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How to Become
A Registered Nurse

Registered Nurses (RNs) are in high demand and short supply in today's health care industry, mainly due to an increasing emphasis on preventive care, the expected long-term care needs of a growing elderly population, and technological advances in patient care. Those wishing to enter this demanding field should first become familiar with what registered nurses do and learn what it really takes to begin a career in this rewarding profession.

What Does a Registered Nurse Do?

Registered nurses provide direct care to patients in a wide variety of settings and venues, including physician's offices, outpatient treatment facilities, home health care agencies, and hospitals. They're responsible for providing care to patients, which they can learn about by attending one of the many registered nursing schools available in the U.S., including:

      • Administrating medication
      • Completing patient rounds
      • Consulting or reporting to other health care professionals
      • Explaining follow-up care to patients
      • Helping establish plans for patient care
      • Operating medical machinery
      • Performing various diagnostic tests
      • Recording patients' medical histories

Most RNs work in comfortable and well-lit health care facilities, but when they actually come into work can vary from job to job. As an example, those employed in hospitals and nursing care facilities may need to work nights, weekends, or holidays or be on call or subject to work on short notice. Nurses who work in settings that do not have 24-hour care, such as schools, offices, and some government agencies, may be more likely to work a normal 40-hour weekly schedule. Here are some other things to expect as an RN:

  1. Be on your feet. RNs spend considerable time walking, standing, bending, and stretching.
  2. Be subject to physical strain. Nurses are particularly prone to back injury, due to frequent moving and lifting.
  3. Be subject to emotional strain. This is due to close interaction with ill patients and their families as well as the need for critical decision-making.
  4. Be susceptible to illness. Those who work in health care may be frequently exposed to infectious diseases and toxic/hazardous compounds.
  5. May need to travel. This is particularly relevant for those in the home health care or public health care fields.

A specialized subset of Registered Nurse, known as Nurse Practitioners (NPs), have an advanced level of nursing education and provide a broad range of more advanced health care services. In many cases NPs are primary health-care givers who diagnose patient illnesses and prescribe medicines. In some states, NPs are allowed to open their own clinics and offices. They conduct physical exams, provide physical therapy, and order tests and therapies for patients, depending on their designated scope of practice.

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Steps to Becoming a Registered Nurse

In order to become a registered nurse, you'll need to complete a wide range of educational requirements, take part in hands-on training, and pass an approved licensing exam as required by your state. This comprehensive guide explains each step of the process, while also offering actionable advice that can help you get started.

  1. Explore the field of nursing and determine whether it's a good fit.

    According to Dr. Dorothy Miller, Chair of the Bachelor of Science in Nursing Program at Argosy University in Atlanta, students should always do their due diligence in researching their chosen field before signing up for any type of college program. And if you hope to succeed, your desire to work in the nursing profession must be sincere. Says Miller, "nursing must be a passion for you and only passion will get you through what will be an arduous program."

  2. Find the school that best suits your needs.

    As Miller points out, factors you should consider when choosing a school include details like the school's proximity to your home, available financial aid, accreditation, flexibility, and certification pass rates. When it comes to narrowing down your options and choosing a program, Miller suggests asking yourself the following questions:

    What are your goals? Make sure the school offers a program that meets your career goals.

    Consider the school's location: Are you looking to attend a fully online program or are you okay with attending on-campus courses?

    Look at the specialty you may want to enter. Don't settle. There are so many schools available. If the school does not have a program that meets your goals you will most likely not remain in the program.

    Is the school accredited? Be sure the school you choose is accredited by Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE) - or both.

    What financial aid programs are available? Non-accredited programs may not have adequate financial aid programs.

    Check the school's pass rates for NCLEX exams. This is important. If the school has a poor pass rate on the NCLEX and other certifications you should look for another school.

  3. Decide which type of program or degree to pursue.

    There are several paths one can take to become a registered nurse. Options include a Master of Science in Nursing (MSN), a Bachelor of Science in Nursing (BSN), an Associate of Science in Nursing (ADN), or a diploma. The most common path today is an ADN program, which can typically be completed in two years at a community or junior college. BSN programs, offered by colleges and universities, can take about 4 years to complete. Diploma programs, which are only offered in certain states, can take varying lengths of time to complete.

    Many RNs with an ADN or diploma will choose at some later point in time to work toward a BSN by completing what is known as an RN-to-BSN program. Accelerated MSN programs also are available by combining one year of a BSN program with two years of graduate study.

    When trying to decide which of the four options to pursue, individuals should consider their future career path. The ADN and diploma programs have a more "hands-on" approach to educating students, whereas the BSN and MSN are academic degrees that emphasize research and nursing theory. A BSN is often necessary for administrative positions and is a prerequisite for admission to an MSN program. An advanced RN field, such as a nurse practitioner, usually requires an advanced (MSN) degree.

  4. Take the prerequisites required by your program.

    "Most schools do not allow you to enter directly into the actual nursing program. You usually will be accepted as a pre-nursing student," says Miller. "During this time you will be required to take all of your prerequisites."

    Prerequisites for students in nursing programs of all types include courses such as: anatomy, physiology, English, microbiology, math, biology and chemistry.

  5. Complete the nursing component of your education.

    With your prerequisites behind you, you can focus on the nursing component of your education, which will include plenty of classroom instruction in combination with clinical rotations. Nursing-specific courses can include: Fundamentals of patient care, medical - surgical nursing, psychology, sociology, nutrition, human Development, nursing, science, and pharmacology

  6. Pass the licensing exam to become a registered nurse.

    For students who are seeking initial licensure, the NCLEX is your biggest hurdle after graduation," said Miller. To prepare yourself as much as possible, Miller suggests taking advantage of any NCLEX prep or review courses that are available.

    "I strongly urge you to take this very seriously," explains Miller. "It is a great deal of work, but these courses are designed to help you pass the licensure exams."

  7. Apply for entry level jobs.

    Once you have completed the required coursework and passed all state-required testing for nurses, it's time to apply for entry-level jobs in your field. This is the perfect opportunity for you to leverage the network you built during school or during your clinical rotations. Meanwhile, you could also apply for any entry-level job opportunities you can find on job boards, Internet postings, or medical facility websites.

  8. Continue your education, if desired.

    Professional nursing organizations, through their certification boards, have voluntary certification exams that can allow you to demonstrate clinical competency in a particular specialty. For example, passage of the American Association of Critical-care Nurses specialty exam allows a nurse to use the initials "CCRN" after his or her name. Other organizations and societies have similar procedures. The American Nurses Credentialing Center, the credentialing arm of the American Nurses Association, is the largest nursing credentialing organization and administers more than 30 specialty examinations. If you want to learn an advanced skill and certification, there are plenty of ways to continue learning and building your resume within the nursing profession.

How to Become a GREAT Registered Nurse

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An interview with Chair of the Bachelor of Science in Nursing Program at Argosy University in Atlanta
Dr. Dorothy Miller

To learn more about what it takes to enter the nursing profession and be the best you can be, we turn to Dr. Dorothy Miller, Chair of the Bachelor of Science in Nursing Program at Argosy University in Atlanta.

Q. What are some common characteristics that make a great nurse?

The common characteristics of being a great nurse are passion and compassion. It takes passion to get through the rigorous objectives of a nursing program. It takes passion/compassion to endure 12 hour shifts, work nights and weekends, to risk exposing yourself to needle sticks and other infectious diseases. It takes passion/compassion to take care of that homeless person who hasn't had a bath in weeks. It takes passion/compassion to take care of that little HIV positive baby who has been abandoned in the garbage can! Nursing is a calling not a job!

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"The common characteristics of being a great nurse are passion and compassion."

Q. Are today's nurses required to use computers and technology on a daily basis?

Most hospitals and other health care facilities are using computerized charting systems. This requires the nurse to use technology daily. Nurses use these systems to verify doctor's orders, order medications, order supplies and various other tasks. Also medication administration systems require the nurse to use various hand held devices which requires the nurse to confirm the patient's identify and medications prior to administering medications. This safety check has been very vital to preventing medication administration errors. The use of technology has revolutionized the way the nurse provides care and will continue to evolve as science evolves.

Q. Why do some nurses choose a specialty in their field while others stick to traditional nursing?

Nurses choose specialties for the same reason any other professionals choose specialties. Although we all start out at the bedside we naturally gravitate towards the path that best suits us. Like Lillian Wald who is known as the founder of Public Health Nursing, one seemingly random event causes us to change to a path that becomes our passion.

However, the increase in nursing specialties increases the professionalism of nursing as most nurses in specialty areas are required to have higher degrees. For years, nursing has been seen as less than professional. This is partly due to the limited education that the bedside nurse was required to have. Now the American Nursing Association (ANA) has made a recommendation that all RNs are required to complete a BSN within 10 years of licensure. The National Advisory Council on Nurse Education and Practice has recommended that at least two-thirds of the basic nurse workforce hold baccalaureate or higher degrees in nursing.

Registered Nurse Salary and Job Growth

Registered nurses have a strong job outlook because of the increased demand for health care professionals in the U.S. Additionally, job demand may be strongest in outpatient care centers where same-day services are provided, such as for chemotherapy or surgery, according to the BLS. RNs with a bachelor's degree education or higher could also find some of the best job opportunities.

  • Total Employment (2014): 2,687,310
  • Average Salary (2014): $69,790
  • Job Growth (2012-2022): 19%

Sources:

1.
Dr. Dorothy Miller, Argosy University, interview with the author July 13, 2015
2.
Bureau of Labor Statistics, Occupational Employment and Wages, Registered Nurses, 2014, http://www.bls.gov/oes/current/oes291141.htm
3.
Bureau of Labor Statistics, Occupational Outlook Handbook, Registered Nurses, 2014, http://www.bls.gov/ooh/healthcare/registered-nurses.htm
Interview spotlight
Dr. Dorothy Miller
Chair of the BSN Program at Argosy University

"It takes passion to get through the rigorous objectives of a nursing program. It takes passion/compassion to endure 12-hour shifts, work nights and weekends, to risk exposing yourself to needle sticks and other infectious diseases."

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