How to Get Your Nursing License Step by Step

Understanding Nursing License Requirements and Types

Before beginning the path to a nursing license, you should understand the different types of nursing credentials available in the United States. Each level requires different education and training, and each has distinct responsibilities in healthcare settings.

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A Registered Nurse (RN) is a licensed healthcare professional who has completed at least a two-year or four-year degree program in nursing and passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN). RNs perform a wide range of duties including administering medications, monitoring patient vital signs, coordinating patient care, and educating patients about their conditions. According to the U.S. Bureau of Labor Statistics, there were approximately 2.3 million registered nurses employed in the United States as of 2022, making it one of the largest healthcare professions.

A Licensed Practical Nurse (LPN), also called a Licensed Vocational Nurse (LVN) in California and Texas, completes a shorter training program, usually around one year. LPNs work under the supervision of RNs or physicians and perform basic patient care tasks such as taking vital signs, helping with hygiene, and providing wound care. Some healthcare facilities may hire LPNs for entry-level positions before they pursue RN licensure.

A nursing assistant or Certified Nursing Assistant (CNA) does not require a full nursing license but involves completion of a brief training program, typically 4 to 12 weeks. CNAs assist nurses and patients with daily living activities but cannot perform many medical procedures that licensed nurses can perform.

The choice between these paths depends on your career goals, timeline, and educational preferences. An RN license opens more job opportunities and typically offers higher wages than an LPN or CNA position. However, the LPN route takes less time and may be a practical starting point for some people.

Practical Takeaway: Research the differences between RN, LPN, and CNA roles by reading job descriptions on healthcare employer websites to determine which credential matches your career goals.

Completing Your Nursing Education Program

The foundation of becoming a licensed nurse is completing an accredited nursing education program. This is the most time-intensive step in the process, but it provides the knowledge and clinical skills necessary to work safely with patients.

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For Registered Nurses, there are three main educational pathways. A Bachelor of Science in Nursing (BSN) program typically lasts four years and is offered by universities and four-year colleges. The curriculum includes classroom instruction in anatomy, physiology, pharmacology, nursing theory, and pathophysiology, along with clinical practice in hospitals and healthcare facilities. A two-year Associate Degree in Nursing (ADN) program is offered at community colleges and some hospitals and focuses on the essential nursing knowledge and skills needed for entry-level RN positions. A three-year diploma program, once common, is now less frequently offered but still exists in some institutions and typically combines classroom and hospital-based training.

All nursing programs must be accredited by organizations such as the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). Before enrolling, verify that the program holds current accreditation, as this affects your ability to take licensing exams.

During your nursing program, you will complete several components. Didactic coursework covers the science and theory behind nursing practice. Clinical experiences place you in actual healthcare settings working with real patients under the supervision of experienced nurses and instructors. These clinical rotations occur in various settings including medical-surgical units, intensive care units, obstetrics, pediatrics, and mental health facilities. Most programs require between 800 to 1,200 hours of supervised clinical practice.

The duration of your program depends on which pathway you choose. Starting with prerequisites such as anatomy, chemistry, and biology, a full BSN may take 4 to 5 years if completing prerequisites and the nursing program sequentially. An ADN program typically takes 2 to 3 years when prerequisites are factored in. Diploma programs generally take 3 years.

Practical Takeaway: Visit the websites of nursing schools near you and contact their admissions departments to request information about program length, course schedules (full-time, part-time, evening, or weekend options), and prerequisites you may need to complete first.

Meeting Prerequisites and Academic Requirements

Most nursing programs require you to complete prerequisite courses before or alongside your nursing coursework. These prerequisites ensure you have the foundational knowledge necessary to understand nursing concepts and safely care for patients.

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Common prerequisites include biology (particularly human biology or general biology), chemistry (often inorganic chemistry), anatomy and physiology, microbiology, and mathematics. Some programs also require English composition, psychology, and statistics. Each nursing school sets its own prerequisite requirements, and these can vary significantly between institutions. Before applying to a nursing program, review the specific prerequisites for schools you are interested in attending.

You may already have completed some of these courses if you have a college degree in another field or if you completed general education requirements in a previous college experience. If not, you can take prerequisites at community colleges, four-year universities, or through online options. Many community colleges offer prerequisites at lower costs than universities and have flexible scheduling options including evening and weekend classes.

Beyond prerequisites, nursing programs have academic standards that students must maintain throughout the program. Most programs require a minimum grade point average (GPA), often between 2.5 and 3.0, in both prerequisite courses and nursing courses. Some programs set higher standards, such as requiring a 3.0 GPA in science courses. Failing a nursing course typically requires retaking that course, which delays your progression through the program. If you do not meet the minimum GPA requirements, you may be dismissed from the program.

Additionally, nursing programs conduct background checks and drug screening for all students. Criminal convictions, particularly those related to violence, theft, or drug offenses, may prevent you from entering a program or becoming licensed. You should be honest about your background when applying, as nursing regulatory boards conduct thorough background investigations before issuing licenses.

Practical Takeaway: Create a spreadsheet listing the prerequisites for 3 to 5 nursing programs you are considering, compare them to courses you have already completed, and identify which prerequisites you still need to take and where you can take them.

Understanding the Licensing Examination Process

After completing your nursing education program, you must pass a licensing examination to become a licensed nurse. The examination tests your knowledge of nursing concepts and your ability to make safe clinical decisions. Understanding how this exam works helps you prepare effectively.

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For Registered Nurses, the examination is called the NCLEX-RN (National Council Licensure Examination for Registered Nurses). For Licensed Practical Nurses, it is the NCLEX-PN. These exams are administered by the National Council of State Boards of Nursing (NCSBN) and are computer-based tests offered at testing centers throughout the country.

The NCLEX-RN typically consists of 75 to 265 questions, depending on how the computer algorithm determines your performance. The test uses an adaptive testing format, meaning the difficulty of questions adjusts based on your answers. If you answer a question correctly, the next question becomes slightly more difficult. If you answer incorrectly, the next question becomes slightly easier. The exam continues until the computer has gathered enough information to make a confident determination that you either meet or do not meet the minimum competency level for safe nursing practice.

The content of the NCLEX-RN is organized around four client needs categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. Within each category are specific topics such as infection control, pain management, medication administration, communication, and patient education. The exam includes both multiple-choice questions and other question types such as multiple response (choose all that apply), fill-in-the-blank, hot spot (clicking on specific areas of an image), and ordered response (putting items in sequence).

The passing rate for first-time NCLEX-RN test-takers in the United States is typically around 85 to 90 percent, according to NCSBN data. However, this varies by nursing program and individual factors. You must schedule your exam through the Pearson Vue testing service and pay the examination fee, which is currently around $200. Most states allow you to take the exam within a certain timeframe after graduating from your nursing program.