July 1, 2021 · 4 min read

Math Needed in Nursing School

When it comes to patient safety, math is an essential tool for nurses at all levels of practice.

sheila mickool

Written and reported by:

Sheila Mickool

Contributing Writer

two nurses studying at laptop
two nurses studying at laptop

In nursing, math isn’t just a prerequisite for admission to a college-level program or something you pass on a test for a license. It’s a core component of a nursing education and a skill set you’ll use every day throughout your career.

The safety of patients is the top priority in nursing—and math is an essential tool in accomplishing that at all levels of practice, says Donna R. Swope, an adjunct professor of nursing at Stevenson University.

Math skills are critical for nurses when they perform the basic yet important task of administering medication.

“Adopt the mindset that nurses and math are forever intertwined in the protection of the patient,” Swope says. “Don’t think of it as cramming for a test and then allowing the content to slip away.”

Math skills are critical for nurses when they perform the basic yet important task of administering medication. “In the process of testing, manufacturing, distribution, and prescription of medications, nurses stand as the last level of protection as they are the ones who actually administer the drug to the patient,” explains Swope.

Math calculations, measurement conversions, and data interpretation occur throughout the process, which includes:

  • Adhering to the “rights” of administering medication: the right patient, right medication, right dose, and right time.
  • Preparing a dose with a number of variables in mind, including the patient’s weight and the recommended dose per pound.
  • Preparing a dose according to patient ability; for example, considering whether a patient is only able to swallow the medication if it is crushed or in liquid form.
  • Adjusting dosage according to a patient’s response; for example, the flow rate of an intravenous drug is increased or decreased according to a patient’s blood pressure.

Nurses also use math in the creation and interpretation of research related to healthcare and nursing practice. That’s why undergraduate and graduate nursing programs require coursework in research and statistics.

“Nurses must be able read, analyze, and interpret research studies and make changes in procedures, protocols, and policies so that the standards of care that inform their practice are always up to date,” Swope says.

Practice Makes Perfect

You learned most of the math you’ll use in nursing in middle school and high school. If you don’t remember most of it, you’re not alone. Preparing to take a pre-assessment test like the PAX or TEAS (Test of Essential Academic Skills) for admission to a nursing program will help you review and solve math and algebra problems.

There are many practice guides and tests available. Community colleges also offer precollege-level math courses, should you need them.

Dosage Exams and Clinical Nursing Courses

In most programs, students generally take an introductory clinical class that includes a review of dosage and the math involved in handling medications. “Basics such as ratio/proportion, algebraic formulas, conversions, and apothecary measurements are reviewed and students are tested on their knowledge,” Swope says.

At the university where Swope teaches, “students have three tries to get 100% on the dosage exam at the completion of this review. They must withdraw from the clinical course if this score is not reached,” she says. “Every clinical course that follows includes a dosage exam on the first day of the course with the same standards: three tries to pass the exam.”

Students will find similar testing practices and policies at most nursing schools.

Nursing Program Math Requirements

Completion of two to three years of high school math is the prerequisite for admission to a nursing program at most colleges. However, some of the most competitive nursing programs prefer four years of high school math for Bachelor of Science in Nursing (BSN) programs.

Here’s a rundown of the typical math prerequisites and courses required for graduation from nursing programs. These courses are in addition to the math tests that students take at the beginning of clinical courses.

Note: “One college-level math class” as cited below generally refers to undergraduate math classes such as an algebra, pre-calculus, or calculus class taken in the first two years of college.

Certified Nursing Assistant (CNA)

  • Prerequisites: Solid knowledge of basic math
  • Requirements for graduation: No additional math required

Licensed Practical Nurse (LPN)

  • Prerequisites: Two to three years of high school math, including intermediate algebra
  • Requirements for graduation: Varies from none to one year of college-level math

Associate Degree in Nursing (ADN)

  • Prerequisites: Two to three years of high school math, including intermediate algebra
  • Requirements for graduation: One college-level math class

Bachelor of Science in Nursing (BSN)

  • Prerequisites: Three to four years of high school math, including intermediate algebra
  • Requirements for graduation: One college-level math class and one introductory statistics course

Master of Science in Nursing (MSN)

  • Prerequisites: One college-level math class and one introductory statistics course
  • Requirements for graduation: Descriptive and inferential statistics or biostatistics courses

Doctor of Science in Nursing (DNP)

  • Prerequisites: Descriptive and inferential statistics or biostatistics courses
  • Requirements for graduation: Graduate-level courses in statistics and research design, evaluation, and outcomes 

Doctor of Philosophy in Nursing (PhD)

  • Prerequisites: One college-level math class and descriptive and inferential statistics or biostatistics
  • Requirements for graduation: Varies greatly but usually includes several graduate-level statistics and research methodology courses 

If Math Isn’t Your Strength, You Can Still Succeed

If you have math anxiety, you aren’t alone. Swope suggests students and experienced nurses take advantage of online practice programs, practice workbooks, and tutoring to hone their math skills.

“Nurses also have many resources in the clinical area that will be of help, like calculators on their phones, drug information websites, and built-in safety devices within computerized medication storage (such as allergy alerts),” she says. “And consulting with an experienced colleague is never a bad idea.”


donna swope

With professional insight from:

Donna R. Swope, MS, RN

Adjunct professor of nursing, Stevenson University


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May 20, 2021 · 4 min read

See Yourself as a Second-Career RN

Real nursing student Julie Festa shares her experience going back to school for an Associate Degree in Nursing.

sheila cain

Written and reported by:

Sheila Cain

ASD Writer/Editor

julie dressed in scrubs outside
julie dressed in scrubs outside

You have a career. You have a family. But you’ve always wondered: What would it be like to go back to school? You’re not alone.

Julie Festa, 30, was a research manager in a clinic when she decided to return to school for her Associate Degree in Nursing (ADN). She’s juggling family life, full-time work, and pandemic-related setbacks, but looks forward to celebrating her graduation in May 2022.

Maybe you can see yourself going back to school to pursue your nursing dreams too?

Julie Festa, 30

Nursing student
Pursuing: Associate Degree in Nursing (ADN)

Where are you studying?

St. Vincent’s College at Sacred Heart University, Fairfield, Connecticut

Where are you currently working and what is your job title/position?

I stopped working in January 2021 to focus on my last few semesters of nursing school full time. Prior to that, I worked in a clinic that specializes in clinical research for patients that have Parkinson’s disease or Alzheimer’s disease. I was a clinical research manager there for about seven years and oversaw a team of clinical research coordinators managing a 300-plus participant Parkinson’s disease clinical trial. 

What were your main considerations when choosing an ADN?  

I wanted to find a school that was close to my home and had a nursing program in which I could finish the degree as quickly as possible.

Tell us about your family life.

I am married to my wonderful husband of three years who is a police officer. I am a fur mom to my black lab named Lambeau and tabby cat named Chowder. Between my school schedule and my husband’s work schedule, it can be really hectic at times. We try to prioritize spending time together when we can, especially during my breaks from school. We love to travel together!

What challenges did you face going back to school as an adult and how did you address them?

One of the hardest parts was parting ways with my job that I absolutely loved in order to pursue nursing school full time. It has also been challenging financially, because while I’ve been in school I’ve only worked part time or not at all.

I would never have been able to do this degree without the help of my supportive husband. Even though it can be tough at times, he’s always my biggest cheerleader and pushes me to keep going.

How did you find and decide on your school? What was the process like?

I had met a few people that had completed the program at my school, so I decided to apply there and to a few accelerated second-degree programs. I ultimately chose the program I am in because I was projected to finish the fastest based on the prerequisites and nursing classes required. The application process was fairly simple. I sent in an application, fee, and resume. Once I was accepted, I had to also complete an interview.

When did you start and when do you expect to graduate?  

I started at my school in 2019 because I had to complete a few prerequisite classes before starting the nursing intensive classes. I was projected to graduate in May 2021, but due to COVID-19 and the in-person clinical hours requirements in Connecticut, my class was pushed back almost an entire year. I will now graduate in May 2022—fingers crossed!

Why did you decide to pursue nursing?

While working as a clinical research coordinator and manager I gained a lot of experience with patient care. I absolutely loved working with patients and learning from their experiences. After some time, I essentially hit a glass ceiling in clinical research, (limiting) how far I could grow without medical licensure. I’m the type of person that thrives on continuous growth and learning, so I knew I needed to continue my education if I wanted a career with more opportunities.

What do you love about nursing school in general? 

Nursing school is tough and nearly all-consuming, but I do love our clinical experiences. I love getting to meet new patients and help them to feel better, even if that is just by helping them get cleaned up in the morning. My favorite clinical experience so far has been in labor and delivery. I got to see and assist with a birth, which was amazing.

How is school going so far?

School is going well. I’ve been able to maintain my 3.9 GPA thus far, which has been challenging and required a lot of hours spent studying instead of doing fun activities with my friends and family. I just try to remember why I started and keep in mind that nursing school is temporary, so hopefully all my hard work will pay off.

What is your dream job after school? 

I’m still not 100% sure what I want to do after graduation. If I had to decide right now, I’d say either working as a labor and delivery or postpartum nurse or working on a neurology floor.

What have been some of the unexpected experiences and joys of going back to school as an adult?

Returning to school as an adult has really helped me to realize how far I have come as an individual. I could have never completed this program when I was younger and in college the first time; I was just too immature at the time. Now that I have returned older with more life experience, I am focused and recognize how doing well in school affects your outcomes once you finish.

What advice do you have for other adults who want to go back to school but are uncertain if they should?

If you are an adult considering going back for nursing or any career, my advice would be just do it! Stop waiting and pushing it off because really there will never be a “good time” to start. If this career is something you know wholeheartedly you want to pursue, find a way to make it happen. No, it is not going to be easy, but try to focus on all the benefits you’ll gain once you’ve accomplished your goal.

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May 4, 2021 · 7 min read

8 Ways to Beat Your Math Anxiety

If you have math anxiety, you’re not alone. Learn how to conquer it.

Written and reported by:

Chelsea Lin

Contributing writer

students stand at whiteboard showing math equations
students stand at whiteboard showing math equations

Let’s face it: Math gives us a lot of feelings … and most of them are not the warm and fuzzy kind.

Most estimates put the number of people who suffer from math anxiety at about one out of every five adults. But we’re here to tell you that it doesn’t have to be that way. Dr. Nicola Petty runs a New Zealand-based company called Creative Maths that focuses on helping students learn to love math—yes, even you.

“There’s been this culture in our countries that made disliking math, particularly for girls, seen as socially OK,” she says. “We tend to have a fixed mindset regarding math: We either have a math brain or we haven’t a math brain. And it’s just not true. There’s no science to support it.”

Since math—particularly conversions—is an integral part of nursing school, we talked to Petty and asked students on social media about real-life tips and tricks to overcoming math anxiety. Here are eight ways to counter your fears.

1. Tell Your Math Story

This may sound a little woo-woo, but Petty believes this first step is perhaps the most important in getting over the trauma of our mathematical journeys.

Were you publicly humiliated when you got the wrong answer on that word problem? Did your parents drill you with flashcards and a kitchen timer? It’s important to know where this anxiety came from. Petty says she’s cried through many of these stories from students.

But identifying why you think you’re not a math person is the first step to becoming one. “It’s not your fault,” Petty says. “I like to say, ‘You were probably taught in a way that didn’t suit you,’ which takes the pressure off the teachers and takes the pressure off the student. The biggest message is: It’s not your fault.”

2. Find the Right Study Resources

Nursing students have shared that they’re particularly fearful of dosage calculations—after all, a lot is riding on a nurse’s ability to accurately administer medications to patients. But Julie Festa, a 30-year-old nursing student at St. Vincent’s College in Fairfield, Connecticut, who has suffered from lifelong math anxiety, says these calculations don’t have to be scary, as long as you find the right study materials.

“I learned to cope with anxiety by being really proactive about it,” she says. “I swear by this calculation dosage book. It gets me 90+ on all my math exams! I recommend going through the entire book’s practice questions during breaks between semesters, if possible.”

But Don’t Overdo It

Fellow nursing student Justine Gonz-Alar, who’s pursuing a BSN degree at Chamberlain University, agrees that study resources are essential, but warns that too many just end up working against you.

“Look for resources that help you understand topics better or break down the topic enough for you to understand,” she says, adding that there are many free resources available online. “It can do more harm than good, though, if you have too many in front of you, because you can and will become overwhelmed!”

Petty says that to really know your math, practice is necessary, though you should focus on a variety of problems rather than speed.

Petty, who has worked extensively with older students, and nursing students in particular, says it’s important to know that while schools ask you to learn these calculations, there are checks and balances in place—plus, computers!—when you’re actually on the job.

“Don’t feel fearful that you’re going to kill somebody because you don’t have good math skills,” she says. “What you do need to make sure is that you have a good idea of magnitude in terms of dosage,” as in readily knowing the difference between a microgram and a milligram.

3. Keep Practicing (and Practicing and Practicing)

The old school way of learning math—particularly basics like those dreaded multiplication tables—was rote memorization. But research has found that blindly memorizing facts and timing your speed can lead to unnecessary stress; your math fluency is more than just how fast you can recall information.

Petty says that to really know your stuff, practice is necessary, though you should focus on variety rather than speed. Choose different kinds of problems to work through, and don’t just read through your notes from class, which she says can give you the illusion of competence without actually knowing the material.

Nursing student Marisa Hetland lives by this model to overcome her math anxiety. “Practice, practice, practice!” she says. “There is no way to overcome that fear without doing a ton of practice problems to boost your confidence.”

4. Don’t Wait Until It’s Too Late

Unlike other subjects, such as biology or history, math is cumulative, which means you build knowledge like you would building a brick house, from the foundation up. If insecurity keeps you from speaking up when you don’t understand those foundational lessons, you’re not going to be able to move on to more advanced concepts.

“Don’t wait until you’re so far behind that you’re freaking out,” Petty says. “If you feel like you’re losing your place in class, get help right away. It’s probably indicative of some underlying gaps that will need filling up.”
Petty also makes this point: If something—a family tragedy or health issue, for example—caused you to miss a lot of school at some point in the past, you can’t beat yourself up for not understanding what may have been covered in those lost days/weeks/months.

Just take the time to fill in those gaps and remember that it’s not your fault.

5. Have a Relaxation Strategy

Are you a talented baker? A chess wiz? Petty says identifying something that you’re consistently successful at can help you overcome the feelings of inadequacy that some students experience while learning (or re-learning) math.

“When you start to feel threatened, it helps to have a happy place to go back to, to put yourself back in a place of success,” she says.

6. Don’t Be Afraid of Your Mistakes

“The difference between the people who can do math and the people who can’t is what they do when they make a mistake,” says Petty. More often than not, she sees students throw up their hands—after all, “someone who doesn’t feel confident feels like they have to give up. But that won’t teach you anything.”

Petty’s approach is to analyze her own mistakes with curiosity, asking “Where’d I go wrong?” Once you understand what led to the mistake, you’re unlikely to make it again.

7. Ask for Help When You Need It

Gonz-Alar recognizes that it can be awkward reaching out to classmates for help, particularly in online courses, but your cohort can be one of the best resources when it comes to school success—and not just in mathematics.

“Think about it this way: You can help support each other by asking questions, sharing what and how you all are doing, she says. “You can remind each other when homework is due and share resources. Plus, you never know … you might even find a lifelong friend!”

Tutors also can be an excellent option for help. In elementary through high school, Festa says, tutors helped her get past her math anxiety.

Don’t feel like you must learn everything the first time around. There’s data to support that having heard something before makes it easier when you sit down to revisit it and learn later, Petty says.

Though she’s found a system that works for her in the nursing program, Festa points out that her school—like most—has many resources for students who need a little extra help, from peer tutors and a tutoring center to instructors who encourage students to swing by during open office hours.

Professors Are There to Help

And that previous point is one not to be taken lightly: If you are having a hard time with the course material, or need longer to work on an assignment, talk to your professor.

“Asking for help is not a weakness!” says Gonz-Alar. “I know it’s hard to swallow your pride sometimes, but it’s never wrong to seek help. This doesn’t mean asking the professor for the answer but asking him/her if they have recommended resources that they know might help, or maybe even if they can show you how to do something. They’re there to support you in your success.”

8. Know When to Take a Break

Sometimes the key to successful studying is knowing when to walk away—at least momentarily.

“When you start feeling upset, take a break, go for a walk,” Petty says. “When you start that spiral of ‘I can’t do this,’ it fills your brain up with bad stuff and you get frozen. The very part of the brain we need to process the mathematics is the part that gets frozen by our feelings.” If a professor is teaching material that feels over your head, Petty recommends letting it sail right past—exposing your mind to it now, without worrying about grasping the details and falling into the fear-of-failure trap.

Adult Students Can Have an Edge

Don’t feel like you must learn everything the first time around. There’s data to support that having heard something before makes it easier when you sit down to revisit it and learn later, Petty says. In fact, she believes adults make the best students—despite that old adage about old dogs and new tricks—because they’re intentional about their learning.

Ultimately, try to remember how many others feel just as you do about math. As Gonz-Alar says, “Remember, it’s normal to feel anxious and overwhelmed at first, especially if it is a class that you’ve never had before. Take a breath!”


nicola petty

With professional insight from:

Dr. Nicola Petty

Creative Maths


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March 16, 2021 · 7 min read

Get Ready to Celebrate Nurses!

Nurses Week 2021 is boosting up nurse leaders and looking toward the future of healthcare.

stephanie behring

By Stephanie Behring
Contributing Writer

nurse receiving flowers in hospital room
nurse receiving flowers in hospital room

Every May, nurses are honored with a weeklong national celebration. Nurses Week, which is always May 6-12, honors nurses for the dedication, care, and skill they demonstrate every day. In 2021, Nurses Week has taken on even greater significance as it recognizes the extraordinary work nurses all over the world have done in the past year.

Last year, 2020 was designated the Year of the Nurse. The American Nurse Association (ANA) and the World Health Organization (WHO) have extended that celebration into 2021. There will be events throughout the year for nurses to enhance their education, make connections, and get recognition. So, if you didn’t get to join in last year, there’s still time to participate in the Year of the Nurse.

Last year’s “Year of the Nurse” has been extended through 2021.

The International Council of Nurses (ICN), a worldwide federation of nurses’ associations, announced the theme of Nurses Week 2021: “Nurses: A Voice to Lead,” with a sub-theme of “A Vision for Future Healthcare.”

It’s an incredibly fitting theme for nurses today. There’s been plenty of buzz about nursing leadership in the healthcare community lately: Healthcare organizations are increasingly recognizing the importance of strong nurse leadership, and nurses around the county are rising to the challenge. Nurses are earning higher degrees, taking on leadership roles, and redefining healthcare delivery.

With the Year of the Nurse extended into 2021, there’s a lot to celebrate and look forward to.

What’s the History Behind the Week?

Various groups have been lobbying to recognize nurses dating back to 1953, when U.S. Department of Health, Education, and Welfare’s Dorothy Sutherland unsuccessfully proposed a day for nurses to President Eisenhower. It wasn’t until 20 years later that the ICN proclaimed May 12—the birthdate of the British nurse Florence Nightingale, who is widely known as the founder of modern nursing—as International Nurses Day.

Seven years later, in 1982, President Reagan signed a proclamation declaring May 6 National Recognition Day for Nurses. Since then, the ANA, which has supported the profession since 1896, has been the driving force behind the celebrations. It’s added more reasons and ways to celebrate and honor the contributions that nurses make to the community, including designating May 8 as National Student Nurses Day.

Student nurses are celebrated as well: May 8 is National Student Nurses Day.

While some aspects of the week—such as discounts and freebies for nurses—are exclusive to Nurses Week, there are opportunities for enrichment, recognition, and awards all year long.

How You Can Participate

You can participate in Nurses Week in a variety of ways. From attending a multi-day conference to entering a contest on your phone, there’s a way to participate that fits your schedule. Check out our roundup of conferences, contests, and freebies below to get started.

Attend a Conference

Conferences are a great way to develop your skills, build your knowledge, and expand your nursing network. It’s a great year to attend a conference, since there are several events both virtual and live to choose from. So whether you’ve always wanted to attend a conference from your living room or you’re looking forward to booking a flight, check out some of the events below. If you need more incentive, don’t forget that you might even be able to get employer reimbursement for attending. Be sure to ask!

This summit, offered by the American Association of Colleges of Nursing and City of Hope, focuses on palliative care training and will be held virtually April 15-16.

If you’re interested in clinical research, check out this virtual conference presented by the Cleveland Clinic April 26-27.

The Ohio University School of Nursing is presenting this virtual conference, which offers the opportunity to earn 4.5 continuing education hours on May 4.

You can earn up to 21 pharmacology contact hours by attending this virtual conference presented by the American Psychiatric Nurses Association June 10-13.

Billed as “THE Healthcare Travel Conference,” this annual event, held September 26-29 in Las Vegas, focuses on traveling healthcare professionals and offers the opportunity to earn continuing education hours.

This large conference with more than 150 speakers is in its fifth year of operation and will be held in a hybrid virtual and live format (live sessions in Orlando) October 18-20.

This biannual event brings together nurses around the globe and is being held virtually Nov. 2-4.

Enter a Contest

There are a handful of contests designed to reward nurses for the hard work they do every single day, with many bestowing gift cards or cash to the winners. Keep in mind that some contests are limited to certain regions. Be sure to read the rules carefully before you enter.

Winners are picked every quarter for this contest, which awards $1,000 to nurses for a much-needed night of fun. While you might think this award is only for California nurses, it’s actually open to any currently employed or retired RN or LPN, members of the Ohio Nurses Association (ONA), and members of the Oregon Nurses Association (ONA).

Show your fellow nurses how you practice self-care by submitting a photo by May 12 to Cross Country Nurses’ Facebook or Instagram page. You could win a $500 gift card if your entry is chosen.

This ongoing contest aims to show the faces of nursing and recognize the exceptional work nurses perform. You can enter by submitting a photo that shows how you or your team face daily challenges. You can win $100 for an individual photo and $500 for a group photo.

Get Freebies and Discounts

Many businesses and websites offer discounts and free items for nurses in May. Nurses can usually expect to find:

  • Discounts on uniforms
  • Free coffee from national chains
  • Free meals and snacks at participating restaurants
  • Discounts on housewares
  • Discounts on classes or free CEUs (The ANA’s free professional development webinar on May 19, “Nursing: Scope and Standards of Practice, 4th Edition,” will help you further your professional career while saving you some money.)

The Nurses Week website is a great place to check frequently for discounts and giveaways for nurses.

Join in on Social Media

You can jump into the celebration today by checking out what’s happening on social media. During Nurses Week you can use the hashtag #nursesweek to tag your posts and check out what your fellow nurses are doing. Throughout the year, you can connect with other nurses by using these popular nursing hashtags:

  • #nurse
  • #nurses
  • #nurselife
  • #yearofthenurse
  • #nursesofinstagram

While you’re at it, follow our hashtags #allnursingschools and #allnursingstory on Instagram and Facebook. Get inspired by personal stories of nurses and nursing students for your own educational journey—plus, watch videos and be in the know about latest updates in the field.

Jump Start Your Career

Nursing leadership is a focal point of Nurses Week 2021. This year is a great time to focus on your own healthcare future and take a few steps forward in your nursing career.

Find a Mentor

A mentor can help you figure out where you want your career path to go in the long run. It can be helpful to talk to someone who has been in the field longer than you and has accomplishments similar to your goals. Not sure how to find a mentor? You can begin by reaching out to a professor, starting a conversation with a coworker in a leadership role, or networking.

Get a Credential

Adding a new credential to your resume is a great way to boost your career. You can find courses in a variety of nursing specialties—like critical care nursing or obstetrics—that can help you gain knowledge and stand out in your field. You might even be able to secure a scholarship. You can start by checking out some of the most popular certifications available to nurses.

Go for an Advanced Degree

Have you been meaning to go back to school? The energy and positivity surrounding Nurses Week may give you the motivation you need to earn that degree you’ve been considering. Whether you’re looking to advance your degree by earning a Master of Science in Nursing (MSN) or you’re hoping to turn your licensed practical nurse (LPN) training into a Bachelor of Science in Nursing (BSN) degree, now is a good time to get started.

Remember to Practice Self-Care

As medical professionals who are often in a high-stress environment, nurses experience a personal toll in their line of work. Nurses often work long shifts caring for the medical and emotional needs of multiple patients. In fact, a report recently published in the Journal of the American Medical Association found that among nurses who quit their jobs, 31.5% report being burned out as their primary motivating factor for leaving.

More than 30% of nurses who quit their jobs say burnout is the reason why they leave.

“Nurses have to be willing to take care of themselves,” says Rosa Crumpton, RN, BSN, BS, MBA, HCM, a nurse manager at the Veterans Administration Medical Center in Seattle. She says nurses used to always helping others can often find it challenging to put their own needs first. “It goes against everything that has been ingrained in us. This means we have to make our needs known, take our breaks, say no to overtime, and create some boundaries between work and home.”

Self-care can ease your stress, helping you recharge and deliver your best patient care. You don’t need an elaborate ritual. Try these tips to take a little time for yourself:

  • Get enough sleep
  • Unplug from social media for a while
  • Take time to exercise
  • Eat healthy meals
  • Spend time with friends
  • Read a favorite book or watch a favorite movie

If you’re feeling extra overwhelmed, don’t be afraid to reach out. Having support can be an important part of self-care. Beyond talking to friends, Crumpton suggests tapping into your employer’s employee assistance program if you’re feeling stress and burnout.

“This is an anonymous resource that often offers counseling and other mental health services, free of charge,” Crumpton says. “You may also be able to talk with chaplain services if you’re in a hospital setting. Another idea is to form a support group with other healthcare professionals, just to decompress.”


rosa crumpton

With professional insight from:

Rosa Crumpton, RN, BSN, BS, MBA/HCM

Nurse Manager


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Go for the Next Level

From an LPN to a Doctorate in Nursing, explore a variety of programs that will energize and educate you.

February 17, 2021 · 7 min read

7 Tips for Crushing It in the Online Classroom

Nursing students studying for their degrees online have some advice for excelling in a virtual program.

Written and reported by:

Chelsea Lin

Contributing Writer

student in video call with textbook and notes
student in video call with textbook and notes

More than 90% of college students are now taking at least some of their classes online, an increase of nearly 200% over 2017, according to EducationData.org. It’s a trend that’s expected to continue, but not all students are prepared for how different online learning can be from attending classes on campus.

“The greatest challenge for students taking online courses is self-regulation,” says Chris Drew, who is based in Vancouver, British Columbia, and teaches remotely at Swinburne University in Melbourne, Australia. “[Students] need to remember to put in the same time, dedication, and effort as if you were studying on campus.”

We asked nursing students who are pursuing degrees online to share their advice for learning outside of the traditional classroom. Here are their top tips for success.

Tip No. 1: Form a Study Group

sherryl perez

This sounds like obvious college 101 advice, but for remote students, study groups can not only help you learn course material but also build community with peers who could be mere miles away, or in another state.

Sherryl Perez (pictured), who’s pursuing a master’s entry-level nursing program at the University of California, San Francisco, says the ideal study group is composed of students who have “similar learning habits and include some people who can challenge you to think about the material at a higher level of thinking.”

She recommends finding an online platform that works for your cohort to post days and times for study sessions and ask questions about assignments. Slack, a Facebook group, and WhatsApp are just some examples of your options.

You’ll also need to choose an online platform to meet. Zoom and Microsoft Teams are two of the most popular, but there are many to choose from.

Study groups for remote classes can help you build community with peers who could be mere miles away, or in another state.

Julissa Haya credits study groups for her survival in the pediatric nurse practitioner program at UCSF. “Study groups are a great way to learn from each other, especially if you are an auditory learner,” she says. “It’s also a great way to divide those long study guides, come together, and go over them as a group.”

Drew, author of the Helpful Professor blog, adds that there’s also a social component to these small groups. “A study group is not only about studying,” he says. “It’s also about feeling less isolated. It’s about getting that sense of community that so many online students sorely miss.”

Tip No. 2: Leverage Those Lectures

If your memories of in-person learning are punctuated by missed alarms and midclass daydreams, you’re not alone. Online students can face the same pitfalls, but recorded lectures can fill in the blanks.  

Ferlyn Mabanglo, who is pursuing an Associate Degree in Nursing (ADN) at Cypress College in California, says planning which days she’ll review lectures is crucial to staying organized.

“Depending on your school, online lectures may be prerecorded and you can review them on your own time (asynchronous), or lectures are recorded in live time while students watch (synchronous),” she says. “Reviewing asynchronous material on [specific days] will help divide your attention effectively rather than reviewing asynchronous lectures every day.

“For synchronous lectures, these are discussed in the beginning of the term where you know which set days you need to be online for a live recording.”

Tip No. 3: Organize Your School Space

estela guevara

Getting a good night’s sleep may be critical to learning, but that doesn’t mean you should be studying in bed. In fact, you’ll learn best if you have a clean, organized study space that’s not where you like to nap.

Estela Guevara (pictured), who is pursuing her Bachelor of Science in Nursing (BSN) at UCSF, says she’s learned to organize her workspace at night. She sets out her planner, pens, notebooks, glasses, and a cup of water, so when her alarm goes off for those 8 a.m. classes, she’s ready to go.

“I’m a Type A personality,” Guevara says, “and it definitely relieves a lot of anxiety.”

You’ll learn best if you create a designated study space—and, no, your bed doesn’t qualify.

Tip No. 4: Embrace Apps

Sure, technology can be a distraction while you’re trying to study. But it can also be a key to success if you take advantage of apps and programs designed specifically to help you learn and stay organized.

Here are some favorites of our online student experts:

  • Study apps:
    Stephania Ulett, a nursing student at Chamberlain University in Florida, says YouTube, and the apps Simple Nursing, Level Up RN, and Picmonic, provide lectures, learning tools, study guides, and test prep to help you master material. Apps like these “will be your best friends while in nursing school,” Ulett says.
  • Transcription apps:
    Perez recommends transcription apps such as Otter if you want to transcribe live lectures into text. She says apps like these can be a great learning tool if it’s more effective for you to read notes than to listen to a lecture the second time around.
  • Time management apps:
    Guevara relies on Flora, a gamified productivity app that challenges you and your friends to grow trees—virtually and in real life—based on how productive you are. This app can help you get through to-do lists and stay off your phone and away from the rabbit hole of endless social media scrolling.

Tip No. 5: Don’t Be Afraid to Ask for Help

As a teacher, Drew says he’s surprised by how few online students reach out for help or clarification regarding assignments, but sometimes it’s the best thing you can do.

“Anxiety and stress levels peak when you’re unsure of what to do,” Drew says. “We’re here to help you—so make use of that! Asking for clarification can help you feel like you’re on steady footing and proceed in your work with confidence.”

Mabanglo recommends asking for an extension on deadlines “when life happens” to help balance your workload.

“Professors will sometimes remind students of this option,” she says. “However, even if they don’t, it doesn’t mean you can’t ask. Professors want you to succeed, and my advice is to always ask and explain your situation.”

Tap Your Family for Help

  • Drew offers this advice for students with children: “Ask your partner or family to look after the kids for a dedicated few hours per week so you can study without distractions.”

Tip No. 6: Create a Schedule and Stick to It

Good study habits are the key to success, says Drew, and when you’re learning from home, that means creating a schedule. Think of it “like having shift hours at work,” he says, and stick to it.

“Online students often work full-time jobs and squeeze school into the evening hours,” Drew says. “While this is a big benefit of online studies, also remember to give your studies the time and dedication they deserve.”

No Coasting Allowed

  • Remote learning can put more responsibility on students to stay on top of classes, Drew says, so you need to pay special attention to following through on your work.

“It can be very easy for an online student to delay a task until the end of the week or ignore an email,” Drew says. “This seems to be a much bigger problem for online classes because you can coast under the radar more easily. No one’s going to be leaning over your shoulder each week in class checking up on you.”

If you have a hard time focusing for long chunks of time, Mabanglo and Guevara recommend the Pomodoro Technique, a time-management method that uses a timer to break work into 25-minute blocks followed by a five-minute break. There are several time-management apps based on this technique.

Good study habits are the key to success, says Drew, and when you’re learning from home, that means creating a schedule and sticking to it.

In terms of completing assignments, Drew advises getting into the habit of writing papers early so you have breathing room in case something unexpected pops up in your work or home life.

Finish them early, but don’t necessarily turn them in early: Drew says you’ll want to revisit those drafts and edit them with fresh eyes a few days before you submit them.

Tip No. 7: Don’t Forget Self-Care

stopwatch graphic

When you’re juggling work, school, and family obligations—any of which can be a full-time job on its own—putting yourself first at times can feel selfish. But taking care of your mental and physical health can help you be prepared for class and whatever else life may throw at you.

Guevara says her self-care is feeding her body well. “I love to cook, so I just make sure that I’m cooking more than I’m eating out,” she says. “I believe nutritious eating is going to benefit me.”

Sometimes, the first thing that goes when we stress is self-care, but Guevara says to fight this counterproductive urge.

“I’ve heard from students that maybe they were so stressed they stopped running,” she says. “And making time to run on their lunch breaks gives them the energy they need to get homework done later.”

Sleeping well, practicing mindfulness, and checking in with friends can all help you succeed.

Joseph Mingo III, who is pursuing a BSN at Galen College of Nursing, says it so simply: “Reward yourself!”

Now, who wants a cookie?

Think we missed a crucial tip? Send yours to our Facebook or Instagram account!

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chris drew

With professional insight from:

Chris Drew

Professor, Swinburne University


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January 5, 2021 · 7 min read

How to Get Credit for Prior Learning in Nursing Programs

If you’re ready to move to the next level of nursing in school, you may qualify for academic credit based on your experience outside a classroom.

anna giorgi

Written and reported by:

Anna Giorgi

Contributing Writer

nurse staff training at patient bedside
nurse staff training at patient bedside

Getting credit for prior learning can help you save time and money when you advance your nursing education. Whether you’re a certified nursing assistant (CNA), licensed nurse practitioner (LPN), or registered nurse (RN), you may be able to apply your knowledge and experience toward credits that can help you complete a nursing program without taking coursework on content you already know.

Credit for prior learning takes into account knowledge and experience gained outside a classroom.

Nursing programs that offer this option recognize that students can gain knowledge from both formal and informal, or experiential, learning.

The Role of Prior Learning Assessments

Programs award credit for prior learning in several ways, including using evaluations called prior learning assessments (PLAs). PLAs measure your knowledge against college-level content.

In a recent study, the Council for Adult and Experiential Learning (CAEL) and the Western Interstate Commission for Higher Education (WICHE) reported that students who received PLA credit saved nine to 14 months of study time by earning credits for about a semester of full-time study. For these students, the PLA credits translated into savings of between $1,500 and $10,200 in education costs.

While there’s a practical advantage to reducing the time it takes to complete a program, this benefit may also support academic success. In the same study, 49% of adult students who received PLA credit completed their postsecondary degree or certificate, while only 27% of students who didn’t receive credit achieved that goal.

“When you’re applying for a program and you have a lot of experience that you think is relevant, it’s always worth asking to see if there are ways to get credit or advanced standing based on what you already know and can do,” says Becky Klein-Collins, CAEL’s associate vice president, Advancement and Impact.

How Credit for Prior Learning Works

Credit you receive for prior learning will depend on a program’s guidelines and your ability to demonstrate your knowledge. You’ll find that programs differ on:

  • The number of prior learning credits they award
  • The types of courses you can skip
  • The total number of prior learning credits you can apply toward a specific program

Some programs may only allow you to apply general education courses or electives to prior learning credits. Other programs may have fewer restrictions and give you credits toward core nursing courses. 

Another consideration: Nursing programs typically align with criteria set by state nursing boards, so your options may vary by state.

  • Pro Tip
    Make sure to verify that any prior learning credit meets the requirements of the state in which you will take your licensure exam. Otherwise, you’ll risk having an education that doesn’t qualify you for licensure.

With so much to consider, make sure to meet with an admissions counselor to figure out your eligibility for prior learning credits and the nursing program’s policies.

“Meeting with an advisor is an absolute must before you enroll or pay one penny of tuition or fees,” Klein-Collins says. “Typically, for adult students who are juggling a lot in terms of a current job, family responsibilities, and other responsibilities that you may have, you’re going to be prioritizing programs that are going make it easy to fit into your life and get you to where you want to go.”

Make sure to meet with an admissions counselor to figure out your eligibility for prior learning credits.

Many nursing programs are designed for students who want to progress from one level of nursing to the next. These programs award credit for formal learning and professional experience by designing curriculum that avoids duplication of coursework.

Here’s a look at some options.

Stackable Credits

If your school offers programs for more than one level of nursing, find out whether it offers stackable credentials. In this scenario, students who have earned a certificate, such as a CNA, may be able to progress to a licensed practical nurse diploma or Associate Degree in Nursing (ADN) at the same school because the programs build on one another.

Bridge Programs

Bridge programs give consideration to the education, license, and professional credentials you’ve already earned. Some may also allow you to apply your professional experience toward program credits. Popular bridge programs include LPN to RN, and RN to BSN.

Accelerated Programs

Accelerated nursing programs are geared toward students who have a bachelor’s or graduate degree in a non-nursing major. These programs allow students to concentrate on core nursing content and clinical skills without repeating the general education courses they took for their previous degree.

Transfer College Credits

If you have credits from an accredited school, you may be able to transfer them to satisfy some of the requirements in another program. Many schools have online calculators to determine if a course you’ve taken would count toward a course in a program you’re considering.

Find out if your previous school has agreements with other institutions that accept credits toward nursing programs. This is common among community colleges and four-year schools.

Competency-Based Education

If you know most of the material presented in a class, you may be able to leverage your knowledge in a nursing program that offers competency-based education.

These programs allow you to skip semester- or quarter-long courses and test out of sections or units when you’ve learned the coursework, speeding your progress.

Pro Tip
Even if you have transferable coursework, you’ll need to make sure it hasn’t expired. Many STEM courses expire after 10 years due to advances in science and technology. 

“Particularly for occupational programs, where the programs are overseen by state licensing boards, there are likely stipulations about how long your credits are good,” Klein-Collins says.

Credit by Prior Learning Assessment (PLA)

nurse student in classroom

If you have relevant knowledge or experience gained outside the classroom, you may be able to earn college credit from a PLA.

“When those opportunities are available, there would have to be some sort of formal evaluation or assessment of the learning that the student acquired from previous work experience, not simply an award of credit or advanced standing because a person held a specific position for a certain number of years,” Klein-Collins says.

This could be a good route if you’re a CNA or LPN without formal college credits but with relevant knowledge that you can demonstrate.

There are several assessments, so check with your nursing program to determine which ones they accept.

The most common assessments include:

CLEP and DSST

CLEP (College-Level Examination Program) and DSST (DANTES Subject Standardized Tests) are approved by the American Council on Education (ACE) to award college credit:

  • CLEP offers 34 exams accepted at more than 2,900 colleges and universities.
  • DSST offers 37 exams accepted at more than 1,900 colleges and universities.

Passing a test by either group can entitle you to three or more college credits, depending on your school’s criteria.

Nursing Challenge Exams

Nursing challenge exams are tests created by nursing programs that allow students to demonstrate their knowledge of specific subjects.

The National League for Nursing (NLN) offers five Nursing Acceleration Challenge Examinations (NACE) for standardized evaluation of nursing knowledge. The exams are primarily for LPN students seeking advanced placement in RN or BSN programs and align with courses found in many nursing schools:

  • Nursing Care of the Child
  • Nursing Care of the Childbearing Family
  • Foundations of Nursing
  • Nursing Care of the Adult Client
  • Nursing Care of the Client with Mental Disorder

Nursing Portfolio Assessment

Some nursing programs accept a portfolio to determine whether you qualify for credit or advanced standing in a nursing program. A nursing portfolio typically includes:

  • School transcripts
  • Licenses
  • Letters of recommendation
  • Continuing education certificates

It can also include awards, specialty certifications, and other documentation that proves your range of experience.

Nursing faculty review portfolios to determine if a person’s experience fits the program and the amount of credit or advanced placement they receive.

Credit for Training

You may be able to earn credits or advanced placement for employment, volunteering, or military training.

  • The American Council on Education (ACE) assesses non-college-based courses, exams, and professional licenses and credentials. You can search the ACE National Guide to find out if you’ve completed a program that may qualify for credit toward your nursing program.
  • The National College Credit Recommendation Service (NCCRS) assesses training and educational programs offered outside the traditional college classroom. Search the NCCRS online directory to determine whether you’ve completed a course that may be eligible for credit.

Finding the Right Program

If you qualify for credit for prior learning, you’ll want to choose a program that offers the best reward for your knowledge.

“It’s important to ask really good questions about how well the program is connected to local employers where you are, so that they can help you find a job at the other end of it,” Klein-Collins says. “None of it is worth anything if you can’t get a job when you’re done.”

Five Questions to Ask About Credit for Prior Learning

When evaluating a nursing program, ask these questions to find out what you need to know about credit for prior learning:

How does the school award credit for prior learning or prior learning assessments?

What is the maximum number of transfer or PLA credits that I can apply toward the program?

How long will it take to complete the program with any transferred credits or credit for prior learning?

Does the school have a pathway for stackable certificates or degrees that I can apply toward this program?

Do local employers have a strong track record of hiring program graduates?


becky klein collins

With professional insight from:

Becky Klein-Collins

Associate Vice President, Advancement and Impact
Council of Adult and Experiential Learners


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November 30, 2020 · 9 min read

Your Questions About Nursing School, Answered

Wondering about the difference between an ADN and a BSN and what it could mean for your nursing career? We answer that question—and many more.

Written and reported by:

Chelsea Lin

Contributing writer

intense woman nurse working on desktop
intense woman nurse working on desktop

Deciding where, if, when, and how to pursue a career in nursing is no easy feat. Whether you’ve spent years contemplating the profession or are just getting started in your research, we know it can be confusing to navigate the back-to-school experience.

We gathered your questions shared on social media and in our surveys, and here, we present answers to some of the questions prospective nursing school students most commonly ask.

Don’t see your question here?
Email your questions to questions@dev-ans-06-01-2021.mystagingwebsite.com and we’ll do some research for you.  We’re also on Facebook and Instagram. You can talk to us there anytime.


Education and Training

Can I apply my previous nursing or healthcare experience toward becoming an RN and/or earning a higher degree?

Registered nurses (RNs) must have at least an Associate Degree in Nursing (ADN), but some students decide to pursue a Bachelor of Science in Nursing (BSN). If you’re already working in the medical field, there are multiple pathways to work toward becoming an RN.

 Here are two examples:

How much math and science do I have to take to become a nurse?

These subjects appear to be a common fear among prospective students, and the answer depends on the type of nursing you pursue. If you’re interested in the LPN/LVN route, your training program will likely include science courses like anatomy, physiology, human growth and development, and basic nutrition. You may need to meet a math requirement to get into an LPN program.

Whether in an ADN or BSN degree program, a prospective registered nurse will likely need to take health-related science courses, as well as meet math requirements (and liberal arts, too).

Don’t let math anxiety keep you from pursuing your career goals. Revisit the basics—fractions are your friends!—if you feel like you’ve forgotten them since school. And don’t be afraid to hire a tutor to help you navigate college-level coursework that seems daunting.

I am a certified nursing assistant (CNA) and a certified medical assistant, and I have practiced in both fields. Do I have to go back to school to become an LPN, or can I just take the LPN exam, get licensed, and start work?

Having experience as a CNA is valuable in terms of knowing that nursing is the right field for you but, unfortunately, most CNA programs don’t apply toward course requirements to become an LPN. To become an LPN, you’ll still have to complete an approximately yearlong training program and then take the NCLEX-LPN exam to qualify for a license.  

Can I really get a nursing degree online?

Since nursing is a hands-on profession, even online nursing programs require in-person clinical training with real patients. Programs that combine online learning with real-world practice are called hybrids.

If you’re pursuing a bachelor’s degree and already have a combination of clinical hours and a current RN license, you may be able to find a program that is exclusively online.

Do schools help students find placements to meet clinical training hours, or do I have to do that?

Most schools have faculty advisors who will help find students placements for their clinical training hours. This is definitely something you should ask about, though, as you look at nursing programs.

Registered Nursing

What degree do I need to become an RN?

woman nurse holds ipad

To become an RN, you’ll need either an ADN or a BSN. There are pros and cons to each, of course: An ADN can be less of a time and monetary commitment, making it a good jumping-off point for prospective students with financial concerns, another job, or family to take care of.

A BSN, on the other hand, can lead to a job with more responsibility and higher pay.

If you choose the ADN route now, you can always go after that BSN later. You can even pursue a master’s or doctoral degree in nursing.

What’s the best way to become an RN?

“One of the things I love about nursing is that there are so many doors to get into the nursing profession,” says Beverly Malone, CEO of the National League for Nursing, a membership organization for nurse faculty and leaders in nursing education.

Where to start “depends on your situation,” she says. “Match who you are with what you need,” meaning look for a program that suits your personal and family situation but also helps you achieve the nursing goal you’ve set.

If your goal is to be an RN, you’ll have to complete an ADN or BSN nursing program, pass the NCLEX-RN exam, and earn a state license.

An LPN-to-RN program allows LPNs to use their experience and prior coursework toward earning an ADN or BSN. The LPN-to-BSN route will take longer but can pay off better in terms of salary and job opportunities.

International Students

If I’ve already worked as a nurse in another country, what do I need to do to work in the U.S.?

You’ll need to meet several requirements to work in the U.S., a process that can take several years. Before you apply, you’ll need:

  • A degree from an accredited nursing program
  • An RN license in your country
  • An RN license in your country

If you meet these requirements, you can start the application process for a visa. This will involve an English-language test, a review of your credentials, a qualifying exam, and more.

School Search

What should I look for in a school?

Picking a school is not a decision to rush—you’ll want to feel welcomed, inspired, and that you’ve gotten the most for your effort and money. Here are a few things to consider:

  • Admissions requirements
  • Accreditation status, ensuring the program meets requirements for state licensing and professional certificates
  • Graduation rate
  • Pass rates for the NCLEX-RN and the NCLEX-LPN nursing exams, required nationwide
  • Percentage of recent graduates working in nursing
  • Ranking among other state programs

Malone says, besides these factors, “look at the faculty. Examine and investigate what you’re buying. Look to see what kind of relationships (the program) has with the community—that’s even bigger than career placement.

“If you’re looking for a school that recognizes the community and believes in it, you’ll find those kind of relationships (with churches, community centers, and the like.”)

National League for Nursing CEO Shares her Top 3 FAQs

Even after 52 years of nursing, National League for Nursing CEO Beverly Malone still describes her profession with the kind of effervescent joy of a new graduate. “Purpose, passion, and power—that’s what nursing is,” she says. As a nursing advocate, she fields plenty of questions. Here are answers to her top three. 

Is there a shortage of nurses?

“Yes, there’s really a shortage,” Malone says. “Most of us are over 40, even over 50, so there’s this whole issue of how we’re going to replace those who are going to retire or move on.”

Why did you choose to be a nurse?

“I have a great-grandmother who raised me and she was a community healer,” Malone says. “I worshipped the ground she walked on. I thought there was nothing better than to be needed by your community and make a difference in your community,” which Malone says is precisely what nurses do.

Is being a nurse difficult?

Malone thinks it’s the blood people worry about the most, and maybe dealing with accidents where there are multiple things going on at the same time. “But what you find is that you get into your helping mode,” she says. “‘We’ve got to save lives here, colleagues, let’s do it.’ Nurses are such doers, completers of actions. We’ll accompany you through some of the worst things that can happen, and what an honor that is! It’s worth the challenges; it’s so fantastic. We’re one of the few who wake up in the morning and know exactly why we’re here.”

General

Is there a nurse’s oath like the one for physicians?

Yes—while doctors take the Hippocratic Oath, nurses take the Nightingale Pledge, named for Florence Nightingale, who is considered the founder of modern nursing. The pledge calls on nurses to elevate the standard of their profession.

Licensing

Who grants nursing licensure and who can take it away?

After you complete your training, you’ll need to pass the NCLEX-RN exam and apply for a nursing license in the state in which you plan to work. You’ll send your transcripts, application, and fee to the state board that handles licensing. Each state has its own requirements.

If your nursing license is revoked due to violations of your state’s Nurse Practice Act, you might be able to petition the state board to reinstate it

What if I let my license lapse? What do I need to do to start working again?

If you let your license lapse for just a short time, you can generally renew it—perhaps by paying a late fee—without much trouble. But an extended inactive license could require refresher courses. Check your individual state requirements.

Can an LPN with an expired license become a CNA without further training?

While a CNA is a level down from an LPN, you might still be required to take CNA training, which is set by federal law, and a certification exam to be placed on your state’s CNA registry.

If you aren’t on the registry, nursing homes and Medicare and Medicaid facilities can’t hire you, according to Genevieve Gipson, RN, MEd, RNC, and director of the National Network of Career Nursing Assistants and Career Nurse Assistants Programs Inc.

Your state may have a waiver program or make exceptions, however, so check with your board of nursing or state health department to see if it has special requirements for trained LPNs who want to be CNAs.

Costs and Financial Aid

How much is tuition for nursing programs?

Tuition costs vary widely depending on the type of program you choose—private university versus community college, for example. Another factor is what kind of nurse you want to be.

For example, if you want to be an RN, you can choose a two-year ADN program or a four-year BSN program. Your best bet is to reach out directly to the schools you’re interested in and get the most up-to-date costs.

Are there additional costs to nursing school?

Yes—tuition isn’t the only cost you’re looking at. Here are a few others:

  • Scrubs and equipment
  • Textbooks
  • Additional tests and screenings (background check, drug screening, etc.)
  • Licensing fees

How do I get financial aid?

To qualify for financial assistance, including grants and loans, your school must be accredited, and you’ll need to submit a Free Application for Federal Student Aid (FAFSA). But that’s not the only avenue to financial aid.

male nurse with stethoscope holds ipad

Look into scholarships that you may qualify for—there are many options out there, including scholarships specifically for nursing students, single parents, first-generation college students, and more.

Can I go to school for free? I’ve heard about loan forgiveness—how does that work?

“Free” may be a stretch, but there are programs out there, like Nurse Corps, that will pay your tuition, fees, and other educational costs. In return, you must commit to working in an area where there’s a critical shortage of nurses for a set period of time, once you graduate.

Another government program, the Nursing Education Loan Repayment Program, has similar terms. It requires nurses to work for up to three years in an area with an underserved population and, in return, it’ll pay off up to 85% of your loan balance.

How do I get tuition reimbursement from my employer?

If your employer offers tuition reimbursement, talk with your benefits representative about the organization’s reimbursement policy. It might have very specific terms for reimbursement, including the types of classes you take and whether you complete a program. Your employer also might require documentation from the school you attend.

Salary

Will earning a BSN make a difference in my RN salary versus whether I just have an associate degree?

Earning a BSN can definitely have a positive impact on your salary: It can make you more desirable to employers, qualify you for a wider variety of jobs, and open doors to leadership opportunities.

Careers and Jobs

What’s the role of a CNA, and can the job vary by state?

Educational and licensing requirements for certified nursing assistants (CNAs) do vary by state, but the role is generally the same everywhere: helping patients with activities of daily living, such as eating, bathing, grooming, toileting, and moving around. It can be a physically demanding, though rewarding, profession.

What’s the difference between the roles of an LPN and RN?

The differences are distinct. LPNs provide basic medical care for patients, like checking their vitals, ensuring their comfort, and discussing healthcare issues with them. RNs, on the other hand, may perform diagnostic tests, administer medications, put together treatment plans, and supervise other medical workers, including LPNs.

Can travel nurses work with an associate degree, or is a bachelor’s required? Do they need a specialty?

Travel nurses, who work temporary positions in areas with shortages, must have an RN license, which means an ADN is fine. Having a specialty is not necessary, though it may lead to more destination options and higher pay. 

Applying and Enrollment

I’ve requested information from some schools but haven’t heard back. Who do I contact?

Reach out directly to the nursing programs, if that’s an option. A quick phone call usually will yield better results than an email, especially if you’re following up with specific questions.

Otherwise, contact the program’s admissions department—and remember, staff is there to help sell you on the school, so get your questions answered!


beverly malone

With professional insight from:

Beverly Malone

CEO of the National League for Nursing


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October 23, 2020 · 15 min read

The Top States for Nurses to Work

From salaries and cost of living to educational resources and job prospects, we’ve ranked the 50 states for nursing professionals.


niki stojnik

Written and reported by:

Niki Stojnic

Contributing writer


Whether working in the ER, in a family practice clinic, or anywhere in between, registered nurses are in demand—everywhere. In fact, nurses comprise the largest portion of the healthcare workforce, according to the American Association of Colleges of Nursing: There are more than 3.8 million registered nurses (RNs) nationwide, and they make up one of the largest segments of the U.S. workforce.

All of that means you can be choosy as you’re deciding where to live and work as a nurse. The employment options for nursing are good in all 50 states, but factor in average salaries, cost of living, the flexibility to work across state lines and other information, and some states come out clearly on top. 

We’ve ranked all 50 states based on three main considerations:

  • Average salary of a registered nurse (adjusted for cost of living)
  • Density of RN jobs in a given area (location quotient)
  • Demand for the profession in the region

In each state’s profile, we included the average salary to highlight the cost of living difference, as well as some other helpful data. Combined, these factors fill in a picture of:

  • What you might be able to expect in terms of job availability
  • Where to look for jobs at different salary levels
  • How salaries compare to the state and national average
  • Where you might find more continuing education programs, based on the number of schools nearby

Higher Education May Take You Further, Wherever You Live

Access to education is increasingly important because your options for employment, regardless of where you live, could get even better if you are a registered nurse prepared with a Bachelor of Science in Nursing degree or higher. 

“Employers are looking for highly skilled nurses able to translate the latest scientific evidence into practice,” Deborah Trautman, president and CEO of the American Association of Colleges of Nursing, says about the marketability of earning a bachelor’s degree, especially if you’re looking to make a jump across state lines. “They are also looking for nurses to lead and contribute to team-based care as interprofessional practice takes hold in many settings.”

“All of these new demands underscore the need for a well-educated nursing workforce able to meet contemporary practice expectations,” says Trautman. “Research shows that more highly educated RNs are linked to lower patient mortality rates, fewer medication errors, and other positive care outcomes.”


Growth and Opportunity Across the Country

In addition to representing a big part of the workforce, the nursing profession isn’t slowing down any time soon, either. The U.S. Bureau of Labor Statistics (BLS) projects 7.2% growth in this career through 2029. Thanks to increased demand for healthcare services from a large baby boomer population, more demand for preventive care, and an increase in chronic conditions, coupled with ongoing nursing shortages that existed even before the pandemic, the need for nurses is bigger than ever.

Nurse Licensing is state specific, but you can currently work across state lines with the same license in 34 states.

The rewards for working as a registered nurse are strong—and some incentives are getting stronger. The national average salary for registered nurses is $77,460 and higher for those working in medical and surgical hospitals ($79,460) and outpatient care centers ($84,720), according to the BLS. In addition to a shortage of nurses with baccalaureate degrees, demand for nurses with master’s degrees also outpaces supply.

And while licensing is state-specific, you’ll be able to work across state lines in 34 states that are part of the Enhanced Nursing Licensure Compact.

No matter where in the United States you’re pursuing your nursing degree or looking to land a job—whether you want to stay close to home or embark on a new adventure as a travel nurse—use this guide to help narrow down your options.

State of Demand: Top Five Places that Need Nurses the Most

Where most states expect about a 2.5% change in demand for registered nurses, these five regions have the highest potential demand through 2021, according to Projections Central. And that means more opportunities could exist here for the next generation of professionals.

State

Anticipated Change in Demand for Nurses


Arizona

6.9%

Utah

5.3%

Colorado

5%

Nevada

5%

New York

4.9%

The Rankings

Glossary of terms

(see Methodology for more information)

AACN: American Association of Colleges of Nursing, the national association for nursing academics, which works to establish and implement quality standards for nursing education and promote public support for nursing education, research and practice.

COL: Cost of living

Location quotient: The ratio of the concentration of nurses in an area compared to the national average; above one means a higher concentration of nurses than average, and below one means a lower concentration than average.

Pending legislation: States that are in the process of entering the Enhanced Nursing Licensure Compact.

50

Louisiana

$65,850
Average RN Salary
  • COL-adjusted salary: $34,412
  • Highest average salary: New Orleans-Metairie, $69,500
  • Lowest average salary: Lafayette, $60,940
  • Location quotient: 1.05
  • Change in demand for nurses: N/A
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 12 AACN-member schools

Notes: Louisiana’s highest salary is centered on the well-known New Orleans area but hits below the national average; however, the concentration of nurses is above average.

49

Oklahoma

$64,800
Average RN Salary
  • COL-adjusted salary: $35,672
  • Highest average salary: Oklahoma City, $66,510
  • Lowest average salary: Lawton, $56,290
  • Location quotient: 0.95
  • Change in demand for nurses: 2.1%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 12 AACN-member schools
48

Virginia

$71,870
Average RN Salary
  • COL-adjusted salary: $38,156
  • Highest average salary: Washington-Arlington-Alexandria (D.C., Maryland, Virginia, West Virginia), $83,370
  • Lowest average salary: Kingsport-Bristol-Bristol (Tennessee, Virginia), $56,330
  • Location quotient: 0.84
  • Change in demand for nurses: 2.5%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 27 AACN-member schools
47

Wyoming

$68,690
Average RN Salary
  • COL-adjusted salary: $38,792
  • Highest average salary: Cheyenne, $77,680
  • Lowest average salary: Casper, $64,360
  • Location quotient: 0.92
  • Change in demand for nurses: 1%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: One AACN-member school (University of Wyoming)

Notes: The least populous state in the country is filled with natural beauty—but a peak salary at around the national average, a lower-than-average location quotient, one AACN school, and sluggish demand could make it less appealing for new grads.

46

Hawaii

$104,060
Average RN Salary
  • COL-adjusted salary: $39,477
  • Highest average salary: Honolulu, $106,550
  • Lowest average salary: N/A
  • Location quotient: 0.88
  • Change in demand for nurses: 2.3%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: Four AACN-member schools

Notes: One of two states that breaks $100K for average salary, the high cost of living in this island paradise cuts that number down to size. Demand trends are upward but concentration of nurses is a little below average.

45

Tennessee

$62,570
Average RN Salary
  • COL-adjusted salary: $32,873
  • Highest average salary: Memphis (Tennessee, Mississippi, Arkansas), $66,730
  • Lowest average salary: Cleveland (yes, there’s one in Tennessee, too), $53,360
  • Location quotient: 1.04
  • Change in demand for nurses: 1.9%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 26 AACN-member schools

Notes: Memphis has the highest average salary in this Southern state; the metropolitan area sprawls across three states: Tennessee, Mississippi, and Arkansas.

44

Iowa

$60,590
Average RN Salary
  • COL-adjusted salary: $30,425
  • Highest average salary: Iowa City, $68,920
  • Lowest average salary: Davenport-Moline-Rock Island (Iowa, Illinois), $54,640
  • Location quotient: 1.05
  • Change in demand for nurses: 2.2%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 15 AACN-member schools
43

Arkansas

$61,330
Average RN Salary
  • COL-adjusted salary: $32,236
  • Highest average salary: Memphis (Tennessee, Mississippi, Arkansas), $66,730
  • Lowest average salary: Fort Smith (Arkansas-Oklahoma), $59,120
  • Location quotient: 1.02
  • Change in demand for nurses: 2.7%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 10 AACN-member schools

Notes: The highest mean salary, per BLS, is actually in Memphis, which shares borders with Arkansas and Mississippi; but two hours west, the Little Rock-North Little Rock-Conway metropolitan area has a comparable salary that’s just a little lower, at $66,300.

42

Kansas

$62,450
Average RN Salary
  • COL-adjusted salary: $32,653
  • Highest average salary: Topeka, $66,270; Kansas City (Missouri, Kansas), $68,130
  • Lowest average salary: Wichita, $57,470
  • Location quotient: 1.07
  • Change in demand for nurses: 2.6%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 14 AACN-member schools

Notes: The Sunflower State’s largest metro area, Kansas City, straddles Kansas and Missouri and has the highest salary, but Topeka, the state’s capital to the west, isn’t too far behind at $66,270. A higher-than-average location quotient and healthy demand makes it a solid option.

41

South Carolina

$64,840
Average RN Salary
  • COL-adjusted salary: $32,733
  • Highest average salary: Hilton Head Island-Bluffton-Beaufort, $69,620
  • Lowest average salary: Myrtle Beach-Conway-North Myrtle Beach (South Carolina, North Carolina), $62,750
  • Location quotient: 1.09
  • Change in demand for nurses: 2.1%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 12 AACN-member schools

40

Montana

$69,340
Average RN Salary
  • COL-adjusted salary: $33,550
  • Highest average salary: Missoula, $71,980
  • Lowest average salary: Great Falls, $67,140
  • Location quotient: 1.08
  • Change in demand for nurses: 2.4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Three AACN-member schools

39

Maryland

$77,910
Average RN Salary
  • COL-adjusted salary: $34,486
  • Highest average salary: Washington-Arlington-Alexandria (DC, Maryland, Virginia, West Virginia), $83,370
  • Lowest average salary: Cumberland (Maryland, West Virginia), $71,610
  • Location quotient: 0.97
  • Change in demand for nurses: 3.1%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 12 AACN-member schools

38

Idaho

$69,480
Average RN Salary
  • COL-adjusted salary: $38,578
  • Highest average salary: Coeur d’Alene, $76,650
  • Lowest average salary: Idaho Falls, $61,740
  • Location quotient: 0.96
  • Change in demand for nurses: 4.3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Three AACN-member schools

Notes: The highest mean salary here is in Coeur d’Alene, an outdoorsy, scenic panhandle city—and it’s close to the large, neighboring Washington city of Spokane.

37

Georgia

$69,590
Average RN Salary
  • COL-adjusted salary: $39,726
  • Highest average salary: Atlanta-Sandy Springs-Roswell, $73,610
  • Lowest average salary: Brunswick, $53,200
  • Location quotient: 0.83
  • Change in demand for nurses: 4.3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 23 AACN-member schools

36

New Jersey

$84,280
Average RN Salary
  • COL-adjusted salary: $42,397
  • Highest average salary: New York-Newark-Jersey City (New York, New Jersey, Pennsylvania), $93,280
  • Lowest average salary: Allentown-Bethlehem-Easton (Pennsylvania, New Jersey), $69,100
  • Location quotient: 0.97
  • Change in demand for nurses: 2.8%
  • Cross-state licensing permitted: Partial implementation, allowing nurses who hold active unencumbered, multi-state licenses issued by Nurse Licensure Compact member states to practice.
  • Ongoing education opportunities: 20 AACN-member schools

Notes: It’s hard to beat the dense metro New York-Newark-Jersey City, which has the top salary spot; but farther south, resort hub Atlantic City-Hammonton holds its own at second place for this state, with an above-average salary at $82,460, plus healthy demand statewide.

35

Alaska

$90,500
Average RN Salary
  • COL-adjusted salary: $47,009
  • Highest average salary: Anchorage, $88,860
  • Lowest average salary: Fairbanks, $85,150
  • Location quotient: 0.96
  • Change in demand for nurses: 2%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: One AACN-member school (University of Alaska Anchorage)

34

Vermont

$70,240
Average RN Salary
  • COL-adjusted salary: $31,905
  • Highest average salary: Burlington, South Burlington, $70,630
  • Lowest average salary: Northern Vermont nonmetropolitan area, $69,650
  • Location quotient: 1.13
  • Change in demand for nurses: 1.3%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: Three AACN-member schools

33

South Dakota

$59,540
Average RN Salary
  • COL-adjusted salary: $26,127
  • Highest average salary: Rapid City, $60,600
  • Lowest average salary: East South Dakota nonmetropolitan area, $57,880
  • Location quotient: 1.5
  • Change in demand for nurses: 3.7%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Seven AACN-member schools

32

Maine

$69,760
Average RN Salary
  • COL-adjusted salary: $30,421
  • Highest average salary: Bangor, $75,740
  • Lowest average salary: Lewiston-Auburn, $66,020
  • Location quotient: 1.17
  • Change in demand for nurses: 2%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Five AACN-member schools

31

Mississippi

$59,750
Average RN Salary
  • COL-adjusted salary: $30,924
  • Highest average salary: Jackson, $64,230; Memphis (Tennessee, Mississippi, Arkansas), $66,730
  • Lowest average salary: Hattiesburg, $52,500
  • Location quotient: 1.29
  • Change in demand for nurses: 1.3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Eight AACN-member schools

30

West Virginia

$63,220
Average RN Salary
  • COL-adjusted salary: $32,720
  • Highest average salary: Washington-Arlington-Alexandria, (D.C., Maryland, Virginia, West Virginia), $83,370
  • Lowest average salary: Southern West Virginia nonmetropolitan area, $57,520
  • Location quotient: 1.39
  • Change in demand for nurses: 2.4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Eight AACN-member schools

29

Florida

$67,610
Average RN Salary
  • COL-adjusted salary: $34,833
  • Highest average salary: Naples-Immokalee-Marco Island, $76,040
  • Lowest average salary: Sebring, $46,520
  • Location quotient: 1.02
  • Change in demand for nurses: 4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 33 AACN-member schools

28

Missouri

$64,160
Average RN Salary
  • COL-adjusted salary: $34,999
  • Highest average salary: Columbia, $68,960
  • Lowest average salary: Joplin, $46,640
  • Location quotient: 1.2
  • Change in demand for nurses: 2.6%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 23 AACN-member schools

27

Utah

$67,970
Average RN Salary
  • COL-adjusted salary: $35,026
  • Highest average salary: Salt Lake City, $70,040
  • Lowest average salary: Logan (Utah, Idaho), $62,970
  • Location quotient: 0.71
  • Change in demand for nurses: 5.3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Eight AACN-member schools

26

Nebraska

$66,640
Average RN Salary
  • COL-adjusted salary: $36,240
  • Highest average salary: Omaha-Council Bluffs (Nebraska, Iowa), $67,240
  • Lowest average salary: Sioux City (Iowa, Nebraska, South Dakota), $58,030
  • Location quotient: 1.19
  • Change in demand for nurses: 2.6%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Six AACN-member schools

25

Indiana

$66,560
Average RN Salary
  • COL-adjusted salary: $36,428
  • Highest average salary: Chicago-Naperville-Elgin (Illinois, Indiana, Wisconsin), $77,430
  • Lowest average salary: Fort Wayne, $59,950
  • Location quotient: 1.08
  • Change in demand for nurses: 3.2%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 26 AACN-member schools

24

New Hampshire

$73,880
Average RN Salary
  • COL-adjusted salary: $37,152
  • Highest average salary: Boston-Cambridge-Nashua (Massachusetts, New Hampshire), $96,510
  • Lowest average salary: Dover-Durham, (New Hampshire-Maine), $71,420
  • Location quotient: 1.07
  • Change in demand for nurses: 3.4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Eight AACN-member schools

23

Pennsylvania

$71,410
Average RN Salary
  • COL-adjusted salary: $37,361
  • Highest average salary: New York-Newark-Jersey City (New York, New Jersey, Pennsylvania), $93,280
  • Lowest average salary: Youngstown-Warren-Boardman, (Ohio-Pennsylvania), $58,640
  • Location quotient: 1.24
  • Change in demand for nurses: 2.7%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: 41 AACN-member schools

22

Ohio

$68,220
Average RN Salary
  • COL-adjusted salary: $37,820
  • Highest average salary: Cleveland-Elyria, $71,650
  • Lowest average salary: Youngstown-Warren-Boardman (Ohio, Pennsylvania), $58,640
  • Location quotient: 1.13
  • Change in demand for nurses: 2.6%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: 39 AACN-member schools

21

Wisconsin

$72,610
Average RN Salary
  • COL-adjusted salary: $40,034
  • Highest average salary: Minneapolis-St. Paul-Bloomington (Minnesota, Wisconsin), $84,400
  • Lowest average salary: Eau Claire, $62,680
  • Location quotient: 1.06
  • Change in demand for nurses: 2.4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 20 AACN-member schools

20

Connecticut

$83,440
Average RN Salary
  • COL-adjusted salary: $40,686
  • Highest average salary: Danbury, $92,380
  • Lowest average salary: Waterbury, $76,200
  • Location quotient: 1.03
  • Change in demand for nurses: 1.8%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 12 AACN-member schools

19

New York

$87,840
Average RN Salary
  • COL-adjusted salary: $41,269
  • Highest average salary: New York-Newark-Jersey City (New York, New Jersey, Pennsylvania), $93,280
  • Lowest average salary: Southwest New York nonmetropolitan area, $63,360
  • Location quotient: 0.92
  • Change in demand for nurses: 4.9%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 52 AACN-member schools

Notes: The highest mean salary, centered on the New York-Newark-Jersey City metro area, bumps the state average way up. The lowest mean salary is a close call between Ithaca, at $63, 520, just a touch above the Southwest New York nonmetropolitan area.

18

Texas

$74,540
Average RN Salary
  • COL-adjusted salary: $43,906
  • Highest average salary: Houston-The Woodlands-Sugar Land, $81,350
  • Lowest average salary: San Angelo, $61,760
  • Location quotient: 0.86
  • Change in demand for nurses: 3.6%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 44 AACN-member schools

17

New Mexico

$73,300
Average RN Salary
  • COL-adjusted salary: $44,005
  • Highest average salary: Santa Fe, $75,810
  • Lowest average salary: Las Cruces, $68,120
  • Location quotient: 1.04
  • Change in demand for nurses: 2.9%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Four AACN-member schools

16

Oregon

$92,960
Average RN Salary
  • COL-adjusted salary: $48,030
  • Highest average salary: Portland-Vancouver-Hillsboro (Oregon, Washington), $95,420
  • Lowest average salary: Albany, $80,490
  • Location quotient: 0.95
  • Change in demand for nurses: 3.1%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: Six AACN-member schools

15

Washington

$86,170
Average RN Salary
  • COL-adjusted salary: $49,108
  • Highest average salary: Seattle-Tacoma-Bellevue, $90,730
  • Lowest average salary: Bellingham, $59,300
  • Location quotient: 0.86
  • Change in demand for nurses: 4%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 12 AACN-member schools

Notes: The highest mean salary centers on the densest economic engine in this Pacific Northwest state, the Seattle-Tacoma-Bellevue region. There’s a robust demand for registered nurses here, and additional opportunity in smaller metropolitan regions as well, including Spokane on the agricultural and arid east side of the state, and in and around the state capital, Olympia.

14

Rhode Island

$82,310
Average RN Salary
  • COL-adjusted salary: $42,335
  • Highest average salary: Norwich-New London-Westerly (Connecticut, Rhode Island), $84,640
  • Lowest average salary: Providence-Warwick (Rhode Island, Massachusetts), $82,170
  • Location quotient: 1.29
  • Change in demand for nurses: 1.6%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: Three AACN-member schools

13

Alabama

$60,230
Average RN Salary
  • COL-adjusted salary: $30,332
  • Highest average salary: Montgomery, $65,200
  • Lowest average salary: Decatur, $49,980
  • Location quotient: 1.23
  • Change in demand for nurses: 3.8%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 12 AACN-member schools

12

North Dakota

$66,290
Average RN Salary
  • COL-adjusted salary: $33,212
  • Highest average salary: Fargo (North Dakota, Minnesota), $68,110
  • Lowest average salary: Bismarck, $62,050
  • Location quotient: 1.14
  • Change in demand for nurses: 4.1%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Five AACN-member schools

11

Kentucky

$63,750
Average RN Salary
  • COL-adjusted salary: $33,317
  • Highest average salary: Cincinnati (Ohio, Kentucky), $70,370
  • Lowest average salary: Bowling Green, $59,240
  • Location quotient: 1.14
  • Change in demand for nurses: 3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 17 AACN-member schools

10

North Carolina

$66,440
Average RN Salary
  • COL-adjusted salary: $34,667
  • Highest average salary: Fayetteville, $71,790
  • Lowest average salary: Mountain North Carolina nonmetropolitan area, $60,310
  • Location quotient: 1.1
  • Change in demand for nurses: 4%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 24 AACN-member schools

9

Delaware

$74,100
Average RN Salary
  • COL-adjusted salary: $37,908
  • Highest average salary: Philadelphia-Camden-Wilmington (Pennsylvania, New Jersey, Delaware, Maryland), $77,640
  • Lowest average salary: Dover, $69,400
  • Location quotient: 1.28
  • Change in demand for nurses: 4.3%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Two AACN-member schools

8

Colorado

$76,230
Average RN Salary
  • COL-adjusted salary: $40,875
  • Highest average salary: Boulder, $80,040
  • Lowest average salary: Eastern and Southern Colorado nonmetropolitan area, $64,330
  • Location quotient: 0.97
  • Change in demand for nurses: 5%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: 14 AACN-member schools

Notes: In contrast to its similarly sized scenic and outdoor-activity oriented neighbor to the north, Wyoming, this more densely populated state makes the top 10 list of states for nurses, with a higher-than-average increase in demand, 14 colleges for continuing education, and a just slightly above-average cost of living.

7

Illinois

$73,510
Average RN Salary
  • COL-adjusted salary: $41,871
  • Highest average salary: Chicago-Naperville-Elgin (Illinois, Indiana, Wisconsin), $77,430
  • Lowest average salary: Davenport-Moline-Rock Island (Iowa, Illinois), $54,640
  • Location quotient: 1.06
  • Change in demand for nurses: 3%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 38 AACN-member schools

6

Michigan

$73,200
Average RN Salary
  • COL-adjusted salary: $43,436
  • Highest average salary: Ann Arbor, $79,340
  • Lowest average salary: Upper peninsula of Michigan nonmetropolitan area, $63,250
  • Location quotient: 1.1
  • Change in demand for nurses: 2.1%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: 25 AACN-member schools

Notes: The highest average salary here is in the home of the University of Michigan, Ann Arbor. Cross-state licensing is pending legislation, while the concentration of nursing jobs across the state and the demand are about average.

5

Arizona

$78,330
Average RN Salary
  • COL-adjusted salary: $45,854
  • Highest average salary: Arizona nonmetropolitan area, $85,510
  • Lowest average salary: Lake Havasu City-Kingman, $69,450
  • Location quotient: 0.94
  • Change in demand for nurses: 6.9%
  • Cross-state licensing permitted: Yes
  • Ongoing education opportunities: Eight AACN-member schools

Notes: Prescott, located in central Arizona a couple of hours north of the state’s capital, just edges out the Phoenix-Mesa-Scottsdale metropolitan area in salary ($79,370 vs. $79,200). But ultimately the highest salary goes to the state’s nonmetropolitan area, the only state on our list where that is the case.

4

Minnesota

$80,130
Average RN Salary
  • COL-adjusted salary: $46,114
  • Highest average salary: Minneapolis-St. Paul-Bloomington (Minnesota, Wisconsin), $84,400
  • Lowest average salary: Duluth, $68,040
  • Location quotient: 1.21
  • Change in demand for nurses: 2.7%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 23 AACN-member schools

3

Massachusetts

$93,160
Average RN Salary
  • COL-adjusted salary: $49,100
  • Highest average salary: Boston-Cambridge-Nashua (Massachusetts, New Hampshire), $96,510
  • Lowest average salary: Massachusetts nonmetropolitan area, $79,720
  • Location quotient: 1.1
  • Change in demand for nurses: 2.6%
  • Cross-state licensing permitted: Pending legislation
  • Ongoing education opportunities: 25 AACN-member schools

Notes: Cross-state licensing is pending here, so keep an eye on it if you are keeping your travel options open. Demand here is above average, and the concentration of nurses is also above average.

2

California

$113,240
Average RN Salary
  • COL-adjusted salary: $62,451
  • Highest average salary: San Jose-Sunnyvale-Santa Clara, $140,740
  • Lowest average salary: Chico, $85,080
  • Location quotient: 0.86
  • Change in demand for nurses: 3.6%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: 51 AACN-member schools

Notes: This large state has a salary swing that reflects the diversity of landscape and living throughout. Sleepy college town Chico in the north has dramatically different needs than Silicon Valley’s sprawling San Jose area.

1

Nevada

$88,380
Average RN Salary
  • COL-adjusted salary: $52,054
  • Highest average salary: Las Vegas-Henderson-Paradise, $91,330
  • Lowest average salary: Reno, $78,800
  • Location quotient: 0.81
  • Change in demand for nurses: 5%
  • Cross-state licensing permitted: No
  • Ongoing education opportunities: Six AACN-member schools

Notes: Our number one state just beats out its neighbor to the west in a few areas: Cost-of-living takes a smaller chunk of change from the mean salary here, while it logs a slightly higher percentage demand trend through 2021.


Methodology and Sources

To determine the best states for nurses to work and live in, we ranked all 50 states on three main considerations: salary adjusted for cost of living, job opportunity, and change in demand for nurses. We then sorted by each of our three factors, to see how states were distributed in each category—for example, how many states had average (mean) salaries of $40,000 or above, how many had a 2% change in job demand, etc. Based on that, we assigned points to number ranges for each.

We added each state’s points together, and then sorted based on their totals. Naturally, there were ties (except for one state that earned 10 points!). To break those ties, within each grouping, we sorted further by salary, weighing states with higher mean salaries more heavily.

Salary adjusted for cost of living

This number comes from the average cost of living for a single adult in the U.S. ($33,480, the total cost of food, shelter, transportation, and utilities—calculated from a 2018 Consumer Expenditure Survey from the U.S. Bureau of Labor Statistics (BLS) multiplied by the cost of living (COL) index in each state, which is then subtracted from the average annual salary of a registered nurse in each state, according to 2019 figures from the BLS. The resulting figure demonstrates remaining disposable income.

Points Assigned

$50,000–$60,000 or higher = 4 points
$40,000 = 3 points
$30,000 = 2 points
$20,000 = 1 point

Location quotient

This number is the ratio of the concentration of nurses in an area to the national average, from the BLS. It is a measurement of job opportunity available in a state. A value of one is average; above that means a higher concentration of nurses than average, and below that means a lower concentration than average.

Points Assigned

1.1–1.5 = 4 points
1–1.09 = 3 points
0.6–1 = 2 points

Change in demand for nurses

This number, sourced from State Short Term Occupational Projections (2019–2021) from Projections Central, demonstrates the need for nursing in an area by comparing the number of nurses employed in a state in 2019 to projected numbers through 2021.

Points Assigned

5%–6.9% = 4 points
3%–4.9% = 3 points
0%–2.9% = 2 points

We added further details to each state’s profile, including the average salary to illustrate the cost-of-living difference, as well as areas in each state with the highest and lowest mean salaries (note: the BLS often groups regions and states with some figures, especially if a metropolitan area borders multiple states). We also highlight employment projections and added other insights where applicable.

In addition, we include the number of schools available where you can pursue additional training, but did not use it to rank. Access to ongoing education—based on the number of colleges in each state that offer nursing training, per the American Association of Colleges of Nursing—is included because continuing learning is an integral part of maintaining a nursing career. Note: the figure does not include non-member colleges or colleges with associate degree programs.


How Nursing Licensure Varies by State

If you’re considering a move out of state to start your career as a registered nurse, it’s important to keep licensure in mind. Nursing licensure is very state specific, so take a look at the credentials needed to get a job in the state you are aiming for by checking its board of nursing; the National Council of State Boards of Nursing has a drop-down menu linking to each state’s board, which has licensing information and industry news.

In addition, 34 states are part of the Enhanced Nursing Licensure Compact. If you have a license in one of these states as your primary residence, you can practice with your license across participating state lines (another six states are in the process of enacting legislation to join the compact). This is an especially good option for those who want to consider travel nursing or similarly mobile specialties.


State-Specific Financial Aid

Financial aid in the form of grants, scholarships, or loans vary greatly by school—and by state. While some states offer residents enticing incentives to start your education, there are other place-bound opportunities that can help pay for current schooling or help pay off loans once you’re out in the workforce. (Don’t forget to fill out the FAFSA to receive any financial aid!)

Loan Forgiveness

Options vary by state and school, but some states offer loan forgiveness for agreeing to work in specific areas or facilities in need for a couple of years. Because of this requirement, you will want to consider this option carefully if you’re looking to move out of state.

Grants and Scholarships

There are many scholarships available for nursing students, and many state-specific scholarships have emerged to address nursing shortages in certain areas. Your school’s financial and merit aid office will be one of the best sources of information for finding such scholarships in your area.

You can also look into options that reward you for pursuing certain specialties in a specific state. For example, in Washington, the Washington State Opportunity Baccalaureate Scholarship provides up to $22,500 in financial aid, along with career-launching support services, to students pursuing high-demand STEM and healthcare majors.


deborah trautman

With professional insight from:

Deborah Trautman, PhD, RN, FAAN

President and Chief Executive Officer of the American Association of Colleges of Nursing (AACN)


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October 13, 2020 · 7 min read

Is a DNP the New MSN?

A doctorate may be replacing the master’s as the go-to degree for some advanced nursing programs. Is yours one of them?

Written and reported by:

Stephanie Behring

Contributing writer

woman works on laptop in dimly lit office
woman works on laptop in dimly lit office

Working toward advanced practice registered nurse (APRN) licensure is a common goal for many nurses looking for an elevated position that offers increased autonomy, more opportunities to advance, and potentially better pay. For years, the Master of Science in Nursing—or MSN— has been the go-to degree for nurses seeking these advanced roles.

But change is in the air. A doctoral degree will be the entry-level degree mandated for nurse anesthetists (one of several APRN nursing roles) by 2025. Requirements for nurse practitioners and clinical nurse specialists may not be far behind: while the MSN is currently the standard, many nursing associations are recommending a move to a doctorate as the entry-level degree requirement for these advanced nursing roles.


What’s a Doctorate and Why the Shift?

A doctoral degree—most often, the Doctorate of Nursing Practice in the nursing profession—is an advanced degree that allows nurses to broaden their scope of practice. The degree takes a few years longer to earn than an MSN, but it also goes more in depth than an MSN degree. A doctorate will build on the nursing knowledge you already have and can prepare you for high-level and leadership roles.

The move to a DNP and other doctoral degrees reflects both the increasingly complex knowledge APRNs need and the increased role of nurses in healthcare leadership.

The move to a DNP and other doctoral degrees reflects both the increasingly complex knowledge APRNs need and the increased role of nurses in healthcare leadership. Because of this, “it makes sense for nursing to have its own practice doctorate, especially for those who are working in advanced practice, leadership levels, and teaching,” says Sara Hunt, DNP, MSN, FNP-C, PHN, a family nurse practitioner who holds a doctorate.

Patient safety and quality of care are other huge factors in the push toward doctorates, especially following an influential report from the Institute of Medicine (IOM) back in 1999 that highlighted the significant physical and monetary cost of errors made in hospitals and suggested ways to mitigate them. Hunt believes the IOM recommendations have made a significant impact on the growing push toward doctoral degrees.

Some other factors driving the shift, according to Hunt, are:

  • The rapid expansion of knowledge in the field of nursing
  • The increased complexity of basic patient care
  • Shortages of nursing personnel
  • Demands for a higher level of preparation for leaders who can design and assess care
  • Shortages of doctorally prepared nursing faculty

What APRN Roles Are Affected?

Nursing association recommendations that encourage nurses pursuing an advanced practice role consider a doctorate instead of a master’s can be confusing. Is a doctoral degree required or not? The answer depends on the nursing role you’re seeking. 

Certified Registered Nurse Anesthetists (CRNAs)

Certified Registered Nurse Anesthetists (CRNAs) are the only APRN-level job with a definitive change in directive. Right now, an MSN degree is sufficient, but you’ll need a doctoral degree to earn APRN licensure in the field after 2025. While a DNP is a popular option, students can also choose to earn another doctoral degree, including:

  • Doctor of Philosophy (PhD)
  • Doctor of Education (EdD)
  • Doctor of Nursing Science (DNS or DNSc)
  • Doctor of Nurse Anesthesia Practice (DNAP)