How to become a nurse

1. 1Pick your entry point: CNA, LPN or RN

   Sources 7, 8, 1

   Decide how far you want to go first. A CNA program is the quickest way into patient care, at least 75 hours under federal rules for nursing home aides. An LPN program takes about a year. The RN route takes 2 to 4 years but leads to the most jobs and the path to advanced practice. Many nurses climb in stages, working as a CNA or LPN while they study.

2. 2Take nursing prerequisites

   Time: One semester to 1 yearCost: Community college tuitionSources 1, 5

   RN programs usually require college anatomy and physiology, microbiology, chemistry, psychology, English and math, and many use an entrance test. Grades in the sciences weigh heavily because nursing seats are limited by clinical placements. Check each program's list, since BSN programs often build prerequisites into the first two years, while associate programs may expect them done before you apply.

3. 3Complete an approved RN program (ADN or BSN)

   Time: 2 years (ADN) or 4 years (BSN)Cost: $4,716/yr (ADN) or $9,456/yr (BSN) median public in-state tuitionSources 1, 4, 5, 9, 6

   Both degrees qualify you for the NCLEX-RN when the program is approved by your state board of nursing. Accreditation also matters: ACEN accredits all types of nursing programs, and CCNE accredits bachelor's and graduate programs. ADNs cost less and finish sooner; many hospitals prefer or require a BSN, and it is needed for graduate school. People with a bachelor's in another field can take accelerated BSN programs.

4. 4Pass the NCLEX-RN and get your license

   Time: 1-3 months after graduationCost: $200 (2026); $350 from Feb. 1, 2027Sources 3, 2, 10, 1

   Apply to your state board of nursing for licensure, then register for the NCLEX with Pearson VUE. The NCLEX is a computerized adaptive test, so its length depends on how you answer. States add their own requirements, such as criminal background checks. If you live in one of the 43 Nurse Licensure Compact jurisdictions, you can apply for a multistate license that lets you practice in the other compact states; a few members are still putting the compact into effect, so check with your board.

5. 5Start as a staff nurse and build experience

   Time: 1-2 yearsSources 1

   Most new RNs begin on a hospital unit or in a clinic, home health agency or nursing home, and some hospitals run structured programs for new graduates. Employers may require BLS or CPR, and some units also want ACLS. After a year or two you can move to a specialty such as ICU, emergency or labor and delivery, and earn voluntary certifications in areas like gerontology, pediatrics or ambulatory care.

6. 6Optional: advance to a BSN or graduate degree

   Time: 1-4 yearsCost: Varies; employers sometimes reimburseSources 1, 11, 14

   ADN nurses can finish an RN-to-BSN program, often while working. To become a nurse practitioner, nurse midwife or clinical nurse specialist, you need at least a master's degree and national certification; nurse anesthetists now need a doctorate of at least 36 months and at least a year of full-time critical care experience. Management, teaching and research roles increasingly require graduate degrees.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Clinical judgment

Nurses are often the first to notice a patient getting worse and must decide quickly whether to act, watch or call a physician.

Medication safety

Giving the right drug and dose to the right patient at the right time, many times a shift, leaves little room for error.

Prioritizing under pressure

A hospital nurse cares for several patients at once and has to decide constantly whose need comes first.

Teaching in plain language

Patients go home with new medications and wound care, and how well they follow instructions depends on how clearly the nurse explains them.

Physical and emotional stamina

Twelve-hour shifts on your feet, lifting patients and caring for people who are very ill or dying take resilience.

O*NET 31.0 rates these skills as most important for the occupation: active listening, speaking, critical thinking, reading comprehension, writing.

Training cost

$9.6K–$38.0K

Before financial aid

Time

2-4 years

Typical path

Median pay

$97,550

All US jobs: $50,980

Payback once qualified

Under 1 year

Pay above the all-jobs median vs. cost

RN route only. Low: 2 years x College Scorecard median public in-state tuition for nursing associate programs, $4,716 = $9,432, plus the $200 NCLEX-RN registration fee. High: 4 years x the nursing bachelor's median, $9,456 = $37,824, plus $200. The NCLEX fee rises to $350 on Feb. 1, 2027. Not included: prerequisite courses, program and clinical fees, uniforms, background checks, state license fees, books and living costs. Median federal loan debt is $15,304 for nursing associate graduates and $21,935 for bachelor's graduates.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Nurse practitioner$132,300 median

  Requires a master's or doctoral NP program and a national certification exam in a population focus, such as family or adult-gerontology.

• Nurse anesthetist (CRNA)$236,590 median

  Requires at least one year of full-time critical care nursing, a doctoral nurse anesthesia program of at least 36 months and the NBCRNA certification exam.

• Nurse midwife$134,040 median

  Requires a graduate nurse-midwifery program and national midwifery certification; labor and delivery experience helps.

• Nurse manager or director of nursing$123,860 median

  Starts with charge nurse roles; senior roles increasingly call for a master's in nursing leadership or health administration.

• Nursing instructor$82,250 median

  Clinical instructors usually need at least a BSN or MSN; full-time faculty and researchers often need a doctorate.