A registered nurse (RN) is a licensed healthcare professional who monitors, treats, and educates patients across nearly every medical setting. RNs earn a median salary of $93,600 per year and represent one of the largest workforces in healthcare, with job growth projected at 5 percent through 2034.
What an RN Does Day to Day
The core of an RN’s job is direct patient care. That includes assessing patients, recording vital signs, administering medications and treatments, running diagnostic tests, and updating health records with observations about a patient’s condition and behavior. But the role extends well beyond bedside tasks. RNs coordinate with doctors, specialists, social workers, and nutritionists to build and adjust care plans. They also spend significant time educating patients and their families on managing conditions at home, understanding medications, and recognizing warning signs.
In a hospital setting, a typical shift involves structured rounds where the nurse reviews each patient’s status with the broader care team. During these rounds, an RN might flag whether a urinary catheter is still necessary, check that fall-prevention measures are in place, verify IV access, and discuss barriers to discharge with social workers. The specifics shift depending on the unit and patient population, but the pattern of assessment, coordination, and documentation stays consistent.
How RNs Differ From LPNs and Nurse Practitioners
Nursing has a clear hierarchy, and understanding where RNs fit helps clarify the role. Licensed practical nurses (LPNs) provide basic patient care and assist RNs or physicians by monitoring health, updating records, and carrying out treatments. They have less autonomy and a narrower scope than RNs.
RNs sit in the middle. They have broader clinical authority, can perform diagnostics, administer complex treatments, and take a lead role in care coordination. Nurse practitioners (NPs) sit above RNs. NPs can prescribe medications like antibiotics and narcotics in all 50 states, and in nearly half the states they have full practice authority, meaning they can run their own practice much like a primary care physician. Becoming an NP requires a master’s or doctoral degree beyond the RN credential.
Education Pathways
There are two main routes to becoming an RN. The faster option is an Associate Degree in Nursing (ADN), a two-year program typically offered at community colleges. Some schools offer accelerated versions that finish in 18 months. The second option is a Bachelor of Science in Nursing (BSN), a four-year undergraduate program at a college or university. Both pathways qualify you to sit for the licensing exam, but many employers now prefer or require a BSN.
After completing either program, you must pass the NCLEX-RN, the national licensing exam. The exam uses an adaptive format that adjusts question difficulty based on your answers, and the current passing standard is set through March 2026. Once you pass, you apply for licensure in your state and can begin practicing. All nursing licensure in the U.S. is state-based, so requirements and renewal rules vary somewhat depending on where you work.
Where RNs Work
Hospitals employ the largest share of registered nurses, but the role exists in virtually every corner of healthcare. RNs work in outpatient clinics, surgical centers, schools, home health agencies, nursing homes, insurance companies, public health departments, and corporate wellness programs. Some work in less obvious settings like informatics, where they help design and manage electronic health record systems, or in case management, coordinating long-term care for patients with chronic conditions.
Specializations and Certifications
After gaining experience, RNs can pursue specialty certifications that formalize expertise in a specific area. The American Nurses Credentialing Center offers board certifications in fields including cardiac-vascular nursing, pediatrics, psychiatric-mental health, medical-surgical care, pain management, gerontology, and ambulatory care, among others. Each certification requires meeting eligibility criteria and passing a specialty exam.
Specializing changes both the work and the earning potential. A nurse on a cardiac unit focuses on heart rhythm monitoring, post-surgical recovery, and medication management for heart failure. A psychiatric-mental health nurse works with patients experiencing behavioral or emotional conditions. Pediatric nurses tailor their assessments and communication to children and their parents. The underlying nursing skills are the same, but the clinical knowledge and daily responsibilities look very different across specialties.
Salary and Job Outlook
The median annual wage for registered nurses reached $93,600 as of May 2024, according to the Bureau of Labor Statistics. Pay varies widely based on location, specialty, experience, and work setting. Nurses in metropolitan areas and those working night or weekend shifts typically earn more. Travel nurses, who take short-term contracts at facilities with staffing shortages, often earn significantly above the median.
Employment is projected to grow 5 percent from 2024 to 2034, which is faster than the average for all occupations. An aging population, increasing rates of chronic disease, and ongoing demand for healthcare services all contribute to steady job availability. Nursing consistently ranks among the most in-demand professions in the country.
The Timeline From Start to Practice
If you’re starting from scratch, the fastest route to working as an RN is roughly two to two and a half years: complete an ADN program, pass the NCLEX-RN, and obtain your state license. The BSN route takes about four years but opens more doors for advancement and is increasingly expected by larger health systems. For people who already hold a bachelor’s degree in another field, accelerated BSN programs compress the coursework into 12 to 18 months. From there, pursuing a nurse practitioner role adds another two to four years of graduate education.