in a classroom. Every program includes hundreds of hours of supervised clinical rotations in hospitals, clinics, long-term care facilities, and community health settings. In Virginia, for instance, RN programs must provide a minimum of 500 hours of direct patient care under faculty supervision. Simulation labs (practicing on mannequins and virtual patients) can count for up to 25% of those hours, but the rest must be hands-on with real patients.
Clinical rotations cycle you through different specialties: medical-surgical, pediatrics, obstetrics, mental health, and critical care. You’ll start with basic tasks like taking vital signs and administering medications, then progress to more complex responsibilities. These rotations serve a dual purpose: they prepare you for the job, and they help you figure out which area of nursing you actually want to work in.
Pick an Accredited Program
Before enrolling anywhere, verify that the program is accredited. The two main accrediting bodies for nursing education in the U.S. are the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Both are recognized by the U.S. Department of Education. ACEN accredits all levels of nursing programs, from practical nursing through doctoral programs. CCNE focuses on baccalaureate and graduate-level programs.
Accreditation matters for practical reasons. Many employers will only hire graduates of accredited programs. If you later want to pursue a master’s or doctoral degree, most graduate schools require your BSN to come from a CCNE- or ACEN-accredited program. And some state boards won’t let you sit for the NCLEX-RN without graduating from an approved school.
Pass the NCLEX-RN Exam
After graduation, you’ll register for the NCLEX-RN through Pearson VUE and apply for licensure through your state board of nursing simultaneously. The NCLEX-RN is a computerized adaptive test, meaning it adjusts the difficulty of questions based on your answers. The exam covers safe and effective care, health promotion, psychosocial integrity, and physiological integrity. It can range from 85 to 150 questions, and most people finish in two to three hours.
The national first-time pass rate for U.S.-educated candidates hovers around 85% to 90%, so the odds are in your favor if you’ve done well in your program. Most graduates spend four to eight weeks studying after graduation using review courses and practice question banks. If you don’t pass on the first attempt, you can retake it after a 45-day waiting period.
Get Your State License
Passing the NCLEX-RN doesn’t automatically make you licensed. You also need to complete your state’s administrative requirements. Every state requires a criminal background check and fingerprinting. You’ll submit your application, fingerprints, and fees to your state board of nursing. Applications typically remain active for six months while you complete the process, and if they expire, you’ll need to reapply and pay a new fee.
Most states participate in the Nurse Licensure Compact (NLC), which means a single multistate license lets you practice in any member state. If your state isn’t part of the compact, you’ll need to apply for a separate license in each state where you want to work. For compact licenses, you’ll need to submit a new set of fingerprints with every multistate application.
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. That figure varies significantly by setting and location. Nurses in hospitals and metropolitan areas tend to earn more than those in outpatient clinics or rural communities. Specialty certifications and advanced degrees push salaries higher.
Employment for RNs is projected to grow 5% from 2024 to 2034, faster than the average for all occupations. An aging population, increasing rates of chronic conditions, and retirements within the nursing workforce are all driving demand.
Specializing After Licensure
Once you’re working as an RN, specialty certifications let you focus on a specific patient population or clinical area. The American Nurses Credentialing Center (ANCC) offers certifications in areas like cardiac-vascular nursing, pediatric nursing, psychiatric-mental health nursing, pain management, medical-surgical nursing, and ambulatory care. Each requires meeting eligibility criteria (typically a certain number of practice hours in that specialty) and passing a certification exam.
Specializing isn’t required, but it signals expertise to employers and often comes with higher pay. Many nurses work in general medical-surgical units for a year or two after licensure to build a foundation before pursuing a specialty. Others know from their clinical rotations exactly where they want to land and pursue certification as soon as they’re eligible.
For nurses who want to move into advanced practice roles like nurse practitioner, nurse midwife, or nurse anesthetist, a master’s or doctoral degree is the next step. Those programs typically require a BSN, at least one to two years of clinical experience, and a separate advanced-practice certification and license.