Be a Nurse

Nursing shortages are common.[1] 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.

Steps

Starting Out

  1. 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. To get into a good nursing school, you need decent grades as well.
    • Many nursing schools require a pre-entrance exam to be accepted into the nursing program as well. Many schools offer different programs, but know that all require prerequisite courses. Typical prerequisite courses have up to four years required from high school and college of English, math, science, social studies, and possibly even a couple years of a foreign language.[2]
  2. Get an entry-level job in the healthcare arena. While not always mandatory, some schools do require previous healthcare experience in order to be accepted to their program.[2] 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.
    • When you are CNA before a nurse, it gives you a good stepping stone into the healthcare world, and your future nursing coworkers will appreciate that you were an aide before a nurse.
    • Even volunteering at a local hospital or doing admin work at a clinic looks great on your resume and exposes you to the environment. If you like the hospital environment, you’ll have a better idea of the realities of nursing as a career. The more experience you have in this setting, the better—regardless of what kind of experience it is.
    • Some may find that performing the aide work makes them realize nursing isn’t for them as well.
  3. Decide if becoming an LPN/LVN 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 do the basic essential care of the patient, pass medications, and report the status of the patient directly to the Registered Nurse (RN) or the doctor, usually under the supervision of an RN.[3] They're still nurses, just with less autonomy. Most nurses can become LPNs in around 18 months.[4]
    • LPN/LVNs take the NCLEX-PN examination, as opposed to the NCLEX-RN examination.[5]
    • Recent trends in the profession have shown LPNs fading out of the hospital setting and into long-term care facilities and offices.[6]
  4. Decide if becoming an RN is right for you. RNs focus on the pathophysiology behind it all. Normally, there is an RN in “charge” of the LPNS, but along with that, the RN is responsible for the LPN’s patients. Therefore, the LPN and RN need to understand and communicate with each other often for the safety of the patient.
    • The RN must think critically on the job rather than simply performing tasks. Analyzing lab results, passing medications, educating patients why they take medications, performing plans of care, and supervisory roles are often part of the RN’s job.[4][7]
  5. Decide which program best suits your needs. Becoming a nurse is easier than ever with online school and weekend options. The work is still difficult, but the flexibility is now available. Some programs are exclusively online. This may be ideal for those with families. Some students need a classroom setting to learn and benefit from that environment. Different options are available for each type of nurse.
  6. Look into LPN programs. There are programs that are accelerated for LPNs. Look into your specific state for accredited programs, as well as the pass rates for their students on the NCLEX-PN.[8]
    • For most, this is just a pit stop on the way to being an RN. If that speaks to you, talk to your school about their ADN or BSN program. They may have an LPN designation built in once you're halfway through. Otherwise, know that you can become an LPN after approximately eighteen months or so of training (mostly through hospitals or community colleges).
  7. Look into RN programs. The typical route to becoming an RN includes an Associate’s Degree in Nursing (ADN) followed by a Bachelor of Science in Nursing (BSN). There is a recent push for RNs to have their BSN over an ADN degree. The BSN degree focuses more on the research in nursing. Nurses also have more prospects with a BSN as many employers require new nurse applicants to have it.
    • You can expect to spend two-to-three years obtaining an ADN and a BSN is a full, four-year degree for a full-time student, which means the BSN is a much more expensive option.
    • Both degrees allow recipients to sit for the NCLEX exam upon graduation.[5]
    • The leap in RN-to-BSN programs offered has grown more popular in recent years, a 22.2% leap between 2011 and 2012.[9]
    • Getting your BSN allows you to eventually pursue leadership positions, teach nursing students, lead the administrative side, etc. Having a four-year degree at all in today's society is invaluable as well.[10]
  8. Consider alternate routes. A couple of other routes exist for becoming a nurse as well.
    • Nursing 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.[11]
    • 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.[12] Some states even have special designations for this.
  9. Apply to a nursing school. 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. You will have to decide if you want to take full- or part-time classes, how much you can spend, if you want to live in campus, and if you want to take any of the classes online.
    • Be aware that the widely known nursing shortage has led to long waiting lists at some schools.[13] It's best to inquire about this before you set your heart on one.
    • If you already work for a hospital, see if any programs are affiliated with it. You may receive discounts if so.
  10. 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. On-the-job experience is always a perk as well.
    • If you can, get letters of recommendation from people who also work in healthcare. Ask the professional reference in person rather than by email. If you do not work in healthcare, request a recommendation letter from someone else who knows your work ethic and desire to become a nurse.[14] Ask in advance. Don’t rush the person.
    • On the essay, don't write about what you think is a good answer; write what you believe. Using words from the heart will make you stick out from other applicants.[15]

Studying and Getting Licensed

  1. Be a top-notch student. You'll be studying anatomy, physiology, microbiology, chemistry, nutrition, psychology, and other social and behavioral sciences.[16] Prepare to spend a lot of time studying hard to do well in such intensive courses.
    • If you need inspiration to study, remember that people's lives will be in your hands once you’re a nurse. If you need more motivation, remember that the graduation exam costs $200 to take each time. If you fail it, you can't take it for another 45-to-90 days.[17]
  2. Ace your clinicals. Clinicals are part of your education, but they’re out of the classroom and in the action. If you are a hands on learner, you'll really enjoy clinicals. Most clinicals are done in replacement of a school day and last throughout the entire nursing program. They focus on a specialization, such as medical-surgical, pediatrics, maternity, or psychiatric. You will learn many skills here, but you have to be willing and ready to learn.[18]
    • Clinicals are a normal working day, except not paid like residents in a medical-degree program.
    • It's normal to be stressed during clinicals.[19] After all, you're working with real people, and you're still a newbie. Everyone goes through this, and the feeling does go away. Continue to study and seek out opportunities.[18]
  3. Prep for the NCLEX-RN. The exam is also known as “the boards.” It's a series of questions (between 75 and 265[20]) that will test your knowledge in a variety of different domains. You're given five 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.
  4. Pass the exam and get licensed. The best way to pass is to study hard and get plenty of sleep between studying. Know that 81% of candidates pass on the first try, so you have a great chance if you come prepared.[21]
    • Consider taking advantage of one of the prep courses available to help with studying the possibly overwhelming amount of information.[22]
    • The average number of questions is around 125, and the average test takes about 2.5 hours.[23]
  5. Look for employment in your desired department. Most nurses will have an idea where they want to work by this point. You may enjoy the adrenaline rush of the ER, the focus of the OR, working with kids in pediatrics, working with babies in labor and delivery, working with the elderly and long-term care patients, etc. If you're unsure, a medical-surgical unit will help with solidifying skills and prioritization.[24]
    • 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. If you do choose to go into pediatrics, you'll be faced with a lot of situations that just aren't fair.[25] There are a few options in the pediatric area, including general pediatrics, pediatric intensive care units, pediatric oncology units, and home care for pediatrics.
    • Mother/baby units can be very difficult to get into. Everyone wants to work with patients who are happy, excited, and healthy. Remember, these areas are also very high stressed with two lives in your hands at one time. When it is sad in these units, it’s very sad.
    • If you do get into this unit, be ready to commit to a night shift job for many years because most nurses who work in OB do not leave.
    • 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. Otherwise prepare for the possibility of working night shifts.[26]
  6. Consider your ideal work environment. 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, in nursing homes, etc.
    • There's also the option of Become a Traveling Nurse.
    • Many places have nurses working third shift, on-call, or on standby. Your ideal environment may also allow you to choose between eight-, ten-, or twelve-hour shifts. Floating between different departments may also be an option.
  7. Apply for jobs. 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.[27]
    • However, some places do prefer new grads (they cost less money), and the need for nurses is still booming.
    • Practice interview questions often and be prepared for anything.[28] Ask about your potential employer's turnover rate as well. If its 20% or higher, it may not be the place for you to start.[29]
    • Ask to shadow a day or two before you decide you want to work there. The attitudes of your fellow coworkers may have an impact on your decision.[30]
    • Ask about guidance. Expect that you will have training with a preceptor. It depends what unit you work on, but you will get trained. Most orientation programs last between 6-12 weeks.[31]

Advancing Your Career

  1. Get specialized. After X number of hours in your department, there's probably some certification you'll be able to get. Achieving a certificate makes you look like an expert in your field and may open doors for more opportunities. Your hospital should offer you a course, seminar, or training class to certify you in this area.[32]
    • Some available certifications include: Ambulatory Care, Cardiac-Vascular Nursing, Faith Community Nursing, Forensic Nursing, Genetics Nursing, Gerontological Nursing, Hemostasis Nursing, Informatics Nursing, Medical-Surgical Nursing, Nurse Executive, Nurse Executive - Advanced, Nursing Case Management, Nursing Professional Development, Pain Management Nursing, Pediatric Nursing, Psychiatric–Mental Health Nursing, Public Health Nursing - Advanced, Rheumatology Nursing, etc.[32]
    • With that should come a slight increase in pay, and certifications look great on a resume. If the opportunity comes, take it!
    • You need so many hours on the floor of that department before you're even eligible for these certifications. Think of it more as a badge of honor instead of as a specialization or certification.
  2. Be mentally ready. Nurses have to face many difficult situations. 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.[33]
    • Many institutions have groups for when incidents happen on units. These groups help debrief situations and are supportive emotionally to the staff.
    • The schedule of a nurse can be pretty intense. You could work three twelve-hour shifts in a row before getting four days off. If you're working overtime, it could be more. It could also mean night shifts. You may even be on-call on your days off as well. Sleep may not be your constant companion. Stay aware of your schedule and avoid any states of fatigue.[34]
  3. 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 is still your professional responsibility to be up to date on your current certifications. Every department will have requirements for your job. Common requirements are basic life support, advanced cardiac life support, and others specific to your department of choice. For labor and delivery, for example, BLS, ACLS, neonatal resuscitation, and fetal monitoring are often required.
    • 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 Nurse Licensure Compact Agreement, allowing each other's nurses to work within their boundaries. Currently it's at twenty-four states and counting.[35]
    • 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.[36] By searching the internet for your state’s requirement, you will find specific website for your state’s board of nursing.[37]
    • Unless you lapse in renewal, you will never have to retake the NCLEX.[36]
  4. 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 one or two 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 pursue a joint BSN/MSN in two-to-three years. You will have to meet additional certification and licensure requirements. However, it's certainly worth looking into with the 27% higher average salary when compared to regular RNs. In 2011, ADNs earned about $64k while BSNs earned $76k.[38]

Tips

  • Clinical experience is often provided in a hospital setting, but can also occur in clinics, nursing homes and health departments.
  • Several entities provide credentialing, including the National League for Nursing and the American Nursing Credentialing Center.
  • Salaries and opportunities for advancement are highest for four-year Registered Nurses.
  • Nursing programs must be accredited by the National League for Nursing Accrediting Commission.[39]

Related Articles

Sources and Citations

  1. ↑ http://ppn.sagepub.com/content/7/3_suppl/34S.short
  2. ↑ 2.0 2.1 http://www.nursingschoolspath.com/typical-nursing-program-prerequisites.html
  3. ↑ http://nursinglink.monster.com/rn-jobs/articles/3674-find-your-path-to-the-rn-title
  4. ↑ 4.0 4.1 http://www.practicalnursing.org/considering-lpn-school
  5. ↑ 5.0 5.1 https://www.ncsbn.org/nclex.htm
  6. ↑ http://www.nursezone.com/nursing-news-events/more-news/Are-LPN-Jobs-Moving-Outside-the-Hospital_26658.aspx
  7. ↑ http://www.allnursingschools.com/nursing-careers/article/registered-nurse-vs-licensed-practical-nurse/
  8. ↑ http://www.practicalnursing.org/considering-lpn-school#how-do-i-choose-a-good-lpn-program
  9. ↑ http://www.aacn.nche.edu/news/articles/2012/enrolldata
  10. ↑ http://www.rn.ca.gov/careers/steps.shtml
  11. ↑ http://www.discovernursing.com/starting-out#.UlceqJxhHZc
  12. ↑ http://www.schools.com/visuals/how-to-become-a-nurse-practitioner.html
  13. ↑ http://nursinglink.monster.com/education/articles/3676-choose-the-nursing-school-that-fits-you
  14. ↑ http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=1493957
  15. ↑ https://www.essayedge.com/medical/editing/nursing/nursing-school-admission-essay/details
  16. ↑ http://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-4
  17. ↑ https://www.ncsbn.org/2321.htm
  18. ↑ 18.0 18.1 http://magazine.nursing.jhu.edu/2010/11/group-think/
  19. ↑ http://nursinglink.monster.com/education/articles/3678-complete-your-rn-program
  20. ↑ http://www.learn4good.com/nursing/how_to_become_a_nurse.htm
  21. ↑ https://www.ncsbn.org/3826.htm
  22. ↑ http://classroom.synonym.com/nclex-online-review-courses-2563.html
  23. ↑ https://www.ncsbn.org/2323.htm
  24. ↑ http://www.medscape.com/viewarticle/744221_3
  25. ↑ http://blog.soliant.com/careers-in-healthcare/is-pediatric-nursing-right-for-you/
  26. ↑ http://nursewithoutborders.org/survival-tips-nurses-working-night-shift/
  27. ↑ http://money.cnn.com/2013/01/14/news/economy/nursing-jobs-new-grads/index.html
  28. ↑ http://journals.lww.com/nursing/fulltext/2003/01001/65_interview_questions_for_nurses.13.aspx
  29. ↑ http://nursinglink.monster.com/education/articles/3679-consider-possibilities-for-your-first-job
  30. ↑ http://www.americannursetoday.com/tripping-over-the-welcome-mat-why-new-nurses-dont-stay-and-what-the-evidence-says-we-can-do-about-it/
  31. ↑ http://ajcc.aacnjournals.org/content/19/2/184.full
  32. ↑ 32.0 32.1 http://www.nursecredentialing.org/certification.aspx
  33. ↑ http://www.jstor.org/discover/10.2307/3461343?uid=3739560&uid=2129&uid=2&uid=70&uid=4&uid=3739256&sid=21106531292533
  34. ↑ http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1239110
  35. ↑ https://www.ncsbn.org/nlc.htm
  36. ↑ 36.0 36.1 http://www.rn.ca.gov/applicants/reinstate8yr.shtml
  37. ↑ http://www.nursingcenter.com/lnc/journalarticle?Article_ID=636579
  38. ↑ http://www.elearnportal.com/resources/careers/rn-vs-bsn-pay-difference
  39. ↑ http://nlnac.org/

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