How To Become a Nurse (6 Steps to a Nursing Career)

Nursing is one of the few fields where you can enter through several different doors and keep climbing for the rest of your career. You can start as a certified nursing assistant in a matter of weeks or train for years to become an anesthetist. What stays constant: every state and the District of Columbia require you to graduate from an accredited program and pass a licensing exam before you touch a patient as a licensed nurse. Here is the path, step by step.

Steps to becoming a nurse

1. Decide which type of nurse you want to be

Start with two questions: what setting do you want to work in, and what role do you want to play. RNs work in hospitals, clinics, and physician offices. CNAs cluster in nursing homes and long-term care. If you want to support a team and get to the bedside fast, a CNA or LPN/LVN path gets you there. If you want to coordinate care, manage staff, or practice independently, you are looking at RN or advanced practice. Most nurses eventually specialize, so if you already know you want critical care or geriatrics, plan your education around it.

2. Earn your nursing degree

Your target role dictates your degree. Every nursing program combines classroom work with supervised clinical hours, and the clinical rotations are where you learn how a unit actually runs.

What each credential qualifies you for:

• CNA diploma or certificate: Certified Nursing Assistant (CNA)
• LPN/LVN diploma or certificate: Licensed Practical Nurse (LPN) / Licensed Vocational Nurse (LVN)
• Associate Degree in Nursing (ADN): Registered Nurse (RN)
• Bachelor of Science in Nursing (BSN): Registered Nurse (RN)
• Master of Science in Nursing (MSN): nurse educator, Advanced Practice Registered Nurse (APRN)
• Doctor of Nursing Practice (DNP): advanced leadership and research roles

An ADN gets you to the bedside as an RN faster than a BSN. The tradeoff is hiring: many hospitals, especially acute-care settings, prefer BSN-prepared nurses. Plenty of ADN nurses bridge to a BSN later, often on employer tuition reimbursement. There is also ongoing discussion and proposed legislation in some states around requiring a BSN to practice as an RN.

3. Pass the NCLEX and get licensed

Once you finish school, you sit for a licensing exam. Requirements by role:

• Certified nursing assistant (CNA): pass a state competency exam, earn a state license.
• Licensed practical nurse (LPN): complete a state-approved certificate program, pass the NCLEX-PN, earn a state license.
• Registered nurse (RN): complete a diploma, ADN, or BSN, pass the NCLEX-RN, earn a state license.
• Nurse practitioner (NP): complete an MSN, pass the NCLEX-RN and a national certification exam (for example, through the American Nurses Credentialing Center or the American Academy of Nurse Practitioners), earn a state license.
• Nurse midwife (CNM): complete an MSN, pass the NCLEX-RN and the American Midwifery Certification Board (AMCB) exam where your state requires it, earn a state license.
• Nurse anesthetist (CRNA): complete an MSN, or a DNP if you matriculated after January 1, 2021, pass the NCLEX-RN and the National Board of Certification and Recertification for Nurse Anesthetists exam, earn a state license.

4. Find a nursing job

The nursing shortage is projected to continue, so new graduates have options. Your clinical rotations already gave you a feel for which settings fit. Nurses work in hospitals, medical offices, nursing homes and extended-care facilities, home health, schools, government offices, community centers, military bases, nonprofits and clinics, and corporate settings.

5. Keep up with continuing education

Most states require continuing education every two years, reported as contact hours or continuing education units (CEUs). The required number varies by state. Check with your state board of nursing for your exact requirement.

6. Maximize your potential through advanced training

Healthcare changes constantly, and the nurses who keep learning get the opportunities. Three moves pay off: specialize in a clinical area that fits your strengths, earn certification to prove that expertise, and pursue an advanced degree. A master's opens the door to nurse practitioner, clinical nurse specialist, certified nurse midwife, and certified nurse anesthetist roles.

Levels of nursing

Bridge programs let you carry prior education and experience forward. LPN-to-RN and RN-to-BSN paths are common, and RN-to-MSN programs let working RNs finish their undergraduate work and move straight into graduate courses at one school.

Entry-level nursing

Certified Nursing Assistant (CNA). Helps patients with daily tasks like bathing and feeding, answers call lights, cleans rooms, and reports changes to a nurse. Credential: post-secondary certificate or diploma, four to 12 weeks. Median annual salary: $39,530. Choose it if you want into the field quickly with hands-on experience.

Licensed Practical Nurse (LPN). Works under an RN providing basic care: dressing changes, bathing, and, depending on state rules, medication administration. Called a licensed vocational nurse in California and Texas. Credential: certificate or diploma, about one year. Median annual salary: $62,340. Choose it if you want to start soon and bridge to RN later, since many RN programs give credit for LPN experience.

Registered Nurse (RN). Coordinates patient care, administers medication, assists with exams and procedures, educates patients, and supervises LPNs and assistants. Credential: associate degree (two years) or bachelor's (four years). Median annual salary: $93,600. Choose it if you want range, advancement, and a foundation for graduate study.

Advanced nursing

Advanced programs require a bachelor's before enrolling.

Certified Registered Nurse Anesthetist (CRNA). Manages anesthesia and pain before, during, and after procedures, determining the type and amount of anesthesia and how it is administered. Credential: master's (two years); everyone matriculating after January 1, 2022, must enroll in a doctoral program, and doctoral education is now required to enter nurse anesthesia practice. Median annual salary: $223,210.

Certified Nurse Midwife (CNM). Provides prenatal, postpartum, and newborn care and refers to a physician when major complications arise. Credential: master's (two years). Median annual salary: $128,790.

Nurse Practitioner (NP). Serves as a primary care provider, diagnoses, and prescribes; in some states NPs practice independently and run their own offices. Credential: master's (two years), with national nursing organizations recommending the DNP as the entry-level degree. Median annual salary: $129,210.

Nursing Informatics Specialist. Works on system development, quality control, data use, and training nurses on new technology, with patient confidentiality front and center. Credential: bachelor's (four years) or master's (two years). Median annual salary: $67,310 for clinical informatics coordinators, reported within the larger computer systems analyst group.

Nurse Leader / Nurse Administrator. Manages staff and schedules, analyzes services, controls costs, and monitors resources. Credential: bachelor's (four years) or master's (two years). Median annual salary: $117,960 for medical and health services managers.

Clinical Nurse Specialist. Delivers advanced care in a specialty area, diagnoses, builds and adjusts treatment plans, orders and evaluates diagnostics, leads other nurses, and develops policy. Credential: master's (two years); the NACNS recommends the DNP as the entry-level degree by 2030. Median annual salary: $135,320.

Salary source: U.S. Bureau of Labor Statistics, Occupational Employment Statistics.

Career changes within nursing

After years at the bedside, plenty of nurses change direction, and most of those changes run through more school. Earn a master's to specialize, or a shorter certificate if you do not want a full MSN. Move into teaching as a nurse educator if you like guiding new staff; colleges hire master's- and doctorate-prepared nurses for faculty roles. Move into research with a PhD or Doctor of Nursing Science (DNSc).

Accelerated BSN for career changers

If you already hold a bachelor's in another field, you do not have to repeat general education. An accelerated BSN, usually about 18 months, focuses purely on nursing coursework after any required science and math prerequisites. You graduate ready to sit for the NCLEX-RN. Your finance or teaching background is not a disqualifier; it is a different starting line.

Skills you need

Good nurses pair academic strength with people skills. The ones that matter most: empathy, communication, critical thinking and problem-solving, attention to detail, teamwork, professionalism, conflict resolution, and adaptability. You will lean on different ones on different shifts, but all of them get used.

Pros and cons of nursing

The job runs to extremes. On the upside, the work is meaningful, you watch patients recover and go home, demand is high enough that you can find work almost anywhere, schedules often mean longer shifts but fewer days, and the pay is solid. The median RN salary of $93,600 runs almost $20,000 above the mean wage across all occupations.

The downside is real too. You witness pain, suffering, and death, which drives burnout, and patients in crisis can be frightened and combative. You are exposed to infection daily. The work is physically hard, much of it on your feet, and it is mentally taxing under constant time pressure, sometimes with life-or-death decisions. Going in clear-eyed about both sides is the point.

Job outlook

As of 2021 the BLS counted 3,130,600 registered nurses in the United States, and demand keeps growing. Both ADN and BSN nurses qualify for RN licensure, but a BSN positions you for management. The BLS projects strong growth driven partly by retirement: more than one million nurses are expected to reach retirement age over the next 10 to 15 years, according to the Health Resources and Services Administration. Factoring in those who retire or leave the field, the BLS projects about 189,100 RN openings per year, on average, from 2024 to 2034 (BLS, May 2024), with overall RN employment growing about 5%.

Growth is not evenly distributed. The ANA points to community-based care, geriatrics, informatics, and care coordination, plus disease management, primary care, prevention, and wellness. To make yourself more marketable, learn a second language (Spanish is in highest demand), earn certification in a specialty, and stay flexible about employers and locations early on.

How to find nursing jobs

New nurses hit a familiar wall: employers want experience. Networking is how you get around it. Join your local ANA chapter and go to events; specialty groups like the Emergency Nurses Association and the National Association of School Nurses have local chapters too. Treat clinicals as an extended interview. Be the attentive student with a good attitude, build a real relationship with your preceptor and their managers, and stay in touch after the rotation ends, because that is who calls you when a position opens.

Geography matters. Some states will run short on nurses while others run a surplus, so moving toward demand opens doors. The BLS projects about 189,100 RN job openings nationally each year through 2034, concentrated in large states like California, Texas, Florida, New York, and Pennsylvania. Military nursing is another route, with active-duty and reserve options and possible loan repayment. Volunteering builds both experience and connections, especially if you target your intended specialty.

15 growing nursing specialties

1. Nursing informatics specialist. Uses data and electronic health records to improve workflows and care quality, and trains staff on new technology. The discipline dates back decades and keeps expanding as EHRs and mobile tools become standard.

2. Virtual nurse. Delivers guidance and care by video or phone, triages online appointments, and keeps continuity for homebound patients as telemedicine grows. Requires at least an ADN or BSN and strong communication.

3. Nurse midwife. Serves as a primary care provider for women and newborns, not just delivering babies. The BLS projects 11.1% growth through 2034, faster than average, and national bodies recommend an expanded midwife role, particularly in inner-city and rural areas.

4. Travel nurse. Fills short-term assignments in other cities or countries, sometimes in disaster zones or during strikes. Open to RNs, NPs, LPNs, and CNAs. Pay tends to run above average and housing is often provided. Adaptability is the core requirement.

5. Nurse educator. Trains the next generation of nurses. The AACN reported that more than 80,407 qualified applicants were turned away in 2020, partly because of a faculty shortage, and that shortage is set to worsen as current educators retire.

6. Home-care nurse. Treats older adults, new mothers, accident recovery, and chronic illness in the home. Demand is rising as hospital stays shorten and more complex treatments move home.

7. Case management nurse. Coordinates a patient's care, monitors costs and resources, and supports families, increasingly for older patients managing chronic illness over years.

8. Geriatric nurse. Focuses on conditions common in aging, such as cancer, Alzheimer's disease, and osteoporosis, and advocates for patients who struggle to communicate. The National Council on Aging estimates about 80% of older adults have a chronic condition.

9. Critical care nurse. Works mostly in ICUs with patients suffering burns, cardiac events, and other serious conditions. Demands sharp decision-making, comfort with advanced technology, and a fast pace.

10. Neonatal/perinatal nurse. Perinatal nurses care for women before, during, and after birth. Neonatal nurses care for infants up to 28 days old, including premature and critically ill babies in the NICU. Both educate families on newborn care.

11. Pediatric nurse. Cares for patients from infants to teens who often do not understand their treatment, so trust and parent communication are central. Works in offices, children's hospitals, and pediatric critical care.

12. Psychiatric nurse. Helps close a wide access gap. The U.S. Department of Health and Human Services reports that only 44% of adults and fewer than 20% of children and adolescents with diagnosable mental health conditions get help. Psych nurses assist with interviews and diagnosis and work across hospitals, treatment centers, outpatient and correctional settings, and schools.

13. Trauma/ER nurse. Manages acute injury and illness, often making split-second decisions and handling triage, intubation, and surgical prep. Physically and emotionally intense, and no two shifts are alike.

14. OR nurse. Also called perioperative or surgical nurses, they care for patients before, during, and after surgery. Demand follows the aging population and the shift toward outpatient surgery centers. Requires teamwork, precision, and calm.

15. Labor and delivery nurse. Coaches women through childbirth, administers medication, watches for complications, and supports new mothers. The role swings from joyful to heartbreaking, so it takes critical thinkers who can shift gears instantly.

Technology and nursing

Technology keeps changing how nurses work. You will communicate with patients by email and video, and OR nurses already assist physicians using robotic surgical systems. Expect to learn new tools across your whole career.

Artificial intelligence is the next frontier. Some systems use AI-supported virtual assistants to route patients to the right provider and absorb administrative work, which frees managers to put nurses where human interaction matters most.

Three other areas are reshaping practice. Genetics and genomics can flag disease risk and inherited mutations, and since nurses spend the most time with patients, gathering family history and guiding patients through testing decisions increasingly falls to them. Biometrics, identifying people through fingerprints, voice, and other physical traits, reduces medical errors and tightens record security. Social media offers networking and support but carries real risk; the ANA's social networking principles hold nurses to the same professional standards online as anywhere else, especially around patient privacy.

Frequently Asked Questions

How long does it take to become a nurse? It depends on the role. A CNA can train in four to 12 weeks, an LPN in about a year, and an RN in two years (ADN) to four years (BSN). Advanced practice roles add a master's or doctorate on top of RN licensure.

Do you need a BSN to become an RN? No. You can become a licensed RN with an associate degree (ADN) and pass the same NCLEX-RN. Many hospitals prefer BSN-prepared nurses, and plenty of ADN nurses bridge to a BSN later, often with employer tuition help.

What exam do you take to become a nurse? RNs pass the NCLEX-RN and LPNs pass the NCLEX-PN, both administered through the NCSBN. CNAs take a state competency exam instead.

How much do registered nurses make? The median RN wage was $93,600 in May 2024 (BLS), about $20,000 above the median across all occupations. Advanced practice roles pay more: nurse practitioners earn a median of $129,210.

Is nursing a good career outlook? Yes. The BLS projects about 5% RN employment growth from 2024 to 2034, with roughly 189,100 openings per year, driven heavily by a wave of retirements.

Can I become a nurse if my degree is in another field? Yes. Accelerated BSN programs, usually about 18 months, let career changers skip general education and focus on nursing coursework before sitting for the NCLEX-RN.