How to become a registered nurse

1. 1Take the science prerequisites

   Time: One semester to a yearCost: Community college tuitionSources 1

   Nearly every nursing program requires college courses before or alongside nursing classes, usually anatomy and physiology, microbiology, chemistry, psychology, statistics and English composition. Grades in these courses, along with an entrance test at many schools, decide admission, so aim high. Taking prerequisites at a community college is usually the cheapest option, but confirm the credits will transfer to the program you want.

2. 2Choose ADN, BSN or an accelerated program

   Time: One application cycleCost: Application feesSources 2, 4, 1

   An ADN at a community college is the shortest and cheapest route to the NCLEX. A BSN takes longer but is preferred or required by many hospitals and is needed for most graduate nursing roles. If you already hold a bachelor's degree in another field, an accelerated BSN compresses the nursing coursework into 11 to 18 months. Whatever you pick, make sure the program is approved by your state board of nursing.

3. 3Complete nursing school and clinical rotations

   Time: 2-4 yearsCost: $4,716/yr (ADN) to $9,456/yr (BSN) median public in-state tuitionSources 1, 7

   Nursing courses cover health assessment, pharmacology, adult medical-surgical nursing, maternity, pediatrics, mental health and community health. Every program includes supervised clinical rotations in hospitals and other settings, where you care for real patients under an instructor. Clinical shifts can start very early or run into evenings and weekends, so a full-time job alongside school is hard to manage.

4. 4Pass the NCLEX-RN

   Time: Usually within a few months of graduatingCost: $200 (rising to $350 on Feb. 1, 2027)Sources 3, 5, 10

   First apply to your state board of nursing for licensure, then register with Pearson VUE for the NCLEX-RN. The exam is a computerized adaptive test, so the number of questions depends on how you perform, and since 2023 it has included Next Generation NCLEX case-study items that measure clinical judgment. Official results come only from your state board. NCSBN has announced that the $200 registration fee goes to $350 for registrations on or after February 1, 2027.

5. 5Get licensed and start as a staff nurse

   Time: Weeks to a few monthsCost: State license feeSources 1, 6, 8

   Once the board receives your passing result and any background check it requires, it issues your RN license. Most new graduates start as staff nurses on hospital units, often in a nurse residency or orientation program. Employers usually also require BLS certification, and many units require ACLS. If you live in a Nurse Licensure Compact state, a multistate license lets you practice in the other compact states.

6. 6Add a BSN or specialty certification

   Time: Varies by programCost: Varies; some employers reimburse tuitionSources 1, 11

   ADN nurses often finish an RN-to-BSN program while working, and AACN counts more than 600 that are offered at least partly online. Experienced nurses can also earn specialty certifications through professional associations in areas such as critical care, emergency, pediatrics or gerontology. Certification is usually voluntary but some employers require it. A BSN is also the starting point for master's or doctoral programs that lead to advanced practice roles.

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 assessment

RNs are the ones at the bedside when a patient's breathing, blood pressure or confusion starts to change, and catching it early prevents emergencies.

Medication safety

Nurses give most hospital medicines, so checking doses, allergies and drug interactions every time is the last barrier against errors.

Prioritizing under pressure

A hospital nurse may have several patients needing something at once and must decide in minutes who needs care first.

Clear communication

Nurses relay findings to doctors, hand off patients at shift change and explain discharge instructions to worried families.

Physical stamina

Twelve-hour shifts on your feet, plus lifting and turning patients, make back injuries a real risk without good technique.

Emotional resilience

RNs deal with pain, death and frightened families regularly and still have to stay steady for the next patient.

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

Low: 2 years of an associate degree at the College Scorecard median public in-state tuition for nursing ($4,716 a year) plus the $200 NCLEX registration fee. High: 4 years of a bachelor's degree at the median public in-state tuition ($9,456 a year) plus $200. The NCLEX fee rises to $350 for registrations on or after February 1, 2027. State license fees, background checks, books, uniforms and room and board are extra.

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

• Nurse practitioner$132,300 median

  Takes a BSN, RN experience and a master's or doctoral nurse practitioner program, then national certification and state APRN licensure.

• Nurse anesthetist (CRNA)$236,590 median

  Requires a BSN, critical care experience and a graduate nurse anesthesia program, followed by a national certification exam.

• Nurse midwife$134,040 median

  Needs a graduate nurse-midwifery program and national midwifery certification; labor and delivery experience helps with admission.

• Charge nurse, nurse manager or director of nursing

  Promotion comes with experience and leadership; BLS says senior nursing management jobs more and more often call for a master's in nursing or health administration.

• Nursing specialty roles$97,550 median

  Many RNs move into critical care, labor and delivery, pediatrics or travel work after a year or two of general experience, often adding specialty certification.