How Do I Become a Nurse?


© 2007-present by Kathy Quan RN BSN PHN All Rights Reserved

While job prospects have diminished in many fields since 2007, healthcare has continued to grow. With the nursing shortage predicted to get worse as the economy strengthens, and many Baby Boom nurses are finally able to retire, jobs for nurses should once again become abundant throughout the world.

Unfortunately, along with the shortage of practicing nurses comes a Catch 22 shortage of nursing educators. Therefore, nursing programs have been difficult to get into, and many still have waiting lists. The wait is worth it. Wages will continue to increase, and experienced nurses will be in high demand for years to come. There are a number of excellent schools without waiting lists.

Begin with a CNA
You may want to begin your career as a nursing assistant or aide. Also known as a CNA This requires a short course of study, and is usually available from your local adult education department or community college system. In some instances, it may give you an advantage in getting into a nursing program as well. (For some nursing programs it is required.) It also provides you with a source of employment while you pursue your nursing career, as well as practical experience and direct insight into the world of nursing.

Surgical Technician
There are other programs such as becoming a Surgical Tech which don’t require you to become a nurse first, but can lead into a path towards nursing. Often these programs are available through technical schools or adult education programs.

Licensed Practical or Vocational Nurse
Moving on up the career ladder, you may choose to become and LPN/LVN (Licensed Practical or Vocational Nurse). This is generally a one-year to eighteen-month course of study typically from a vocational school or community college. Upon completion, the LPN/LVN takes nursing boards through the NCLEX (National Council Licensure Examination) program and upon passing is granted a license through the state where the board exam is taken. The LPN/LVN works under the direct supervision of a physician or an RN.

Note: In California and Texas the practical nurse is known an LVN, and in the other 48 states LPN is the title. Around the world there are many other titles for the practical nurse.

The LP/VN role has been known for many years as "the practical or bedside nurse," but it has been expanding in recent years. Once theses nurses provided bed baths, back rubs, and performed procedures such as dressing changes and enemas. Medication administration once required extra courses as did phlebotomy. Now they are part of the education and IV's are being added to the list as well.

Since 2000 however, many hospitals have eliminated the LP/VN position and strictly use RNs and either CNAs or unlicensed patient care assistants. This was done with a push towards requiring RNs to have bachelor degrees and to therefore elevate the level of nursing education across the board in hospitals. However, with the shortage of RNs, some facilities have had to re-hire LP/VNs to fill vacancies. LP/VNs have been limited to other employers such as skilled nursing facilities, assisted living facilities, clinics and physician's offices.

Many LP/VNs enjoy their roles as the more task oriented nurse and choose to provide direct patient care without the added responsibilities of an RN. However, it is not uncommon for students to choose to become an LP/VN as a means of support as they pursue their RN (Registered Nurse). Some RN schools offer course credit to LPNs or allow you to challenge some courses through exams. It certainly adds to the value of a nursing student for admission criteria. This practice of giving course credit is not as common as it once was, however, with the shortage of nurses reaching crisis levels in some locations, we may see more of this again.








Registered Nurses
For RNs there are more choices to be made in regards to levels of education. Historically, hospitals offered three-year diploma courses where students lived and worked in the hospital while they earned a nursing diploma, and then sat for their boards to become RNs. As nursing roles expanded far beyond the realm of hospital nursing, these programs began to close. Today, very few remain, and most of those are affiliated with 2-year (Associate’s Degree) programs.

ADN vs BSN
The two most popular RN programs are the ADN (Associate Degree Nurse) and the BSN (Bachelor of Science Nurse). The ADN course is typically a two-year degree program from a community college, and the BSN a four-year program from a college or university.

The ADN program is often focused more on practical applications of nursing where as the BSN program expands into the theoretical realms of patient care. Most institutions pay on a scale based on level of education as well as experience.

In recent years there has been a big push to mandate the BSN as the minimum requirement to be a professional nurse. Sound arguments both for and against this have been well presented, and thus it is still being debated and likely to continue. The nursing shortage is playing a big role in the practicality of this. However, for professional advancement in particularly management , the BSN is usually required.

After graduation from any of these courses of study, nurses all sit for their boards to become Registered Nurses. This exam is known as the NCLEX-RN.

In choosing any nursing program is important to make sure it is accredited by the National League for Nursing Accrediting Commission (NLNAC). This ensures that you will be able to sit for your boards. Not all schools are accredited, and can delay your licensing process.

Advanced Degree RN
There are also many advanced degree options including Nurse Practitioner (NP) programs, as well as Masters and Doctoral degree programs with various areas of focus, specialization and practice. Most management and educational positions require advanced degrees.

A great resource for nursing programs is Nursing Programs 2016 (Peterson's Nursing Programs) also available at local libraries, high school and college career centers, and for purchase from most large bookstores.

Make Sure it's Accredited!
There's nothing more heartbreaking than spending time and money to obtain a nursing education and then to find out you can't take the NCLEX and practice as a nurse because the school wasn't appropriately
accredited. Yes, there are unscrupulous folks out there. If it sounds too good, it's probably not accredited. And some states may accredit a program while others will not. This can be especially true of online nursing programs.

Additional Reading:
How to Finance Your Nursing Education
How to Find an LPN program
How to Find an Accredited Nursing Program
Entrance Exam Information