How to Become a Registered Nurse (RN)

Steps to Become a Registered Nurse

1. Complete a nursing education program approved by your state’s nursing regulatory body. You will need either a nursing diploma, an associate degree in nursing, or a bachelor’s degree in nursing. Some states also require national nursing accreditation, so check the requirements of the board where you plan to practice (NCSBN, Approval of Nursing Education Programs, as of September 30, 2026).
2. Prepare to sit for the nurse licensing exam.
3. Take and pass the National Council Licensure Examination for registered nurses (NCLEX-RN).
4. Obtain licensure in the state where you wish to practice. Requirements vary by state. Learn more about state-by-state requirements for RN licensing.

Most RNs enter practice with either a bachelor’s degree from a four-year college or university or an associate degree from a community college, according to the American Association of Colleges of Nursing (AACN, Nursing Workforce Fact Sheet, updated September 2026). For the NCLEX-RN, you register with Pearson VUE, and your state board of nursing decides whether you are eligible to test, so contact the board where you plan to practice for its requirements (NCSBN, as of September 30, 2026).

How long does it take to become an RN?

The time it takes depends on the education pathway you choose:

• Bachelor of Science in Nursing (BSN): BSN programs are offered by four-year colleges and universities, according to the AACN (Nursing Workforce Fact Sheet, updated September 2026).
• Accelerated BSN: For adults who already have a bachelor’s or graduate degree in a non-nursing field, fast-track baccalaureate programs take 12 to 18 months to complete, including prerequisites, according to the AACN (Accelerated Baccalaureate and Master’s Degrees in Nursing, updated May 2026).
• Associate degree or diploma: Program length varies by school and by whether you study full time, so check the published schedule of the program you are considering.

Licensure adds time after graduation. Your state board of nursing must determine that you are eligible to take the NCLEX-RN, and NCLEX registrations stay open for 365 days while the board makes that determination, according to the NCSBN (NCLEX registration page, as of September 30, 2026).

What is a Registered Nurse?

A registered nurse is a healthcare provider who has graduated from a state-approved nursing program, passed the NCLEX-RN and holds a nursing license from a state board of nursing (NCSBN, Nursing Terms, as of September 30, 2026). There are many types of registered nurses, mainly defined by their areas of specialization.

Registered nurses have a broad spectrum of responsibilities. They contribute to patients' plan of care, administer medication, and provide advice and emotional support to patients (O*NET OnLine, Registered Nurses summary report, as of September 30, 2026).

After becoming an RN, nurses can take additional courses and pursue specialty certification to show they have expertise in an area of specialization. Certification comes from a certifying body, not from completing a course alone. For example, the American Nurses Credentialing Center’s MEDSURG-BC certification requires an active RN license, practice experience in the specialty and a competency-based examination (ANCC, as of September 30, 2026).

Types of Registered Nurses

Addiction Nurse

Also known as substance abuse nurses, RNs specializing in addiction may have chosen this career because they or someone they love has suffered from addiction to drugs, alcohol or other substances. Addictions nurses practice in a wide variety of settings, including treatment centers, hospitals, schools, private practices, primary care and other community agencies (IntNSA, About, as of September 30, 2026). The Addictions Nursing Certification Board (ANCB) administers the Certified Addictions Registered Nurse (CARN) certification (ANCB, Getting Certified, as of September 30, 2026). The International Nurses Society on Addictions (IntNSA) is a professional society for nurses who work in addiction care.

Cardiovascular Nurse

Nurses who specialize in cardiovascular care work in settings such as cardiac care units (CCUs), telemetry and progressive care units, heart failure clinics and cardiac catheterization labs, according to the AACN (Cardiac Medicine Certification page, as of September 30, 2026). Certifications for cardiovascular nurses include the Cardiac Medicine Certification (CMC), a subspecialty certification offered through the American Association of Critical-Care Nurses (AACN) for nurses who care for acutely or critically ill adult cardiac patients (AACN, as of September 30, 2026).

Critical Care Nurse / ICU Nurse

Critical care nurses work in intensive care units (ICUs) and CCUs. Sometimes ICU nurses are referred to as critical care nurses and vice versa. They specialize in caring for acutely and critically ill patients. Certifications for ICU and CCU nurses are also administered by the AACN, which offers the CCRN (Adult) certification for nurses who provide direct care to acutely or critically ill adult patients in settings such as intensive care units, cardiac care units, trauma units and critical care transport/flight (AACN, as of September 30, 2026).

Gastroenterology Nurse

Nurses who work in gastroenterology provide gastroenterology and endoscopy nursing care in institutional and private practice settings. Certifications for gastroenterology nurses are administered by the American Board of Certification for Gastroenterology Nurses (ABCGN), which offers the Certified Gastroenterology Registered Nurse (CGRN) credential. The CGRN exam covers general nursing care, gastroenterological procedures, patient care interventions, and infection prevention and control (ABCGN, Eligibility & Exam Information, as of September 30, 2026).

Medical-Surgical Nurse

Medical-surgical nurses care for individuals experiencing a wide array of acute and chronic health conditions across the lifespan, in a variety of care environments across the healthcare industry, according to the Academy of Medical-Surgical Nurses (AMSN, Medical-Surgical Nursing Definition, adopted July 22, 2026). The Medical-Surgical Nursing Certification Board (MSNCB) offers the CMSRN credential (MSNCB, as of September 30, 2026), and the American Nurses Credentialing Center (ANCC) offers the MEDSURG-BC certification (ANCC, as of September 30, 2026).

Neonatal Nurse

According to the AACN, a neonatal nurse specializes in the care of acutely and critically ill neonatal patients and may work in areas such as a neonatal intensive care unit (NICU; pronounced “nick-you”), cardiac care unit, trauma unit or critical care transport/flight (AACN, CCRN (Neonatal), as of September 30, 2026). The AACN administers a CCRN (Neonatal) certification for these nurses.

Occupational Health Nurse

An occupational health nurse provides health and safety programs and services to workers. Occupational health nurses focus on the prevention of illness and injury and on protection from work-related and environmental hazards. They also act as case managers who coordinate and manage the care of ill and injured workers, including matters related to workers’ compensation, the Family Medical Leave Act (FMLA) and disability benefits (American Association of Occupational Health Nurses, as of September 30, 2026). The American Board for Occupational Health Nurses (ABOHN) offers a certification program (ABOHN, COHN / COHN-S Eligibility, as of September 30, 2026).

Public Health Nurse

Nurses who work in public health may work for health departments, nonprofits and other organizations that carry out public health work. The National Board of Public Health Examiners (NBPHE) lists local and state health departments, nonprofits focused on public health, universities and federal agencies among the settings it gives as examples of public health work experience (NBPHE), as of September 30, 2026). Public health nurses work with communities, the individuals and families that make up those communities, and the systems that affect community health, according to the Minnesota Department of Health (Public Health Interventions: Applications for Nursing Practice, 2nd ed., page updated July 23, 2025). RNs with five years of public health work experience and a bachelor’s degree can apply for the Certified in Public Health (CPH) credential that’s administered by the National Board of Public Health Examiners (NBPHE, as of September 30, 2026). NBPHE reports that it is developing a separate Certified in Public Health Nursing (CPHN) certification for public health nurses (NBPHE, as of September 30, 2026).

What do RNs do?

The duties of an RN vary, depending on where they work, how long they’ve been a nurse and their area of specialization. Typically, RNs have clinical and administrative responsibilities (O*NET OnLine, Registered Nurses summary report, as of September 30, 2026).

Clinical Responsibilities of RNs

• Assessing patients’ conditions and vital signs
• Giving medications and treatments prescribed by doctors and other healthcare providers
• Contributing to and setting up patients’ care plans
• Consulting and collaborating with other healthcare providers
• Preparing rooms, sterile instruments, equipment and supplies
• Performing and analyzing diagnostic tests
• Educating patients and their families

Administrative Responsibilities of RNs

• Recording medical histories and symptoms
• Directing and supervising less-skilled nursing and healthcare personnel

Where do RNs work?

RNs work in doctors’ offices, long-term care facilities, nursing homes, hospitals, clinics, government and education. According to the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics program, most RNs work in hospitals. BLS estimated 3,379,720 RNs in the United States in May 2025, not counting self-employed nurses. Here’s a breakdown of RNs’ most common work environments in May 2025. Percentages are our calculation: each industry’s RN employment divided by the national total.

• Hospitals — 2,020,230 RNs (60%)
• Ambulatory health care services, including doctors’ offices, home health care and outpatient care centers — 648,820 RNs (19%)
• Nursing and residential care facilities — 198,830 RNs (6%)
• Federal, state and local government (excluding state and local hospitals and schools, and the U.S. Postal Service) — 169,640 RNs (5%)
• Educational services — 95,240 RNs (3%)

Registered Nurse Salary

How much do RNs make? Wages vary by state and by industry, as the figures below show. According to the U.S. Bureau of Labor Statistics, RNs in the United States had a median annual wage of $97,550 in May 2025. The mean annual wage was $101,420. RNs who work in government (as defined in the list above) had the highest median annual wage of the industries listed above at $110,780, followed by RNs who work in hospitals ($100,220), ambulatory health care services ($91,230), nursing and residential care facilities ($84,300) and educational services ($78,620).

Here are the top-paying states for RNs, according to BLS data for May 2025, ranked by median annual wage:

1. California – $140,270
2. Hawaii – $136,320
3. Oregon – $129,010
4. Washington – $124,200
5. Alaska – $109,480