How to Become a Registered Nurse (RN)Edited by Nancy Lynn Swezey, BSN, RN, CNOR
As the healthcare delivery system in the U.S. continues to evolve, healthcare practitioners at all levels are playing a more active and present role in patient care. There are nearly three million registered nurses (RN) working in the U.S. in a wide variety of healthcare settings. RNs have arguably the most frequent and direct interactions with patients and often act as close confidants to patients while managing their health conditions. Pursuing a career as an RN is not only rewarding but provides real benefits for patients and their communities.
What Is an RN?
A registered nurse (RN) is a licensed healthcare professional that has graduated from nursing school and has met the educational and licensure requirements outlined by the state in which they practice. RNs are responsible for supporting patient care and working alongside other medical professionals to optimize healthcare delivery. RNs function as healthcare professionals and holistic caregivers who are responsible for the comfort and health management of patients. RNs are crucial members of any patient’s healthcare team and are found in a wide variety of settings.
What Does an RN Do?
RNs support physicians and other advanced practitioners in providing healthcare services and treating patients with all kinds of medical conditions. RNs typically administer medications, assess patients regularly, assist with procedures, promote health and wellness, and educate patients and their families about disease prevention and management. For RNs with an advanced degree, patient diagnosis and treatment plans may also be within their scope of practice.
RNs can work across the spectrum of healthcare settings. Their responsibilities depend on context, but RNs generally perform any combination of the following functions:
- Perform regular head to toe assessments
- Monitor treatment outcomes
- Assist physicians during diagnostic procedures and surgeries
- Conduct phlebotomoy and lab work
- Educate patients about self-care and healthy habits
- Wound care
- Oversee nursing task distribution and ancillary staff, including certified nursing assistants
- Act as a vital contributor to the patient’s multidisciplinary team
Some common specialty areas for RNs are:
- Acute/intensive care
- Cardiovascular medicine and surgery
- Primary and community care
- Community health promotion
- Infectious disease
- Labor and delivery
- Obstetric, gynecologic, and women’s health
- Surgery and procedural
Where Can an RN Work?
An RN can work in a variety of healthcare settings outside of a hospital, such as:
- Physicians’ offices: This is a great option for RNs who prefer to work a 9-to-5 schedule.
- Nursing homes: As the population ages, the number of RN jobs available in nursing homes is also rising.
- Home healthcare services: This field provides flexibility and autonomy. Home health is an emerging field, helping patients to receive necessary care at home, rather than in hospitals and other care facilities.
- Military nursing: RN careers within the military offer an opportunity to serve the country and receive many educational and career opportunities.
- Travel nursing: Short-term assignments in a traveling nurse career allow experienced RNs to travel to areas of need around the country. Assignments can last anywhere between eight and 26 weeks.
Nursing work environments can be demanding, as many hospitals and other inpatient healthcare facilities are open 24/7, requiring round-the-clock staffing. Some RNs work on-call, which means that they must be available to work without much notice for given periods of time. Others work overnight and must adjust their lifestyle and circadian rhythm to unnatural work hours.
In general, there are certain personal characteristics that can help an RN be successful in any work environment. These include:
- Physical fitness and agility
- Prioritization and organization skills
- Time management
- Communication and interpersonal skills
- Flexibility and resilience
- Empathy and compassion
Career Outlook and Demand
The U.S. Bureau of Labor Statistics estimates that employment of RNs will rise 15% from 2016 to 2026 — a faster rate of growth than many other employment sectors. There are a few reasons why this is expected. As the population of the U.S. continues to live longer, nurses will be increasingly called on to help manage chronic conditions and provide patient education for aging Americans. Additionally, financial pressures and higher acuity needs are causing hospitals to discharge patients as soon as possible. Because of this, nurses are expected to fill the care gap by helping patients transition back to a home setting while managing their medical conditions.
According to the U.S. Bureau of Labor Statistics, in 2018, the median salary for RNs was $71,730 per year. This varies greatly by state and type of institution. Generally, earnings increase with experience and advanced education. About 10% of RNs earn more than $106,000 per year.
How to Become an RN – Education
There are several different educational avenues that those interested in the field of nursing can take to become an RN. At a minimum, RNs must have an Associate Degree in Nursing (ADN) from an accredited community college or institution of higher learning. Aspiring RNs can also pursue a Bachelor of Science in Nursing (BSN), which is a four-year degree and generally leads to a higher wage. Many states and institutions and states are implementing standards that now require RN’s to have or to be pursuing a BSN.
Prerequisites for nursing generally include:
- Anatomy and physiology
- Humanities and sociology
Once enrolled in nursing school, the curriculum generally includes:
- Research and evidence-based practice
- Critical care
- Obstetrics and gynecology
- Community health
- Psychiatry and mental health
Applying to Nursing School
Those seeking to become a registered nurse can earn either a Bachelor of Science in Nursing (BSN) or an associate degree in nursing (ADN). Each path has its own set of requirements and factors to consider.
A BSN takes about four years to complete. Admission requirements vary from school to school, but applicants generally:
- Have a relatively high GPA (such as 3.0), particularly in the sciences
- Provide a personal essay and references
- Have completed prerequisite coursework
- Undergo background checks, drug testing, and health clearance
An ADN takes less time to complete and has many of the same academic requirements.
Many prospective RNs obtain entry-level nursing jobs, like certified nursing assistant, before enrolling in a nursing degree program. This may offer applicants a competitive advantage and introduces them to principles of nursing, patient care, and patient interaction.
For an RN, continuing education is required for maintaining licensure. In the ever-evolving field of health science, continuing education is essential for nurses to stay current on healthcare advances and optimally effective for patients. Many employers provide continuing education and require nurses to complete specific work to remain in good standing. Specific continuing education course requirements vary by state, but some common topics include:
- Treatment and care nuances for patients with HIV/AIDS
- Avoiding medical errors
- Resident and patient rights
- Effective emotional support practices
- Healthcare documentation
- Emergency management
- Emerging technology and research-based best practice
- Elderly patient care
To become a practicing nurse, prospective RNs must first obtain licensure by passing the National Council Licensing Examination for Registered Nurses, or the NCLEX-RN exam. The NCLEX-RN tests understanding, knowledge and competency in subject areas relevant to nursing. The exam’s main content areas are:
- Maintaining a safe and effective healthcare environment that focuses on protecting both patients and fellow healthcare providers
- Management of care and safety and on infection control across healthcare settings
- Health promotion and maintenance with a focus on strategies for optimal health and early detection of disease
- Psychosocial integrity of patients
- Physiological integrity of patients
- Patient safety
- Disease management
- Patient education
Frequently Asked Questions About RNs
How Long Does It Take to Become an RN?
The length of time it takes to become an RN depends on the educational path students take in nursing. If a prospective student is pursuing an ADN, it will take between two and three years to complete. Diploma programs at hospitals take about three years, while bachelor’s degrees in nursing offered at universities take four years to complete. These estimates may be longer if a student plans to take classes on a part-time basis.
What Is the Difference Between an LPN and an RN?
Even though Licensed Practical Nurses (LPNs) and RNs have similar responsibilities, there are some very important differences between the two in terms of scope of practice. First, LPNs report to RNs and are primarily responsible for entry-level patient care, which includes helping with testing, taking vital signs, administering medication and helping patients with activities of daily living. LPNs are not required to hold a university-level degree, but they do need to complete a state-approved program prior to practicing nursing.
Why Become a Nurse?
A career in nursing is both personally fulfilling and important for the overall health and wellness of society. As a bonus, nursing is a high-growth field with a great deal of potential for advancement. There is a rising demand for RNs, and this demand will only continue to grow as the baby boomer population ages and requires more healthcare services. Nursing is also a dynamic career. Advancements in medicine and health technologies pave the way for nurses to take on greater and more varied roles in the healthcare delivery system.
How Many Hours Do Nurses Work?
The number of hours an RN works per shift depends largely on the setting. RNs that work in private clinics, for example, may work from 9-to-5, while an RN in an emergency care facility may work 12-hour-long shifts three days per week. Often, RNs plan to work for longer than scheduled in order to make sure patient needs are met. Hospitals, in particular, are often understaffed. In general, RN schedules are considered flexible, with plenty of opportunity for overtime.
What Can an RN Do That an LPN Cannot?
Under the law, LPNs must be supervised by RNs while providing patient care. RNs are responsible for medication management, patient education, and patient well-being, while an LPN has more of an assistant role. RNs can give medications that LPNs cannot and can administer them through routes which LPNs are not authorized to do. Another major difference between an RN and an LPN is the amount of education required to hold the position. RNs require a professional nursing degree to practice. Certification for LPNs, however, can be completed in as little as one year.