How to Become a Registered Nurse: Duties, Responsibilities, Education, Requirements, Certifications, Job Outlook, and Salary
If you’re an EMT or Paramedic and you’re considering a career change in the broader healthcare field, nursing may be your calling. Like emergency medicine, nursing is a challenging and rewarding job that provides the opportunity to help others on a daily basis. As a medical first responder, your education and experience will give you added value in the field of nursing and help you advance your career. Furthermore, you’ve already proven that you possess the type of skills and mind-set needed to excel in the fast-paced and demanding field of healthcare.
Nursing can be an alternative career choice for those who possess EMS experience. Although further education and licensing is required to become a nurse, many first responders can offer a uniquely valuable perspective to nursing profession.
(See our full list of alternative jobs for EMTs and Paramedics).
As with Emergency Medical Services (EMS), the work of a Registered Nurse (RN) may offer great job security, as nurses will always be needed in healthcare. Furthermore, there’s an increasing demand for these skilled healthcare professionals. The Bureau of Labor Statistics predicts 7% growth in employment of Registered Nurses through 2029, primarily due to an aging baby-boom population in our country.
Continue reading to learn everything there is to know about becoming a Registered Nurse and how EMT training and experience can enrich your future in this noble profession.
Why Become a Nurse?
Registered Nurses play a vital role in the healthcare system. Attending to more than just a patient’s medical needs, RNs also support patient comfort, well-being, and health education. Registered nurses have the opportunity to heal hearts, minds, and bodies. Being a nurse is a rigorous and demanding profession that requires extreme commitment, but for those who want to make a positive difference, it’s the job of a lifetime!
How Can EMS Experience Prepare Me for a Career in Nursing?
EMTs and Paramedics frequently cross over to the field of nursing. Similarly, many nurses accept jobs in the area of Emergency Medical Services (EMS). There are many similarities in the roles of nurses and EMS professionals and they often work closely together. The experience, knowledge, and skills that EMS workers acquire are valued and respected among nurses and nurse employers. Some advantages of being an EMT or Paramedic are highlighted below:
- Ability to Work Under Pressure –Anyone who has worked as an EMT or Paramedic has proven they can work under stressful and often unpredictable circumstances. They can think on their feet, which is an important quality for a Registered Nurse.
- Medical Training –Emergency medical training gives future Registered Nurses an additional perspective when treating patients, especially those who require immediate emergency treatment.
- Communication –EMTs and Paramedics must communicate with a variety of people every day—including patients, family, onlookers, doctors, nurses, and law enforcement. This is excellent practice for the aspiring nurses, as they must also communicate with many of these groups.
- Organizational Skills –EMTs and Paramedics begin and end their day with lists, set tasks, records, and documentation. Following strict operating procedures is also a cornerstone in the nursing field.
- Strong Stomach – As with nurses, EMTs and Paramedics are exposed to a range of illnesses and injuries. If an EMT can observe, assess, and treat a wound or illness in the field, they will have the confidence to treat these ailments in a hospital or healthcare facility.
Registered Nurse Job Description
Registered Nurses (RNs) provide and coordinate patient care. They educate patients and the public about health issues and provide advice and emotional support to patients and their families. Most RNs work as part of a team with doctors and other healthcare specialists. In contrast to Licensed Vocational Nurses (LVNs) or Licensed Practical Nurses (LPNs), RNs may fill a wide variety of roles depending on their level of education and experience. Those with a master’s degree can advance their careers to become Advanced Practice Registered Nurses (APRNs).
What Does a Registered Nurse Do?
Although their duties and titles vary depending on their patient-care responsibilities, RNs typically perform the following duties:
- Administer medicines and apply treatments
- Assess the condition of their patients
- Consult and collaborate with doctors and other healthcare professionals
- Explain the steps for post-care after treatment
- Help perform diagnostic tests and analyze the results
- Observe patients and record all relevant developments and conditions
- Operate and monitor medical equipment
- Record patient medical histories and symptoms
- Guide patients and their families on how to manage illnesses or injuries
RNs can develop areas of expertise and will often have titles that reflect that specialization. For example, an oncology nurse works with cancer patients, geriatric nurses work with elderly patients, and pediatric nurses work with children and teens.
Examples of nursing specializations:
- Addiction Nurses care for patients who need help to overcome addictions to alcohol, drugs, and other substances.
- Cardiovascular Nurses care for patients with heart disease or heart conditions and people who have had heart surgery.
- Clinical Nurse Specialists (CNSs) provide direct patient care in a nursing specialty, such as psychiatric-mental health or pediatrics. They also work with other nurses and medical staff to improve the quality of care. CNSs also may conduct research and may advocate for certain policies.
- Critical Care Nurses work in intensive-care units in hospitals, providing care to patient with serious, complex, and acute illnesses and injuries that need close monitoring and treatment.
- Genetics Nurses provide screening, counseling, and treatment for patients with genetic disorders, such as cystic fibrosis.
- Hospital Administrators can be registered nurses who assume leadership, management, and administration of a healthcare system, hospital or hospital network.
- Legal Nurse Consultants use their expertise as a healthcare provider to consult on medical-related legal cases.
- Neonatal Nurses take care of newborn babies who have health issues.
- Nephrology Nurses care for patients who have kidney-related health issues stemming from diabetes, high blood pressure, substance abuse, or other causes.
- Nurse Educators teach and prepare other nurses for entry into practice and provide continuing education to licensed nursing staff.
- Nurse Midwives guide patients through the entire process of pregnancy and delivery.
- Public Health Nurses promote public health by educating people on warning signs and symptoms of disease or managing chronic health conditions. They may also run health screenings, immunization clinics, blood drives, or other community outreach programs.
- Rehabilitation Nurses care for patients who have temporary or permanent disabilities or chronic illness.
Where Do Nurses Work?
Registered nurses held about 3.1 million jobs in 2019. The largest employers of RNs were as follows:
|Hospitals; state, local, and private||60%|
|Ambulatory healthcare services||18%|
|Nursing and residential care facilities||7%|
|Educational services; state, local, and private||3%|
Ambulatory healthcare services include physician offices, home healthcare, and outpatient care centers. Nurses who work in home health will travel to the patient’s home. Public health nurses may travel to community centers, schools, and other sites. Some nurses travel frequently in the United States and throughout the world to help care for patients in places where more healthcare workers are needed.
Nurse Work Hours
Registered Nurses can work a wide range of schedules, depending on their employer and job duties. RNs who work in hospitals and nursing care facilities usually work in shifts to provide round-the-clock coverage. They may work nights, weekends, and holidays. They may be on-call, which means they must be available to work on short notice, sometimes around the clock. Nurses that work 8- or 10-hour shifts, typically work 40 hours per week. Nurses that work 12-hour shifts may work 36 hours per week. Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to have regular business hours.
What Are the Working Conditions for RNs?
Registered Nurses are often in close contact with people who have infectious diseases, and they frequently come into contact with potentially harmful and hazardous drugs and other substances. Therefore, RNs must follow strict guidelines to guard against diseases and other dangers, such as accidental needle pricks and exposure to radiation and other chemicals. RNs may spend a lot of time walking, bending, stretching, and standing. They are vulnerable to back injuries because they often must lift and move patients.
Registered Nursing Career Outlook
Nurses are in great demand! Overall, job opportunities for Registered Nurses are expected to be favorable. The Bureau of Labor Statistics predicts 7 percent growth in employment of Registered Nurses through 2029, which is higher than average for all occupations.
As the baby-boom population ages, the overall need for healthcare services is expected to increase. As a result, RNs will be needed to care for older patients in a wide variety of healthcare settings, including hospitals, residential care facilities, and home health environments. RNs will also be needed to educate and care for patients with a growing number of chronic conditions, such as arthritis, dementia, diabetes, and obesity.
In addition, more and more procedures are now being performed at outpatient care centers and physician offices, where patients receive same-day treatments, such as chemotherapy, rehabilitation, and surgeries. These facilities will also need more RNs to provide care.
In general, Registered Nurses who have a Bachelor of Science in Nursing (BSN) degree will have better job prospects than those without one. Some employers may also prefer candidates who have some related work experience or certification in a specialty area, such as gerontology or pediatrics.
How Much Do Registered Nurses Make?
According to the Bureau of Labor Statistics, Registered Nurses make an average salary* of about $77,000 per year, while the average hourly rate is about $37 per hour.
The lowest 10 percent can earn up to around $52,000 annually, while the highest 10 percent can make up to $111,000 a year, or more.
Highest Paying Industries for Nurses
|Industry||Average Hourly Pay||Average Salary|
|Outpatient Care Centers||$40.73||$84,720|
|Psychiatric & Substance Abuse Hospitals||$35.87||$74,610|
|Home Health Care Services||$35.41||$73,660|
|Nursing Care Facilities||$33.53||$69,740|
Highest Paying States for Registered Nurses
|State||Average Hourly Pay||Average Salary|
Highest Paying Cities for Registered Nurses
|City||Average Hourly Pay||Average Salary|
|San Jose, CA||$67.67||$140,740|
|San Francisco, CA||$66.35||$138,000|
|Santa Cruz, CA||$64.42||$134,000|
|Yuba City, CA||$57.34||$119,260|
|Santa Barbara, CA||$52.38||$108,940|
How to Become a Nurse
To become a Registered Nurse, you must either earn an associate or bachelor’s degree in nursing, or a vocational nursing diploma. To be licensed however all aspiring RNs must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Higher-level nurses usually require a Master of Science in Nursing (MSN) degree, additional training, and specialized certifications.
Registered Nurse Training
Nursing education programs usually include courses in anatomy, physiology, microbiology, psychology, and other social and behavioral sciences, as well as liberal arts. Programs typically combine nursing classes with supervised clinical externships.
- Bachelor of Science in Nursing (BSN) degree programs typically take 4 years to complete
- Associate Degree in Nursing (ADN) and Associate of Science in Nursing (ASN) degrees usually take 2 to 3 years to complete
- Diploma programs can be completed in as little as 12 months.
Bachelor’s degree programs usually include additional education in physical and social sciences, communication, leadership, and critical thinking. A bachelor’s degree is often necessary for administrative positions, research, consulting, and teaching.
In general, graduates of any of the three education programs (bachelor’s, associates, or diploma) can become licensed and qualify for entry-level positions as a staff nurse. More and more employers, however, are requiring a bachelor’s degree. Registered nurses with an ADN, ASN, or diploma may go back to school to earn a bachelor’s degree through an RN-to-BSN program.
There are also master’s degree programs in nursing (MSN). Some of these combine a bachelor’s and a master’s degree into one program. There are also accelerated programs for those who already hold a bachelor’s degree (in any field) who wish to enter the field of nursing.
Registered Nurses must be licensed by the state in which they work. To become licensed, nurses must graduate from an approved nursing program and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
The NCLEX-RN test is organized into four major patient-needs categories:
- Safe and Effective Care Environment
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
The following processes are fundamental to the practice of nursing and are integrated throughout the patient-needs categories and subcategories:
Nursing Process – a scientific, clinical reasoning approach to client care that includes assessment, analysis, planning, implementation, and evaluation.
Caring – interaction of the nurse and patient in an atmosphere of mutual respect and trust. In this collaborative environment, the nurse provides encouragement, hope, support, and compassion to help achieve desired outcomes.
Communication and Documentation – verbal and nonverbal interactions between the nurse and the patient, the patient’s significant others, and the other members of the health care team. Events and activities associated with patient care are recorded in written and/or electronic records that demonstrate adherence to the standards of practice and accountability in the provision of care.
Teaching/Learning – facilitation of the acquisition of knowledge, skills, and abilities promoting a change in behavior.
Culture and Spirituality – interaction of the nurse and the patient (individual, family or group, including significant others and populations) which recognizes and considers the client-reported, self- identified, unique, and individual preferences to patient care, the applicable standard of care and legal considerations.
The NCLEX-RN is a variable length computerized adaptive test and can range from 75-145 questions. Of these questions, 15 are pretest items that are not scored. Regardless of the number of questions administered, the time limit for this examination is five hours. The time allotted for the examination includes an introductory screen, all optional breaks, and the examination.
Other requirements for licensing, such as passing a criminal background check, vary by state. Each state’s board of nursing provides specific requirements. For information on the NCLEX-RN examination and a list of state boards of nursing, visit the National Council of State Boards of Nursing.
Nurses may also become certified through professional associations in specific areas, such as ambulatory care, gerontology, or pediatrics. Although certification is usually voluntary, it demonstrates adherence to a specific level of competency, and some employers require it.
In addition, registered nursing positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS), or advanced cardiac life support (ACLS) certification.
Important Personal Qualities for Registered Nurses
Caring and compassion
Caring has always been one of the most important qualities of a nurse, and it makes all the difference to patients.
Registered Nurses must assess changes in the health status of patients, such as determining when to take corrective action.
Registered Nurses must be able to communicate effectively with patients to understand their concerns and evaluate their health conditions. RNs need to clearly explain instructions, such as how to take medication. RNs also need to communicate effectively with other healthcare professionals, patients, and their families.
Registered Nurses must be precise because they must ensure that patients get the correct treatments and medicines at the right time. Mistakes can have critical consequences.
Registered Nurses need emotional resilience and the ability to cope with human suffering, emergencies, and other stress factors.
Nurses often work with multiple patients who have a variety of health needs. The ability to coordinate numerous treatment plans and records is critical to ensure that each patient receives appropriate care.
Nurses should be comfortable performing physical tasks, such as lifting patients. In many settings, RNs will be on their feet for most of their shift.
Registered nurses must balance multiple patients with competing needs. The ability to prioritize and concentrate on the most critical issues first is crucial. It’s also important to know when a quick break is needed.
Career Advancement in Nursing
Most Registered Nurses begin as staff nurses in hospitals or community health settings. With experience, good performance, and continuing education, they can move to other settings or be promoted to positions with more responsibility.
Many RNs advance into management, moving from Nurse or Head Nurse to more senior-level administrative roles, such as Assistant Director or Director of Nursing, Vice President of Nursing, or Chief Nursing Officer. Increasingly, management-level nursing positions require a graduate degree in nursing or health services administration.
Some nurses move into the business side of healthcare. Their nursing expertise and experience can prepare them to manage ambulatory, acute, home-based, and chronic care businesses. Employers need registered nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance.
Other nurses work as post-secondary educators or researchers in colleges and universities. These positions typically require a Ph.D.
Beginning Your Nursing Career Journey as an EMT or Paramedic
If you’re a caring, capable, and compassionate person who wants to help others on a daily basis, being a Registered Nurse could be the ideal career for you.
If you’re already an EMT or Paramedic, you may already have a head-start towards a fulfilling career in nursing. Otherwise, becoming an EMT or Paramedic can equip you with the skills and experience to advance your nursing career down the road.
If you would like to gain real-world experience before dedicating yourself to a career as a Registered Nurse, you can start by enrolling into an accredited EMT program. Emergency medical services are an excellent way to test the waters before fully committing to many related fields in healthcare, healthcare technology, and public services. To learn about other career paths for EMS professionals, read our guide on alternative jobs for EMTs and Paramedics.
The requirements to be an EMT are rigorous, the job is challenging, and the work environment is stressful and sometimes dangerous, but most EMS professionals find the work extremely rewarding. Being an EMT, like being a nurse, is often much more than a career—it’s a calling.