How to Become a Registered Nurse

Registered nurses usually take one of three education paths: a bachelor's degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program. Registered nurses must also become licensed by passing a national licensing examination.

How to Become a Registered Nurse About this section Some registered nurses work in hospital operating rooms.

Registered nurses usually take one of three education paths: a bachelor's of science degree in nursing (BSN), an associate’s degree in nursing (ADN), or a diploma from an approved nursing program. Registered nurses must also be licensed.

Education

In all nursing education programs, students take courses in nursing, anatomy, physiology, microbiology, chemistry, nutrition, psychology and other social and behavioral sciences, as well as in liberal arts. BSN programs typically take four years to complete; ADN and diploma programs usually take two to three years to complete.

All programs also include supervised clinical experience in hospital departments such as pediatrics, psychiatry, maternity, and surgery. A number of programs include clinical experience in extended and long-term care facilities, public health departments, home health agencies, or ambulatory (walk-in) clinics.

Bachelor's degree programs usually include more training in the physical and social sciences, communication, leadership, and critical thinking, which is becoming more important as nursing practice becomes more complex. They also offer more clinical experience in nonhospital settings. A bachelor's degree or higher is often necessary for administrative positions, research, consulting, and teaching.

Generally, licensed graduates of any of the three types of education programs (bachelor's, associate’s, or diploma) qualify for entry-level positions as a staff nurse.

Many registered nurses with an ADN or diploma find an entry-level position and then take advantage of tuition reimbursement benefits to work toward a BSN by completing an RN-to-BSN program. There are also master’s degree programs in nursing, combined bachelor’s and master’s programs, and programs for those who wish to enter the nursing profession but hold a bachelor’s degree in another field.

Advancement

Most registered nurses begin as staff nurses in hospitals or community health settings. With experience, good performance, and continuous education they can move to other settings or be promoted to positions with more responsibility.

In management, nurses can advance from assistant unit manager or head nurse to more senior-level administrative roles, such as assistant director, director, vice president, or chief of nursing. Increasingly, management-level nursing positions require a graduate degree in nursing or health services administration. Administrative positions require leadership, communication and negotiation skills, and good judgment.

Some RNs choose to become advanced practice registered nurses (APRNs). APRNs work independently or in collaboration with physicians. They may provide primary care, and, in most states, they may prescribe medications. APRNs require at least a master's degree. Each state’s board of nursing can provide the specific regulations regarding APRNs.

Some nurses move into the business side of healthcare. Their nursing expertise and experience on a healthcare team equip them to manage ambulatory, acute, home-based, and chronic care businesses.

Employers—including hospitals, insurance companies, pharmaceutical manufacturers, and managed care organizations, among others—need registered nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance.

Other nurses work as postsecondary teachers in colleges and

universities

Pay

The median annual wage of registered nurses was $64,690 in May 2012.

Note: All Occupations includes all occupations in the U.S. Economy.

Source: U.S. Bureau of Labor Statistics, Occupational Employment Statistics

The median annual wage of registered nurses was $64,690 in May 2012. The median wage is the wage at which half of the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $44,190 and the top 10 percent earned more than $95,130.

Note: All Occupations includes all occupations in the U.S. Economy.

Source: U.S. Bureau of Labor Statistics, Occupational Employment Statistics

The median annual wage of registered nurses was $64,690 in May 2012. The median wage is the wage at which half of the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $44,190 and the top 10 percent earned more than $95,130.

As shown in the tabulation below, median annual wages for registered nurses in private general medical and surgical hospitals were $66,650 in May 2012 highest among those industries employing much of the occupation.

General medical and surgical hospitals; private $66,650

Offices of physicians 62,880

General medical and surgical hospitals; local 62,690

Home health care services 60,690

Nursing care facilities 58,180

Many employers offer flexible work schedules, child care, educational benefits, and bonuses. About 19 percent of registered nurses are union members or covered by a union contract.

Because patients in hospitals and nursing care facilities need round-the-clock care, nurses in these settings usually work in rotating shifts, covering all 24 hours. They may work nights, weekends, and holidays. They may also be on call, which means they are on duty and must be available to work on short notice.

Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to work regular business hours.

In 2012, about 20 percent of registered nurses worked part time.

Job Outlook

Employment of registered nurses is expected to grow 26 percent from 2010 to 2020, faster than the average for all occupations. Growth will occur primarily because of technological advancements; an increased emphasis on preventative care; and the large, aging baby-boomer population who will demand more healthcare services as they live longer and more active lives.

Job Outlook About this sectionRegistered Nurses

Percent change in employment, projected 2010-20

Health Diagnosing and Treating Practitioners 26%

Registered Nurses 26%

Total, All Occupations 14%

 Duties

Registered nurses typically do the following:

Record patients' medical histories and symptoms

Give patients medicines and treatments

Set up plans for patients’ care or contribute to existing plans

Observe patients and record the observations

Consult with doctors and other healthcare professionals

Operate and monitor medical equipment

Help perform diagnostic tests and analyze results

Teach patients and their families how to manage their illnesses or injuries

Explain what to do at home after treatment

Some registered nurses oversee licensed practical nurses, nursing aides, and home care aides. For more information, see the profiles on licensed practical and licensed vocational nurses; nursing aides, orderlies, and attendants; and home health and personal care aides.

Registered nurses sometimes work to promote general health by educating the public on warning signs and symptoms of disease. They might also run general health screenings or immunization clinics, blood drives, or other outreach programs.

Most registered nurses work as part of a team with physicians and other healthcare specialists.

Some nurses have jobs in which they do not work directly with patients, but they must still have an active registered nurse license. For example, they may work as nurse educators, healthcare consultants, public policy advisors, researchers, hospital administrators, salespeople for pharmaceutical and medical supply companies, or as medical writers and editors.

Registered nurses' duties and titles often depend on where they work and the patients they work with. They can focus on the following specialties:

A specific health condition, such as a diabetes management nurse who helps patients with diabetes or an oncology nurse who helps cancer patients

A specific part of the body, such as a dermatology nurse working with patients who have skin problems

A specific group of people, such as a geriatric nurse who works with the elderly or a pediatric nurse who works with children and teens

A specific workplace, such as an emergency or trauma nurse who works in a hospital or stand-alone emergency department or a school nurse working in an elementary, middle, or high school rather than in a hospital or doctor's office.

Some registered nurses combine one or more of these specialties. For example, a pediatric oncology nurse works with children and teens who have cancer.

Similar Occupations About this sectionThis table shows a list of occupations with job duties that are similar to those of registered nurses.

Occupation Job Duties ENTRY-LEVEL EDUCATION 2012 MEDIAN PAY

 

Dental Hygienists Dental hygienists clean teeth, examine patients for oral diseases such as gingivitis, and provide other preventative dental care. They also educate patients on ways to improve and maintain good oral health.

Associate’s degree $68,250

Diagnostic Medical Sonographers Diagnostic medical sonographers use special imaging equipment that directs sound waves into a patient’s body (in a procedure commonly known as an ultrasound, sonogram, or echocardiogram) to assess and diagnose various medical conditions.

Associate’s degree $64,380

 

EMTs and Paramedics Emergency medical technicians (EMTs) and paramedics care for the sick or injured in emergency medical settings. People’s lives often depend on their quick reaction and competent care. EMTs and paramedics respond to emergency calls, performing medical services and transporting patients to medical facilities.

Postsecondary non-degree award $30,360

 

Postsecondary non-degree award $40,380

 

Physician Assistants Physician assistants, also known as PAs, practice medicine under the direction of physicians and surgeons. They are formally trained to examine patients, diagnose injuries and illnesses, and provide treatment.

 

Master’s degree $86,410