How to Become a Nurse: The Osmosis Ultimate Guide
Published on Apr 12, 2021. Updated on Jun 20, 2024.
Getting Started On Your Nursing Journey
Nursing isn’t just a profession; it’s a rewarding career that requires compassion, empathy, a genuine desire to care for others, and a commitment to lifelong learning. With the ongoing nursing shortage in many parts of the world, the demand for skilled nurses has never been higher. Now is the perfect time to embark on a nursing career!
This guide will outline the diverse roles within nursing, from Licensed Practical Nurses (LPNs) to Registered Nurses (RNs). We’ll explore the education requirements, program durations, salary ranges**, work settings, and the licensing journey while sharing resources for those considering a nursing career.
Taking the First Steps: Is Nursing Your Calling?
The first step to becoming a nurse is taking time to self-reflect to determine if a nursing career suits you. Many nurses trace their journey to a personal experience that ignited their passion, often inspired by a nurse or other healthcare professional. Some choose to explore the profession by working in an entry-level role, such as a certified nursing assistant or emergency medical technician; however, prior experience in an entry-level job isn’t always necessary because you’ll get the training you need in nursing school and gain hands-on practice during clinicals.
Once you have decided a nursing career is a good match for you, your next step is to complete the necessary educational requirements. Let’s take a look at the various levels of nursing and examine the time commitment, roles, and requirements for each role.
Definitions
Before we get started, let's clarify some important terms:
Registered Nurse (RN): A graduate of an accredited registered nursing program who successfully passed the National Council Licensure Examination (NCLEX®-RN) and obtained state board of nursing licensure.
Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN): A graduate of an accredited licensed practical or vocational nursing program who has successfully passed the National Council Licensure Examination (NCLEX®-PN) and obtained a state board of nursing licensure.
National Council Licensure Examination-Registered Nurse (NCLEX-RN): An exam taken by US and Canadian nursing students to receive a license to practice as a registered nurse.
National Council Licensure Examination-Practical Nurse (NCLEX-PN): An exam taken by US and Canadian nursing students to receive a license to practice as a licensed practical or vocational nurse.
Licensure: The process nurse candidates use to apply to practice after passing their boards; licensure is granted by boards of nursing.
Accreditation: A nursing program that's nationally or officially recognized or authorized.
Licensed Practical/Vocational Nurses (LPNs/LVNs)
Work Settings: LPNs/LVNs work in various healthcare settings, including hospitals, nursing homes, clinics, provider offices, and in-home health.
Salary Range**: The median annual wage for LPNs/LVNs is around $48,820, with the lowest 10% earning approximately $35,440 and the highest 10% earning about $64,610.
Registered Nurses (RNs)
Work Settings: RNs work in various healthcare settings, including hospitals, outpatient offices, outpatient care centers, schools, and in-home health.
Salary Range**: The median annual wage for RNs is approximately $75,330, with the lowest 10% earning around $53,410 and the highest 10% earning about $116,230.
When it comes to employment prospects, the Bureau of Labor Statistics indicates that the employability of registered nurses is projected to grow by 6% from 2022 to 2032, which is faster than the average for all occupations.
Prerequisites for Accredited Nursing Programs
To become an LPN or LVN, a high school diploma or equivalent is typically required before enrolling in a nursing program. However, there are a few vocational programs that allow you to obtain your high school diploma and your LPN or LVN at the same time. Typically, an LPN/LVN program takes 12 to 18 months to complete.
There are three educational pathways to choose from to become an RN: a diploma program (2-3 years), an Associate Degree in Nursing (ADN) (2-3 years), or a Bachelor of Science in Nursing (BSN) (4 years) degree. Most programs require prerequisite courses in Anatomy and Physiology, Microbiology, English Composition, Psychology, Developmental Psychology, Sociology, and Nutrition. These may also already be included in your plan of study. Check with each school for details.
Types of Accredited Nursing Programs
Once you’ve fulfilled the prerequisites required for entry into a nursing program, it’s time to consider the type of nursing program available and find the one that aligns with your professional goals and would suit you best. A variety of programs exist, including LPN, LVN, Diploma, Associate, and Bachelor’s programs.
Licensed Practical/Vocational Nursing (LPN/LVN) Programs
LPN and LVN programs can be found in vocational schools, high schools with a vocational focus, community colleges, or college settings.
Diploma Programs
Diploma programs are the oldest and most traditional nursing programs. They typically take one to three years to complete, with most of your learning taking place in a clinical setting. Diploma program graduates can take the same NCLEX-RN exam as those graduating from other nursing programs.
Associate Degree Programs
Associate degree programs take approximately eighteen months to two years to complete. Similar to diploma programs, an associate program provides an extensive hands-on learning experience in a clinical setting. However, they incorporate more classroom education in comparison to diploma programs.
Bachelor Degree Programs
Bachelor's degree programs take approximately four years to complete and are taught primarily in a classroom and clinical setting. Many medical institutions now consider a bachelor’s degree the standard entry-level degree. Some institutions may provide RNs with financial incentives to obtain their bachelor’s degree.
While the program format may vary, most offer part-time options, which extend the duration of your studies but allow you to set a more flexible pace.
TIP: Regardless of which nursing program you choose, you’ll need to prepare to pass the National Council Licensure Examination (NCLEX) to obtain licensure.
Navigating Nursing Course Requirements
With your prerequisites in order and your chosen accredited nursing program awaiting your arrival, it’s time to familiarize yourself with the nursing course requirements you'll encounter in your program.
The specific nursing subjects you study will vary depending on your chosen nursing program. However, there are a few subjects that are common to all nursing programs, including:
Nursing Fundamentals
Medical-Surgical Nursing
Pediatric Nursing
Maternal Newborn Nursing
Mental Health Nursing
Health Assessment
Pharmacology
Additionally, you may have the opportunity to take specialized courses that deepen and improve your understanding of nursing as a general field in areas like critical care nursing, nurse anesthesia, nursing informatics, nurse education, or forensic nursing.
The Nursing Program Experience
Your journey as a nursing student begins the moment you’ve been accepted into a nursing program.
You’ve likely heard that getting through a nursing program is one of the most challenging things you'll ever do. While there are elements of truth to that, your nursing program will provide you with a variety of helpful resources, tools, and opportunities to become a great nurse. The extent to which you use and apply these resources is up to you, but you'll be surrounded by a community of fellow nurses eager to support you in your journey!
Next, let’s look at the typical path you'll follow as a nursing student.
Study Habits
If you’re accustomed to skimming through textbooks or doing last-minute cramming with exams around the corner, brace yourself for a shift in study habits! You'll be expected to read and understand an extensive body of knowledge that requires daily immersion in your study materials. Ultimately, you'll need to have your books and other resources close by. It may be challenging during the first term, but you'll learn to embrace studying as you go.
Beyond Textbooks
Your courses will provide lectures, notes, textbooks, and other coursework content, but nursing programs aren’t all about theoretical knowledge. You’ll be expected to apply what you’ve learned in a clinical setting. Getting out into the clinical setting will help you get a better understanding of how to use the skills you read and learn about in your classes.
There will be a lot of information coming at you all at once! To help you learn more material and perform better academically and clinically, we recommend doing some research into how you prefer to learn! Take a learning style assessment quiz to help you figure out how you learn best.
Class Structure
Each nursing program offers a distinct curriculum tailored to fit their specific goals. The first term of your nursing program typically includes classes, labs, and a clinical component. In general, programs begin in the classroom to build a solid foundation in the fundamentals of nursing. Then, you'll transition to a clinical setting to gain valuable hands-on experience.
You should anticipate spending significant time in the classroom, simulation lab, and clinical settings throughout your program.
What Your First School Term Might Entail
Fundamentals of Nursing is usually the first course you'll take, with lectures, labs, and clinical work associated with this course. You'll develop the competencies necessary to meet the needs of individuals throughout the lifespan and learn how to meet basic human needs and the skills essential for delivering safe and effective care.
Some programs require that you take the following three courses before clinicals, or you may be required to take them at the end of your program if you're in an ADN program and returning for your BSN. Let’s delve into these crucial topics:
Pathophysiology: Covers fundamental aspects of physiology and pathophysiology, providing a solid understanding of the physiological processes for various medical conditions you may encounter during your clinical practice.
Health assessment: You’ll learn how to take vital signs and conduct comprehensive health assessments, such as listening to heart and lung sounds, which are crucial skills for evaluating patients.
Pharmacology: You’ll explore the purpose and action of medications to learn how to administer medications safely and effectively.
Nursing Exams
You will, of course, regularly take exams to assess your knowledge. However, it’s important to note that nursing is not always about what’s right and wrong; sometimes, there’s more than one correct answer! Many nursing exams ask you questions about which actions are “best” or “most appropriate,” so it’s up to you to learn to prioritize patient care.
To excel on your exams, take the time to understand the question thoroughly. By closely examining what's being asked, you'll be better prepared to provide the correct answers.
It’s also important to remember that exams aren’t created to set you up for failure. They’re designed to help you think critically and assess your knowledge, skills, and ability to adapt so you're prepared for the real world of nursing. The ability to think critically and navigate through uncertainty will translate into your nursing practice and become one of your most valued traits as a health professional.
Last but not least, before you take your exams, take the time to study for it properly. Many textbook publishers offer additional resources such as practice questions, case studies, and outlines for the content covered in the textbook. And if your school has access to an interactive learning platform (such as Osmosis), make sure to USE IT! They’re an excellent resource for preparing for exams and determining areas where you need to redirect your learning focus.
Nursing Clinicals
Clinicals are the heart of your nursing education, where what you’ve learned in the lab, classroom, and textbooks come alive! While the timing of clinicals can vary between programs, you'll eventually gain hands-on experience in various clinical settings. Typically, you’ll help to assess and provide care to patients with your nursing instructor or another nurse.
What to Buy
In addition to your textbooks, there are items that are pivotal to your nursing journey. Alongside a stethoscope and your program’s approved scrubs or uniform, you may also need to purchase other nursing items required by your program, such as interactive learning platforms like Sherpath, electronic charting programs like SimChart, which is used in documenting patient care, or smartphone applications designed to help you study.
As you embark on your nursing learning journey, it’s important to remember that it’s natural to find it challenging initially. However, with dedication and some time, you’ll get used to your program’s demands on your time and your unique learning environment.
The Pathway to Nursing Licensure
Once you’ve completed your nursing program, it’s time to get licensed. There are four different types of nursing licenses issued by each state board of nursing:
Registered Nurses (RNs)
Licensed Practical Nurses (LPNs)
Licensed Vocational Nurses (LVNs)
Advanced Practice Registered Nurses (APRNs)
More on types of nursing licensing > How to Navigate Your Nursing Career: Paths, Progression, and Opportunities
It’s important to note that specific state requirements for licensure may vary. However, as a prospective nurse, here are the fundamental steps to obtaining your nursing licensure:
Step #1: Complete an accredited, state-approved nursing program
Accreditation is the cornerstone of education and refers to the formal recognition and approval process undertaken by authoritative organizations or agencies, like the American Association of Colleges of Nursing and the Accreditation Commission for Education in Nursing, to assess and verify the quality and standards of nursing programs. So, if you haven’t attended an accredited program, you won’t be able to take the licensure exam.
Step #2: Register for the NCLEX-RN exam
After completing an accredited, state-approved nursing program, the next step is to register for the National Council Licensure Examination (NCLEX). This standardized test determines whether you're ready to become an entry-level nurse. Successfully passing the NCLEX is required to obtain your nursing license and begin working as a nurse.
With regard to the exam itself, expect to answer as many as 150 questions but no less than 85 questions within a five-hour testing period.
TIP: While taking the NCLEX, just because you get the minimum number of questions and the computer shuts off does not mean that you've passed, but it also doesn't mean that you failed! Check out 5 Myths About the NCLEX® to learn more.
After taking the NCLEX exam, anticipate receiving your official results within approximately six weeks. In the event that you don’t pass (it’s perfectly okay; it happens), you must patiently wait 45 days before re-taking the exam. You’re allowed to take the exam up to eight times per year, with a 45-day waiting period between exams.
To improve your chances of success, many students attend an NCLEX review course outside of their nursing program before taking the NCLEX. These courses often provide valuable insights and strategies to help you prepare for the examination.
The areas covered on the NCLEX include:
Detection and prevention of diseases
Patient care scenarios
Patient comfort
Coping and adaptation
Pharmacological therapies
To learn more about the NCLEX, check out these helpful articles from Osmosis!
Step #3: Apply for a license with your state’s licensing board
After you’ve passed your boards, you're ready to take the next step and get your license. In most states, applying for your nursing license involves a nursing board* that oversees RN and LPN licensure along with required proof of education with official transcripts, an application form, and fees. Once you’ve completed these steps, you’ll officially begin obtaining your nursing license!
Step #4: Complete additional state requirements
After your successful performance on the NCLEX, you'll need to complete additional requirements depending on your state. These include but are not limited to:
A background check
Fingerprints
Verification of education
Verification of passing NCLEX
Some states grant “temporary licenses” while waiting for your full licensure approval. You’ll be considered a graduate nurse, which will allow you to work as a nursing assistant and experience the healthcare setting but not practice your RN skills just yet.
Maintaining Your Nursing License
Once you get your nursing license, you’ll need to maintain it. It’s important to be aware that the requirements for nursing licensure and continuing education can vary significantly from state to state in the US (and country to country outside of the US), including the fee amount, the length of application and review process, clinical hours served and required Continued Education Units (CEU). Make sure to refer to this comprehensive list of every US state and its requirements for nursing licensure and continuing education to stay current.
Nursing Certifications
A nursing certification demonstrates that you have the right expertise, experience, skills, and requisite education to provide specialized knowledge on specific patient populations. While they’re not mandatory, certifications help you prepare for leadership and help to advance your nursing career. Nursing certifications aren’t required, but they contribute to improved knowledge and patient care. The fees associated with your nursing certification are added to the educational expenses you may incur. The fees range from under $100 to nearly $1,000, and renewal periods range from one to five years.
How do I get certified as a nurse?
The exact steps to attain nursing certifications in the US vary by state and certifying body. In general, you'll need to have graduated from an accredited nursing program and have continuing education and clinical experience in the area where you wish to be certified.
Here are some examples of certifications offered to RNs with experience in the specialty:
Ambulatory Care Nursing-AMB-BC™
Cardiac-Vascular Nursing-CV-BC™
Gerontological Nursing-GERO-BC™
Informatics Nursing-RN-BC®
Medical-Surgical Nursing-MEDSURG-BC™
Nurse Executive-NE-BC®
Nurse Executive, Advanced-NEA-BC®
Nursing Case Management-CMGT-BC™
Nursing Professional Development-NPD-BC™
Pain Management Nursing-PMGT-BC™
Pediatric Nursing-PED-BC™
Psychiatric-Mental Health Nursing-PMH-BC™
Certifying Organizations
Nursing certifications are granted by a variety of organizations, all of which fall under the National Commission for Certifying Agencies (NCCA). These organizations cater to different nursing specialties, and each has its own set of requirements and associated fees. For RNs, you can seek your certification from these bodies:
You need to renew your certification according to the changing needs of the healthcare industry and each certifying board.
When you complete professional activities like continuing education, teaching, and volunteering, they’ll be added to your certification to give you even more qualifications.
Getting Your First Job as a Nurse
Getting your nursing license is an outstanding achievement! Now, you're no longer a student; it’s time to enjoy the nursing profession. Granted, getting started may be overwhelming, but don’t worry. These four helpful tips will help you land your first nursing job!
Nursing Program Partnership
A majority of local hospitals reach out to nursing programs whenever they’re looking for new graduates to hire. Having a good relationship with your nursing program instructors could help you get a job interview! Instructors often have connections within the healthcare community and can recommend you to prospective employers.
Consult Nursing Job Boards
While you’re looking for your next opportunity, nursing-specific job boards like Nurse.com and NurseRecruiter.com are invaluable resources. To make the most of these resources, visit these job boards repeatedly, and if there’s a particular facility you're interested in, don’t hesitate to apply.
Follow Up with Prospective Employers
After submitting your application, it’s common for it to take time to hear back from a prospective employer. Typically, it’s reasonable to wait at least one to two weeks before following up with a courteous email. However, if you haven't received any communication after two weeks, it's advisable to take a more proactive approach.
Polite Follow-Up Message
Send a courteous email expressing your continued interest in the position and inquiring about the status of your application. This follow-up can serve as a friendly reminder to the hiring team and demonstrate your genuine interest.
Respectful Persistence
You may send one more follow-up email if you haven’t received a response after your initial follow-up. Persistence can be valuable, as hiring managers are often juggling multiple responsibilities and may appreciate your proactive approach.
Moving Forward
If they remain unresponsive after two follow-ups, it's reasonable to assume that the job is no longer open or not the right fit for you. At this point, redirect your focus and energy toward other prospective opportunities.
By striking a balance between persistence and respect for the hiring process, you maximize your chances of securing the nursing position that aligns with your career aspirations.
Market Yourself
While sending applications is a valuable job-hunting strategy, don’t rely solely on this method to secure your first nursing job. Don’t underestimate the power of networking in your job search, as it can play a vital role in securing a new position.
Leveraging Connections
Reach out to friends, family, and alums from your nursing school to tap into a valuable resource of potential job connections. Someone within your network may know of job openings or be willing to recommend you.
Recommendations Matter
Getting a recommendation from trusted individuals can carry significant weight in the hiring process. When someone you know vouches for your qualifications and character, it can make a positive impression on prospective employers. Don’t hesitate to ask for one!
Determination and Persistence
Like any other job search, landing your first job as a registered nurse requires unwavering determination and persistence. Networking can enhance your chances by uncovering hidden job opportunities and increasing your visibility in the healthcare community.
Maintaining a Healthy Work-Life Balance
In the midst of pursuing your nursing career, it's crucial to prioritize your well-being. It can be challenging to balance the demands of a nursing career with your personal life, but it's essential for your overall health and longevity in the field. Burnout is a genuine concern in healthcare, and taking proactive steps to prevent it is key. Consider integrating mindfulness practices into your routine, such as meditation or yoga, to help manage stress. Additionally, make time for activities you enjoy outside of work, whether it's spending time with loved ones, engaging in hobbies, or simply taking a walk in nature.
Most importantly, mental health is a cornerstone of overall well-being, and as a nurse, it's important to prioritize your mental health just as much as your physical health. If you ever find yourself feeling overwhelmed or struggling emotionally, don't hesitate to seek support. Many healthcare organizations provide employee assistance programs and mental health insurance coverage with confidential counseling services to help you navigate challenges.
In recognition of the unique stressors that healthcare professionals face, there are also numerous resources available specifically tailored to support nurses in their mental health journey. Consider exploring workshops or support groups that focus on stress management and resilience building, or connecting with peers who understand the demands of the profession and can provide a valuable support network.
Remember, an emotionally resilient nurse with a healthy work-life balance is better equipped to provide high-quality care to patients. By investing in your own well-being, you not only enhance your personal and professional life but contribute to the overall strength and sustainability of the nursing profession.
Advancing Your Career
Nursing is an exciting career filled with a variety of opportunities for growth and advancement. Once you’ve obtained your nursing license, we encourage you to explore one or more of the following professional avenues.
Volunteer for Leadership Roles
If your boss is looking for someone to take on more responsibility, consider volunteering! You’ll gain much-needed experience, and it’s one of the best ways to enhance your resume and show that you're already familiar with advanced nursing roles.
Join Professional Organizations
Professional organizations not only look good on your resume but can also help you build the right connections. Here is a selection of various US nursing organizations to consider joining:
Embracing Your Nursing Career
A nursing career offers an incredibly fulfilling and respected profession that allows individuals to make a positive impact on the lives of others. With the ongoing nursing shortage, there are abundant opportunities for those considering a career in nursing. From Licensed Practical Nurses (LPNs) to Registered Nurses (RNs) and Advanced Practice Nurses (APNs), each nursing role requires a specific educational path and offers unique responsibilities and salary ranges.
When choosing the right path to nursing, it's essential to consider personal goals, preferences, and aspirations. Factors such as the desired level of responsibility, scope of practice, educational commitment, and long-term career prospects should be taken into account. Whether you start as an LPN and progress to become an RN or pursue advanced practice nursing education, each step builds upon previous experience and opens doors to new opportunities.
To make an informed decision, it's crucial to thoroughly research educational programs, licensing requirements, and practice settings. Consulting reputable nursing organizations, academic institutions, and state-specific nursing boards* can provide valuable guidance and resources.
Embarking on a nursing career is a rewarding journey that offers the chance to positively impact the lives of patients and communities. By choosing the right path to nursing based on individual goals and aspirations, you can contribute to meeting the healthcare needs of a diverse and ever-evolving society.
References & Resources
*State-specific nursing boards or regulatory bodies (e.g., California Board of Registered Nursing, New York State Education Department - Office of the Professions)
**Please note that specific salary ranges, licensing requirements, and resources may vary by state or country. It's essential to consult your jurisdiction's relevant nursing organizations and regulatory bodies for accurate and up-to-date information.
Contributors & Reviewers
Maria Pfrommer, DNP, Ph.D., FNP-BC, RN, is the Osmosis Director of Nursing Education. Dr. Pfrommer conferred a Doctor of Nursing (DNP) from Duke University, a Ph.D. in Post-Secondary Education from Capella University, and a Master of Science in Nursing (MSN) as a Family Nurse Practitioner from Thomas Jefferson University. Maria brings a wealth of experience in curriculum development, publishing, presenting, and teaching in healthcare. Maria has provided faculty and student development for Elsevier since 2005 on Evolve and has worked on various instructor and student projects as a subject matter expert (SME) with Elsevier, including HESI, Sherpath, Test Banks, TEACH Lessons, case studies, and video scripts.
Kelsey LaFayette, DNP, ARNP, FNP-C, Nursing Content Manager
Elizabeth Lucas, EdD, RN, CNE, Senior Nursing Content Manager
Lisa Miklush, PhD, RNC, CNS, Senior Content Editor
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