Requirements to Be a Nurse in the U.S.
Individuals interested in entering the nursing field may become registered nurses (RNs) or licensed practical nurses (LPNs), also called licensed vocational nurses (LVNs). RNs and LPNs are required to complete a formal education program and obtain licensure.
Educational Requirements to Become a Nurse
Educational requirements differ by type of nurse. Becoming an LPN or LVN requires the least amount of formal education, a year-long training program, while individuals interested in studying towards becoming advanced practice nurses need to complete a master's degree program.
LPN and LVN Training Programs
Entry-level training for licensed practical and licensed vocational nurses can be obtained via 1-year educational programs offered at technical schools, vocational schools or community colleges. LPN/LVN programs involve both lecture-type classes and hands-on clinical practice in a hospital or clinic. Typical courses include anatomy, first aid, nutrition and physiology.
Associate Degree in Nursing
In order to become an RN, candidates need to have earned at minimum an Associate Degree in Nursing (ADN). Completing this degree program allows graduates to take the licensing examination to become RNs. Common courses include anatomy, nutrition, adult care and medicine practices.
Bachelor of Science in Nursing
Bachelor of Science in Nursing (BSN) degree programs allow nursing students to learn about providing care and obtaining work experience in medical settings. Common courses include human development and healthcare, nursing theory, chemistry and infant care.
Master of Science in Nursing
Another type of registered nurse, known as an advanced practice nurse, must complete a Master of Science in Nursing (MSN) degree program. Some MSN programs accept applications only from licensed RNs. Advanced practice nurses include nurse-midwives, nurse anesthetists, clinical nurse specialists and nurse practitioners. Courses in graduate nursing degree programs vary because they are usually focused on the area of concentration.
Career Requirements to Become a Nurse
All nurses have to earn state licensure after they graduate from an educational program. Part of earning licensure is taking the National Council Licensure Examination for Registered Nurses (NCLEX-RN), which is given by the National Council of State Boards of Nursing (NCSBN), a nonprofit organization involved with regulating nurses in the U.S. (www.ncsbn.org). Other licensing criteria may be required for nurses by each state. Continuing education credits are usually required for a nurse to renew her or his license.
Licensure Examination for Nurses
The National Council Licensure Examination (NCLEX) exists in two forms: one for registered nurses (NCLEX-RN) and one for practical nurses (NCLEX-PN). Both exams require candidates to pay a fee, and exams can be taken via computer. The number of questions varies from person to person, depending on performance. The computer keeps giving questions until it is certain whether or not the test-taker is qualified.
Both the NCLEX-RN and the NCLEX-PN include questions about keeping patients and nurses safe by preventing accidents, using ergonomic principles and correctly handling infectious items, according to the NCSBN. Students answer questions about supporting culturally diverse patients in stressful situations, such as abuse, loss, mental illness or chemical dependency. Exam takers must know how to keep patients comfortable, identify appropriate use of medications, calculate doses and recognize adverse effects.
Certification is a way that nurses can show their ability to care for certain groups of people, such as children, the elderly or patients with mental illness. According to the U.S. Bureau of Labor Statistics (BLS), though these credentials are earned voluntarily, some employers may insist that the nurses they hire have additional certifications (www.bls.gov).
Professional organizations, such as the American Nursing Credentialing Center (ANCC), offer a wide array of certifications in diverse specialty areas, including pediatrics, psychiatric care and diabetes management (www.nursecredentialing.org). Another professional organization, the National League for Nursing, offers certification for nurse educators (www.nln.org). Additional education may be required for some certifications.
Advanced Practice Nurse Certification
After earning degrees and obtaining RN licensing, nurse practitioners and other advanced practice nurses may need to undergo an additional process of certification, determined by the state in which they work. Certification allows an advanced practice nurse to perform specific care, depending on the state's regulations. For example, certified nurse practitioners may be able to prescribe medications (needs additional licensure) or serve as a patient's primary health care provider.
Salary and Career Outlook
The BLS estimates a 19% job growth for RNs and a 25% job growth for LPNs/LVNs in the 2012-2022 decade. The BLS also reported in May 2013 that the median annual salary for RNs was $66,220. LPNs/LVNs earned $41,920 as a median annual wage in 2013 as well.
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