How to Become a Nurse: A Complete Guide

A group of RNs and nurse practitioners
A group of RNs and nurse practitioners

Nurses of all educational backgrounds and levels are needed now more than ever. With the population aging and becoming sicker, there is an especially urgent demand for second career nurses. Nurse Practitioners (NPs) and nursing assistants are also highly sought after. 

The increased need for more nurses in the workforce comes with the task of educating nursing students to prepare them for the real world. This article will help you understand how to become a nurse from start to finish, their roles within the health care system, and the income they can expect. The following information will serve as a good starting point for anyone who is interested in becoming a nurse:

 

What is a Nurse?

Working within a team of health care professionals, nurses are responsible for the care and overall wellbeing of individuals who are unable to independently care for themselves for a multitude of reasons. Nurses provide compassionate support in an ever-changing environment.

Nurses work in a wide range of areas and specialties including acute care settings like hospitals and surgical centers, as well as home health agencies, schools, and nursing homes. Roles can range from working as a certified nursing assistant to conducting research on a variety of complicated health care questions at the PhD or doctorate level. 

The majority of the workforce consists of registered nurses (RNs). Most RNs have a bachelor's degree, which is typically acquired at a four-year university. However, this can be completed in as little as two years through certain accelerated nursing programs

 

History of Nursing

The history of nursing dates back to the mid-19th century with Florence Nightingale, who had a theory that the environment around those who are sick could affect the overall health and recovery process of an individual. The theory involved five main environmental areas of concern:

  • Fresh air
  • Pure water
  • Effective drainage
  • Cleanliness or Sanitation
  • Light or direct sunlight

In 1854, Nightingale tested her nursing theory during Britain’s Crimean War. Thanks to her revolutionary ideas during that period, many lives were saved. Nightingale’s approach to caring for the sick proved to be very effective.

At the turn of the 20th century, many industrialized countries began establishing professional associations that ultimately set the standards for both trained nursing assistants and untrained nurses. 

In the mid-1930s, increased technological and clinical demands of patient care required transitioning to a more intensive setting than the home. This need for more specialized care led to the demand for hospital beds and trained nursing staff. By the mid-1950s, hospitals were the largest employer of RNs. This trend continues to this day—even with a growing amount of in-home health options for patients.

Due to these changes in the health care industry over time, the educational path of nurses has also pivoted. This includes training all nurses in typical educational settings. By the 1970s, education had expanded to include doctoral-level programs that emphasized nursing knowledge and research. 

This expansion catered to the more immediate needs within the nursing field and paved the way for the present day, leading to the current nursing trends of today. While the majority of nurses are female, there are many males who have worked in the nursing field throughout history and present day, making up about 13% of the nursing workforce. 

 

Types of Nurses

Making up the majority of the health care workforce, RNs are the most sought-after nursing credential. Education for nurses can range from a necessary certificate to become a certified nursing assistant (CNA) all the way to a doctorate for a nurse practitioner role. Each state has a different set of criteria and scope of practice for each level of nursing. Therefore, the process can vary greatly depending on the state where a nurse is licensed. 

CNAs are nursing assistants who work directly with RNs to provide routine care and collect data for reporting purposes. They help patients with bathing, dressing, and maintaining as much independence as possible. Most CNA programs can be completed in just a few weeks, with few prerequisites and a one-time certifying exam at the end of the program. 

Licensed practical nurses (LPNs) or licensed vocational nurses (LVNs) are nurses who work alongside RNs in direct patient care. LPNs are usually able to monitor and document medical history and communicate with doctors and RNs to provide the best possible care for their patients. The state where the LPN is licensed and the scope of practice defined by the state board of nursing will determine where LPNs are utilized within the workforce. In most states, they can provide routine care and procedures such as dressing changes. Some states permit them to start IVs and administer medications independently. However, they are typically restricted to oral medication administration under the supervision of an RN.

As the largest group of individuals in the health care field, RNs collaborate with LPNs and CNAs to ensure the safety of patients. RNs assess patients' medical conditions, educate patients on disease processes, administer medications, and communicate with physicians and members of the health care team. In addition to managing the care of multiple patients at once, they supervise CNAs and LPNs to ensure that competent and safe care is provided. 

A nurse practitioner (NP) is a registered nurse with an advanced degree, which is typically attained through either a master's or a doctoral program. NPs perform similar duties to physicians, such as diagnosing and prescribing medications for patients. They also conduct assessments, analyze and interpret lab and test results, and create a plan of care through collaboration with each individual patient and their needs.

The job outlook for NPs, a type of advanced practice registered nurse (APRN), is expected to rise by 45% by 2030, which is significantly faster than the average position in health care. Again, the scope of practice can vary greatly depending on the state. Some NPs have full practice authority, while other states require NPs to work under the supervision of a physician.

Nursing professions are dispersed across a variety of settings and work with many different patient populations. Nurses have many specialization areas and settings they can work in, including:

  • Pediatrics 
  • Surgical services
  • Women's health
  • Research
  • Geriatrics
  • Skilled nursing or home health
  • Inpatient psychiatric facilities
  • Specific disease processed
  • Education 

 

A nurse working in an emergency room

 

Nurse vs. Nurse practitioner: What's the difference?

NPs possess at least a master's-level education and are able to specialize in several different areas. Certified nurse anesthetists may administer anesthesia for both routine and complex medical procedures. Most programs require years of critical care clinical experience to apply for additional certifications. Family nurse practitioners (FNPs) are nurse practitioners whose scope of practice ranges across the entire lifespan. FNPs are in growing demand and have the potential to work in many different specialties and settings. 

Like RNs, advanced practice nurses work directly with patients to provide compassionate and appropriate care. Working independently within a team, they do what is best for the patient at any given point throughout their care. 

Because NPs hold at least a master's level of education, they are able to participate in the research and development of policies and procedures and hold more leadership roles. Depending on the scope of practice, NPs may independently order tests and procedures and perform more complex and more invasive procedures than RNs can.

Determining your path comes down to knowing what you are looking for in a career. Some thrive in a leadership role with more autonomy and responsibility, while others prefer to be hands-on with patients at the bedside in an RN role. 

If you are interested in pursuing a career as an NP, read our related blog on How to Become a Nurse Practitioner.

 

Where do Nurses Work?

Many health care facilities are always open. With most nurses employed by hospitals and nursing care facilities, most of their patients require care 24 hours a day. As a result, nurses are commonly employed in full-time positions. However, part-time and per diem roles are also available to provide around-the-clock care. This means shifts can last either eight or twelve hours, depending on your specialty and setting. 

  • CNAs are largely employed in nursing care settings like skilled nursing facilities, with another one-third in hospitals. 
  • The majority of LPNs work in nursing homes and residential care facilities. Hospitals, doctors' offices, and home health settings are the main employers of LPNs. 
  • Hospitals employ the majority of RNs in the workforce. This is followed by outpatient facilities and doctors' offices.
  • The largest employer of NPs is hospitals, followed by outpatient facilities and educational services. 

 

Skills of a Nurse

During any given shift, a nurse performs a multitude of duties and tasks that require specialized training and education. That being said, maintaining a good understanding of yourself and how you work and learn best is one of the most important skills a nurse can learn to develop in order to provide competent care.

  • Performing and monitoring invasive procedures - Nurses are responsible for handling a wide range of procedures. Staying organized and aware of surroundings is critical to maintaining a sterile environment. Nurses are skilled in starting and maintaining intravenous access, as well as drawing blood for laboratory tests.
  • Basic mathematics - Nurses are required to accurately determine the dose of medications and ensure the safety of patients. Most measurements and medication dosages that you will be working with will use the metric system so an understanding of it is important to ensure safety and consistency throughout care.
  • Critical thinking - Nurses work in a highly dynamic industry. Needs are never the same from one patient to the next. Conditions can change rapidly, which requires medical staff to look at the entire person and individualize care. 
  • Communication skills - Working directly with patients, nurses are responsible for providing education and presenting important medical information. Being an efficient and effective communicator is especially important. This includes sharing changes with all necessary individuals and explaining complex medical conditions in a way that makes sense to patients. 
  • Time management - In many settings, nurses are responsible for multiple patients at a time. Patients' needs must be prioritized and clustered to ensure that all necessary tasks are completed. Time management is a skill that benefits both nurses and patients. 

 

Qualities of a Nurse

Nurses are the front line of health care. They work directly with patients, collect data, and facilitate the logistics required at every turn of care. Nurses are experienced in working with people and managing their health-related problems and concerns. They are also trained in looking at the individual as a whole. 

Despite the fact that there are no character requirements for acceptance into a nursing program, certain qualities can help improve the lives of patients as well as make nurses' lives in and out of work run more efficiently including:

  • Emotional stability - Working directly within highly emotionally-charged situations can be challenging for nurses. Understanding yourself, maintaining the ability to control your emotions, and having a healthy outlet to release frustrations may be crucial. A strong support system can also be invaluable for nurses who find themselves in these situations on a daily basis. Knowing you have people who are supporting you during difficult times can be very comforting and play a part in how you process the emotions of the job.
  • Choosing to care for those at their most vulnerable - As a health care professional, you are exposed to many vulnerable moments throughout one's lifetime. You may find yourself in many situations where you have no control over the outcome. Nevertheless, it is imperative to show up supportive for your patients as they go through vulnerable transitions.
  • Physical stamina - Nurses spend most of their time at work on their feet in a fast-paced working environment. Shifts can be very long and there may be limited time to sit down and nourish yourself. Patients are also becoming heavier. Nurses are typically responsible for turning those patients who are bedbound and need assistance. This means that it could be helpful if a nurse is capable of lifting a considerable amount of weight. 
  • Compassion - It’s important to be compassionate and empathetic when it comes to handling patients' conditions. Nurses care for people when they are in a vulnerable state, which can be challenging on an emotional level. 

 

Roles and Responsibilities of a Nurse

RNs are responsible for many aspects of the health care system, including overall patient wellbeing and safety. They also have the medical knowledge that allows them to conduct assessments, prioritize medical interventions, administer medications, and educate patients about simple to complex medical procedures. 

RNs can be given a range of tasks and responsibilities, depending on their clinical setting and official duties. They are responsible for drawing blood, communicating lab results, administering treatment or procedures, and educating patients on their changing health conditions. General duties include:

  • Documenting and communicating health history
  • Communicating with physicians
  • Monitoring responses to medications
  • Consulting with health care team
  • Assessing health status
  • Interpreting vital signs

 

a nurse comforting a young patient

 

Steps to Becoming a Nurse

The course of becoming a nurse can look different from person to person, but the general steps will be the same. The nursing program and state where you are planning to practice will determine the necessary process. 

  1. Complete an official registered nurse program. Many programs are limited entry, which means that there are specific requirements such as a certain GPA and prerequisites. Additionally, an application is needed to be accepted into the program. 
  2. If you are accepted into a nursing program, the following prerequisite courses are typically necessary in order to start. Many also require laboratory hours, so this should be factored in when planning your semester:
    1. Anatomy & Physiology 1 and 2
    2. General Chemistry for Health Science Majors
    3. Developmental Psychology
    4. Microbiology
    5. Sociology or Anthropology
    6. Statistical Analysis
  3. Entrance exam-- Limited entry programs like nursing require an entrance exam to ensure that the minimum math, English and science standards are met. Each program is different and how the entrance exam is applied can inform your approach to it. Some programs will take an average score of prior exams, while others will accept your highest score if attempted more than once. 
  4. Register for the National Council Licensure Examination (NCLEX-RN.) After you have successfully completed an accredited nursing program, you can register to take the exam required for all nurses to become licensed. The NCLEX-RN is a standardized test that determines whether a newly graduated nurse is able to competently and safely perform the duties of the job.
  5. Pass the NCLEX-RN. As a nursing student, you will be required to study for the board certification examination as part of your program. Review courses are available, which offer additional preparation to help you pass the boards on your first attempt. Depending on the type of nursing program, you may be required to complete a review course as part of your tuition while others offer it for an additional cost.
  6. Apply for the state license or compact license with the state board of nursing that you wish to work in. Some states are considered “compact states,” which allows a nurse to obtain licensure in a particular state and practice in several other states that participate in the compact agreement. 
  7. Apply for nursing jobs. Once you pass the NCLEX-RN and earn your nurse license in the state where you have been authorized, you can then apply for nursing positions available in that area.

 

How Much Do Nurses Make?

Nursing salaries vary by level of education, geographical location across the country, and the specialty and setting they work in. Most nurses work in full time positions that typically include retirement and insurance packages. Because there is such high demand for nurses, there are many opportunities to increase income by picking up extra shifts or working a per diem job in addition to your full time position. 

Keeping that variability in mind, median salaries for these common nursing roles are a good estimate of what the typical nurse in each position earns.

  • CNA: The median annual income was $30,850 in 2020. 
  • LPN: The median annual income was $48,820 in 2020. 
  • RN: The median annual income was $75,330 in 2020.
  • NP: The median annual income was $117,670 in 2020. 

 

How Long Does It Take to Become a Nurse?

It is possible to become a nursing professional in as little as 16 months depending on the route and role you're interested in. If you remain focused and have a previous degree before enrolling, there could be prerequisite classes that you do not need to retake. 

There are many different ways to become an RN and various levels of education to get there. Typical nursing programs are held at a four-year university and follow a traditional school semester schedule. Due to the popularity and increased demand for more nurses, there are now many non-traditional options when it comes to nursing school. 

Nowadays, there are a number of nursing programs that are specifically designed for the second degree nurse, with many online class options for convenience. These fast-track nursing programs can be completed in as little as 16 months and can have you in a brand new industry and starting your new career in less than 2 years.

Learn why Marymount's online ABSN students chose our fast-track nursing program to kickstart their new careers.

 

Become a Nurse with Marymount University’s Online ABSN Program

With this information, you are now one step closer to starting a new career in the health care setting. As the industry continues to grow, so does a more skilled workforce and flexible environment. You can be a part of this change and work in a field dedicated to helping those around them. 

Nursing is a fulfilling and rewarding career, offering the ability to provide professionals and patients with competent and compassionate care. Starting with education, this continues throughout all phases of the job. By working as a nurse, you are given the chance to make a difference. 

Marymount University’s accelerated BSN is designed for the second career nurse and offers clinical placement assistance and NCLEX review courses to get you ready for and into the workforce as quickly as possible.

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