Becoming a nurse requires completing an accredited nursing program, passing a national licensing exam, and meeting your state’s background and health screening requirements. The fastest route takes about one year for a Licensed Practical Nurse, while a full Bachelor of Science in Nursing takes four years. Which path you choose depends on how much responsibility you want, how quickly you want to start working, and how far you plan to take your career.
Three Main Educational Paths
There are three standard entry points into nursing, each with a different time commitment and scope of practice.
Licensed Practical Nurse (LPN): This is the quickest path into patient care. LPN programs typically run about one year and are offered at community colleges, technical schools, and some hospitals. LPNs provide basic patient care in settings like long-term care facilities and home health. They generally work under the supervision of a registered nurse, advanced practice nurse, or physician. Depending on your state, you may also supervise certified nursing assistants.
Associate Degree in Nursing (ADN): An ADN takes two to three years, usually at a community college. It qualifies you to become a registered nurse (RN), which comes with significantly broader responsibilities. RNs assess, monitor, and treat patients, supervise LPNs and nursing assistants, and play a central role in patient education and advocacy. This is the most common way people enter the RN workforce without committing to a four-year degree.
Bachelor of Science in Nursing (BSN): A BSN takes at least four years at a university. It leads to the same RN license as an ADN, but many hospitals, especially larger medical centers and magnet hospitals, prefer or require a bachelor’s degree. A BSN also opens doors to leadership roles, specialized units, and graduate programs. If you’re considering eventually becoming a nurse practitioner or nurse anesthetist, you’ll need at least a BSN as your foundation.
Prerequisite Courses You’ll Need
Before you start the core nursing curriculum, you’ll need to complete a set of prerequisite courses. These vary slightly by program, but a typical list includes anatomy and physiology, microbiology, college math, English composition, and developmental psychology. Most programs require a grade of C or better in each prerequisite, with a minimum prerequisite GPA of 2.0. Competitive programs, especially BSN programs at universities, often expect a GPA well above that minimum.
Science courses are the heaviest lift for most applicants. Anatomy and physiology in particular is often a two-semester sequence that covers the body’s major systems in detail. Microbiology introduces the bacteria, viruses, and fungi you’ll encounter in clinical settings. If it’s been years since you’ve taken a science class, some students find it helpful to take a preparatory biology course first.
Clinical Hours and Hands-On Training
Classroom learning is only part of nursing school. Every accredited program includes mandatory clinical rotations where you practice patient care in real healthcare settings, supervised by an instructor. These rotations typically take place in hospitals, clinics, nursing homes, and community health centers.
The exact number of required clinical hours varies by state and program type. As a reference point, some states require a minimum of 400 clinical hours for RN programs and 200 for LPN programs. In practice, many programs exceed these minimums. Your clinical rotations will cycle you through different specialties, including medical-surgical nursing, pediatrics, obstetrics, mental health, and community health, giving you exposure to a range of patient populations before you graduate.
Passing the Licensing Exam
Graduating from a nursing program doesn’t make you a nurse. You need to pass a national licensing exam administered by the National Council of State Boards of Nursing. LPN graduates take the NCLEX-PN, and RN graduates take the NCLEX-RN. Both exams are computerized and adaptive, meaning the difficulty of questions adjusts based on your performance as you go.
The NCLEX tests your ability to apply nursing knowledge to clinical scenarios, not just memorize facts. Questions often present a patient situation and ask you to prioritize interventions or identify the most appropriate action. Most nursing programs build NCLEX preparation into their final semester, and many graduates also use review courses or question banks to prepare independently.
Background Checks and Health Screenings
State boards of nursing require criminal background checks before granting a license. The specifics vary, but boards generally ask about felony and misdemeanor convictions, pending charges, deferred adjudication, probation, and military disciplinary actions. A criminal record doesn’t automatically disqualify you, but certain offenses can. Most boards review these on a case-by-case basis. In Texas, for example, the board also asks whether you’ve been treated for alcohol or drug addiction in the past five years, and whether you have any untreated condition that could impair your judgment or ability to practice safely.
Nursing programs also require health screenings before you begin clinical rotations. You’ll typically need proof of up-to-date vaccinations (hepatitis B, MMR, varicella, flu, and COVID-19 are common requirements), a tuberculosis test, a physical exam, and sometimes a drug screening. These requirements protect both you and the patients you’ll care for.
The Nurse Licensure Compact
Once you’re licensed, your license is issued by a specific state. If you want to work in another state, you normally need to apply for a separate license there. The Nurse Licensure Compact simplifies this by allowing nurses to practice across all participating states with a single multistate license. This is especially useful if you live near a state border, want to do travel nursing, or provide telehealth services to patients in other states.
Physical and Personal Demands
Nursing is physically demanding work. Most shifts involve 8 to 12 hours on your feet, and patient care regularly requires lifting, repositioning, and transferring people who may not be able to move independently. Research published in the American Journal of Nursing recommends 35 pounds as the upper limit for manual patient transfers, though the reality on the floor often involves heavier loads and team lifts. Back injuries are one of the most common occupational hazards in nursing.
Beyond the physical side, nursing requires strong communication skills, emotional resilience, and the ability to stay organized under pressure. You’ll be managing multiple patients simultaneously, coordinating with physicians and other staff, explaining complex medical information to worried families, and making quick decisions when a patient’s condition changes. Comfort with bodily fluids, irregular schedules (nights, weekends, and holidays are standard), and emotionally difficult situations is part of the job from day one.
Moving Into Advanced Practice
If you want to go beyond bedside nursing, advanced practice registered nurse (APRN) roles let you diagnose conditions, prescribe medications, and manage your own patient panels. The four main APRN roles are nurse practitioner, clinical nurse specialist, nurse-midwife, and nurse anesthetist. All require at least a master’s degree, and the field is shifting toward doctoral-level preparation.
Nurse anesthesia programs have already made the transition. As of January 2022, all students entering an accredited nurse anesthetist program must enroll in a doctoral program. The National Organization of Nurse Practitioner Faculties has called for a similar move, recommending the Doctor of Nursing Practice as entry-level preparation for nurse practitioners by 2025. This doesn’t mean current master’s-prepared APRNs need to go back to school, but new students should expect doctoral programs to become the standard path for these roles.