The biggest health profession in the country. Two years of college can get you licensed, and the license works in most states.
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Pay, the path, pros and cons and the facts on one printable page. Good for a wall or a guidance counsellor.
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What you earn and what it costs to get there.
Median
$97,550
Bottom tenth
$68,940
Top tenth
$137,470
The national median is $97,550 a year, and the bottom tenth start near $68,940. Nursing has its own line in the federal wage survey, so these are not borrowed from a wider group. The spread between states is huge: California hospitals pay far above the middle, rural hospitals in the South pay well below it.
About $69,000 to $80,000
New graduate pay, before shift extras
Hospitals add a differential for nights, weekends and holidays, usually a few dollars an hour, and it starts in your first week. A new nurse who works nights can clear several thousand dollars more than one who does not.
$137,470 or more
Intensive care, operating rooms, travel contracts, expensive states
Overtime is where most of the extra comes from, and hospitals are short staffed enough that it is always available. Travel nurses take 13-week contracts in understaffed hospitals for more money plus housing, and burn out faster.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is the associate degree in nursing at a community college at in district rates, about $4,000 for the whole two years, plus the licensing exam at $200 and roughly $300 for the first state licence, uniforms, a stethoscope and the background check. That route is one of the best value deals in American education. The high end is a four year bachelor of science in nursing at an in state public university at roughly $11,000 a year. Note the exam fee rises to $350 on 1 February 2027, and hospitals increasingly prefer the bachelor's degree, so many nurses pay for a bridge program later.
The associate degree route is one of the best value deals in American education: two years of community college for a license that pays near six figures. File the FAFSA (Free Application for Federal Student Aid) every year, because Pell Grants never have to be repaid.
Tuition help to finish your bachelor's
Most hospitals will pay for a nurse with an associate degree to top up to a four-year degree while working.
Shift and weekend differentials
Extra dollars per hour for nights, weekends and holidays, paid on top of base.
Public Service Loan Forgiveness
Nonprofit and government hospitals qualify, which cancels what is left of federal loans after 10 years of payments.
Three-day weeks
Twelve-hour shifts mean many nurses work three days and have four off.
A pension at some employers
State hospitals and the Department of Veterans Affairs still offer real retirement plans.
The exact path from high school to qualified.
Two routes lead to the same license. One is cheaper, one opens more doors later.
High school
Grades 11 and 12
Biology, chemistry, algebra and English. Get a job or volunteer post inside a hospital or care home as early as you can, because admissions committees count it.
Pick your degree
2 or 4 years
An associate degree in nursing at a community college, or a Bachelor of Science in Nursing (BSN) at a university. Both end in the same license. Many hospitals now prefer or require the bachelor's for new hires.
Clinical rotations
Built into the degree
Supervised hours on real wards inside your program: medical, surgical, pediatric, obstetric and mental health. This is where you find out whether you can do the job.
Pass the national exam
6 to 12 weeks after graduation
The NCLEX (National Council Licensure Examination) is computer adaptive: it gets harder when you answer well and stops when it knows enough. Most graduates pass first time.
License and first job
A few weeks to a few months
Apply to the board of nursing in your state. Hospitals run new graduate residency programs of 6 to 12 months to get you onto a ward safely.
Biology
Anatomy and physiology in year one is built straight on it.
Chemistry
Drug calculations and body chemistry run through the whole degree.
Algebra
Dosage math is simple but must be right every single time.
Psychology
Half of nursing is talking to frightened people and their families.
Every state has its own board of nursing and issues its own license, but they all use the same test: the NCLEX (National Council Licensure Examination), written by NCSBN (the National Council of State Boards of Nursing). Most states have joined the Nurse Licensure Compact, which turns one home-state license into permission to work across all the member states. That is what makes travel nursing possible. Renewal every two or three years needs continuing education hours.
Community colleges
The cheapest route to a license. Nearly every county in the country has one running a nursing program.
Public universities
The University of Texas at Austin, the University of Washington, the University of Michigan and most other state flagships run four-year nursing degrees.
Accelerated programs
If you already hold a degree in something else, some schools run a 12 to 18 month nursing degree.
Hospital-funded seats
Some hospital systems pay your tuition in exchange for two or three years of work afterwards.
Things you don't need, but that help.
Earned after a year or two on the floor, not in school.
CCRN (Critical Care Registered Nurse)
For intensive care work. Widely recognized and often worth a raise on its own.
CEN (Certified Emergency Nurse)
Emergency departments. Fast, unpredictable and never boring.
Operating room training
Scrubbing in on surgery. Hospitals usually train you into it rather than hiring for it.
OCN (Oncology Certified Nurse)
Cancer care. Long relationships with patients and heavy emotional weight.
Work as a CNA (certified nursing assistant)
A few weeks of training, then paid hospital work. Nothing tells you faster whether this job suits you.
CPR certification
Cheap, quick and required anyway by the time you start clinicals.
Spanish or another second language
Hospitals hire for it and some pay a differential.
Comfort with blood and bodies
Test this early. It is not a small detail of the job.
A license is a starting point, not a ceiling. With a bachelor's degree and a few years on a ward you can go on to a master's and become a nurse practitioner, who diagnoses and prescribes. Nurse anesthetists, nurse midwives, nurse educators and clinical nurse specialists all start with the same license you do. Others move sideways into case management, informatics, school nursing or public health, and out of shift work entirely.
Day to day, pros and cons, where you'd work.
Twelve hours, usually 7 to 7. Handover first: the outgoing nurse tells you about your four to six patients. Then medications, vital signs, dressings, drips and charting, with call bells interrupting all of it. Doctors round mid morning and you tell them what has changed overnight. Someone gets worse and the plan for the day disappears. You eat standing up, or not at all. The last hour is charting what you did not have time to write down.
The good
The hard parts
Things people don't tell you.
The NCLEX (National Council Licensure Examination) is computer adaptive. Each answer changes the difficulty of the next question, and the test ends as soon as it can tell with confidence whether you are above or below the passing standard. Two people can sit it and answer a very different number of questions.
Registering for the national licensure exam costs $200 today. The National Council of State Boards of Nursing has already voted that the fee rises to $350 in the United States on February 1, 2027.
Most states have joined the Nurse Licensure Compact. A nurse whose home state is a member can work in any other member state without applying again, which is why a nurse in Kansas can take a three-month contract in Arizona on short notice.
The Department of Veterans Affairs runs one of the largest hospital systems in the country and hires nurses through USAJOBS (the official federal hiring site). Federal pay comes off a published table, and the work counts toward Public Service Loan Forgiveness from the first paycheck.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.