How to Be a Nurse

Nursing shortages are common. Nurses are needed in hospitals, clinics, doctors' offices, nursing homes and home health care. Learning how to be a nurse is a great way to enter the healthcare profession.

Edit Steps

Part One: Starting Out

Get your high school diploma or GED. In order to complete the path to becoming any type of nurse (be it an LPN, an RN, or anything else), you need to complete high school. And to get into a good college, you need decent grades, too!
- You'll do well in the oncoming years if you excel (and enjoy) math, science, and English. All three are integral parts of the nursing program, regardless of which path to licensure you take.

Get an entry-level job in the healthcare arena. This step isn't mandatory, but it certainly is a good idea. If you have the time and desire to become a CNA (a Certified Nursing Assistant), that's a great first step. Not only will you start getting experience, but it proves you're serious.
- Even volunteering at a local hospital or doing admin work at a clinic looks great on your resume and gets you in an environment you have to get used to and succeed at. The more experience you have in this setting, the better -- regardless of what kind of experience it is.

Decide whether an LPN/LVN or an RN is right for you. In a hospital, you'll likely run into CNAs, LPNs, and RNs. LPNs are Licensed Practical (Vocational) Nurses. A Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) can administer physician-ordered treatment and medication under the supervision of a Registered Nurse (RN).^[1] They're still nurses, just with less autonomy.
- For most, this is just a pit stop on the way to RNville. If that speaks to you, talk to your school about their ADN or BSN program (discussed next) -- do they have an LPN designation built in when you're halfway through? Otherwise, know that you can become an LPN after a year or so of training (mostly through hospitals or community colleges).
  - LPN/LVNs take the NCLEX-PN examination, as opposed to the NCLEX-RN examination.

Find your path to becoming an RN. You have a few different options when it comes to becoming a nurse. What's more, there are different types of nurses, so it's best you know what you're getting into before you get started:
- Obtain an ADN (an Associate's Degree in Nursing). This typically takes about two to three years and does allow you to sit for the NCLEX exam upon graduation.
- Receive your BSN (Bachelor of Science in Nursing). This is a four-year degree that's offered at many colleges and universities. It, too, allows you to sit for the NCLEX exam.
- Get your diploma from an approved nursing program. Diploma programs have dramatically decreased since the 1970s. Though these are becoming less and less common, it is still a viable option.
- Go through the military. You can train for two to four years through an ROTC Nursing program at a college or university.^[2]
  - What's the difference, really, if they all lead to being a nurse? Getting your BSN allows you to eventually pursue leadership positions, teach, lead the administrative side, etc. Having a four-year degree at all in today's society is invaluable.^[3]
  - If you already have a four-year degree but it's not in nursing, you should be able to devise an accelerated program. All you need to do is send your transcripts to your new school and start asking questions -- it's a very, very common thing.^[4] Some states even have special designations for this.^[3]

Choose a nursing school. Now that you know your stuff, it's time to look at schools. There are so many programs to choose from, how do you start? Well, for starters, what program do you want to pursue? Go from there.
- Once you've decided how you want to achieve this career goal, look at the schools and hospitals (some hospitals offer programs, too) around you. Do you want to live on campus? Do you want to take the courses full or part-time? How much money do you want to spend? And don't forget online classes!
- Because of the fact that the nursing shortage is so widely-known, many people have jumped on this and some schools have long wait lists.^[5] It's best to inquire about this before you get your heart set on one.

Get accepted. Once you've picked a school, you have to apply and get in. How do you do that? Most programs will require transcripts (high school or college), SAT/ACT scores, and essay and letters of recommendation -- and on-the-job experience is always a perk.
- If you can, get letters of recommendation from people that also work in healthcare. That on-the-job experience is not only great for your essay, but it makes the networking that much easier.^[6]
- On the essay, don't write about what you think is a good answer -- write what you believe. After all, you probably have good intentions for being a nurse. Changing the world, helping people, doing something that matters? That stuff's pretty easy to write about when it's true!

Part Two: Studying and Getting Licensed

Be a top-notch student. You'll be studying anatomy, physiology, microbiology, chemistry, nutrition, psychology and other social and behavioral sciences.^[7] These are not lightweight subjects! In order to succeed, you gotta know your stuff.
- The fate of people's lives will be in your hands if this works out. If that's not motivation enough for you, what is? Well, if it helps, the graduation exam costs $200 to take each time and if you fail it, you can't take it for another 45 to 90 days.^[8] That's a lot of time unemployed!

Ace your clinicals. Just like a doctor has a year-long internship devoted to training on the job, nurses have clinicals. It's part of your education, but it's out of the classroom and in the action. Most clinicals focus on a specialization, like medical-surgical, pediatrics, maternity or psychiatric.
- It's normal to be super stressed during clinicals.^[9] After all, you're working with real people and you're still a newbie. But everyone goes through this and the feeling does go away. As long as you study, you'll be golden.

Prep for the boards. That's what the NCLEX-RN exam is called colloquially. It's a series of questions (between 75 and 265^[10]) that will test your knowledge in a variety of different domains. You're given 5 hours to complete the test.
- The number of questions varies person to person. The test will continue until the computer feels it has accurately determined your knowledge level with 95% confidence. Finishing at 75 questions means you either did magnificently or very poorly, so don't worry about the number you get.

Pass the exam and get licensed. The best way to pass is to study, study, study, and sleep. Many to-be nurses get very stressed out about the boards; however, know that 83% of candidates pass on the first try.^[11] Those are good odds!
- The average number of questions is around 118 and the average test takes about 2.5 hours, in case you were curious.^[12]

Look for employment in your desired department. Now that you're licensed and ready and raring to go, it's time to think about what domain of the work world you want to work in. Do you want it to be exciting? Full of babies? All-encompassing? You probably have a hunch, don't you?
- Consider the fact that baby boomers are pretty much taking over. Working with the 55+ demographic would ensure job stability.
- Working with children is great, but it can also be very sad. Know that if you do choose to go into pediatrics, you'll be faced with a lot of images that just aren't fair and shouldn't be.
  - Mother/Baby units can be very difficult to get into -- everyone wants to work with patients who are happy, excited, and healthy.
- Most surgeries nowadays are scheduled. If you prefer working normal hours (plenty of nurses don't), being a surgical nurse may be down your alley.

Part Three: Advancing Your Career

Get specialized. After X number of hours in your department, there's probably some certification you'll be able to get, whether it's med/surg, psych, or geriatrics. Your hospital should offer you a course, seminar, or training class to certify you in this area.
- With that should come a slight increase in pay. Being certified looks good -- so if the opportunity comes, take it!
- One would think that you have to be certified to get the job, but it isn't so. You need so many hours on the floor of that department before you're even eligible. Think of it more as a badge of honor instead of as a specialization or certification.

Be mentally ready. As alluded to in the prior step, there's a lot a nurse has to face. Whether it's a particularly nasty infection, vomit and excrement all over you, or a very sick baby, the job is hard. It is not for the mentally (nor physically) unfit.
- At one point or another, you may feel guilt for something that happened to someone, whether it was out of your control or not. This profession is not something that is always light on the spirit. If you have yet to pursue this as your career, think about this before you make the leap.
- The schedule of a nurse can be pretty intense. You could work 3 twelve-hour shifts in a row and then get four days off. If you're working overtime, it could be more. And it could be night shifts. Or you could be on-call on your days off, too. Sleep may not be your constant companion.

Know your options. Since nurses are needed everywhere and at all times, you can imagine the plethora of forms they take. They work in hospitals, of course, but they also work in private homes, in clinics, in doctor's offices, and in nursing homes and the like. Where do you see yourself?
- There's also the option of being a traveling nurse. You can go pretty much anywhere!
- Many places have nurses working third shift, on-call or on stand-by. You could work 8-hour shifts, 10-hour shifts, or 12-hour shifts. You can also float to different departments, widening your repertoire. What's calling to you?

Get a job. If you've been working at or through a hospital, that's your first go-to. If not, apply anywhere and everywhere you can. Unfortunately with the recent economic slump, it's getting harder and harder to find jobs, nursing jobs included.^[13]
- However, know that some places do prefer new grads (they cost less money) and the need for nurses is still booming.^[7] As long as you're on top of your game, you'll be okay.
- Ask about your potential employer's turnover rate. If its 20% or higher, it may be a sign that you should get out while you still can.^[14]
- Ask about guidance. Some employers will give you extensive training while others will show you where the vending machines are located. Ask if you'll have a guide or preceptor to show you the ropes in your first days.^[14]

Maintain your licensure and credibility. Eligibility requirements for having a license vary by state or area, so maintaining yours depends on where you live. However, your employer will probably routinely have you in workshops, seminars, and certification classes to keep you up-to-date.
- It used to be that if you were licensed in one state, you weren't licensed in another. While that's still technically true, it's slowly changing. Some states have entered into the The Nurse Licensure Compact Agreement, allowing each other's nurses to work within their boundaries. Currently it's at 24 states and counting.^[15]
- You'll need to retake your exams every so often, depending on where you live and whether or not you've been practicing. Look up the laws in your area to make sure your license stays active.^[16]

Pursue further education. Whether you got your LPN, your ADN, or your BSN, there's always room for more education. You can get your Master of Science in Nursing in only 1 or 2 years, allowing you to become a nurse practitioner, clinical nurse specialist, nurse anesthetist, or nurse-midwife. Then you can do pretty much anything and go pretty much anywhere.
- If you only have an ADN, you can do a joint BSN/MSN in two or three years. You will have to meet additional certification and licensure requirements. However, it's certainly worth looking into with the 27% high average salary when compared to regular RNs.^[4]