Learning nursing starts with choosing the right educational pathway for your situation, then completing a combination of classroom courses, lab work, and supervised clinical hours before passing a licensing exam. The process takes anywhere from 12 months to four years depending on the route you pick, and each path leads to a different starting point in the profession.
Choose Your Degree Pathway
The two main entry points into registered nursing are the Associate Degree in Nursing (ADN) and the Bachelor of Science in Nursing (BSN). An ADN is a two-year program typically offered at community colleges, with some accelerated versions finishing in 18 months. It covers the core clinical skills you need to become a registered nurse and sit for the licensing exam.
A BSN is a four-year program at a college or university. It includes everything in an ADN plus deeper coursework in public health, nursing ethics, pathophysiology, and microbiology. Many hospitals now prefer or require a BSN for hiring, and it opens the door to leadership roles, specialty certifications, and graduate school. If you already hold a bachelor’s degree in another field, accelerated BSN programs compress the nursing curriculum into 16 to 24 months of full-time study. Indiana University’s program, for example, runs 16 months including summer sessions, and requires a minimum 2.7 GPA from your previous degree.
Licensed Practical Nurses (LPNs) who want to become registered nurses can use bridge programs that credit their existing training. Missouri State University’s LPN-to-RN bridge program is 65 credit hours completed in one academic year, with LPNs receiving 15 credit hours for prior coursework. These programs typically run through two semesters covering mental health nursing, pharmacology, medical-surgical nursing, and a transition course.
Prerequisite Courses You’ll Need
Before you apply to a nursing program, you’ll need to complete a set of prerequisite courses, mostly in the sciences. The exact list varies by school, but the core subjects are consistent across programs:
- Anatomy and physiology: Usually two semesters covering the structure and function of the human body.
- Chemistry: One or two semesters, sometimes with a lab component.
- Microbiology: Covers bacteria, viruses, and infection, which is foundational to clinical practice.
- Psychology: An introductory course, often with an additional course in human growth and development that covers how people change physically and mentally across the lifespan.
- Sociology or anthropology: Helps you understand social and cultural factors in health.
- English composition and math: General education requirements that most programs expect you to finish before starting nursing courses.
At competitive programs, your prerequisite GPA matters as much as your overall GPA. Some accelerated programs require a 3.0 in prerequisite courses specifically. If you’re planning ahead, spacing these courses over two or three semesters at a community college is a cost-effective way to build a strong application.
Nursing Entrance Exams
Most nursing programs require you to pass an entrance exam as part of your application. The two most common are the TEAS (Test of Essential Academic Skills) and the HESI A2. Your school will specify which one they accept.
The TEAS takes about 3.5 hours and tests reading, math, science, and English language usage. The HESI is four hours long and covers a broader range of subjects: anatomy and physiology, biology, chemistry, grammar, math, physics, reading comprehension, and vocabulary. Competitive programs often set minimum scores around 78 to 80 percent, though higher scores strengthen your application. Study guides and practice tests from the test publishers are widely available, and most students spend four to eight weeks preparing.
What Clinical Training Looks Like
Classroom learning is only part of nursing education. A significant portion of your program will be spent in clinical rotations, where you practice hands-on patient care under the supervision of a nursing instructor. These rotations take place in hospitals, clinics, long-term care facilities, and community health settings.
The Texas Board of Nursing uses a general guideline of three hours of clinical practice for every one hour of classroom instruction, which gives you a sense of how heavily weighted the hands-on component is. You’ll rotate through different specialties, including medical-surgical nursing, pediatrics, maternity, mental health, and community health. Clinical hours include time in skills labs practicing procedures like IV insertion and wound care, simulated patient scenarios, supervised bedside care, and clinical conferences where you discuss cases with your instructor and classmates.
Most students find clinicals the most challenging and rewarding part of nursing school. You’ll work early morning shifts, document patient assessments, and learn to think on your feet. The transition from reading about a condition in a textbook to managing it in a real patient is where nursing education truly clicks.
Online and Hybrid Options
You can complete nursing theory courses entirely online, but clinical training always requires in-person attendance. Hybrid programs combine the two: you watch lectures, complete assignments, and take exams from home, then report to a designated location for labs and clinical rotations. Regis College’s hybrid BSN program, for instance, delivers 100 percent of coursework online while requiring simulation labs on campus and clinical hours at Boston-area hospitals, with a preceptorship in the final semester.
This format works well for students who are working or managing family responsibilities, though clinical schedules are still demanding. If you’re considering a hybrid program, pay attention to where the clinical sites are located. You’ll need to be within a reasonable commuting distance for regular shifts.
How Much Nursing School Costs
Costs vary enormously depending on whether you attend a public or private institution and whether you pursue an ADN or BSN. Data from California’s Board of Registered Nursing illustrates the range clearly.
For an ADN at a public community college, total tuition can be as low as $2,760. At private institutions, ADN programs run from roughly $66,000 to nearly $98,000 for the full program. Public university BSN programs range from about $23,000 to $68,000 in total tuition and fees, while private university BSN programs can reach $294,000 at the highest end. These figures are California-specific, but the pattern holds nationally: community college ADN programs are the most affordable entry point, and private institutions charge a steep premium.
Financial aid, scholarships, and employer tuition reimbursement programs can offset these costs significantly. Many hospitals offer tuition assistance to employees pursuing nursing degrees, and federal grants are available for students who qualify.
Passing the NCLEX
After graduating from your nursing program, you need to pass the NCLEX-RN (for registered nurses) or NCLEX-PN (for practical nurses) to earn your license. This is a computerized adaptive test, meaning the difficulty of each question adjusts based on your previous answers. It covers safe patient care, pharmacology, health promotion, and clinical decision-making.
Your nursing program prepares you for this exam throughout your coursework, and many schools offer dedicated NCLEX prep courses in the final semester. Most graduates take the exam within a few weeks of finishing their program, while the material is still fresh.
Salary and Job Outlook
Registered nurses earned a median salary of $93,600 in 2024, with an average salary of $98,430. Pay varies by region, specialty, and experience level. Nurses in metropolitan areas and those working in critical care, operating rooms, or travel nursing positions tend to earn above the median. Demand for registered nurses remains strong across the country, driven by an aging population and ongoing healthcare expansion.
A BSN opens higher-paying roles faster, but ADN-prepared nurses can begin working sooner and pursue a BSN part-time while earning a full salary. Many hospitals offer tuition support for ADN nurses completing their bachelor’s degree, making this a practical strategy for students who want to minimize upfront debt.