How to Become a Registered Nurse (RN)

How to Become a Registered Nurse (RN)

William J. Kelly, MSN, FNP-C
William J. Kelly, MSN, FNP-C

Author | Nurse Practitioner


How to become an Registered Nurse (RN) is frequently asked and it is a great career to go into! It can be a lot of hard work but it is worth it in the end. I personally was an RN for 4 years and currently I work with them daily as an ER Nurse Practitioner – so I think I can give some insight into becoming an RN.

There are multiple different pathways to become an RN, but I’m going to outline the most common way, as well as the less common pathways.

If you prefer to watch instead of read, check out the video below!

What is a Registered Nurse?

A Registered nurse is a nurse who has been trained to take care of patients in and out of the hospital.

They provide hands-on care to their patients, carrying out orders and advocating for their patients.

Within the hospital, an RNs job includes:

  • Patient assessment
  • Medication and Treatment administration
  • Communication with Providers and other nurses
  • Patient Education and Discharges


When deciding on how to become a Registered Nurse, one of the first things you will need to figure out is which type of program you want to attend.

There are programs that offer various different degrees and various different lengths.

There is no “one size fits all”, and that will become apparent when researching how to become a Registered Nurse.


In order to gain entry into any RN program, you will need your high-school degree or its equivalent (GED).

This is pretty standard for many professions, and most people already inherently understanding this step.

RN programs want to know that you are academically capable in a classroom setting.

However, there are specific pre-requisites and application requirements or recommendations that nursing schools are going to want to see on your transcripts from high school.


Nursing programs want to see certain classes that you have taken in high school in order to be considered for their program.

These pre-requisites classes include:

  • Basic and Advanced Math
  • Science courses (Biology, Chemistry, and Physics are all great ones)
  • English

Not every program is going to require every single one of these, as many can be flexible.

Each program will vary, but check out some programs that you are interested online, and look for their “admission” page, which may give some insight into specific recommendations for high school students.

Many programs require a minimum GPA as well as a certain SAT score – this will depend on the university and program.

The better your GPA and SAT scores, the more competitive your application will be.


In order to be a serious candidate, focus on doing your best in high school and obtaining the best GPA you can.

Additionally, programs like to see that your involved involvement in extra-curricular activities.

Some of these extra-curricular activities include:

  • Sports & Cheer
  • Music & Theater
  • Student Council
  • Journalism
  • Various other Clubs

Taking Advanced Placement (AP) science classes will make you stand out.

These look great to many nursing programs and can potentially offer you university credit, which can make your nursing program a little more manageable.

An additional application boost is real-life work experience in a related field.

Working as a CNA, EMT, Medical scribe, or personal caregiver are all great options that look great to nursing programs!



Nurses can become a registered nurse sooner by obtaining an associate’s degree instead of a bachelor’s degree.

An ADN aims to give students the basic technical and academic knowledge to go into employment.

For nurses, this includes core science classes, as well as your basic “how to be a nurse” classes.

This also includes approximately 700 hours of clinicals within the hospital – learning how to be a bedside nurse.

Typical classes for ADN include:

  • Basic Nursing Fundamentals and Skills
  • Anatomy and Physiology
  • Nutrition
  • Emergency Care
  • Pediatric Nursing
  • Obstetric Nursing
  • Med-Surg Nursing.

Most ADN degrees will take about 2 years to finish.

This is about HALF of how long a BSN takes. This lets the nurses enter the workforce sooner.

If they still desire a BSN or if their facility requires it, an RN-to-BSN bridge program can be taken, usually all online, which can be completed in an additional 1-2 years of education.

Obtaining your BSN this way gives you bedside experience quicker, and helps you make money sooner.

If you want to go into administration or advance your nursing education, obtaining a BSN is required.

ADN vs BSN | ADN Is a 2 year degree that will grant you an associates degree in nursing, and BSN is a 4 year degree that will give you a bachelor of science in nursing. BSN focuses more on research, evidence-based practice, leadership, and ethics, whereas ADN focuses on essential nursing knowledge and skills


Obtaining your Bachelor of Science in Nursing (BSN) is recommended and often needed to do anything “beyond” bedside nursing.

This traditional 4-year degree is what many future nurses choose to attend straight out of high school.

This gives them the “traditional college experience”, but also offers them an excellent nursing education.

Students will learn how to assess their patients, how to assess their patients, and how best to help manage their care.

This involves every aspect of patient care including:

  • Personal care
  • Medication administration
  • Communication with physicians or ancillary staff
  • Delegation
  • and more!

Additionally, they are required to attend clinical as well. Clinicals are learning opportunities within the clinical setting, where student nurses can shadow and assist registered nurses in accomplishing their nursing tasks.

The intent is to obtain first-hand experience and directly learn how to be a nurse. By graduation, most programs require somewhere between 800-1000 hours of clinical.

The “BSN” education for nurses involves all of the classes that the ADN programs offer, in addition to:

  • English
  • Statistics
  • Research
  • Evidence-based practice
  • Leadership
  • Ethics
  • Community Health

Obtaining your BSN is definitely a great option and will set you up for future endeavors and professional advancement.


So what’s the actual difference then between an ADN-prepared and a BSN-prepared RN?

Well even though you complete your program quicker and can start working sooner as an ADN, you are less-educated.

Many facilities require BSN education, and some will hire you but offer you money to help you pay for the BSN portion, contractually requiring you to complete it.

Many magnet hospitals will prefer to hire BSN-prepared nurses.

Some facilities will pay their RNs the same regardless, but many offer incentives for advanced education as well as certifications. So you might make a few more dollars per hour as a BSN vs ADN.

Additionally, you can earn a higher hourly rate by obtaining specialty certifications like Certified Emergency Nurse (CEN) or Critical Care Registered Nurse (CCRN), if that is the specialty that you work in.

Overall, there is a large push for BSN-prepared nurses, and there is some evidence to back this up, with improved patient outcomes correlated with increased nursing education.


I’m not going to elaborate much on this as it is largely being phased out, but Diploma RN programs once used to be a very common way of obtaining your nursing education.

These programs were often run by hospitals that offered a lot of hands-on education and “learn-on-the-job” experiences.

This has largely been replaced with degree-offering programs from universities and colleges.


Once you have all the required prerequisites listed above and know which program(s) you want to attend, you can start applying to programs!

The difficulty in the admittance is going to depend on your application as well as how competitive the RN program is.

Some nursing programs are very difficult to get into!

If unable to immediately get it, some students choose to attend the university of choice as an “undeclared” major, take important classes within the RN curriculum, and then hope to be accepted into the program as a transfer once they’ve proven to do well.

Learn how to become a registered nurse RN by first completing high school, then choosing a nursing program ADN vs BSN, finishing a program including clinical hours, passing the NCLEX-RN, and then applying for RN state licensure

4. Graduate and Pass the NCLEX-RN

Once you finish your RN program, you have to take a competency exam to prove your knowledge as a Registered Nurse.

This test is called the NCLEX-RN, and you will spend a large portion of your education preparing for this test.

Each state board of nursing uses this test as the basis for whether or not you deserve your RN license within their state.

Once you pass (and hopefully in 75 questions), you will have been deemed “worthy” of the RN title after your name, once your state license has gone through.

Once you apply for state licensure by exam, you can apply for state licensure by endorsement for other states.

Or better yet, if your state is part of a compact RN license state, then your license is good for all of those states!


Once you’re licensed, you can get a job as a registered nurse and finally start using that knowledge you’ve obtained to positively impact your patient’s lives as well as your bank account!

Finding a nursing job can sometimes be tough, but if you’re willing to be flexible – there are so many nursing opportunities out there!

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I wanted to talk a little bit about some alternative options when trying to decide how to become a registered nurse.

As always, one size does not fit all and some of these other options may be the perfect fit for you!

1. Accelerated “Direct-Entry” Programs

If you already hold a Bachelor’s degree in another program (i.e. business, math education, Biology), there are programs designed to accelerate your education into becoming an RN.

This is partly due to many of the prerequisites being completed (Gen eds), but also as the programs are intensive and designed for students who just want to “catch up” and become nurses ASAP.

These programs often have science pre-requisites, are very involved, require maximum effort, rarely take “breaks”, and can be completed in as little as 16 months!

At graduation, each participant is awarded a BSN.

2. LPN to RN programs

If you are already a Licensed Practical Nurse (LPN), attending an LPN-to-RN bridge program is an excellent choice to become an RN.

There are programs that award an ADN, as well as programs that award a BSN.

As above, choose which option is best for you.

LPN-to-ADN programs will be able to be completed quicker in 1-2 years, and LPN-to-BSN programs in 2-4 years.

3. Foreign Educated to RN in US

If you obtained your RN education from an accredited RN program in a different country, you can apply for state licensure within the US.

This will require:

  • At least 2 years of RN experience
  • A Foreign-Educated Nurse refresher course
  • English proficiency tests

For more information, check out this article.

So there you have it. If you are wondering how to become a registered nurse, hopefully, this article gave you some insight.

How did you become an RN, and would you recommend anything different? Let us know in the comments below!

Learn how to become a registered nurse RN by first completing high school, then choosing a nursing program ADN vs BSN, finishing a program including clinical hours, passing the NCLEX-RN, and then applying for RN state licensure

How to Become an Emergency Nurse Practitioner (ENP)

How to Become an Emergency Nurse Practitioner (ENP)

If you find yourself wondering how to become an ENP, you’ve found the right resource!

In this article, we’ll not only talk about HOW to become an ENP (Emergency Nurse Practitioner), but we’ll also talk about their job role, and how much money they can expect to make.

If you prefer to watch instead of read, then watch the video below!

What is an ENP?

An Emergency Nurse Practitioner (ENP) is a nurse practitioner who is certified to see patients of all ages in the emergency departments and ambulatory care centers.

An ENP is specialized to see patients in the following clinical settings:

  • EDs (fast-track & Main ER)
  • Trauma Centers
  • Urgent Care Clinics
  • Retail health Clinics
  • Jails and Prisons
  • Mobile units (Flight team, EMS, etc)

What do ENPs do?

At work, an ENP evaluates and treats patients who present to the Emergency Department or urgent care settings.

They may work in fast-track which sees lower-acuity patients (like extremity injuries and coughs/colds), or they may be on the main side seeing chest pains, abdominal pains, headaches, sepsis, strokes, etc.

An ENP will also perform routine ER procedures like:

  • Incision & Drainage of abscesses
  • Suturing & laceration repairs
  • Shoulder & Joint reductions
  • Administering local anesthesia blocks
  • Splinting extremity injuries

They will also be trained for critical and life-saving procedures like:

  • Rapid Sequence Intubation (RSI)
  • Central line placement
  • Chest tube insertion (tube thoracostomy)

They will usually be working in conjunction with an attending physician, especially within emergency departments. These physicians will serve as a resource for help, guidance, or if escalation of care is needed.

How much does an ENP make?

As with most nurse practitioner salaries, an ENP can definitely expect to make at least 6 figures.

According to Zip Recruiter, an Emergeny Medicine Nurse Practitioner (ENP) can expect to make 133K on average or $64/hr, whereas a general nurse practitioner is: 110K per year (53$/hr).

The emergency setting is higher risk and tends to be more stressful with higher risk and less desirable hours, so the increased pay makes sense.

But of course, the pay will fluctuate depending on multiple different factors such as location, the specific company you work for, and how much experience you have.

Many ERs and urgent cares will utilize an RVU pay system, so the busier you are, the higher the acuity of the patients, and the more procedures you do – the more your hourly rate will be.


RVU stands for Relative Value Unit. This is a means to measure the productivity of Physicians or NPs/PAs.

The more patients you see, the higher acuity they are, and the more procedures you perform will all increase your RVUs.

Each facility pays out RVUs differently. They might give you your RVUs monthly, quarterly, or added onto your hourly rate.


So now that we know what an ENP is, what an ENP does, and how much money an ENP makes – how does someone actually become an ENP?


So as with any NP specialty, the first step is to become a registered nurse.

This deserves its own article itself (coming next week), and there are a few different methods you can do, but I’m going to briefly overview the main recommended way.

Long story short, you’re going to need to attend a program that grants you a BSN or a Bachelor of Science in Nursing.

After graduation, you will take the board certification exam called the NCLEX-RN.

Once you pass the NCLEX-RN, you can apply for your state licensure in your specific state, and get a job working as an RN.


So once you get your RN, you can start working as a nurse.

If your goal is to be an ENP, you should prioritize working as an ER Nurse.

This will be huge in developing your assessment skills, getting comfortable with what kind of patients present to the ER and with what symptoms, as well as familiarize yourself with treatments and medications.

It also will give you a chance to change your mind before actually knowing that an ENP certification is what you want.

The amount of time you need to work as an RN before going back is debated to say the least. Some nurses immediately go into their NP program, but this isn’t the norm and is more for FNP.

When it comes to ENP programs, all ENP programs are going to require you to have at least 1 year of work experience as an ER RN. 

While working as an ER nurse, you’ll have between 4-8 patients at a time(closer to 4 if you’re lucky like I was). You will learn SO MUCH as an ER nurse that will benefit you as a future ENP.

The next step is where we have some options because there are 4 different ways to become an ENP once you are an RN and working as a nurse.


This step is where we have some flexibility in becoming an ENP. We have the option of attending a specific ENP program or post-masters certification, applying by portfolio as an FNP, or by completing an ER fellowship.


The ENP certification just officially came out in 2017, so it is still relatively new, and only offered by the AANP.

This means that there aren’t many ENP programs out there, but there are at least 10 as of now.

Some top ENP schools are Emory University and Vanderbilt.

When you attend an ENP program, the content is specific to emergency medicine.

Almost all of your clinical rotations will be in the ER and urgent care settings (aside from FNP curriculum), so you will get great training specific to your area of focus.

All of the ENP programs that I’ve seen are actually dual FNP-ENP, so you will be obtaining your FNP as well.

This means the program may be a bit more expensive and longer than a single specialty program, and require more clinical hours. I am not aware of any stand-alone programs, other than post-masters certificates.

ENP programs will take you on average 3 years to complete, with 600-1000+ hours of clinical in both emergency medicine settings, as well as family practice, women’s health, and pediatrics.

Many nurses will continue to work on a per-diem or part-time basis at the bedside as an RN, which from personal experience, really does help you put into practice what you’re learning, in addition to your formal clinical hours.


A family nurse practitioner (FNP) can go back and obtain a post-masters certificate from an ENP program, where they complete only the ENP portion fo the curriculum. This takes about a year to complete. 


If you don’t attend an ER program you can choose to apply by portfolio. This is for those who are already practicing as an FNP.

A Family Nurse practitioner can apply by portfolio to become an ENP if they meet the following requirements within the last 5 years:

  • Over 2,000 hours in an ER setting
  • Over 100 hours of continuing education hours in emergency medicine, with over 30 being related to emergency procedures


Additionally, an FNP can complete an ER fellowship or residency, which then makes them eligible to sit for the ENP certification exam.

These fellowships typically take 1-2 years to complete, and you will be paid less during the training, but gain great training within the ER.

4 Take the ENP Exam

The last step of becoming an ENP is to take the ENP certification exam once you are eligible to do so.

The ENP certification exam is currently only provided by AANP, and consists of 150 multiple choice questions, 135 of which are scored.

The exam will consist of questions related to medical screening, medical decision making and differential, patient management, patient disposition, and professional, legal, and ethical practices.

Once you pass this test, you are certified as an ENP and can apply for your specific state’s nurse practitioner license, and get a job working in the ER setting as an ENP.

And that’s how you become an ENP, as well as what you will be doing, where you will be working, and what pay you can expect to make as an ENP.

Choosing the right nurse practitioner specialty is important in planning your future as an NP. #NP #Nursepractitioner #nursing

Nurse Practitioner Specialties: What are the Differences?

Nurse Practitioner Specialties: What are the Differences?

Nurse practitioner specialties will dictate which patient population you can treat once you are a practicing nurse practitioner.

There are many different nurse practitioner specialties that you can obtain, and we will outline the differences between them here!

If you prefer video content instead, you can check out my youtube video below!

Why are Nurse Practitioner Specialties Important?

Nurse practitioners are registered nurses (RNs) who attend additional schooling and training to become an advanced practice registered nurse or APRN.

APRN is the umbrella term for various advanced practice nurses, which includes:

  • Nurse Practitioners
  • Certified Registered Nurse Anesthetists
  • Certified Nurse-Midwives
  • Clinical Nurse Specialists

We are going to be outlining the different nurse practitioner specialties that an NP must choose before entering their advanced nurse practitioner program.

When a nurse wants to become a nurse practitioner, they have to attend an advanced nursing program that grants them either a Master’s of Science in Nursing (MSN), or a Doctorate of Nursing Practice (DNP).

These programs are specific to various patient populations – so basically what demographic of patients you will be treating. These are known as nurse practitioner specialties.

It is important to pick the right nurse practitioner specialty before actually going through a program, because this may limit your job opportunities depending on what you want to do in the future, so knowing the difference between these specialties is important.

For example, if you complete an acute care program, you will not be able to sit for a family nurse practitioner certification.

The main nurse practitioner specialties include:

  • Family Nurse Practitioner or FNP
  • Adult-Geriatric Primary Care Nurse Practitioner or AGPCNP
  • Adult-Geriatric Acute Care Nurse Practitioner AGACNP or ACNP for short
  • Emergency Nurse Practitioner
  • Women’s Health Nurse Practitioner (WHNP)
  • Psychiatric and Mental Health Nurse Practitioner (PMHNP)
  • Pediatric Nurse practitioner or PNP
  • Neonatal Nurse Practitioner (NNP)

I want to briefly discuss the differences between these, and some general guidance when choosing a specialty.

Nurse practitioner programs will all have similar base classes such as advanced pharmacology and advanced pathophysiology, but each specific program will branch into classes that are specific to each specialty and patient population.


Family Nurse Practitioner

Family Nurse Practitioner or FNP is the most common Nurse Practitioner specialty, accounting for about half of all NPs – and there’s good reasons for that, because FNPs are the most versatile NP certification that there is.

FNP programs focus on family medicine, spanning from birth to death, ages 0-100+. FNP programs focus on primary care, but specialty clinicals can be completed in the ER, hospitals, and various outpatient specialties depending on the NP program.

Due to the lack of age requirements and general primary care training, FNPs are able to work in many different settings.

While most FNPs will work in outpatient primary care offices, many work outside of primary care like:

  • Specialty Offices (cardiology, orthopedics, etc)
  • Emergency dept and Urgent Cares
  • Inpatient (non-critical care areas)

The benefit of an FNP working in the ER is that they are certified to see patients of all ages. Many ERs have combined pediatric and adult emergency departments, and providers are often expected to see both.

Some states and facilities will hire FNPs to work inpatient in non-critical care areas. This will be state and facility-dependent.

The downside is that while your FNP program will give you the base knowledge you need for these various specialties, most of the hands-on clinical experience will be in primary care, and this can leave you somewhat unprepared for certain specialties such as the ER.

This can lead to a big learning curve outside of primary care areas, and it makes it especially important to get a job with a thorough orientation process and great ongoing support by your supervising and collaborating physicians as well as the nursing staff.

Quick Note

I personally am an FNP and I have worked as an inpatient hospitalist, as well as within the ER. 

Adult-Gerontology Primary Care Nurse Practitioner

Adult-Gerontology Primary Care Nurse Practitioners or AG-PCNP is similar to FNP, but they are limited to evaluating and treating patients who are over the age of 13.

AGPCNPs often work in:

  • Adult internal medicine offices (outpatient primary care)
  • Outpatient specialty offices (cardiology, nephrology, etc)
  • ER and Urgent cares *but needs to be adult-only which can lead to difficulty finding a job*

Adult-Gerontology Acute Care Nurse Practitioner

Adult-Gerontology Acute Care Nurse Practitioners or AG-ACNP (or just ACNP) are those who are specialized to treat adults and geriatric patients within acute and critical care areas. This means primarily within the hospital, both ICU and general floor admissions. They are also limited to seeing patients 13 years or older.

AGACNPs can work in:

  • Inpatient hospitalist positions
  • Inpatient ICU
  • Outpatient specialty offices (Cardiology, nephrology, etc)
  • Nursing Homes and LTAC facilities

Specialty clinics often have on-call and rounding privileges within the hospital, which an ACNP is specifically trained for so this can be a great option for them.

ACNPs can also work in the ER, but will be limited to patients 13 years or older, and this can significantly limit the ability to get a job in this setting. However, the their training in the acute care setting will likely benefit them in seeing emergent patients within the ER.

Some programs offer dual FNP-ACNP certifications, which is the most ideal and the most flexible nurse practitioner specialty certification. However, it will require additional schooling and clinical hours, because you are doing the work for and paying for 2 separate certifications. You will also have to test for both.

Emergency Nurse Practitioner

A newer certification is the Emergency Nurse Practitioner or ENP. There are a few ENP programs now throughout the US, and they allow an NP to specialize in emergency medicine. These NPs will be certified to see patients of all ages within emergency and ambulatory departments (i.e. urgent cares, retail clinics, etc).

The education and training will be specific to ER and ER procedures. So while you’ll get great training, you will be significantly limited on where else you can work other than ER or urgent care facilities.

An FNP with a minimum of 2000 hours of work experience that meets certain requirements is able to apply by portfolio to become an ENP and then has to sit for the ENP certification exam (read the requirements here).

Otherwise, they have to attend an ENP program, or they can complete a fellowship program in emergency medicine.

Women’s Health Nurse Practitioner

Women’s Health Nurse Practitioner is a certification that focuses on women’s primary care needs including:

  • Well-woman exams
  • Reproductive health
  • Breast and cancer screenings
  • Vaginal and urinary complaints
  • and more

Depending on the program, this may be offered in conjunction with a family or adult-geriatric certification as well.

Again, this offers great training specific to women’s health needs. However, it will limit you to this patient population unless you obtain a dual-certificate in something else, or later choose to get a post-masters certification.

But if women’s health is 100% where you want to work forever, then it is a great choice and will give you great experience and training.

This certification exam is not offered by the AANP or ANCC, but rather another organization called the NCC (National Certification Corporation).

Psychiatric Mental Health Nurse Practitioner

Psychiatric Mental health Nurse Practitioner or PMHNP is gaining definitely gaining popularity.

The PMHNP certifies nurse practitioners to treat patients with psychiatric and mental health disorders across the lifespan. This includes treating conditions such as:

  • ADHD
  • Anxiety & Depression
  • Bipolar disorder
  • Schizophrenia
  • and more

Again, this specialty is very specific, and you will not be able to work outside the realm of psychiatric mental health. However, you can work inpatient psych, outpatient psych, or even telehealth which is definitely gaining popularity as well.

Pediatric Nurse Practitioner

Pediatric Nurse Practitioner or PNP certifies a nruse practitioner to see patients from birth to 21 years old. Training and education will be specific to the pediatric population, but you won’t be able to leave that patient population without additional education.

Neonatal Nurse Practitioner

Neonatal Nurse Practitioner or NNP, works with neonates, infants, and toddlers up to the age of 2. Neonates include those who were born prematurely.

And those are the main NP specialties that you will run into. As you can see, sometimes it is straightforward, and other times it can be a little more difficult to choose between programs.

Which NP Specialty Should you Choose?

FNP offers the most flexibility with different specialties and populations but may leave you with a big learning curve if you start working in a non-primary care setting.

This is a good choice if you’re not really sure where you want to work, or if you think you may want to work in multiple different settings in the future. This is also an excellent choice if you want to work in primary care.

AG-PCNP is great if you want to work with only adults in primary care or outpatient specialty offices.

AG-ACNP is a great choice if you love inpatient medicine and want to work within the hospital or long-term care facility, and sometimes outpatient specialty offices.

The other specialties are a bit more straightforward and will give you great education and training and leave you feeling well prepared.

If you want ER or urgent care – do an ENP program.

If you want to work in Women’s health – do a WHNP program.

If you want to work in Psych – do a PMHNP program.

If you want to work with kids – do a PNP program.

If you want to work with neonates – do an NNP program.

However, keep in mind that many of those specialties except for neonatal will also hire FNPs or AG-NPs depending on the states and facilities. Don’t forget though that jobs that require you to see kids won’t hire an AGNP.

While they used to hire FNPs for some psych work, the PMHNP is becoming the standard for psych jobs. Of note though, treating basic anxiety and depression is within the scope of a primary care NP.

All of these different nurse practitioner specialties have similar lengths, costs, and clinical requirements. They will just differ in some of the material that is taught, and the clinical experiences that are offered to their students.

And that is a complete overview of the main nurse practitioner specialties that you can obtain.

Leave a comment down below to let us know what you think about nurse practitioner specialties and which one you think is best!

Choosing the right nurse practitioner specialty is important in planning your future as an NP. #NP #Nursepractitioner #nursing
Nurse Practitioner Specialties: AGPCNP
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10 Tips for a New Charge Nurse

10 Tips for a New Charge Nurse

A charge nurse is so important in keeping a hospital department running smoothly. Whether in the ER, ICU, or inpatient floor settings – the charge nurse is essential to the team.

Many times being a charge nurse comes with years of experience, but sometimes it comes with less than 1 year! (believe me – I was one of them!) Many units may have high turnover, and you can find yourself being a charge nurse with a year or less experience.

While this is nerve-wracking, it is possible to do a good job as a charge nurse, even with not-so-ideal nursing experience.

Here are some charge nurse tips to help you on your way to becoming an amazing charge nurse to serve as a resource to your team.

Oxygen delivery devices and flow rates FB

What Is the Role of a Charge Nurse?

A charge nurse is the “nurse in charge” on the unit. They are the leader of the team (at least for the shift). They are often the nurses on the floor during the shift that has the most experience and knowledge.

Their job will differ depending on which unit they work in, but usually involves:

  • Keeping the floor moving (admissions and discharges)
  • “Floating” and helping the nurses
  • Being used as a resource (aka answer questions)
  • Sometimes taking their own patients as well

In the emergency department, a major role of the charge nurse is throughput. That means keeping the department moving: getting patients who are admitted, discharged, or transferred out of the department, and making space for new patients coming in.

They may even need to take some of their own patients on a busy day/night, and may need to function as a triage nurse after certain times during night shift or when short-staffed (which let’s be real – is basically the norm).


Tip #1: Know The Policies

A major job of a charge nurse is to know the policies inside and out. This is basically the rules of flow of the specific department, aka “how it all works”. 

This includes policies related to the admission, discharge, and transfer process; medication administration policies, transfusion policies, and more.

These policies will be specific to each facility and department, and a nurse will naturally learn these over time with experience on the floor.

However, each facility should have some sort of intranet (online database) or printed resource with policies, which you can look up, print, and save as needed.

Tip #2: Know Your Backup

While it’s ideal to have a charge nurse who has years of experience on the floor, this is just not always possible. Nursing turnover is real, and many departments struggle with nurse retention, especially on night shift.

You may find yourself becoming a charge nurse on night shift with as little as one year of experience or less.

As a nurse with a year of experience or less, you simply cannot be expected to know everything, including all of the policies and how to troubleshoot any situation that arises.

While this can be terrifying, there are resources that are available to you if you just don’t know the answer.

Even though you are the charge nurse of the floor, there should be a “higher-up” that you have access to.

During dayshift, you may have access to the department director or nursing managers. They can often be contacted by telephone if needed even after they end their workday.

During night shift, there is usually a nursing supervisor of the hospital as who can answer questions.

You can also call other charge nurses on other departments to ask for advice during a situation.

If there is an in-house hospitalist team, they can also be used as a resource for medical concerns, or you can call the attending.


I moonlight as a night shift hospitalist, and had a charge nurse on a med-surg unit with less than 1 year experience reach out to me as she was concerned with a patient’s HR going in the 30s during sleep. This patient was asymptomatic and had been bradycardic in the 50s while awake. She was concerned because she had never seen a HR consistently that low, even during sleep. I reassured her that this was okay and even expected in this specific patient, and if he developed any symptoms or abnormal rhythm to notify us immediately.

Tip #3: Good at Throughput

A charge nurse’s primary responsibility is to keep the department moving. This is super important in the emergency department but is important on any nursing floor.

Patients come into the ER and often need IVs started, labs drawn, transported to imaging and back, medications administered, call bells answered, and discharge instructions given. Patients who are admitted need report called and need to be transported to the floors.

Delays in throughput are common, especially within the ER, and may be due to:

  • The nurse being backed up due to too many patients (all too common) or a critical or needy patient
  • The Provider being too busy to discharge or admit their patients immediately
  • Lab or radiology delays
  • Admission delays (i.e. floor nurse too busy to take report)
  • Admission holds (not enough beds upstairs)
  • COVID test results
  • Delays in transportation

A charge nurse can help minimize many of these delays and keep the department moving by being proactive.

They can discuss transport patients, clean stretchers, make phone calls, help out their nurses, and remind the Provider to reevaluate and disposition their patients! These are all ways the charge nurse can help become an expert at throughput.

Tip #4: Help Out

The nurses in the department are busy and overworked. You can say that again!

Being chronically understaffed is all too common. This means nurses are often behind in their assessments, procedures, medication administration, and charting. This can seriously impact throughput as well as patient satisfaction and worst of all, patient outcomes.

As the charge nurse, you will need to find time to help out your nurses wherever they need it. You may need to place IVs, transport patients to or from radiology or the floors, obtain EKGs, triage patients, and give medications that are ordered.

Not only does this make you a good team player, it helps the whole department run smoothly.

There’s nothing worse than a charge nurse who seems to sit there and do nothing the whole shift… DON’T BE THAT CHARGE NURSE!

Tip #5: Charge Nurse by Example

As a charge nurse, it is your job to lead by example. You may not have a formal manager position, but your selection as a charge nurse for a shift means that you are the team leader, at least for the shift.

Don’t do one thing and expect another from your nurses. Constantly help out when you can, maintain good rapport with the patients, providers, and ancillary staff, and conduct yourself with professionalism and integrity.

Tip #6: Stay Calm in Crisis

It is so important to stay calm during emergencies and crises as a nurse, but especially a charge nurse.

It will be your job to put out fires left and right, as well as make sure the nurses on your unit handle emergency situations appropriately.

Emergency situations happen in the hospital all the time – it’s the name of the game. But it’s not just life and death that will test you.

Families may be yelling at you because they’re angry or frustrated, and patients will literally be trying to die on you.

Staying calm is easier said than done, but one thing that helps you stay calm is KNOWING YOUR STUFF.

If you know what the policies are, and what to do in specific emergency situations like cardiac arrhythmias or codes, then you will be more prepared. This should give you a sense of calm, especially when these emergencies inevitably arise. 

There is nothing more stressful than uncertainty.

Tip #7: Good Team Player

Being a good team player is important for any nurse, but especially a charge nurse. There are many ways to be a good team player.

Be a hard worker and willing to help out other nurses. Don’t expect them to return the favor later, but if they are a good team player they eventually will.

As a person who is in “charge”, it’s important to not play favorites. The nurses will resent you, and you need to be as fair to them as possible. This means don’t give your “besties” easier assignments or fewer admissions.

Always have your teams back. Understand situations from their point of view and give them the benefit of the doubt. Nurses aren’t perfect and do make mistakes, but be sure to support them however you can. Don’t immediately throw them under the bus.

These traits are important for not only charge nurses but any leadership position.

Tip #8: Stay Organized

Staying organized is so important for nurses. Charge nurses have an even bigger need to stay organized, because they aren’t just managing their own patients. They are managing the entire department or floor!

Knowing who has what assignment, which patients they have, and what needs to be done is important. In stressful environments, it can be easy to know you have so much to do, but not even know where to get started.

Staying organized is key. Get there early if you need to, make lists and prioritize what needs to be done. Chart in real-time to avoid the backlog of charting weighing you down and making you more stressed.

Also check out: How to Stay Organized as a New Nurse

Tip #9: Good at IVs and Procedures

As the charge nurse, you will be used as a resource. Your nurses will come to you if they have difficulty placing an IV or other procedure, or if they have never done the procedure before.

It is a great idea for the charge nurse to be great at IVs – because this is a common need on any department, but especially within the ER.

Placing lines and drawing blood work is essential for throughput and good patient care, and excelling at this procedure is a great skill set for the charge nurse to have in their scrub pocket.

Practice, practice, practice. Make sure you know all the IV tips and tricks as well.

Related content:

Tip #10: Good at Rhythms and Codes

Probably the most stressful part of being a charge nurse is having the pressure of knowing what to do during emergency situations. These are usually intubations, code blues, or other emergent cardiac arrhythmias.

Knowing your cardiac ECG rhythms is so important for every nurse, but many nurses struggle with this. As the charge nurse – you need to be an expert at this as your nurses will be coming to you for advice or interpretation.

You should know all about each drawer of the code cart, the code cart meds, and how to reconstitute them, and definitely know how to use the defibrillator!

This includes knowing:

  • Cardiac defibrillation
  • Synchronized cardioversion
  • Transcutaneous Pacing

You should also be familiar with the basics of how to recognize a STEMI

If you feel like your ECG rhythm interpretation and cardiac arrhythmia procedure knowledge can use some work, I have a digital course that I think you’ll find super helpful!

If you want to learn more, I have a complete video course “ECG Rhythm Master”, made specifically for nurses which goes into so much more depth and detail.

With this course you will be able to:

  • Identify all cardiac rhythms inside and out
  • Understand the pathophysiology of why and how arrhythmias occur
  • Learn how to manage arrhythmias like an expert nurse
  • Become proficient with emergency procedures like transcutaneous pacing, defibrillation, synchronized shock, and more!

I also include some great free bonuses with the course, including:

  • ECG Rhythm Guide eBook (190 pages!)
  • Code Cart Med Guide (code cart medication guide)
  • Code STEMI (recognizing STEMI on an EKG)

Check out more about the course here!

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How to Stay Organized as a New Nurse

How to Stay Organized as a New Nurse

This post may contain affiliate links, which means I get a commission if you decide to purchase through my links, at no cost to you. Please read affiliate disclosure for more information

Learning how to stay organized as a nurse can be challenging, especially as a new nurse

Use these 7 Nursing Tips on how to stay organized to help keep you organized and efficient!

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How to Stay Organized as a Nurse

The learning curve as a new nurse is super high, and we could all use some tips on staying organized.

There is so much to remember when it comes to all of our patients, and we are expected to know all of their information and often have to recall it in high-pressure situations.

Organization as a nurse takes time and experience, but if you are diligent – you can become that organized nurse that you’ve always wanted to be!

1. Get There Early

On my first day as a nurse, I arrived at 6:50 am bright and early to my new Med-Surg unit – excited to make a good impression.

I walked over to my preceptor and she looked at me and said “you’re late. I’m already getting report. You’re expected to be here at 6:30 tomorrow”.

I had NO idea that I needed to get there so early? But why?

One major tip on how to stay organized as a nurse is to adequately prepare and “read up” on your patients. This takes time, which may mean needing to get there early.

This is especially important on Med-Surg units when you will be caring for multiple patients at once.

Most facilities will have some type of print-out with the patient’s medical information on it including their attending physician, allergies, diagnoses, and their medications.

Using these sheets, look through their medical record for information like:

  • Why they’re admitted and what they’re being admitted for (Look in the H&Ps)
  • Their vital sign trends
  • Their IV access (gauge and location)
  • Their active orders (diet, activity, code status, etc)
  • Any other information you deem to be important

If your facility doesn’t have these printouts, or if you prefer to use your own – bring your own!

I always made my own that I would use. You can sign up for my free patient organization sheets here.

Now when you get nursing report from the previous shift, you will have some baseline information to go off of.

Make sure to have space to write down important information that the previous shift’s nurse gives you.

I would say as a new nurse it is important to get there about 30 minutes early to start writing up on your patients. However, as you gain skills and become more proficient, 5-15 minutes early will likely suffice.

Also, understand that you are not getting paid for this time. Being so – it is not mandatory, but it will help your shift go more smoothly.

Quick note: What worked well for me was briefly reading up on my patients, looking at their vital sign trends, and their main admission diagnoses.

I would get report, assess each patient and pass meds, and then when I got time later on I would read more deeply into the H&Ps, writing down important information to pass along to the next shift.

2. Learn To Prioritize

Learning to prioritize is essential in figuring out how to stay organized as a nurse.

As nurses, we have so many tasks that we need to accomplish, and figuring out which order to do them is can mean the difference between life. That seems extreme, but sometimes can be true!

First, prioritize which patients you should see first.

A patient that has more unstable vital signs or more serious diagnoses should be bumped to the top of your list.

You should probably see the patient with CHF on Lasix and oxygen before you are seeing the patient with a broken hip who was recently medicated and is comfortable.

See those who are “more sick” before those who are “less sick”.

This is because those who have more serious diagnoses are more likely to decompensate.

Seeing them quicker can mean faster intervention and prevention of poor outcomes.

Also make sure you are prioritizing your tasks.

Sure – everyone needs to be charted on and their care plans completed, but making sure medications are administered in a timely manner is likely more important.

In the hospital – unexpected situations are inevitably going to occur.

Maybe you need to take a quick pause on your charting to go give pain medication to a patient who is requesting it.

Assessing a patient who is hypotensive takes precedence over giving your other patient their bedtime pills.

Learning to prioritize and being flexible will help you learn how to stay organized as a nurse, especially within the hospital.

3. Make Lists

In order to prioritize tasks, you actually need to know which tasks need to be performed.

As an experienced nurse – this can become second nature. However, as a new nurse – you are prone to forgetting or missing something.

Since it is so new, you need to write it down to make sure you do everything correctly.

I would always have checkboxes on each of my sheets for each patient. These checkmarks would include:

  • Assess
  • Chart
  • Medicate (with times ordered i.e. 9pm | 12am | 5am)
  • Care Plan
  • Rhythm Strip Interpretation

As a new nurse, you will inevitably be task-oriented. This is unavoidable and ensures that all of your tasks get done.

Once you gain experience, you will improve your critical thinking skills, and completing your tasks will become second nature.

4. Real-Time Chart

I know I said to prioritize medication passes and urgent assessments over charting – and that holds true!

But something that made me an efficient nurse is real-time charting!

Essentially this means right after I saw my patient and assessed them, I would park my computer-on-wheels right outside their door and quickly chart my assessment.

This only takes about 5 minutes while the assessment fresh your mind.

As a new nurse, you will forget to assess certain things that are important to assess! If you real-time chart, you can easily just walk back in and complete your assessment.

This does not take as much time as you think. If you have 6 patients, that’s only about a total of 30 minutes of charting.

Anecdotal Note: I would start assessing and charting my patients after getting report around 7:30, and move onto the next patient.


Once 8pm hit, I could medicate my patients for their night-time med pass. I would assess, medicate, and then chart.


Finally, I would double back on the initial patients to medicate them. This means all my patients would be assessed, medicated, and charted on by 10pm.


This leaves the rest of the night for any admissions, to hourly round on your patients, answer call bells, and perform the other tasks needed like care plans and reading up in their H&Ps.

Related Article: Top 6 Charting Tips for Newbie Nurses

5. Investigate Before Notifying

Another aspect of how to stay organized as a nurse is doing proper investigation before notifying a Provider.

This improves the communication and ensures the patient gets what they need. It can also help avoid a negative interaction with a Provider – which we all know can put a damper on the shift.

Learning to organize your thoughts and relay your concerns to the Provider is not inherently easy. The added pressure doesn’t help!

Make sure to investigate any anticipated questions they may ask. Some examples include:

  • If you are calling about high blood pressure, make sure you write down the BP trends, what they are taking for blood pressure, and if anything had needed to be given for high BP before.
  • If you are calling for additional pain medications, make sure you have an adequate assessment of the pain (new or chronic, location, radiation, etc), what they are currently getting for pain, any PRNs or previous medications given for pain, etc.

Make sure to include any recommendations you may have. Make sure to use a proper SBAR format.

“SBAR” always left me a bit confused and wanting more, so I made up an “IMSBAR” format which you can read all about here!

Related Articles:

6. Stock Up

Learning how to stay organized as a nurse also means always being prepared for whatever can happen. This means having the right equipment at the ready!

Important hospital equipment to stash in your pockets include:

  • 10mL saline flushes
  • Alcohol wipes
  • Medical Tape
  • 4×4 gauze

Important equipment that you should be bringing to work and have on you include:

It may be a good idea to also carry with you a bottle or two of lotion or barrier cream, so you’re not always needing to run to the clean utility room.

Having all this equipment will save you time and make you more efficient and keep you organized.

Related Article: 

7. Know When You’re Actually Working

Knowing when you’re working is an important aspect of how to stay organized as a nurse.

I would be lying if I said I never got a call saying “where are you – you’re on the schedule for today”.

I use Nurse Grid to keep track of my schedule. This app is specifically for nurses. What I love is that you can see your colleague’s schedules as well and even request a shift-switch within the app itself.

It’s simple and yet functional. Whatever app or calendar you use – make sure you always know when you’re working!

Related Articles:

nurse grid

Hopefully, you found some of these tips helpful when searching how to stay organized as a nurse! Are there any other tips that have helped you? What other areas do you struggle with?

Let us know in the comments below!

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How much do Nurses make? RN Salary

How much do Nurses make? RN Salary

This post may contain affiliate links, which means I get a commission if you decide to purchase through my links, at no cost to you. Please read affiliate disclosure for more information

How much do nurses make? If you find yourself wondering about RN salary, you came to the perfect place to find out! I worked as a bedside RN myself and now work as a nurse practitioner. I have firsthand experience regarding RN salary, and I have many nursing colleagues who have helped me gain an understanding of this question.

Is money why nurses do what they do? No! Nurses get into nursing because of course they care and want to help people. But let’s be honest – it is also a career that offers decent pay and benefits, as well as job security. Money is a serious consideration to think about before deciding on any future career plans.

So this article will hopefully give you an insight into how much nurses make, and what RN salary you can expect to make when you become a nurse!

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How Much do Nurses make?

You can easily google this answer and get a general estimate. The problem with that is its not very specific to you or your earning potential. A quick search on Glassdoor will tell you that the average Rn salary in the US is $65,870 per year. But nurses almost never get paid “salary”, but rather are paid hourly.

Most RN jobs within the hospital will be 36 hours per week – or 1872 hours per year. This means that per Glassdoor, the average hourly rate of an RN in the US is $35.19 per hour.  I have nursing colleagues who make this. I can also tell you that I have nursing colleagues who make much less than this on average! So this doesn’t really give you a great indication of how much you can make as an RN, especially as a new grad RN.

According to Medscape’s RN/LPN Compensation report for 2019, the Hourly rate for an RN averaged at $38 per hour, but again this is not specific. This encompasses both hourly and salaried employees and those who work in all sorts of clinical settings with varying amounts of nursing experience.

Factors which influence Nurse Pay:

To help answer how much do nurses make and to give you a better understanding of how much YOU can make as a new graduate RN, there are multiple factors to consider. These include your education and certifications, where you plan on working, which clinical setting, how much experience you have, what type of contract you have, and more!

1. Education and Certifications

What type of education and certifications you hold will impact how much you can make as a nurse.


As a bedside RN, you can hold various different degrees. These include a diploma RN, Associates degree (ADN), Bachelor of Science in nursing (BSN), Master of Science in Nursing (MSN), as well as doctorate degrees like the DNP. However, most bedside RNs have their BSN degree or lower, and those with their Masters or above typically do not work at the bedside but rather in other clinical areas like management, infection control, or education.

Approximately half of bedside nurses have their BSN, and this can provide increased salary as opposed to Associates degree RNs or diploma RNs. The average salary of a BSN was reported to be $80K per year, vs $75K per year as an ADN. While 5K per year might not seem like a lot, it can be the equivalent of a few more bucks an hour.


There are various RN certification exams that a nurse can take to get certified in a specific area. These include the Certified Emergency Nurse (CEN) or the Critical Care Registered Nurse (CCRN) certifications, among others. As an incentive, many facilities will offer a few more dollars per hour for having a specialty certification.

2. Experience

A major factor influencing RN salary is going to be RN work experience. This is common in non-nursing fields as well, but the more experience you have – the more money you can make. This is a benefit of having experience and providing knowledge and resources to younger less-experienced nurses. Additionally, more experienced RNs know their worth and are in a better position to negotiate.

According to Medscape, RNs with less than 5 years of experience made an average of 66K/year, vs those with >21 years experience made 84K per year. This is almost a 20K per year pay difference, which is significant. Glassdoor also supports this 15-20K increase in pay based on significant experience, with new RNs making $53K and experienced with >15 years making $71K. This holds true for nurse practitioners as well, with a 15-20K difference.

3. Location

Where you plan on practicing as an RN will affect your RN salary. How much do nurses make in California versus Indiana? What about NYC vs Texas? Where you work will greatly impact your salary – and this is true for most professions.

According to Glassdoor, the average salary of an RN in San Francisco, CA is $115K! That same nurse can get a job in western PA for $51K. That is a $64K pay difference based on geographical location. However, the cost of living is definitely a factor that needs to be considered, and you might not have as much disposable income as you think you would making $115K in SF. 

In general, the west coast is going to offer the best salary, followed by the New England / NYC area. The mid-west and more rural states are going to generally offer worse pay. Even within the same state, salary can vary greatly. Urban areas will generally pay more, and rural areas less.

4. Clinical Setting

The clinical setting you work in as a nurse can impact how much you make, regardless of your experience or where your facility is located. RNs working in the hospital, with insurance companies, or with occupational health settings can expect similar pay regardless.

The highest paying clinical settings are inpatient settings within the hospital. This usually requires 12-hour shifts, frequent weekend coverage, and sometimes on-call schedules. Home health nurses can expect to make a few thousand dollars less per year, but with that comes the flexibility of working by yourself and typically making your own schedule. Working in an outpatient office or skilled nursing facility will give you a 5-10K/yr paycut (75K vs 83K), and working at a school or university as an RN will offer you the least salary compared with traditional inpatient roles ($65K vs 83K).

As you can see, the clinical setting can influence your pay by almost  20K per year, so this is significant. However, settings that offer lower pay do offer added benefits – often better schedule, weekends/holidays off, and less stress. So everyone needs to weigh the pros and cons.

5. Contract

Another factor to consider in finding out how much nurses make is to look at their contract. Are they Salaried or hourly? Full-time, Part-time, or Per-diem?

According to Medscape, in 2018 salaried RNs made $83K, vs $78K for hourly employees. However, the Full-time hourly rate of $38 was NOT any different from the part-time or per diem rates. I found this interesting, and my personal experience with this is different. Many per-diem employees are often offered a higher hourly rate, as the hospital is not paying for any benefits.

Additionally, some facilities offer special schedules which may offer an increased salary. When I was working through my NP program, I worked the “weekends only” schedule – meaning I worked every Friday, Saturday, and Sunday (36 hours), and in turn, got an additional $10/hour.

As a travel nurse, you can expect to make much more, although benefits tend to be lacking. I did some travel nursing and made about $6K/mo takehome, but I know some travel nurses who often made around $8K/mo takehome. 

6. Shift differential

The last thing to consider is which shift you plan on working. Night-shift offers a whole bunch of pros and cons, but one of the pros is usually a shift differential, which is usually a few extra bucks an hour after 11pm. This usually works out to a few thousand dollars more per year.  

How much did I make as a bedside RN?

To give you a little real-life example, I can let you know how much I made as an RN.

To give you some context – I started to work as a bedside RN on a med-surg floor in 2014. I also started in a small hospital in western Pennsylvania. Rates in this area are NOT good and vastly different than where I work now in urban New Jersey. I started at a whopping $22.60 per hour. I worked nightshift which gave me an additional $2-3/hour. Even so, I was only making about $46K/yr. However my rent was only $450 per month – so I had a decent amount of disposable income! 

Where I work now in Urban NJ, new nurses can expect to start around $35/hour. 

Here are some realistic starting hourly rates for new graduate RNs:

  • San Francisco, CA: $50/hr
  • Seattle, WA: $31/hr
  • NYC, NY: $35/hr
  • Chicago, IL: $28/hr
  • Phoenix, AZ: $28/hr
  • Orlando, FL: $24/hr
  • Boston, MA: $30/hr
  • Western PA: $23/hr
  • Philadelphia, PA: $29.50/hr

Hopefully this gave you some insight on the question “how much do nurses make”. If you’re wondering how much nurse practitioners make – you should check that out here!