Guide to getting an associate degree in nursing (ADN)
The English social reformer Florence Nightingale is credited with laying the foundation of nursing as a professional practice. Nightingale was raised in a well-off British family, but instead of pursing marriage and family life, had a strong calling towards serving the sick. Despite being raised Protestant, she received training from Catholic nursing sisters in France. Upon learning that the mortality rate among British troops fighting in the Crimean War was 41%, often due to disease rather than injuries, she used her political influence to gain permission for herself and a group of upper-class women to travel to Crimea and care for sick and wounded soldiers there.
Although knowledge of the harmful effects of microorganisms such as bacteria was scarce at the time, Nightingale’s focus on scrubbing barracks and hospitals wards clean and letting in fresh air and sunshine nevertheless led to significant reductions in mortalities among soldiers. She used her knowledge of statistics to keep track of the positive effects of her methods, thereby becoming one of the first evidence-based healthcare practitioners. She eventually established the Nightingale School of Nursing, which became famous the world over.
Inspired by Nightingale’s work, social activists around the world sought to improve nursing education The first permanent school of nursing in the U.S. was most likely the nurse training school of the Women’s Hospital of Philadelphia, established in 1872. The school followed Nightingale’s model, introducing a set curriculum, paid teachers, nursing equipment, and practical experience in local hospitals.
Today, nursing a highly regulated professions. Nurses usually earn an associate or bachelor’s degree, complete the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, and gain state licensure before they can practice as a registered nurse (RN). A career in nursing often appeals to level-headed, compassionate, and tenacious individuals. Nurses continue to be in high demand. In 2020, more than 20% of surveyed nurses stated they were planning on retiring in the next 5 years. They are also an ageing group – with the median age of RNs being 52 years, up from 51 years in 2017.
The 4 main types of nurses are:
- licensed practical nurses (LPNs), also known as licensed vocational nurses (LVNs)
- registered nurses (RNs)
- advanced practice registered nurses (APRN)
- nurse practitioners (NP)
An associate degree in nursing (ADN) is often the quickest route to becoming a registered nurse.
For the 20th year in a row, results from the 2021 Gallup Most Honest and Ethical Professions poll place nursing in the highest position: 81% of Americans rated the honesty and ethical standards or nurses as “very high” or “high.”
ADN program basics
The ADN is often pursued by those wishing to enter the nursing profession as quickly as possible. It is a professional degree, meaning it provides hands-on training. Associate degrees are generally earned at community colleges, although they are also available at some 4-year colleges and universities. Certain hospitals also offer ADN programs.
In all 50 states, it’s possible to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam and become a registered nurse with an associate degree. The ADN degree is sometimes also referred to as an ASN (Associate of Science in Nursing) or an AASN (Associate of Applied Science in Nursing).
What can you do with an ADN?
The main career path following completion of an ADN is becoming a registered nurse (RN). Changes to nursing licensure may be on the horizon, however. New York State passed the “BSN in 10” law in 2017, which allows nurses to become registered with an associate degree but requires that they earn a bachelor of science in nursing (BSN) within 10 years of their initial licensure to continue practicing. Similar laws are being discussed in other states, although ongoing nursing staff shortages likely mean that maintaining multiple entry points into nursing will remain important.
Should you choose to eventually pursue a BSN, the ADN is still an excellent initial pathway into nursing practice. It is the quickest route to becoming an RN, and may be a particularly good option if you would like to try your hand at nursing before committing to a 4-year BSN. With an ADN, you could, for instance, complete an RN-to-BSN bridge program after a few years of professional nursing. By transferring credits from you ADN, such a program would take significantly less time than starting a BSN from scratch.
Should you get an ADN?
If you want to become a registered nurse, earning an ADN is an excellent place to start. ADN programs are designed to equip you with the medical knowledge and practical skills you need to deliver patient-centered care in healthcare settings like hospitals and nursing homes.
The above is a short-term comparison between the entire Associate degree market and the ADN. It is a snapshot of earnings 2 years after graduation.
ADN nurses earn a significantly higher salary than the average associate degree holder. This is likely because an ADN is a unique professional degree that enables you to begin work as a registered nurse without further schooling. The same is not true for many associate degree programs, which generally require further education, such as transferring to a bachelor’s degree, before you can specialize in a profession related to your degree.
The payback period is correspondingly shorter for an ADN than an average associate degree – requiring 1.1 years compared to 2.9 years, respectively.
How to pick an ADN program
An important first consideration when choosing an ADN is that the program is accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). This ensures that the degree meets national academic standards. Enrolling in an accredited program also qualifies you for federal financial aid and future licensure, as well as assuring future employers that you have the skills and training needed to practice in the field. In fact, you may not be able to take the NCLEX-RN exam and become a licensed RN with a degree from an unaccredited school.
ADN programs don’t usually offer as many specialization options as BSN programs, due to their shorter time frame. With an ADN, you can further specialize in fields such as pediatric nursing, medical surgical nursing, or psychiatric mental health nursing by pursuing additional certification through the American Nurses Credentialing Center.
Louisa May Alcott, author of Little Women, was a volunteer nurse for the Union Army. Hospital Sketches, a book she wrote in 1863 based on her experiences, raised public awareness of the work nurses were doing in military hospitals.
Can you earn an ADN online?
The above table shows the percentage of programs available either completely in person or fully online. Figures that do not add up to 100% indicate the existence of hybrid programs.
Compared to other associate degrees, nursing programs are very rarely offered online. In fact, there are significantly more BSN than ADN online programs (20.6% and 1.4%, respectively). Accredited programs advertised as online likely nonetheless include in-person clinical hours, as these are required for licensure as an RN. For this reason, be wary of programs advertised as 100% online.
How much does an ADN cost?
Vermont, Utah, and New Hampshire have some of the most expensive ADN programs in the country, with programs in Vermont costing almost twice the national average. South Carolina, Michigan, Mississippi, Georgia, and Texas offer some of the most affordable ADN programs.
See above how cost and earnings vary depending on the type of institution. Payback refers to how many years it takes students to cover the median costs while earning the median salary. Payback is calculated by subtracting the median earnings of a high school graduate from the median earnings related to this degree.
ADN programs at public institutions cost significantly less than at private ones, while offering similarly high earnings, and a significantly faster payback period.
Financial aid and scholarships for ADN students
As with most degree programs, the first steps in applying for most types of aid involve filling out the FAFSA form on the Federal Student Aid website. Arrange a meeting with the student financial aid service at your chosen college to uncover options that are provided by the school, or that you may be unaware of.
Loan forgiveness for BSN programs
Many nursing programs are also eligible for loan forgiveness programs, including:
- Nurse Corps Loan Repayment Program (NCLRP) – The Health Resources and Services Administration supports nurses by paying up to 85% of their nursing education debt. Registered nurses, advanced practice registered nurses, and nurse faculty are eligible after working for at least 2 years in a Critical Shortage Facility (CSF).
- Public Service Loan Forgiveness Program (PSLF) – PSLF forgives the remaining federal loans after a minimum of 120 qualifying monthly payments (approximately 10 years) while working full-time for a qualifying employer. Qualifying employers are usually government and nonprofit organizations.
- State-level Loan Forgiveness for Nurses – Each state offers some form of loan forgiveness for nurses, so it is a good idea to look into the details for your state. Eligibility, residency, and work commitment requirements vary. You can find more information on individual state webpages.
Scholarships for ADN programs
What to expect from an ADN program
On average, associate degrees in nursing take 2 years to complete, although some programs take as little as 18 months. The coursework in an ADN is designed to equip you with the practical skills and medical knowledge you need to work as an RN.
The National League for Nursing has identified the following core competencies for graduates of nursing programs:
- human flourishing
- nursing judgment
- professional identity
- spirit of inquiry
Associate degrees in nursing are more general than BSNs, meaning that they do not come with special concentrations like neurology or palliative care. The focus is usually on applying science to nursing practice. Some of the main skills learned in an ADN program include:
- assisting physicians during medical procedures
- dressing wounds
- running diagnostics tests
- reviewing patient treatment plans
- educating patients on self-care
What are the admission requirements for an ADN?
Keep in mind that ADN programs are quite competitive. Along with a high school diploma or GED, you may need to demonstrate having successfully completed high school coursework in biology, chemistry, and math.
Other common requirements include:
- a “proficient” competency level or higher on the Assessment Technology Institute Test of Essential Academic Skills (ATI TEAS)
- a GPA of 2.0 or higher or even 3.0 or higher if certain college-level prerequisite courses have not been completed
- transcripts, letters of recommendation, and a personal statement or essay
- additional factors such as first aid and CPR training or volunteer experience may improve your chances of getting accepted
Internships and clinical rotations
Accredited ADN programs incorporate clinical experience into nurse training. Trainee nurses in clinical rotations assist low-level procedures and circulate through different hospital departments, gathering practical, real-world training in preparation for entering the workforce as skilled and experienced nurses.
To take the NCLEX-RN, an associate’s or bachelor’s degree in nursing from an accredited program are required. Accredited ADN programs thus prepare you for this exam.
What type of courses are there in an ADN?
Most ADN programs require core coursework in foundations of nursing, microbiology, chemistry
behavioral health, English, and communications.
Foundational courses often include:
This course focuses on the procedures, theories, and skills related to nursing care of adults and older adults. Clinical evaluation and the use of evidence-based nursing interventions are studied, as well as how culture and socioeconomic context impact needs and care.
This course covers key concepts of professional nursing responsibilities, with a focus on nursing practice in diverse healthcare settings with patients across the lifespan.
This course explores the factors that impact patients’ wellbeing. The effects of stress and complex mental health issues on patients and their families is studied, in addition to the complexities of mental health nursing approaches.
For much of the 20th century, nursing schools in the U.S. only accepted women. This was declared unconstitutional in 1982, when a judge ruled that the single-sex admission policy at a nursing school violated the 14th Amendment. The number of male nurses has more than tripled since the 1970s.
What careers can I have with an ADN?
Registered nurses work under the supervision of the patient’s physician to coordinate and deliver their care. They are often the first point of contact for family members, and they are instrumental in providing patients with instruction on managing their injury or health concerns at home.
District of Columbia
- supervising LPNs, CNAs, and other healthcare personnel with fewer credentials
- consulting with other members of a patient’s care team and coordinating duties
- helping patients prepare for medical tests or surgery
- adjusting treatment plans based on how the patient responded to previous interventions
- monitoring patients’ diet, physical activity, and medication schedules
- taking vital signs and administering medication
- helping doctors and testing technicians perform diagnostic tests
- helping perform diagnostic tests such as MRIs or blood tests
- monitoring and operating several types of medical equipment, e.g., heart rate monitors
How to become
RNs earn an associate degree in nursing (ADN) or a BSN. After earning their degree, nursing students pass the NCLEX-RN exam. Depending on the employer and position offered, they may also need certification in basic life support or cardiopulmonary resuscitation (CPR).
Outpatient nurseMedian salary: 67K US$
These types of nurses work in outpatient, or what are sometimes called ambulatory healthcare settings. These are hospitals and other facilities where patients seek treatment and minor surgeries or procedures and usually go home the same day. Outpatient nurses are responsible for taking patient histories, performing some diagnostic tests, administers medication, and developing patient care plans in collaboration with other medical professionals.See more
Physician’s office nurseMedian salary: 58K US$
These types of nurses are usually employed in private doctor’s offices. They are responsible for patient intake, assisting physicians with examinations and routine treatments, and training and assisting lower-level nurses with complex patient issues and procedures. They may also perform some routine patient procedures, including administering vaccines and taking biological samples such as throat swabs.See more
An ADN is one of the 2 primary paths to becoming a registered nurse. It is usually an 18-month to 2-year journey that offers a wide range of career possibilities and work environments upon graduation. As an RN with an ADN, you will be equipped to care for patients of all ages. This means being able to work directly with patients as a healthcare professional, earning a good salary, while also having the opportunity to pursue a BSN or other advanced credentials in the future should you choose to do so.
ADN nurses are typically focused on technical clinical tasks and day-to-day patient care. For those interested in expanding their range of options and entering leadership roles, spearheading broader initiatives within a healthcare institution, or educating future nurses, pursing an RN-BSN program a few years down the line may be the right option.
Frequently asked questions
Should I get an ADN or a BSN?
While an ADN is the quickest and most affordable path to becoming a BSN, and offers many career options, a BSN could mean more opportunities and better pay. Luckily, the ADN leaves doors open for finishing an accelerated BSN a few years down the line should you choose to do so.
Can I complete an ADN part time?
Part-time ADN programs available, usually taking 3-4 years to complete. These may be a good option if you are juggling a full-time job, childcare, or other demanding responsibilities while studying.
What is the difference between an RN and a BSN?
Sometimes, nurses are referred to as RNs (registered nurse) and BSNs (registered nurse with BSN) to distinguish between their levels of education. This terminology is not official and refers to whether a nurse holds an ADN or a BSN.
What is the difference between an RN, LPN, and an LVN?
The title LVN is used in Texas and California, while LPN is used in the remaining states. LPNs and LVNs both have to pass the NCLEX-PN to practice nursing, and work under the supervision of RNs and physicians. However, they are not required to hold an ADN or BSN degree.
AACN is the voice for nursing education. They establish quality standards for academic nursing, influence the nursing profession to improve healthcare, and promote public support for professional nursing education, research, and practice. AACN represents nearly 840 member schools at public and private universities nationwide.
ANA is a professional organization that looks to protect and further nursing as a vocation and career. They have many resources for both registered nurses and students alike. Joining ANA also gives nurses the chance to connect with other professionals across the country.
NSNA brings together student nurses to help them prepare for licensure and entry into the career. They also promote the development of skills and standards that will further the nursing profession as a whole and can offer scholarships and other forms of mentorship to their members.
With more than 170,000 members in the U.S., the NNU is the largest union for nurses in the country. It was founded in 2009, following the unification of 3 other organizations – including United American Nurses – and protects and advances the interests of nurses and patients alike. Registered nurses should strongly consider joining this union.