Becoming a registered nurse takes two to four years depending on the degree path you choose, and every path ends at the same destination: passing the national licensing exam called the NCLEX. The process breaks down into four main stages: completing prerequisites, earning a nursing degree, passing the NCLEX, and obtaining your state license. Here’s what each stage looks like in practice.
Choose Between a Two-Year and Four-Year Degree
Two degree options lead to registered nurse licensure. An Associate Degree in Nursing (ADN) takes 18 months to two years. A Bachelor of Science in Nursing (BSN) takes up to four years. Both qualify you to sit for the NCLEX and work as an RN, but the degrees open different doors once you’re in the field.
Hospitals increasingly prefer or require a BSN, particularly for leadership roles, specialty units, and magnet-designated facilities. The median annual wage for registered nurses was $93,600 in May 2024, and nurses with a BSN generally have access to higher-paying positions and faster advancement. If you start with an ADN to get working sooner, you can complete an RN-to-BSN bridge program later, often within 12 months and frequently online.
A third option exists if you’re already a licensed vocational or practical nurse (LVN/LPN). Bridge programs let you skip redundant coursework and move directly into upper-level nursing classes, shortening the path to either an ADN or BSN.
Complete Your Prerequisites
Before you can enter a nursing program, you’ll need a set of prerequisite courses, mostly in science. A typical prerequisite list includes:
- Anatomy and physiology (usually two semesters with labs)
- Microbiology (with lab)
- Chemistry (one to three courses depending on the program)
- Nutrition
- Statistics or college-level math
- English composition
- Introductory psychology and/or sociology
Science prerequisites alone can total 26 to 33 credits. Nursing programs are competitive, so your GPA matters more than just meeting minimums. The University of Washington, for example, technically requires a 2.0 cumulative GPA but notes that admitted students score “significantly higher.” Their science prerequisite GPA floor ranges from 2.8 to 3.0 depending on how many science courses you’ve finished at the time of application. Aiming for a 3.0 or above in your sciences gives you a realistic shot at most programs.
Pass a Nursing Entrance Exam
Most nursing schools require a standardized entrance exam, typically either the ATI TEAS or the HESI A2. These aren’t pass-or-fail in the traditional sense; each school sets its own cutoff scores.
The TEAS covers four sections: reading (64 minutes), math (54 minutes), science (63 minutes), and English (28 minutes). A common benchmark is 75% or above in each section, though the science section sometimes has a lower threshold around 59%. The HESI A2 tests similar subjects, with many programs requiring 85% or higher. Both exams test foundational knowledge you’ll have covered in your prerequisites, so the best preparation is simply doing well in those courses and then reviewing with a study guide specific to the test your school uses.
What Nursing School Itself Looks Like
Once admitted, nursing school combines classroom learning with hands-on clinical rotations. Classroom courses cover pharmacology, pathophysiology, health assessment, pediatrics, mental health nursing, and other specialties. You’ll also spend significant time in simulation labs practicing skills like IV insertion, wound care, and patient assessment on mannequins before working with real patients.
Clinical rotations place you in hospitals, clinics, long-term care facilities, and community health settings under the supervision of a licensed nurse or instructor. States vary in how many clinical hours they require, but the range gives you a sense of the commitment: Delaware requires at least 400 hours, Virginia requires 500 hours of direct patient care, and Washington requires at least 600 hours for BSN programs. Your program will schedule these rotations throughout your final semesters, often in 8- to 12-hour shifts that mirror real nursing schedules.
Expect nursing school to feel like a full-time commitment even if your class hours don’t look overwhelming on paper. Clinical days are long, study loads are heavy, and the pace picks up considerably compared to prerequisite courses.
Pass the NCLEX
After graduating, you’ll apply to take the NCLEX-RN, the national licensing exam administered by the National Council of State Boards of Nursing. This is the single test that determines whether you can practice as a registered nurse.
The current version, called the Next Generation NCLEX, uses a computerized adaptive format. The exam adjusts its difficulty based on your answers, getting harder as you answer correctly and easier after incorrect responses. It includes traditional multiple-choice questions alongside newer question types that present clinical scenarios requiring you to make several connected decisions, similar to what you’d face on the job.
One notable change from the previous format: partial credit scoring. Rather than marking complex questions as entirely right or entirely wrong, the exam awards points for partially correct reasoning and deducts points for incorrect selections. This means you can earn credit for demonstrating sound clinical judgment even if you don’t get every element of a question perfect. However, some paired questions still require both parts to be correct to earn any credit at all.
Most nursing graduates take the NCLEX within a few weeks of graduating. First-time pass rates for BSN programs typically hover around 85% to 90%, while ADN pass rates vary more widely by school. If you don’t pass on the first attempt, you can retake it after a waiting period, which varies by state but is commonly 45 days.
Get Your State License
Passing the NCLEX isn’t quite the last step. You also need to apply for licensure through your state’s board of nursing, which involves a background check. Every state requires fingerprinting and a criminal history review. You’ll need to disclose all criminal history except minor traffic offenses, and that includes charges that were dismissed, sealed, or resolved through diversion programs. DUI and reckless driving are not considered minor traffic offenses for this purpose.
A criminal record doesn’t automatically disqualify you in most states, but certain serious offenses can. Florida, for instance, publishes a list of automatic disqualifying offenses in its statutes. If you have any criminal history, review your state’s specific rules before investing years in a nursing program. Many state boards will provide a preliminary evaluation if you ask.
One piece of good news on the licensing front: 43 states and territories now participate in the Nurse Licensure Compact. If you live in a compact state, your license allows you to practice in any other compact state without applying for an additional license. This is especially valuable if you live near a state border, want to do travel nursing, or plan to provide telehealth services across state lines.
Timeline From Start to Finish
If you’re starting from scratch with no college credits, the fastest realistic path is about two and a half years: one year of prerequisites followed by an 18-month ADN program. A BSN path takes closer to four years total, including prerequisites completed during your first two years of university.
If you already have a bachelor’s degree in another field, accelerated BSN programs compress nursing coursework into 12 to 18 months, assuming you’ve completed the science prerequisites. And if you’re a working LPN/LVN, bridge programs offer the shortest route since you’ve already completed clinical training and foundational coursework.
Job prospects on the other side are strong. Employment for registered nurses is projected to grow 5% from 2024 to 2034, faster than average across all occupations. That growth, combined with ongoing retirements in the nursing workforce, means new graduates in most parts of the country find employment quickly.