Guide to Becoming a Registered Nurse (RN) in the US


Aarushi Jain
Updated on Sep 23, 2022 03:51 PM IST

Aspiring to become a Nurse in the USA? Well, if your answer is a Yes, then this is the right article for you! Here, we will explore everything about how to become a Registered Nurse in USA and other relevant information. 

Guide to Becoming a Registered Nurse (RN) in the US

How to Become a Registered Nurse in USA: The global healthcare industry is rapidly increasing, particularly in the aftermath of the COVID-19 pandemic. This is undoubtedly producing an urgent demand for medical specialists all around the world, including in numerous nations such as the United States.

Registered Nurses (commonly known as RNs) in the United States are in great demand for a variety of reasons, including the advancement of new technologies, an ageing population, and current nurses retiring. According to the Bureau of Labor Statistics (BLS), employment in healthcare professions will expand 16% from 2020 to 2030, substantially faster than the country's national average.

The ageing baby boomer generation (those born between 1946 and 1964) is driving up demand for medical services. According to the US Census Bureau, there will be 73 million baby boomers in the US in 2020, and by 2030, all boomers will be at least 65.

When all of these reasons are considered, as well as the joy that comes from helping others, the benefits of being a Registered Nurse have never been better. As a result, here is an all-in-one guide that will help you know how to become a Registered Nurse in USA, their different types, salary prospects, and more.

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Who is a Registered Nurse in the USA?

Before we know about how to become a Registered Nurse in USA, we need to know what is meant by a Registered Nurse in the United States.

A Registered Nurse (also known as RN) is a healthcare worker who has been licenced or certified by the state to provide and coordinate patient care after completing specialised training and passing a thorough national exam (NCLEX-RN). Registered nurses work in a variety of direct patient care jobs and can specialise in virtually any sector of medical care. Outside of the clinical context, they might also engage in healthcare consulting and education.

In many respects, Registered Nurses constitute the backbone of the American healthcare system. They are responsible for a variety of tasks and work directly with patients, physicians, and other healthcare professionals.

Types of Registered Nurses in the USA

Now that we have a brief knowledge about Registered Nurses, let us witness some of the most prominent types of Registered Nurse that can be found in the USA:

Addiction Nurse

The first and the most commonly available type of Registered Nurse in the USA is an addiction Nurse. Addiction nurses, also known as substance abuse nurses, may have chosen this vocation because they or someone they love has struggled with addiction to drugs, alcohol, or other substances. Addiction nurses work at rehab institutions, hospitals, and outpatient treatment programmes.

Cardiovascular Nurse

Another type of Registered Nurse in the USA is the Cardiovascular care nurse. These RNs work in hospitals, coronary care units (CCUs), and medical practices that treat patients with heart disease. The American Association of Critical-Care Nurses (AACN) is in charge of cardiovascular nurse certification.

Critical Care Nurse or ICU Nurse

Critical Care Registered Nurses work in intensive care units (ICUs) and critical care units (CCUs). ICU nurses are sometimes referred to as critical care nurses and vice versa. They specialise in care for patients who are hospitalised for severe diseases that need 24-hour monitoring. The AACN also provides certification for ICU and CCU nurses.

Gastroenterology Nurse

Gastroenterology Registered Nurse in the USA assist patients with gastrointestinal illnesses including the stomach and digestive tract. They might help doctors with colonoscopies and endoscopies. The American Board of Certification for Gastrointestinal Nurses oversees the gastroenterology nurse certifications (ABCGN).

Medical-Surgical Nurse

Medical-surgical nurses are another type of Registered Nurse in the USA who often work in hospital settings with significant patient loads five to seven per day on average. These nurses are certified by the Medical-Surgical Nurse Certification Board (MSNCB) and the American Nurses Credentialing Center (ANCC).

Neonatal Nurse

A neonatal nurse is someone who cares for babies who were born prematurely or with life-threatening or persistent conditions. They may work in a neonatal intensive care unit (NICU), a critical care unit (CCU), an intensive care unit (ICU), a trauma unit, or another healthcare environment. The AACN grants certification to these Registered Nurses in the USA.

Occupational Health Nurse

An Occupational Health Registered Nurse in the USA works in a clinical environment, but may also work as a full-time nurse for a major organisation. A major manufacturing corporation, for example, would hire an occupational health nurse to assist prevent injuries, manage workplace health concerns, and handle workers' compensation and family medical leave. A certification programme is available through the American Board for Occupational Health Nurses (ABOHN).

Public Health Nurse

A Public Health Registered Nurse in the USA may work for government agencies, nonprofit groups, or other organisations that promote public health via education and screening. Rather than treating individuals in private clinics, public health nurses treat the entire community. RNs with five years of public health experience and a bachelor's degree can apply for the National Board of Public Health Examiners' Certification in Public Health.

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Job Responsibilities of a Registered Nurse in the USA

Registered Nurses' duties or job responsibilities in the US vary based on where they work, how long they have been a nurse and the area of speciality in which they work. RNs are often responsible for both clinical and administrative duties. Moreover, the job responsibilities of Registered Nurses can be divided into two parts:

Clinical Responsibilities

  • Examining the health and vital signs of patients

  • Giving drugs and treatments that doctors and other healthcare practitioners have prescribed.

  • Contributing to and establishing patient care plans.

  • Collaboration and consultation with other healthcare providers.

  • Monitoring and operating medical equipment.

  • Diagnostic tests must be performed and analysed.

  • Patients and their relatives are being educated.

Administrative Responsibilities

  • Making a record of medical history and symptoms.

  • Other healthcare personnel, such as LPNs, CNAs, and medical assistants, are directed and supervised.

How to Become a Registered Nurse in USA?

Now that we have gathered excellent information about the Registered Nurses in the USA, here is a complete step-by-step guide on how to become a Registered Nurse in the USA for aspirants:

Step 1: Finish an Accredited Registered Nurse Programme

Students must complete an approved curriculum to become a Registered Nurse in the USA. Nursing diplomas, associate degrees, and bachelor's degrees are among the alternatives.

A two-year associate degree in nursing is the usual duration, while accelerated programmes might minimise this time. A bachelor's degree in nursing typically requires four years of full-time study or two years for those enrolled in an associate-to-RN bachelor's programme.

If you already have a bachelor's degree in a discipline other than nursing, you can pursue a second-degree programme. You may also choose to begin your education with a four-year bachelor's programme, which will allow you to advance into positions/roles such as administration, nursing consulting, research, advanced nursing or teaching.

Step 2: Give NCLEX-RN Examination

Registered Nursing programmes should assist you to prepare to take the NCLEX-RN test. You should register with the National Council of State Boards of Nursing after graduation to take the tests. When it comes time to sign up for the test, candidates will get an Authorization to Test notification. This computerised test comprises 119 questions on average and must be finished in six hours. The NCLEX-RN is divided into four sections based on practical nursing skills and knowledge:

  • Health Promotion and Maintenance

  • Psychosocial Integrity

  • Physiological Integrity

    • Basic Care and Comfort

    • Pharmacological and Parental Therapies

    • Reduction of Risk Potential

    • Physiological Adaptation

  • Safe and Effective Care Environment

    • Management of Care

    • Safety and Infection Control

Those who do not pass the test must wait at least 45 days before retaking it. The national average NCLEX-RN pass rate is between 70% and 75%. After passing the NCLEX-RN, you can apply for licensure with your state board of nursing. You will be required to provide your test results, and evidence of schooling, and typically pass a criminal background check.

Step 3: Obtaining a State License

Every state and territory in the United States requires hired Registered Nurses to be properly licenced. Mandates differ by state, so check with your state board of Nursing to determine if there are any additional requirements, such as a background check.

Step 4: Look for Jobs as a Registered Nurse in the USA

Once you acquire your state Registered Nursing licence, you will be able to explore all of the opportunities that nursing provides. Even after completing nursing school, you may not realise how many various things you can perform with a US Registered Nurse licence.

Nurses work in any environment where people live and work. Their adaptive, practical healthcare abilities will always be in high demand. And the variety of specialisations and circumstances in which they may use those abilities means that there are thousands of different sorts of specialisations and environments in which you can work as an RN.

Step 5: Pursue Additional Training/Education (If Required)

A master's degree is required if a Registered Nurse in the USA wishes to become an advanced practice registered nurse and specialise in their expertise. After finishing this study, you will be able to apply for positions such as Certified Nurse Specialist, Nurse Practitioner, Nurse Anesthetist, and Nurse Midwife.

Also, if you want to pursue higher education being a Registered Nurse, you can enrol in a PhD programme. Those seeking careers as scientific researchers or university professors in the nursing sciences may be interested in DNP or PhD programmes. You can also pursue additional certificates in critical care, acute care, or nurse management

Registered Nurse Salary in the USA

After knowing so much about how to become a Registered Nurse in USA, one question must be digging deep into your head about how much a Registered Nurse would earn in the USA. Registered Nurse salaries in the United States are determined by a variety of criteria, including area, state, kind of nurse, academic qualification, previous job experience, and others.

Registered nurses in the United States make an average of USD 75,330 as per the BLS. RNs working in government receive the highest average salary of roughly USD 84,490, followed by RNs working in hospitals (USD 76,840), ambulatory care services (USD 72,340), nursing care facilities (USD 68,450), and education (USD 64,630).

The following states have the highest annual mean incomes for Registered Nurses in the USA:

State in USA

Salaries in USD











Registered Nurse Job Prospects in the USA

According to the BLS, employment of Registered Nurses in the USA will expand at a rate of 9% from 2020 to 2030, which is about the same as the average for all occupations. There are several causes for this, including an older population and more healthcare access as a result of the Affordable Care Act.

Also, the increased need for Registered Nurses will come from places other than hospitals, such as outpatient and long-term care facilities. As could be expected, job growth is not uniform across the country. The table below shows the top 10 US states with the highest predicted growth from 2020 to 2030.

US States

Predicted Job Growth Percentage







New York














There is no doubt that nursing is a rewarding profession that can provide long-term job satisfaction and security. As a result, Registered Nurses with a relevant bachelor's or master's degree have a wide range of job opportunities in the USA and can move directly into leadership roles after graduation.

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Where do Registered Nurses work in the USA?

RNs work in doctor's offices, nursing homes, long-term care institutions, hospitals, clinics, government, and education. The majority of registered nurses work in hospitals, according to the BLS report on registered nurses. As of 2020, the following are the most common job areas for registered nurses:

  • Hospitals: 61%
  • Doctors’ offices, home health and outpatient care: 18%
  • Nursing care facilities: 6%
  • Government & Education: 8%

What are the common steps to becoming a Registered Nurse in USA?

  • Complete a nursing education programme that is accredited. 
  • Get ready to take the nursing licencing exam.
  • Take the National Council Licensure Examination for Registered Nurses and pass it (NCLEX-RN).
  • Get your licence in the state where you want to practise. Requirements vary by state. Learn more about state-by-state requirements for RN licensing.

How many years does it take to complete a Registered Nurse degree in USA?

Associate Diploma in Nursing or ADN programmes typically last two years and prepare you to take the NCLEX licensure exam to become a registered nurse. A BSN degree is normally a four-year curriculum. While it will take you longer to complete than an ADN, it will also provide you with a highly sought-after credential.

How much is US nurse's salary?

The average Registered Nurse salary in the United States is USD 82,750, with a median (50th percentile) of USD 77,600. As of May 2021, California is the highest-paying state for nurses, with RN wages averaging USD 124,000 (according to the BLS).

Is the NCLEX exam for becoming a Registered Nurse difficult?

Getting ready to take the NCLEX is enough to make anyone worried. It is indeed a challenging exam that will serve as a significant stepping stone in your career as a registered nurse. Remember that the majority of people pass the NCLEX on their first attempt. However, preparation and confidence are essential for success.

Can I take the NCLEX without a nursing degree?

Yes, candidates without an undergraduate degree in nursing or a healthcare-related domain of study can take the NCLEX-PN exam. For example, if a person has a degree in Economics, they can still apply for the NCLEX-PN if they first complete a corresponding diploma or certificate course required to sit for the exam.

Can you become a Registered Nurse in USA in 2 years?

Yes. You could complete an ADN or ABSN degree in 1-2 years. The length of time is determined by your past college work. Prospective nursing students must also consider the number of clinical hours necessary. Additional time is required for NCLEX-RN preparation.

What advancement opportunities are available after becoming a Registered Nurse in USA?

Becoming a Registered Nurse in the USA  allows you to enhance your career in healthcare. RNs must maintain their education in order to do so. To become an advanced practice nurse, one must first obtain a master's or doctorate in nursing. Obtaining qualifications in particular areas of nursing necessitates the completion of continuing education courses.

What is accreditation in Nursing programmes and why is it important?

Accreditation signifies that a nursing programme has been certified to fulfil industry standards by an independent agency, such as the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. This is significant since companies or employers regularly hire only graduates of recognised nursing programmes.

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