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Your path into nursing in the United States, step by step

By Megan Hollis · Updated on

Female nurse in teal scrubs walking down bright empty hospital corridor

You know you want a hands‑on health career that matters. Nursing offers clear entry points, from bedside care to advanced practice, in hospitals, clinics, and community settings. This page walks you through the decisions you need to make — which license to pursue, which program fits your life, how accreditation works, how the NCLEX and state licensure fit together — and points you to trustworthy sources at each step.

What kind of nurse do you want to be?

  • Licensed practical/vocational nurse (LPN/LVN): Entry‑level bedside care after a state‑approved practical nursing program; licensure uses the NCLEX‑PN, which all U.S. boards of nursing accept as part of initial licensure, according to the National Council of State Boards of Nursing.
  • Registered nurse (RN): Direct care plus coordination, education, and leadership across hospitals and community settings. The U.S. Bureau of Labor Statistics (BLS) describes typical RN roles and settings in the Occupational Outlook Handbook for Registered Nurses.
  • Advanced practice registered nurse (APRN): With graduate education and national certification, many RNs advance to nurse practitioner, nurse‑midwife, nurse anesthetist, or clinical nurse specialist roles; these are outlined in the BLS RN profile and in academic guidance from the American Association of Colleges of Nursing.

If you are still comparing broader health roles, you can also look at nearby options such as a medical assistant career, a physical therapist assistant career, or roles covered in our overview of fastest growing healthcare jobs.

Which education pathway fits your timeline and goals?

  • LPN/LVN programs: Usually one academic year at a career/technical school or community college, ending in eligibility for the NCLEX‑PN as noted by the NCSBN.
  • RN programs: You can become an RN via an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). The AACN supports academic progression and encourages BSN preparation and seamless ADN‑to‑BSN pathways, while recognizing multiple entry points into the profession (AACN position on academic progression; see also AACN’s note on ADN programs and articulation).
  • APRN preparation: Graduate programs (MSN or DNP) build on the RN license and lead to national certification and state APRN licensure, described by the AACN’s DNP overview.

How do accreditation and state approval work?

For RN and graduate programs, the Commission on Collegiate Nursing Education (CCNE) accredits baccalaureate and higher degrees, and is recognized by the U.S. Secretary of Education; details are outlined by the AACN/CCNE. Many practical, diploma, associate, and higher‑degree programs are accredited by the Accreditation Commission for Education in Nursing (ACEN), which explains its scope in its FAQ. Accreditation is separate from your state board’s approval, but both matter for eligibility to take the NCLEX and to be licensed.

If you decide another oral‑health path suits you better, compare training and earnings for a dental hygienist role.

What tests and licenses do you need?

  • The exam: After a state‑approved program, RN candidates take the NCLEX‑RN and LPN/LVN candidates take the NCLEX‑PN. All U.S. boards of nursing use these exams as part of initial licensure, per the NCSBN. Registration is managed through your nursing regulatory body and Pearson VUE, as described on the NCLEX registration page (how NCLEX registration works).
  • Your state license: Each state board sets application steps (education verification, background checks, fees). NCSBN provides a central hub with board links and licensure guidance to help you find your state’s exact requirements (Nurse Licensure Guidance).
  • Working across states: If your primary residence is in a Nurse Licensure Compact (NLC) state and you qualify, you may be issued a multistate license that authorizes practice in other compact states without additional licenses. See NCSBN’s page on licensure compacts and the NLC.

For a walkthrough tailored to new students, you can also read our step‑by‑step take on getting into nursing.

A practical sequence you can follow

  1. Decide your first license goal (LPN/LVN, RN, or APRN) based on how soon you want to practice and where you want to work. The BLS profile for Registered Nurses shows the breadth of RN roles and settings.
  2. Make a shortlist of state‑approved, accredited programs that fit your timeline and budget. Check CCNE‑accredited programs through AACN/CCNE and ACEN‑accredited options via ACEN’s resources (CCNE information; ACEN scope).
  3. Apply and complete prerequisites (chemistry, anatomy/physiology, microbiology, and general education are common for RN programs), which the BLS notes as typical nursing curriculum components in its RN overview.
  4. Graduate and apply to your state board for licensure eligibility; register for and pass the NCLEX appropriate to your license per NCSBN and NCLEX registration.
  5. Start working, then consider advancement (e.g., RN‑to‑BSN, MSN/DNP) following guidance on academic progression from the AACN.

How to tell you’re on track

  • Your program is both state‑approved and accredited (CCNE for most baccalaureate/graduate programs via the AACN/CCNE; ACEN across program levels per ACEN).
  • You know your state’s licensure steps and timelines through the NCSBN’s licensure guidance tool.
  • You understand where RNs and APRNs work and the skills you’ll use, as outlined in the BLS RN profile.
  • If you plan to move or practice telehealth, you’ve checked whether your residence and target states are in the NLC via NCSBN’s page on licensure compacts.

That’s the backbone: pick the license, choose a properly accredited and approved program, pass the NCLEX, get your state license, and build from there. If you discover along the way that another allied‑health role fits better, explore our comparisons of medical assisting, physical therapist assisting, and dental hygiene. To focus specifically on nursing admissions and timelines, start with our overview on how to become a nurse.

Frequently asked questions

Do you need a BSN to become an RN?

No. You can become a registered nurse (RN) with either an associate degree in nursing (ADN) or a Bachelor of Science in Nursing (BSN). Many professional groups encourage BSN preparation and seamless pathways to higher degrees, but both ADN and BSN routes can lead to RN licensure when the program is accredited and approved by a state board.

What test do you take to get licensed?

After completing a state‑approved program, RN candidates take the NCLEX‑RN and practical/vocational nurse candidates take the NCLEX‑PN. All U.S. boards of nursing use these exams as part of initial licensure. Your state board determines eligibility and issues the license after you meet all requirements.

Can you work in multiple states with one nursing license?

If your primary residence is in a Nurse Licensure Compact (NLC) state and you meet compact rules, you may be issued a multistate license that lets you practice (physically or via telehealth) in other compact states without getting additional licenses. If you live in a non‑compact state, you need individual licenses for each state where you practice.

Who accredits nursing programs in the US?

Two national accreditors most often seen are CCNE, which evaluates baccalaureate and graduate nursing programs, and ACEN, which accredits programs at all levels including practical, diploma, associate, and higher degrees. Accreditation is separate from state approval but both matter for licensure eligibility.

What jobs can you get as a nurse besides hospital bedside roles?

Registered nurses work in clinics, home health, schools, public health, long‑term care, and more. With experience and graduate education, many become advanced practice registered nurses (APRNs), including nurse practitioners, nurse‑midwives, nurse anesthetists, and clinical nurse specialists.