Registered nurse complete career guide

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A registered nurse (RN) is somebody who has successfully graduated from a nursing program and obtained a nursing license from the authorized licensing body of the country, state, province, or government. Unlike licensed practical nurses, who only assist doctors or RNs, a registered nurse is able to provide direct care to their patients.

Some of the main responsibilities of an RN include administering medication, managing patients, conducting assessments, and helping to schedule operations or procedures. They work alongside doctors and other healthcare members of staff, keeping them updated on any relevant information regarding the patient. Registered nurses can work in most healthcare settings, including hospitals, outpatient clinics, and nursing homes.

To become a registered nurse, you will need to acquire an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). Obtaining a master of science in nursing (MSN) can increase the number of job opportunities available to you. In these programs, you learn about anatomy, microbiology, nutrition, psychology, and chemistry. The main focus is on applying these subjects to nursing practice.

If you are thinking about becoming a registered nurse, then keep reading. We will be discussing everything there is to know about this profession, including the standard salary of RNs, what skills and qualifications you need, and why exactly you should pursue this career.

Why pursue a career as a registered nurse?

There are several reasons why you should pursue a career as a registered nurse, beyond the good salary. For starters, your country needs healthcare workers, especially in light of the coronavirus pandemic. This makes it unlikely that there will be a shortage of jobs for registered nurses, making this career path more reliable than others. Furthermore, becoming an RN allows you to make a real difference in the world and the lives of those around you. If you are somebody with a great deal of compassion, then you will probably find this work highly rewarding. You have the opportunity to connect with patients and their families, helping them in ways that few others can.

Registered nurses do need to be able to keep a level head in stressful situations. People who panic during a crisis will likely not be suited to this profession. The job can also take an emotional and physical toll, so registered nurses need to be robust. If you are a new or single parent, you could struggle with the long hours, hectic pace, and night shifts. However, there are less stressful jobs in nursing available. For example, you might become a clinic nurse, nurse administrator, or school nurse.

How do you become a registered nurse?

We spoke briefly about how to become a registered nurse earlier in this article. Now, let’s break everything down in more detail. For full-time students, it can take anywhere between 2 years to 4 years to become a registered nurse. Inevitably, it takes longer for part-time students. Here is more information on the qualifications you will need to acquire and what happens next after graduating:

Associate degree in nursing (ADN)

To become a registered nurse, you can complete an associate degree in nursing. This program is offered by community colleges across the United States and usually takes 2 years to complete. It focuses on technical training, teaching students how to treat patients, educate patients, and provide emotional support to families. The median wage for registered nurses with an ADN is $71,000.

Note that the main difference between a registered nurse with an ADN and BSN is that the latter has studied for a longer time. As such, they have a greater knowledge of the field and can apply for more specialized jobs. Some employers will not hire RNs with an ADN, preferring them to have a bachelor of science in nursing. People with this qualification are most often hired by hospitals.

Bachelor of science in nursing (BSN)

Most universities in the U.S. offer programs for a bachelor of science in nursing. This degree takes the average full-time student 4 years to complete. If you want to become a registered nurse, we highly recommend earning a BSN, as most employers ask for this qualification. Some of the main things that are studied on these programs include pharmacology, anatomy, pathophysiology, assessment of health and illness, health restoration and maintenance, psychology, and leadership management. As such, a BSN can help you to progress into teaching positions, research, consulting, and administrative roles.

NCLEX-RN Exam

After earning either an ADN or BSN, you will then need to pass the National Council Licensure Examination (NCLEX-RN). This is required to become a licensed registered nurse who can obtain employment. It is a standardized test that is run by the National Council of State Boards of Nursing (NCSBN). Each question is designed to evaluate whether you have internalized the knowledge from your ADN or BSN program, determining whether you are capable of safely practicing. You need to answer a satisfactory number of questions correctly to pass.

Master of science in nursing (MSN)

To further advance your career as a registered nurse, you can also undertake a master of science in nursing. The duration of these programs is 2 years on average for full-time students, but part-time students can take anywhere between 2 to 5 years to complete one. As you can acquire higher-position jobs with an MSN, the average salary of registered nurses with this qualification is $95,000. Some of the most popular jobs include becoming a nurse administrator, advanced nurse practitioner, clinical nurse specialist, or nurse educator.

Doctor of nursing practice (DNP)

Beyond an MSN, you can earn a doctorate of nursing practice which is the highest education degree within the nursing profession. To acquire a DNP, you will need to complete anywhere between 3 to 6 years of study. Most programs ask their applicants for an MSN, too. Some schools do offer courses to post-graduates with a baccalaureate. These courses will take longer than those designed for students with an MSN. The standard salary of registered nurses with a doctorate of nursing practice is $103,000. This varies a little, depending on the profession. For example, psychiatric nurse practitioners earn $113,000, whilst clinical nurse managers earn $104,000.

Registered nurses are usually employed by state, local, and private hospitals. However, they can acquire work in other environments. Ambulatory healthcare services will employ RNs, as will residential and nursing care facilities. Educational services for state, local, or private organizations might also hire RNs with an interest in teaching others about the subject. The government also employs registered nurses.

Salary and demand outlook for registered nurses

Estimated growth in registered nursing was already very high, 12.1% against a national average of 5.3% (2018-2028) – prior to the COVID pandemic. The COVID pandemic served to expose already existing shortages in the U.S. nursing market, and it is thus reasonable to assume that the already aggressive demand increase projections might turn out to be underestimations. We also point out that COVID burnout cannot help with an already high nursing turnover of 7% annually (210,400 registered nurses annually out of a labor pool of 3,059,800). Leaving aside the devastating effects of COVID on nurses, compared to the majority of 2020’s job market, nursing performed well – economically speaking. Annual employment and salary upward trends flattened but remained positive. Perhaps pent-up demand from COVID shortages will lead to a relatively large jump over the next few years.

Future outlook
future outlook tooltip icon

Future Outlook Projections are taken from the Projections Management Partnership (PMP). The PMP is funded by the Department and Labor, Employment and Training Administration, with direct support from the Bureau of Labor Statistics. The PMP provides data-driven projections of future workforce needs.

2,986,500

Registered Nurses total employment

210,400

Registered Nurses annual openings
future outlook tooltip icon

Annual openings include jobs available due to both an increase in demand, and regular employee turnover (retirees, career switchers, etc.).

12.1%

Estimated increase in Registered Nurses jobs (2018-2028)
future outlook tooltip icon

The estimated increase in jobs (2018-2028) is the increase in total jobs expected and does not consider employee turnover.

Very high job growth-0 Very high job growth-1

Very high job growth
future outlook tooltip icon

To provide context to estimated job growth, we employ a “fire and ice” system, which compares projected career growth to the national average of 5.2%, as follows:

<-10% = 3 ices
Btwn -5 to -9.9% = 2 ices
Between -5% to-.1% = 1 ice
between 0- 5.5% = neutral
Between 5.5%-10% = 1 fire
Between 10-20% = 2 fire
>20%=3 fires

At the state level, we simply sort the states from fastest growing to slowest within the particular career, or 1st to 50th.

The fastest growth states

1.

Arizona

+35%

2.

Colorado

+29.5%

3.

Utah

+28.2%

4.

New York

+24.6%

5.

Georgia

+22.5%

6.

Nevada

+22.3%

7.

Maryland

+21.7%

California, Oregon, and Hawaii remain the top 3 spots for nurses from a salary perspective, even when adjusting for the cost of living. Alabama, Mississippi, and South Dakota are currently challenging environments for registered nurses, both due to relatively low average salaries, as well as a high number of nurses compared to the state population. (25.6, 26.7, and 31.9 respectively, against a state average of 22.0).

Registered Nurses salary information by state

Nominal
Real salary
future outlook tooltip icon

The nominal salary is the unadjusted salary paid.

The real salary is adjusted to consider the purchasing power by state. We multiply the nominal salary by a state purchasing parities index to indicate the relative value of salaries by state. For instance, while New York or California might pay the highest nominal salary, these states are relatively expensive and so the real value of the salary is often less than a cheaper to live in state with a lower nominal salary.

BLS
Payscale
future outlook tooltip icon

When available we provide 2020 state level salary information from the Bureau of Labor Statistics showing 10th, 50th, and 90th percentile earnings to provide the range of salary experienced by each career. Salary data is aggregated from the actual reported income of the US labor force, and is considered the most trustworthy data source for salary information.

Payscale is a salary survey service meant to provide employers and employees with salary data at local levels to benchmark and compare. While Payscale has a much smaller sample size than BLS, Payscale does update more frequently so data may be considered fresher. Payscale also indicates salaries at a wider range of roles whereas BLS sometimes aggregates numerous professions into one category which may skew salary data. For this reason, we find Payscale to be a good secondary salary indicator. All information received from payscale is via a paid API. You can read more about payscale and their data methodology here.

Highest salary states

1.

California

$118,410

Average salary

2.

Hawaii

$110,410

Average salary

3.

Oregon

$96,790

Average salary

4.

Alaska

$94,070

Average salary

5.

Massachusetts

$90,290

Average salary

6.

New York

$89,840

Average salary

7.

Washington

$89,650

Average salary

Last five years employment and salary
future outlook tooltip icon

We utilize historic annual BLS salary and total employment statistics to create a trend line which illustrates the job market over time for a particular career.

National

Average Wage Total employment
2016: $68,450 2,857,180
2017: $70,000 2,906,840
2018: $71,730 2,951,960
2019: $73,300 2,982,280
2020: $75,330 2,986,500

The skills you will need as a registered nurse

There is no denying the fact that being a registered nurse is difficult. Not only do you have a lot of responsibility, but the work is also physically and emotionally draining. Additionally, most jobs for registered nurses involve doing night shifts. So, how do you know whether you can successfully undertake this role? Let’s look at some of the main skills that are required.

Organization

Registered nurses need to be highly organized as they juggle several jobs at once. They are also responsible for ensuring patients are provided with the right care. For example, registered nurses will usually have to fill out medical charts for allocating medication. Doing so incorrectly can have dire consequences for a patient.

Communication

You need to have excellent communication skills as a registered nurse. The work involves conversing with colleagues and doctors, transferring information about each patient so the correct treatment plan can be formed for them. Moreover, registered nurses must be able to communicate information to their patients in an accessible way, helping them to stay fully informed. If you are bilingual, then your skills will be highly desired by healthcare organizations, as non-native language speakers are common in hospitals.

Stress management

As we have mentioned several times already, being a registered nurse can be stressful. Wards are often busy and there are always going to be high stakes involved when it comes to patient care. As such, RNs need to remain calm and collected, no matter how strenuous the job might be at times.

Compassion

Registered nurses provide direct care to patients, some of whom are going to be more difficult than others. To effectively care for their patients' mental and physical health, RNs must be compassionate, validating, and non-judgmental.

Attention to detail

Small mistakes can be hugely detrimental in healthcare settings. This means that registered nurses must be detailed-oriented people to ensure that patients are being delivered the correct care. For instance, some patients will be allergic to certain medications, so RNs need to carefully read their medical files.

Critical thinking

Registered nurses are usually critical thinkers. They are capable of recognizing issues with their patients and making the right decisions or judgments. People who are observant, attentive, and analytical tend to succeed in this profession.

Who is best suited to a career as a registered nurse?

Individuals with the above-mentioned skills are well-suited to a career in nursing. It goes without saying that people who want to work remotely should not become an RN. This job is hands-on and cannot be completed online unless you work in an administrative or teaching position. Being a registered nurse is also not very convenient for new parents or single parents because of the shiftwork requirements. However, most people can acquire part-time work as an RN. This is an appealing option as the hours are more flexible and the salary is still decent.

How to advance your career as a registered nurse

If you are already a registered nurse with an ADN or BSN qualification, then you might be looking for different ways to advance your career and move into higher-paying positions. Earning an MSN or DNP is an excellent way to do this. These qualifications can sharpen your existing knowledge of nursing, helping you to access more specialized jobs. For instance, instead of being a nurse practitioner, you can become an advanced registered nurse practitioner with an MSN.

Registered nurses can also partake in advanced nursing programs if they want to further their knowledge in a specific part of the field. Completing one of these programs is a fantastic way to develop your resume and improve your chances of securing work in your area of interest. For example, there are programs for health informatics, family nurse practitioners, nurse educators, researchers, and administrators.

American Nurses Association (ANA) 

ANA advances protects and represents the interests of nursing professionals.