Registered Nurses

Registered nurses, or RNs, care for patients by treating their illnesses and injuries, administering medications, performing exams, and educating them on how to manage their medical conditions. They often specialize in a certain area of nursing care, such as geriatrics, pediatrics, or obstetrics. To become a registered nurse, you must graduate from an accredited nursing program resulting in an associate degree, bachelor's degree, or diploma in nursing. You must then pass the National Council Licensure Examination, or NCLEX-RN, as a requirement to become licensed as a nurse in your state, though individual states may have further requirements beyond the NCLEX for nursing licensure. As nurses gain experience, they may pursue voluntary certification in their specialty through various credentialing organizations.

All state licensure is based on public safety and protecting the consumer. It’s to establish certain criteria that say that people have met a standard that people feel make them competent to be a nurse.

Stephen PattenPresident of the National Association of Clinical Nurse Specialists

Getting RN Licensure and Certification

Licensure requires registered nurses to prove they have both the education and the clinical experience necessary to provide effective nursing care to patients. It also means they are held to a certain standard in their state because their license can be revoked for behavior that could negatively impact their patients, such as gross negligence, incompetence, or certain criminal convictions. In fact, many states require people applying for a nursing license to submit fingerprints for a criminal background check. "All state licensure is based on public safety and protecting the consumer," said Stephen Patten, president of the National Association of Clinical Nurse Specialists. "It's to establish certain criteria that say that people have met a standard that people feel make them competent to be a nurse."

To be eligible for licensure, you must complete an accredited nursing program that includes supervised clinical experience either in a hospital or other patient care environment. After completing this program, students sit for the NCLEX-RN, a national exam that measures whether someone has mastered the competencies required to begin as an entry-level nurse. The test covers four main client care areas, including safe and effective care environment; health promotion and maintenance; psychosocial integrity; and physiological integrity, according to the 2010 NCLEX-RN Test Plan. Students who pass the NCLEX and fulfill all other requirements by their state board of nursing are eligible for licensure in their state. "A nursing license is granted by a state regulatory body and ensures a nurse is safe to practice," said Terri Gaffney, senior director of new product development at the American Nurses Association.

Several national organizations, such as the American Nursing Credentialing Center (ANCC) and the National League for Nursing, offer credentials to nurses who have significant experience in specific nursing specialties. The requirements for credentialing vary. For instance, to earn the gerontological certification from the ANCC, you must have at least two years of experience as an RN, at least 2,000 hours of clinical practice in gerontology within the past three years, and have completed 30 hours of continuing education in gerontological nursing within the past three years.

Maintaining RN Licensure and Certification

Healthcare is a constantly changing and advancing field. Registered nurses must keep on top of these advancements so that they can continually improve the quality of care they provide. For this reason, merely obtaining a nursing license is not enough — RNs must routinely maintain their licensure through continuing education and renew their licenses periodically, according to their state's requirements. Even if your state does not require nurses to accumulate continuing education for renewal, your employer may require or encourage continued nursing education. "I think that most nurses, including myself, want to be practicing at the cutting edge of their practice, and we want the best possible outcomes for our patients," Patten said. "The only way you do that is through formal and informal continuing education."

Online learning is very popular and many nurses take advantage of this vehicle.

Terri GaffneySenior Director of New Product Development at the American Nurses Association

Often, the most important factor in renewal is the completion of continuing education (CE) credits. The number of CE credits required for renewal differs by state. For example, Washington requires 45 hours of CE for renewal every three years, according to the Washington State Nurses Association, while California requires 30 hours of CE every two years to maintain an active license, according to the California Board of Registered Nursing. Specific information pertaining to license renewal and CE requirements can be obtained through your state's board of nursing.

Nurses who must accumulate CE to maintain a specialty credential should refer to their credentialing organization for additional information on specialized CE requirements. "Nurses who are certified in their specialty by ANCC are required to demonstrate continued competence in their specialty area," Gaffney said. "Continuing education is one way of doing so."

RNs have demanding jobs and may work odd hours, making continuing education difficult at times to work into their schedules. We suggest completing your course work on your own schedule by taking your classes online. "Online learning is very popular and many nurses take advantage of this vehicle," Gaffney said. While older nurses tend to gravitate to the more traditional, face-to-face means of earning CE, younger nurses tend to pursue online options, Patten said, adding that most professional organizations offer online CE.

The classes you will need to take depend on your state's requirements, so we recommend consulting with your state board of nursing prior to signing up for online CE courses, and verifying that credits earned online are approved for your CE requirement.

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