How to Become a Registered Nurse (RN)

Registered nurses are the heart of the healthcare system. They assess patients, administer medications, coordinate care, educate patients and families, and advocate for the people in their charge. It's one of the most fulfilling and financially rewarding careers you can build — and the demand for qualified RNs has never been higher.

The BLS reports registered nurses earn a median annual wage of $86,070. Employment is projected to grow 6% through 2033, with tens of thousands of new positions opening every year as the population ages.

What Does a Registered Nurse Do?

RNs work in hospitals, clinics, schools, home health agencies, and countless other settings. Core responsibilities include:

• Assessing and monitoring patient health status
• Administering medications and treatments as prescribed
• Collaborating with physicians and healthcare teams on care plans
• Educating patients about managing their conditions
• Recording medical histories and documenting care

The day-to-day experience varies enormously by specialty — an ER nurse and a pediatric nurse work in very different environments.

Step 1 — Choose Your Educational Path

There are three main educational pathways to become an RN, all of which allow you to sit for the NCLEX-RN licensing exam:

• Associate Degree in Nursing (ADN): 2 years at a community college. The fastest and most affordable path — ideal for career changers. ADN nurses are fully licensed RNs, though many hospitals prefer BSN nurses for certain roles.
• Bachelor of Science in Nursing (BSN): 4-year degree from a university. Opens more doors for advancement and is required for many specialty and leadership roles.
• Direct-Entry MSN: For those who already have a non-nursing bachelor's degree — typically 2–3 years accelerated program.

Step 2 — Pass the NCLEX-RN

The NCLEX-RN (National Council Licensure Examination) is the standardized licensing exam all RN candidates must pass. The exam is administered by the National Council of State Boards of Nursing (NCSBN) and uses an adaptive format — it adjusts the difficulty of questions based on your answers.

As of 2023, NCLEX uses the Next Generation NCLEX (NGN) format, which emphasizes clinical judgment over simple recall. Strong preparation programs include UWorld, Kaplan, and Hurst Review.

Step 3 — Apply for Your State License

After passing the NCLEX-RN, you apply for a nursing license through your state's Board of Nursing. If you plan to work in multiple states, look into the Nurse Licensure Compact (NLC) — a multi-state agreement that allows RNs to practice in all 40+ member states with a single license.

Step 4 — Choose Your Specialty

One of the best things about nursing is the incredible variety of specialties available. After gaining 1–2 years of experience, nurses typically pursue specialty certification in areas like:

• ICU / Critical Care (CCRN): High acuity, high pay — $90,000–$110,000+
• Emergency Room (CEN): Fast-paced, variable cases
• Oncology (OCN): Cancer care, deeply meaningful work
• Labor and Delivery (RNC-OB): Maternity and newborn care
• Psychiatric Nursing (PMH-RN): Growing demand with the mental health crisis
• Perioperative / OR Nursing (CNOR): Surgery setting, specialized skills

RN Salary by Specialty and Setting

• New graduate RN: $58,000–$72,000/year
• Staff RN (2–5 years): $75,000–$95,000/year
• ICU/Critical Care RN: $90,000–$115,000/year
• Travel Nurse: $80,000–$130,000+/year (housing and stipends included)
• Nurse Practitioner (with MSN): $115,000–$135,000/year

Advancing Your Nursing Career

RNs have a clear advancement ladder. From staff nurse, you can move to charge nurse, unit manager, director of nursing, or pursue an advanced practice degree to become a Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), or Clinical Nurse Specialist (CNS).

CRNAs are among the highest-paid healthcare professionals without a medical degree, earning a median of $214,000 per year according to the BLS.

Explore our full Registered Nurse career profile for nursing school rankings, state salary maps, and specialty comparisons.