Becoming a registered nurse (RN) in the USA involves a clear, three-step pathway: earning the appropriate nursing degree, successfully passing the national licensure examination, and obtaining a license in the state where you intend to practice. This structured approach ensures that all nurses meet a high standard of education and competency before entering the healthcare field.
Essential Steps to Becoming a Registered Nurse
The journey to becoming a licensed nurse in the United States is well-defined, requiring dedication to education and professional standards.
Step 1: Earn the Appropriate Nursing Degree
The foundational step to a nursing career is completing an accredited nursing education program. Several degree options are available, each offering a different scope of practice and career trajectory.
- Associate Degree in Nursing (ADN): Typically a two-year program offered by community colleges, the ADN prepares students for entry-level nursing roles. While quicker to complete, some healthcare facilities increasingly prefer or require nurses with a Bachelor of Science in Nursing (BSN).
- Bachelor of Science in Nursing (BSN): A four-year program offered by colleges and universities, the BSN is widely considered the gold standard for entry-level nursing. It provides a more comprehensive education, including leadership, public health, research, and critical thinking skills. Many hospitals and healthcare systems are moving towards a BSN-prepared nursing workforce due to evidence linking BSN-prepared nurses to improved patient outcomes.
- Accelerated BSN (for those with a bachelor's in another field): If you already hold a bachelor's degree in a non-nursing field, you can pursue an accelerated BSN program, which condenses the nursing curriculum into a shorter timeframe, often 12-18 months.
- Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP): For those aspiring to advanced practice registered nurse (APRN) roles such as nurse practitioners, nurse anesthetists, nurse midwives, or clinical nurse specialists, or for leadership, education, or research positions, an MSN or DNP is required. These graduate-level degrees build upon the foundational nursing knowledge.
Key Consideration: Regardless of the chosen degree, ensure the program is accredited by recognized bodies like the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Accreditation is crucial for eligibility to take the NCLEX exam and for future employment.
Step 2: Pass the NCLEX Exam
After completing an accredited nursing program, the next critical step is to pass the National Council Licensure Examination (NCLEX). This standardized exam assesses the knowledge, skills, and abilities essential for safe and effective nursing practice.
- NCLEX-RN: This exam is for graduates of ADN and BSN programs who wish to become Registered Nurses.
- NCLEX-PN: This exam is for graduates of Practical/Vocational Nursing programs who wish to become Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs).
The NCLEX uses a Computer Adaptive Testing (CAT) format, meaning the difficulty of questions adjusts based on your answers. Preparation resources, including study guides, online courses, and practice exams, are widely available to help candidates succeed.
Step 3: Obtain State Licensure
Passing the NCLEX is a significant milestone, but it does not automatically grant you the right to practice. You must then apply for licensure through the Board of Nursing (BON) in the specific state or U.S. territory where you intend to work.
Licensure requirements vary slightly by state but generally include:
- Proof of graduation from an approved nursing program.
- Passing scores on the NCLEX.
- A criminal background check.
- Submission of an application and associated fees.
- Fingerprinting (in some states).
Nursing Licensure Compact (NLC): Many states participate in the Nurse Licensure Compact (NLC), which allows a nurse to have one multi-state license with the ability to practice in their home state and other compact states. This can be particularly beneficial for travel nurses or those working near state borders. If a state is not part of the NLC, nurses must apply for licensure by endorsement, which involves meeting that state's specific requirements.
Summary of Nursing Pathways
The table below outlines common pathways to nursing licensure in the USA:
| Degree Type | Program Length (Approx.) | Typical Role | Required Exam | Pathway to RN |
|---|---|---|---|---|
| Associate Degree in Nursing (ADN) | 2 years | Entry-level RN | NCLEX-RN | Yes |
| Bachelor of Science in Nursing (BSN) | 4 years | Entry-level RN | NCLEX-RN | Yes |
| Accelerated BSN | 12-18 months | Entry-level RN | NCLEX-RN | Yes |
| Master of Science in Nursing (MSN) | 2-3 years (post-BSN) | Advanced Practice RN (APRN), Educator, Leader | Varies by specialty | Yes |
| Doctor of Nursing Practice (DNP) | 3-4 years (post-BSN/MSN) | Advanced Practice RN (APRN), Clinical Leadership | Varies by specialty | Yes |
Continuing Your Nursing Journey
Once licensed, nurses are required to maintain their license through continuing education, professional development, and license renewal, which typically occurs every two years. The specific requirements vary by state. Many nurses also choose to pursue certifications in specialized areas (e.g., critical care, pediatrics, oncology) to enhance their skills and career opportunities.
