Registered Nurse (RN): What Is It & How to Become One

With nearly 5.2 million registered nurses in the United States workforce, nurses make up the largest component of the healthcare industry. Nurses are bedside caregivers, executives, academic researchers, educators, and more. For the 21st year in a row, polled Americans ranked nurses the highest among all careers for honesty and ethics. If you are interested in joining this highly respected profession, keep reading to learn the steps necessary to become an RN.

What is a Registered Nurse?

A registered nurse (RN) is a graduate of an accredited nursing degree program who has obtained a nursing license from a state board of nursing. Although most nurses choose to care for patients in a hospital setting, many pursue alternate career paths using their nursing expertise in other nonclinical settings.

What do Registered Nurses Do?

Registered nurses are experts in patient care. A nurse’s scope of practice – what they are allowed to do or not do — is defined by state-specific Nurse Practice Acts. Although nurses fulfill many different roles, these are a few core functions: assessment, education, skill performance, leadership, and advocacy. 

Assessment: Nurses perform thorough assessments at every level, from the individual patient to the larger population. They triage patients to determine their acuity of illness, taking vital signs (heart rate, blood pressure, respiratory rate, etc.) and interpreting them based on the patient’s presentation. They assess specific body systems and make care decisions based on observations. 

Education: Nurses provide significant healthcare education to patients, their families, and communities. Some nurses choose to make teaching their specialty and become diabetes educators, CPR instructors, nursing school professors, or unit-based educators who instruct staff nurses on best practices and skills.  

Skill performance: Nurses are required to learn many different practical skills, including wound care, catheterization, IV insertion, medication administration, and countless others while in nursing school. But skill-learning doesn’t stop after nursing school ends. Advancements in equipment, techniques, and technology constantly affect how care is provided. 

Leadership: Nursing has an extraordinary number of opportunities for leadership careers. Whether as a charge nurse on an in-patient unit or heading up a hospital task force, you’ll find nurse leaders in every aspect of healthcare. Nurse executives are vital decision-makers in hospitals, staffing companies, and research firms. 

Advocacy: Nurses use their expertise to ensure patients have a voice in their care. Nurses often spend the most time with the patient, so it’s their job to recognize potential problems and alert the interdisciplinary team. Nurses promote care coordination by interfacing with many disciplines like social work or physical therapy. Because nurses are often the last line of defense against patient safety events, nurses often catch harmful situations and recognize “near miss” scenarios. Nurses are also often instrumental in implementing safety policies and quality assurance reporting.

Common Duties And Responsibilities of Registered Nurses

The tasks and responsibilities of nurses vary based on their role and setting. Over half of all registered nurses work in acute care hospitals, performing actions like:

• Head-to-toe physical assessments of patients
• Documentation of the patient’s medical history and current health status
• Preparing the patient for exams, tests, and procedures
• Administering medications, IV fluids, and blood products
• Creating and updating the patient plan of care
• Collaborating with physicians and other medical providers
• Obtaining blood, urine, and sputum samples
• Educating patients and families on their disease processes and treatments
• Supervising licensed practical nurses and nursing assistants 

Where do Nurses Work?

There is no shortage of nursing specialties. Nurses can choose to work in hospitals, outpatient settings, schools, doctor’s offices, and even from home. The following are some of the most common nursing specialties:

• Critical care 
• Emergency room (ER) 
• Operating room (OR) 
• Labor and delivery (L&D) 
• Home health 
• Hospice 
• Long-term care 
• Case management
• Occupational health
• Oncology
• Pediatrics
• Psychiatric
• Public health
• Rehabilitation
• Wound and ostomy care
• Ambulatory care

The schedules of nurses also vary. Nurses frequently work three 12-hour shifts per week, constituting a full-time schedule. Part-time and PRN (as needed) schedules are also common. Some nurses in doctor’s offices work regular Monday-Friday schedules. Other nursing roles, like home health or ambulatory care, may require on call rotations. Since health care is a 24/7 job, nurses can expect to work weekends and holidays.

How Can You Become a Registered Nurse?

You must first obtain a high school diploma or GED. You can then choose the type of nursing degree you want to pursue and then select an accredited nursing program.

There are three main education options to become an RN: 

• Associate Degree in Nursing (ADN)
• Bachelor of Science in Nursing (BSN) 
• Master’s of Science in Nursing (MSN)

Step 1: Complete Your Nursing Education

Associate Degree in Nursing (ADN)

An associate degree is the entry-level degree to become an RN. After obtaining prerequisite courses like chemistry, anatomy and physiology, and mathematics, ADN nursing programs are completed in two years. ADN programs are commonly administered through community colleges and technical schools, making them cost-effective. 

Bachelor of Science in Nursing (BSN)

Bachelor's degrees are four-year programs covering additional nursing concepts like evidence-based practice and research. Many employers prefer new graduates to have a minimum of a bachelor’s degree, as studies show hospitals with bachelor-prepared nurses have lower mortality rates, fewer readmissions, and a lower cost burden. 

Master’s of Science in Nursing (MSN)

A master’s degree in nursing is a graduate degree that prepares nurses for further specialization in education, leadership, and advanced careers. MSN programs typically offer “tracks” for the student to choose, such as:

• Nurse Practitioner
• Certified nurse midwife
• Public health
• Informatics

Bridge Programs

Bridge programs allow a nurse who has already completed one degree path to obtain an advanced degree quickly. For example, the nurse can choose an ADN to BSN bridge program, a BSN to MSN bridge program, or even an ADN to MSN bridge program. The benefit is obtaining a higher degree in less time. Some ADN to BSN programs can be completed in as little as six months.

How to Decide Which Program is Best For You

When you begin researching nursing programs, ensure the programs you are interested in are accredited, which means they meet a standard of excellence set by nursing agencies. Secondly, the best program is the one that fits your lifestyle. Consider the following:

• Length of program: Some accelerated programs can be completed in as little as two years, while higher degrees (bachelor’s or master’s) will take a minimum of four years.
• Schedule: Some programs require a full-time commitment, while others are part-time and work around your schedule. This is especially true of bridge programs.
• Method of instruction: While you will have to participate in hands-on clinical rotations at some point in your nursing education, some programs offer online and hybrid classroom courses.
• Cost: If you are eligible for financial aid, your nursing education at a community college could cost little to nothing. You can expect to pay much more at a private university. BSN degrees vary, costing anywhere from $20,000-$100,000. Depending on your degree focus, MSN degrees are also in this higher range, from $35,000 to $100,000.

Step 2: Pass The NCLEX Exam

After graduating from an accredited nursing program, you are eligible to sit for the National Council of State Boards of Nursing National Council Licensure Examination (NCLEX). The NCLEX is a computerized test that determines the candidate's ability to practice nursing safely and effectively at an entry level. 

Step 3: Apply For RN licensure

Congratulations, you passed the NCLEX! You can now apply for licensure as a registered nurse with your state board of nursing. Depending on which state you live in, you may be eligible to apply for a multistate license, which allows you to work as a registered nurse in any state in the Nurse Licensure Compact (NLC). There are currently 41 states that participate in the NLC.

Step 4: Begin Work as a Nurse

After you receive your nursing license, you are legally licensed to provide nursing care. You may choose to seek new graduate nursing residency programs, which are designed to offer extensive education and on-the-job support to ensure your transition from a student to a nursing professional. Many new nurses are eager to work in hospital settings, but there is no specific path that a nurse must take. Nursing school familiarizes students with an array of specialties, and each nurse will have the opportunity to decide where they would like to practice.

Step 5: Advancing Your Education (Optional)

After obtaining an RN license and practicing as a nurse, you may choose to specialize in a particular field and obtain a certification to demonstrate your expertise. Many RNs pursue post-graduate or doctorate degrees to become advanced practice registered nurses (APRNs). APRNs have the opportunity for higher-paying job opportunities by becoming nurse practitioners or certified registered nurse anesthetists (CRNA). 

How Much Do Nurses Earn?

The Bureau of Labor Statistics reports that in 2022, registered nurses’ median pay was $81,220 per year or $39.05 per hour. Nurses are often paid hourly, but some jobs offer salaried positions. Many hospital roles offer shift rate differentials — additional money on top of the base hourly rate — for evenings, nights, weekends, and holiday hours.

Is Nursing For You?

Nursing school is a difficult and stressful endeavor. Before embarking on your nursing career, ensure you understand the time and effort you must dedicate to your nursing education. RNs are naturally empathetic and combine critical thinking with compassion to provide holistic patient care.

Registered nurses are needed in all settings and locations, so you will never have to worry about job security. Plus, RN salaries afford a stable lifestyle with opportunities to expand your education and earning potential. A registered nursing license opens the door to hundreds of career options so you can find the specialty or role that best suits your personality.