Registered nurses (RNs) are the backbone of the healthcare system. They provide direct patient care in every clinical setting: hospitals, clinics, nursing homes, schools, community health centers, home health agencies, and patients’ homes. RNs monitor patients’ health status, administer medications and treatments, educate patients and families about health conditions and self-care, coordinate care across the healthcare team, and advocate for patients’ needs and preferences. With approximately 3.2 million practicing RNs, nursing is the largest healthcare profession in the United States. The profession offers tremendous variety: RNs can work in emergency departments, intensive care units, operating rooms, labor and delivery, pediatrics, oncology, psychiatry, public health, research, education, and dozens of other specialties.
Education Pathway
There are two primary educational pathways to become an RN. Associate Degree in Nursing (ADN, 2 to 3 years): Offered at community colleges and some universities, the ADN provides the minimum education required to take the NCLEX-RN® licensing exam. ADN programs are shorter and less expensive than BSN programs, making them accessible to students who need to enter the workforce quickly or who have financial constraints. However, many employers (particularly hospitals) increasingly prefer or require BSN-prepared nurses, and many ADN graduates pursue BSN completion (RN-to-BSN programs) after entering practice. Bachelor of Science in Nursing (BSN, 4 years): Offered at universities, the BSN provides a broader education that includes research, public health, leadership, and community nursing alongside clinical training. BSN graduates generally have more career mobility, higher starting salaries, and better prospects for advancement into leadership, education, and advanced practice roles.
After completing either program, you must pass the NCLEX-RN® (National Council Licensure Examination for Registered Nurses) to obtain your RN license. The NCLEX-RN® is a computerized adaptive test that evaluates your readiness for entry-level nursing practice. See our NCLEX-RN® prep guide. For a comparison of the two pathways, see our BSN vs. ADN comparison.
What RNs Do
The daily work of an RN depends on the clinical setting and specialty. A medical-surgical floor nurse in a hospital might care for 4 to 6 patients per shift, administering medications, monitoring vital signs, performing assessments, communicating with physicians about changes in condition, educating patients about their diagnoses and discharge plans, and documenting everything in the electronic health record. An emergency department nurse triages patients, starts IVs, administers emergency medications, assists with procedures, and manages multiple acutely ill patients simultaneously. An intensive care unit nurse provides one-on-one care for critically ill patients, managing ventilators, vasoactive drips, and complex monitoring equipment. A pediatric nurse cares for children from infants to adolescents, adapting clinical skills and communication to the developmental level of each patient. A public health nurse works in the community, conducting screenings, administering vaccines, and promoting health education.
Nursing shifts are typically 8 or 12 hours, and hospital nurses often work nights, weekends, and holidays. The work is physically demanding (standing for extended periods, lifting and repositioning patients, walking several miles during a single shift, and performing repetitive tasks that strain the musculoskeletal system) and emotionally demanding (witnessing suffering, death, and the profound grief of families, while maintaining professional composure and compassion throughout each encounter). It is also deeply rewarding: nurses consistently rank as the single most trusted profession in annual Gallup public opinion surveys, a distinction they have held for over two decades, and the direct, sustained patient contact that defines nursing creates relationships and moments of connection that many nurses describe as the most meaningful part of their careers.
Salary and Job Outlook
The median annual salary for RNs is approximately $98,430, according to the Bureau of Labor Statistics. Salaries range from approximately $65,000 for entry-level positions in lower-cost areas to $120,000+ for experienced nurses in high-cost areas, specialized units (ICU, OR, ER), or travel nursing positions. BSN-prepared nurses generally earn $5,000 to $10,000 more per year than ADN-prepared nurses. The nursing profession is projected to grow 6 percent through 2032, with approximately 193,000 openings per year due to growth and replacement needs. Nursing shortages, particularly in rural areas and specialized units, create strong demand and negotiating power for RNs.
Career Advancement
Nursing offers one of the clearest and most well-defined career advancement ladders in all of healthcare. Starting as an RN, you can advance to charge nurse (shift leader), nurse educator, nurse manager (unit leadership), clinical nurse specialist (advanced clinical expert), nurse practitioner (NP, with additional education), nurse anesthetist (CRNA, one of the highest-paid nursing roles), nurse midwife, nursing professor, chief nursing officer (hospital executive), and many other leadership and advanced practice roles. Each step involves additional education, experience, or certification. The breadth of career options within nursing means that you can continually grow and change direction without leaving the profession.
Getting Started
Middle school: Explore healthcare through volunteering and learn about the human body. High school: Take science courses (biology, chemistry, anatomy if available), begin clinical volunteering or CNA certification, and research BSN programs. Undergraduate: Complete a BSN program or, if you hold a non-nursing bachelor’s degree, enroll in an accelerated BSN program (12 to 18 months). Pass the NCLEX-RN® and begin your nursing career.
Specialty Certifications: After gaining experience as an RN, you can pursue specialty certifications that demonstrate advanced expertise and often increase your salary. The most common certifications include CCRN (Critical Care Registered Nurse) for ICU nurses, CEN (Certified Emergency Nurse) for ED nurses, CNOR (Certified Perioperative Nurse) for OR nurses, RNC-OB (Inpatient Obstetric Nursing) for labor and delivery nurses, OCN (Oncology Certified Nurse) for oncology nurses, and dozens of other specialty-specific certifications. Specialty certifications are voluntary but valued: certified nurses earn $5,000 to $10,000 more per year than non-certified nurses in many markets, and the certification process deepens your clinical expertise and professional credibility.
Travel Nursing: Travel nursing is a unique employment model where RNs take temporary assignments (typically 8 to 13 weeks) at hospitals and healthcare facilities across the country. Travel nurses fill staffing gaps caused by seasonal demand, geographic shortages, or special circumstances. The appeal includes significantly higher pay (travel nurse salaries can be $80,000 to $150,000+ per year, with tax-free housing stipends and travel reimbursements), the opportunity to live and work in different cities and states, and flexibility in scheduling. The challenges include instability (contracts end, and the next assignment is not guaranteed), being the “new person” at every facility, and the difficulty of maintaining personal relationships while moving every few months. Travel nursing is popular among younger RNs without family obligations and among experienced nurses who want financial acceleration.
Nursing and Health Equity: Nurses are on the front lines of health equity. They care for patients from every socioeconomic, racial, ethnic, and cultural background, and they witness firsthand how social determinants of health (poverty, housing instability, food insecurity, lack of insurance, discrimination) affect patient outcomes. Nurses who are aware of these dynamics and committed to equitable care are in a position to advocate for systemic changes that improve health for the most vulnerable populations. If you are drawn to healthcare because you want to address health disparities and serve underserved communities, nursing provides direct access to the communities and patients most in need. See our health equity page and social determinants of health page.
References
Bureau of Labor Statistics. “Registered Nurses.” BLS, 2025. https://www.bls.gov/ooh/healthcare/registered-nurses.htm. Accessed March 2026.