Registered nurses work closely with physicians and other health care personnel to provide excellent care to patients. Registered nurses coordinate patient care, keep track of vital signs and other pertinent information, administer treatment plans and medications, perform medical tests and analyze results, and educate the patient and family members on how to handle their condition upon discharge. Those who wish to become a registered nurse must complete a nursing degree program and embark on the proper training.
Registered nursing degree programs
Registered nurses can choose from three educational paths: the bachelor's degree, the associate degree, or a diploma from an accredited nursing program.
- The nursing diploma typically takes two or three years to complete. Courses include anatomy and physiology, chemistry, nutrition, microbiology, psychology, and social and behavioral sciences. Students receive supervised clinical experience throughout their education, preparing them to take on the role of registered nurse upon graduation and completion of appropriate testing.
- The associate degree in nursing, or ADN, also takes two or three years to complete, and includes the same courses as the diploma program. The graduate of the ADN program does earn an associate degree, and that can serve as a stepping stone to earning further degrees in the future.
- The bachelor of science in nursing, or BSN, typically takes four years to complete. The BSN offers more clinical experience than the other degree options, and is considered the basic requirement for nurses who might want to go into administration, consulting, research or teaching. In addition to the usual courses one would expect from a nursing program, the BSN expands the educational scope with courses in leadership, communication, critical thinking, and the physical and social sciences.
Those who have earned their diploma or ADN can move forward into the RN to BSN program. This program allows registered nurses to earn their bachelor's degree while continuing to work in their current positions. There are nursing degree programs available for those who want to become a registered nurse and already hold a bachelor's degree in a related field.
Some registered nurses may also be poised to move into the master's degree program. These programs are suitable for those who want to enter administration or leadership positions, teach on the post-secondary level, become an advanced practice nurse, or become a certified nurse specialist, or CNS. Those who want to delve into serious research studies or consulting might need a doctoral degree in nursing.
All states require registered nurses to be licensed. Aspiring nurses must graduate from an accredited nursing program and earn a passing score on the National Council Licensure Examination, or NCLEX-RN.
Registered nurse training
Registered nurses must earn supervised clinical experience during their pursuit of a degree. In addition to required licensing, nurses can also choose to become certified in any number of specific areas. Some possible certifications through the American Nurses Credentialing Center include:
- Ambulatory care nursing
- Cardiac-vascular nursing
- Medical-surgical nursing
- Nursing case management
- Genetic nursing
- Pediatric nursing
- Rheumatology nursing
There are numerous other options for registered nursing certifications. Certification is typically voluntary, though some employers may require certain certifications of their nursing applicants.
Career outlook for registered nurses
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The national median annual wage for a registered nurse was $66,220 in May 2013, according to the Bureau of Labor Statistics (BLS.gov). The lowest 10 percent of the profession made up to $45,630 per year, while the upper 10 percent made at least $96,320 annually. Top-paying states include California, Hawaii, Massachusetts, Alaska and Oregon.
The vast majority of nurses worked in hospitals. Nurses often work rotating shifts, including nights, weekends and holidays. They might also work overtime and be on call.
Work for registered nurses is expected to grow by 19 percent from 2012 to 2022, according to the BLS. This robust growth will be driven by new health care legislation that allows greater access to medical care, an aging population and the uptick in chronic conditions. The growth of outpatient care centers, long-term care facilities and home health care will also play a role in employment growth. Registered nurses who hold at least a BSN degree are expected to see the best job prospects, according to the BLS.
How to Become a Registered Nurse
Registered nurses work closely with patients, handling numerous responsibilities, including recording vital signs, administering medications, ordering and analyzing diagnostic tests, and educating patients and family members. The career path for a registered nurse begins with earning the proper degree and license. The first step down that career path is homework and in-depth research into how to become a registered nurse.
Registered nursing program requirements/prerequisites
Becoming a registered nurse starts with earning a nursing degree or diploma from an accredited institution. Options include the bachelor of science in nursing, the associate degree in nursing, or a nursing diploma. Those who want to enter any of these programs must begin with a completed application, including an official high school transcript (and college transcript, assuming college credits have been earned), minimum test scores, and any other specific requirements for admission set forth by the school of their choice.
The minimum schooling for a registered nurse is the nursing diploma or the associate degree in nursing, which typically take two to three years to complete. Courses in anatomy, physiology, nutrition, psychology, microbiology, chemistry, and social and behavioral sciences are typical for any nursing program. The bachelor's degree program takes four years to complete and focuses on these core courses as well as those in leadership, communication, critical thinking and the physical and social sciences. All programs require supervised clinical work.
Necessary skills and qualifications for registered nurses
All states require registered nurses to be licensed. Licensing requirements include graduation from an accredited nursing program and a passing score on the National Council Licensure Examination, or the NCLEX-RN. After licensing, nurses can pursue certifications that enhance their knowledge and skill set, enabling them to work with particular groups of patients. Specific areas of certification include pediatrics, ambulatory care, pain management, mental health and cardiac-vascular nursing, among others.
No matter where they work, registered nurses might see situations or injuries that are disturbing; therefore, an emotional even keel and the ability to keep their feelings in check is crucial. At the same time, empathy and compassion for the patient and their family matters a great deal. Nurses must have excellent communication skills, decisive critical thinking and top-notch organizational abilities. Since patient outcomes can hinge on proper dosages, accurate measurements of vital signs and the proper recording of both, nurses must have exquisite attention to even the smallest details.
Registered nursing working environment
Employment growth for registered nurses is expected to be robust, with an increase of 19 percent from 2012 to 2022, according to the Bureau of Labor Statistics (BLS.gov). Much of that growth will be driven by an aging population, better access to health care, the growth of outpatient care facilities, and the rise in chronic conditions.
Nurses must have the physical stamina to handle standing, walking and bending throughout their shift. They are at risk for back injuries, as they often move patients, and might be exposed to potentially harmful drugs and other substances, as well as the possibility of back injuries and aggressive patients.
Nurses usually work in comfortable, well-lit environments; in 2012, 61 percent were employed by hospitals. Home health and public health nurses often travel to schools, private homes, community centers and the like. Most nurses work full-time, and might work rotating shifts that include weekends, nights and holidays. Some nurses might also be on call. Those who work full-time in schools or offices of physicians will likely keep normal business hours.
Registered Nurse License
What is the National Council Licensure Examination for Registered Nurses (NCLEX-RN)?
After earning the Bachelor Degree, Associate Degree, or Diploma from a state-approved nursing program, candidates are required to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) before performing as an entry-level registered nurse.
The NCLEX-RN exam was developed by the National Council of State Boards of Nursing (NCSBN), a not-for-profit organization put in place to regulate the nursing profession. It consists of boards of nursing in all 50 states, and four United States territories: American Samoa, Guam, Northern Mariana Islands, and the Virgin Islands. They also extend membership to other countries and territories.
Learn more about the registered nurse degree.
Each individual state board is responsible for administering the NCLEX-RN to its residents. The exam is available year-round and costs $200. Scores are measured using an innovative testing format based on the difficulty of the questions answered, not on the overall score. Test items include fill-in-the-blank, multiple-choice, and items asking for identification on a picture, graph, or chart. Students would also be tested on their ability to prioritize a list of tasks in a procedure. On average, candidates can expect to answer 119 test items and spend about two and a half hours completing the examination.
How difficult is the exam?
Pursuing the exam immediately after earning a degree or diploma is highly recommended. Individuals at a more recent stage of study have higher proficiency levels and will succeed with less effort. According to statistics from the National Council of State Boards of Nursing the probability of a passing score is likely. The likelihood of passing only increases with the level of the nursing degree earned. In 2008 over 129,000 US students took the NCLEX-RN exam. A passing rate of 87.5% was accomplished among the candidates with the Bachelor Degree and 86.2% by those with the Associate Degree.
Learn more about the registered nurse schools.
Is continuing education required for a practicing registered nurse?
Each state mandates specific Continuing Education Unit (CEU) requirements to maintain a nursing license. For example, California requires 20 hours of CEUs and license renewal every two years. Registered nurses certified in a specialty are required to have a greater number of CEUs, a certain percentage of which must relate to the specialty. CEUs can be achieved through conferences, lectures, or hospital classes, covering topics from general nursing knowledge and leadership to specific areas of interest. States do not require submission of CEU hours, however random audits are performed and those lacking proof of license risk suspension.
Registered Nurse Salary
What is a registered nurse?
Registered nurses coordinate and deliver patient care as well as provide support, advice and information about various health conditions and treatment plans. They often find employment in hospitals, doctor's offices and regional medical clinics but may work in other, less traditional settings, depending on their training and title. Registered nurses can choose to specialize in one or more specific areas, and their jobs may include the supervision of licensed practical/vocational nurses, nursing assistants or other clinical personnel.
What is a registered nurse's salary?
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The median annual registered nurse salary figures were higher than the national average for all occupations in 2012, according to the Bureau of Labor Statistics (bls.gov), with nurses in some specializations and certain geographical areas taking home better wages than others. An individual registered nurse salary can be above or below the national median for the profession, depending on factors such as training, experience, level of education and occupational demand versus workforce supply.
Is it difficult to find a job as a registered nurse?
According to bls.gov career opportunities for registered nurses are expected to rise faster than the average for all occupations between 2012 and 2022. A number of possible reasons are given for the projected growth in the field, including rising admission rates at inpatient long-term care facilities, a generally aging U.S. population and higher diagnosis rates for arthritis, diabetes, obesity and other chronic conditions.
Is there room for advancement as a registered nurse?
Advancement for registered nurses is available through a few different channels. Some clinical facilities make it possible for long-standing registered nurses to move into roles of greater administrative responsibility without requiring them to earn further any academic degrees, while others may prefer management candidates who have earned a bachelor's or master's degree.
Registered nurses who return to school may also choose to stay in an academic setting and become nurse educators.
Positions as nurse anesthetists, nurse midwives or nurse practitioners -- known collectively as advanced practice registered nurses (APRNs) -- are also available for registered nurses who earn graduate degrees in one of the APRN specialties.
Do registered nurses need to be licensed or certified?
A registered nursing license is required in all U.S. states, territories and the District of Columbia. The State board of nursing in each area is responsible for determining the academic and practical requirements that must be met before the National Council Licensure Examination for registered nurses, or NCLEX-RN, can be taken.
Registered nurses may also choose to earn specialized certifications in their particular area of practice. These certifications, although not often mandatory, demonstrate dedication to an elevated standard of care and may be preferred by certain employers.
American Nurses Credentialing Center, ANCC Certification Center, http://www.nursecredentialing.org/Certification
Registered Nurses, Bureau of Labor Statistics, Occupational Employment Statistics, May 2013, http://www.bls.gov/oes/current/oes291141.htm
Registered Nurses, Bureau of Labor Statistics, Occupational Outlook Handbook, January 8, 2014, http://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-1
American Nurses Credentialing Center, ANCC Certification Center, http://www.nursecredentialing.org/certification.aspx
Registered Nurses, Bureau of Labor Statistics, Occupational Outlook Handbook, http://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-1
Registered Nurses, Occupational Employment and Wages, Bureau of Labor Statistics, 2012
Registered Nurses, Occupational Outlook Handbook, Bureau of Labor Statistics, 2012
Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, Occupational Outlook Handbook, Bureau of Labor Statistics, 2012
National Occupational Employment and Wage Estimates, Bureau of Labor Statistics, 2012