Education and Prerequisites
To become a Registered Nurse, candidates typically complete an accredited nursing program and pass a national licensing exam. The most common pathways include an Associate Degree in Nursing (ADN), a Bachelor of Science in Nursing (BSN), or an approved diploma program. The National Council of State Boards of Nursing (NCSBN) oversees the NCLEX-RN exam, which is required for licensure in all U.S. states and territories. According to the Bureau of Labor Statistics, most RNs enter the profession with an associate or bachelor's degree, and many employers increasingly prefer BSN-prepared nurses for leadership roles. Programs combine classroom instruction in anatomy, pharmacology, and microbiology with supervised clinical rotations in hospitals and other care settings. The shift toward BSN-preferred hiring reflects hospitals' focus on patient outcomes and Magnet designation standards.
Admission requirements generally include a high school diploma or GED, prerequisite courses in chemistry and biology, and a minimum GPA. Many programs use competitive selection processes, and some require the Test of Essential Academic Skills (TEAS) or Health Education Systems, Inc. (HESI) exam. Clinical hours are a core component, with students completing hundreds of hours in acute care, community health, and specialty units. Accredited programs are listed by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Completing an accredited program ensures eligibility for the NCLEX-RN and meets state board of nursing standards.
Licensure and Certification
After graduating from an accredited program, candidates must apply for the NCLEX-RN through their state board of nursing. The exam uses computerized adaptive testing and covers safe and effective care environments, health promotion, and psychosocial integrity. Pass rates vary by program, and first-time pass rates are often published by state boards and nursing schools. Once licensed, RNs must complete continuing education to maintain their license, with requirements differing by state. Some states require specific coursework in pain management, infection control, or domestic violence. The NCLEX-RN exam structure and content outline provide detailed guidance on question formats and competency areas.
Beyond the initial RN license, many nurses pursue specialty certifications in areas such as critical care, oncology, or pediatrics. Organizations like the American Nurses Credentialing Center (ANCC) and the American Association of Critical-Care Nurses (AACN) offer credentialing exams. Certification often requires a combination of clinical hours and continuing education units. Magnet hospitals, which meet rigorous nursing standards, frequently encourage or require specialty certification for their nursing staff. These credentials can enhance career mobility and are valued by employers including large health systems and academic medical centers.
Career Outlook and Employment
The Bureau of Labor Statistics projects steady demand for Registered Nurses, driven by an aging population and increased need for chronic disease management. RNs work in hospitals, outpatient clinics, long-term care facilities, and home health agencies. Top employers include large nonprofit health systems, government hospitals, and ambulatory surgical centers. The median annual wage for RNs is well above the national average for all occupations, with additional pay for shift differentials, overtime, and specialty certifications. BLS occupational outlook for Registered Nurses provides detailed wage and employment projections by state and sector.
Advanced practice roles, such as Nurse Practitioners, require additional education beyond the RN level, often a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP). RNs can