How to become a nurse in North Carolina
With a low cost of living, a high quality of life and a thriving healthcare industry, North Carolina offers a wide range of opportunities for nurses of all levels and specialty areas. Whether you prefer living in the mountains, beachside or in a large city, becoming a nurse in North Carolina can be the start of a rewarding career that matches your personal and professional goals. Read on to learn what’s involved in becoming a nurse in North Carolina.
“Geographically, North Carolina offers three distinct areas to live and work, including the Coastal Plains, Piedmont and Mountains,” says Dr. Tracy Arnold, DNP, RN, CNE, Director of the Hunt School of Nursing at Gardner-Webb University in Boiling Springs, North Carolina.
“North Carolina is home to multiple military bases, allowing nurses to serve military personnel in VA hospitals or military-owned healthcare facilities. The Research Triangle, located in Raleigh, Durham and Chapel Hill, is situated among major academic centers, allowing nurses to work at research facilities and teaching hospitals. More rural areas throughout North Carolina allow nurses to work with underserved and/or remote communities through community clinics or telehealth,” says Arnold.
5 steps to becoming a nurse in North Carolina
Get a nursing degree from a state-approved nursing program.
To become a nurse in North Carolina, you must complete a pre-licensure nursing program approved by the North Carolina Board of Nursing (NCBON). You can choose from three different types of programs based on your personal and professional goals.
Programs to become a registered nurse (RN):
• Bachelor of Science in Nursing (BSN)
• Associate Degree in Nursing (ADN)
Programs to become a licensed practical nurse (LPN):
• LPN diploma program
“The decision to pursue an ADN versus a BSN depends on each person’s situation. ADN programs are typically offered at community colleges, which are less expensive and may provide day, night and weekend options for program completion. BSN programs are typically offered at universities, are more expensive and may provide both in-person and online options, but may require relocation to attend,” says Arnold.
Apply for and earn your nursing license.
Earning a nursing degree is required to apply for a nursing license in North Carolina. After completion of an approved nursing program, you can start the application process for a nursing license:
• Access the NCBON Nurse Gateway to complete an examination application.
• Create a username and password to access your information and applications if you don’t have an existing profile on the NCBON website.
• Complete the application for the type of National Council Licensure Examination (NCLEX) you want to take.
• Pay the $75.00 registration fee to NCBON.
• Provide electronic verification or a transcript of an approved nursing program. North Carolina nursing schools automatically send this information to the NCBON within 30 days of program completion. Out-of-state graduates must provide a final “official” transcript from their institution.
• Register to take the NCLEX with Pearson VUE, the official NCLEX exam administrator for NCOB and pay the $200 exam fee at least two weeks before you complete your nursing program.
• After completion of your application, approval of your educational program, and payment of Pearson VUE registration, you should receive an Authorization to Test (ATT) via email in about 10 business days.
• Complete fingerprint-based State Bureau of Investigations (SBI) and Federal Bureau of Investigation (FBI) criminal history, which will be necessary to receive a nursing license.
• Schedule your examination appointment with Pearson VUE and take your licensure exam.
• Receive your official results from the NCBON.
Find a nursing job in North Carolina.
Nurses in North Carolina work in a wide range of employment settings that include the following:
• Assisted living facilities
• Hospitals
• Rehabilitation facilities
• Insurance companies
• Medical research companies
• Walk-in clinics
• Urgent care facilities
• Public health organizations
• Physicians’ offices
• School Nursing
• Nursing homes
• Military bases
Contact the career services department of your educational institution to learn about the ways they can help you find a job. In addition to major job websites like Indeed, search the following online resources for nursing jobs in the state:
• North Carolina Nurses Association (NCNA) Career Center
• Careers with the State of North Carolina, a listing of government jobs in North Carolina
The “career” section of websites for hospitals, health systems, medical centers, clinics, and other employers that match your professional goals.
Keep up with continuing education.
You must meet specific continuing education requirements to qualify for renewal of your nursing license. For active nurses, this typically involves the following:
• 15 contact hours of continued education AND
• 640 hours of active practice within the previous two years
However, there are other ways to meet these criteria depending on your professional situation. Consult the NCBON Continuing Competence Requirements for complete details to ensure that you meet the criteria necessary for license renewal.
Renew your license every two years.
Nurses in North Carolina must renew their nursing license on the last day of their birth month every two years. If you fail to renew your license when necessary, it is automatically placed on expired status at midnight on the last day of the expiration month. The renewal period opens 90 days before the expiration date of your current license.
If your license expires, you will be prohibited from working as an RN or LPN in North Carolina until you reapply for licensure by completing the reinstatement application process.
How much do nurses make in North Carolina?
According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary for nurses working in North Carolina is $81,860. The median annual salary for all nurses in the U.S. is $93,600.
Factors such as education, employer, specialty certifications and demand can affect the exact salary that you receive. “The salary for BSN-prepared nurses is typically higher than for ADN-prepared nurses,” says Arnold.
The breakdown among annual salary tiers for registered nurses in North Carolina and in specific metro areas of the state includes:
10%$64,180
25%$74,710
50%$81,860Median
75%$98,720
90%$107,110
Median Hourly Wage$39
Job growth4.9%
Total Employment108,510
| Metro area | Median Salary | Bottom 10% | Top 10% |
|---|---|---|---|
| Burlington, NC | $87,110 | $65,580 | $102,740 |
| Raleigh-Cary, NC | $84,870 | $67,460 | $107,800 |
| Charlotte-Concord-Gastonia, NC-SC | $84,780 | $67,140 | $107,280 |
| Winston-Salem, NC | $84,270 | $69,050 | $108,320 |
| Greensboro-High Point, NC | $84,200 | $67,660 | $105,380 |
| Fayetteville, NC | $81,260 | $61,940 | $119,230 |
| Rocky Mount, NC | $81,090 | $61,490 | $102,680 |
| Greenville, NC | $80,870 | $65,110 | $148,810 |
| Asheville, NC | $80,720 | $62,770 | $110,860 |
| Goldsboro, NC | $79,910 | $66,600 | $100,980 |
Source: U.S. Bureau of Labor Statistics (BLS) 2024 median salary; projected job growth through 2034. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.
How long does it take to become a nurse in North Carolina?
The time it takes you to become a nurse in North Carolina depends on many factors such as the type of degree you choose and whether you attend school part-time or full-time. Other factors, such as the time it takes for the required agencies to process and approve your application for licensure, can vary based on the time of year and staffing. The following timelines are general estimates of the average time you can expect at each stage of the licensure process:
Earn a degree from a program approved by the North Carolina State Board of Nursing
Average time: 1 to 4 years
The amount of time it takes to complete your education depends on the type of program you choose. The average time to for program completion with full-time attendance is typically the following:
- Bachelor of Science in Nursing: 4 years
- Associate Degree in Nursing: 2 to 3 years
- Licensed Practical Nursing diploma: 1 year
Register and apply for licensure on the NCBON website
Average time: 1 to 2 hours
You can apply for a North Carolina nursing license online in an hour or two. Having all your identification information ready before you register can help you complete the process faster.
Register and pay the fee for the NCLEX-RN or NCLEX-PN with Pearson VUE
Average time: 1 to 2 hours
Registering and paying for your NCLEX is a step that is separate from your application for licensure. The NCBON advises that you register with Pearson VUE at least two weeks before graduation.
Wait for an Authorization to Test (ATT)
Average time: 10 business days after approval of documentation
You will receive an Authorization to Test (ATT) via email from Pearson VUE in about 10 days after all the following criteria are completed on your profile:
- Your application and payment are marked as “Received”
- Your North Carolina program (NC Program Verified) is verified by your Program Director or your Out-of-State Program is verified via transcript
- Your Pearson VUE registration is complete
Complete a Criminal Background Check
Average time: 6 weeks
Applicants for a nursing license in North Carolina must complete a criminal background check performed by LiveScan. LiveScan is a digital fingerprinting service that transmits your fingerprints directly to the State Bureau of Investigation (SBI) and Federal Bureau of Investigation (FBI) for processing.
Completing this criminal background check is necessary to receive a North Carolina nursing license. To avoid delays in getting a license, initiate the background check before taking your NCLEX test. Your criminal background check is valid for one year after it is received by the NCBON.
Schedule and take the NCLEX-RN or NCLEX-PN
Average time: as soon as possible after receiving your ATT
Your ATT is valid for 90 days, so you must take the NCLEX before it expires. It is advised that you take the NCLEX exam as soon as possible after receiving your ATT to have the best chance of passing. Most nurses take the NCLEX within 45 days after program completion. The National Council State Boards of Nursing (NCSBN) requires a 45-day waiting period to retest if you fail at your first attempt.
If you are unsuccessful with the first NCLEX-RN attempt, you are eligible to test for NCLEX-PN for an LPN license in North Carolina. There is no waiting period if you choose this option.
Wait for your test results
Average time: About 4 weeks after testing
You will likely receive test results from the NCBON within about four weeks after testing. You may be able to find out whether you passed your NCLEX within two business days after taking your exam if you purchase the NCLEX Quick Results Service. However, these results are not official and can’t be used to expedite your license.
Receive your nursing license.
Average time: 5 business days
Your North Carolina nursing license will be issued electronically within five business days of passing the NCLEX unless you have not fulfilled the requirements for a criminal background check. If you are unsuccessful, you will receive a re-examination packet within 30 calendar days.
Note: Using these timeframes as a guide, the total time to nursing licensure, including education, license application and testing, for a BSN-prepared nurse in North Carolina would average about four years and three months.
Continuing education for nurses in North Carolina
North Carolina nurses must meet “continuing competence,” or continuing education requirements for nurses to qualify for renewal of their nursing license every two years. To meet the requirement to renew a nursing license in North Carolina, you must complete one of the following:
The Board of Nursing provides an extensive list of acceptable providers of continuing education. Examples of providers include national credentialing bodies, national and state nurses associations, professional journals and providers of professional continuing education to healthcare professionals.
Is North Carolina a compact state?
Yes. North Carolina is a member of the Nursing Licensure Compact (NLC). The NLC is a multistate agreement in which participating states mutually recognize RN and LPN licenses among member states.
Nurses who live in North Carolina and hold an unencumbered North Carolina nursing license will have the privilege to practice in any of the other compact states. However, when you change your primary state of residence to another compact state, you have 60 days to apply for and obtain a nursing license in your new state.
“North Carolina is a compact state, which opens opportunities for nurses residing outside of North Carolina to still work within the state. Holding a compact license also allows for opportunities to work in telehealth positions,” says Arnold.
Useful organizations to know for prospective North Carolina nurses
The following organizations are the key licensing and regulatory agencies for nurses and nurses aides in North Carolina:
North Carolina Board of Nursing (NCBON): NCBON regulates the practice and licensing of all nurses in North Carolina. Their authority covers licensed practical nurses (LPNs), registered nurses (RNs), and advanced practice registered nurses (APRNs) in the state.
North Carolina Department of Health and Human Services (HCDHHS) Division of Health Service Regulation (DHSR): The DHSR oversees the registry, training and competency programs for nurse aide I and other unlicensed healthcare workers and their employers.
The following membership organizations provide a wide range of educational, networking, and advocacy services for nurses in North Carolina:
North Carolina Nurses Association (NCNA): This state chapter of the national American Nurses Association (ANA) helps nurses at all stages thrive by staying on the cutting edge of nursing practice, policy and education.
North Carolina Association of Nursing Students (NCANS): NCANS serves as the statewide professionalizing vehicle of North Carolina nursing students to support them in their transition from nursing students to licensed nurses.
Find out how to become a nurse in your state
The process of becoming a nurse is different depending on the state in which you are seeking licensure. Each state has different requirements and standards that you should be aware of.
Here are some of the top nursing states in the U.S. and the steps to become a nurse in each:
Job outlook for nursing in NC
The number of registered nursing jobs nationwide is expected to grow 4.9% through 2034, which is double the average for all U.S. occupations according to the U.S. Bureau of Labor Statistics (BLS). Many of these openings are expected to occur as a result of nurses who transfer to different occupations or retire.
The increasing demand for nurses is above average in North Carolina. Long-term employment trends from the U.S. Department of Labor project 12% growth for registered nurses through 2030 in North Carolina.
The most significant nurse workforce shortage relative to workforce supply is expected in nursing home/extended care/assisted living settings, according to “NC Nursecast: A Supply and Demand Model for Nurses in North Carolina,” a report by The Program on Health Workforce Research and Policy at the Cecil G. Sheps Center.
Your nursing education may give you an advantage in meeting this demand. “Many organizations do prefer BSN-prepared nurses as there is a plethora of data that shows hospitals with more BSN-prepared nurses have better patient outcomes and lower mortality rates. Magnet hospitals are also known for hiring more BSN-prepared nurses,” says Arnold.
While a traditional BSN typically takes four years, you may be able to achieve this goal with an accelerated BSN program that requires less time. If you have your ADN and want to earn a BSN, you can take advantage of ADN-to-BSN programs with online options that allow you to continue working while you earn your BSN, says Arnold.
Requirements for foreign-educated nurses
North Carolina has specific licensure requirements for nurses who are educated outside the United States and other member board jurisdictions. You must meet the following non-negotiable requirements for licensure by examination:
- Provide documentation of education from one of the following organizations:
- International Education Evaluations, Inc. (IEE)
- Commission on Graduates of Foreign Nursing Schools (CGFNS)
- Pass one of the following English proficiency examinations:
- TOEFL (Test of English as a Foreign Language
- IELTS (Academic)–International English Language Testing Service
- A CGFNS certificate or VisaScreen
- Obtain a valid Social Security Number/Card
- Complete a satisfactory criminal background check
You may take the NCLEX before obtaining a Social Security card but you need a Social Security card before you will be awarded a nursing license.
After meeting the special requirements, you must follow the application and examination process required for licensure by examination.
Useful resources for NC nurses
Professional nursing organizations provide valuable networking and educational resources for nurses at all levels of experience. State-level organizations for nurses in North Carolina address a range of professional interests, ranging from general nursing practice to more specialized areas of nursing. Some of these organizations include:
North Carolina Organization of Nurse Leaders (NCONL): This state affiliate of the American Organization for Nursing Leadership (AONL) works to strengthen nurse leadership through professional development, facilitate nursing research to advance nursing practice and influence health care policy related to the nursing profession.
North Carolina Affiliate of National Association of Clinical Nurse Specialists (NCNACNS): As an affiliate of the National Association of Clinical Nurse Specialists (NACNS), NCNACNS is dedicated to advancing the unique values and expertise that clinical nurse specialists embody.
North Carolina Affiliate of American College of Nurse-Midwives (NCACNM): As the state chapter of the American College of Nurse-Midwives (ACNM), NCACNM sets the standard for excellence in midwifery education and practice in North Carolina.
North Carolina Association of Nurse Anesthetists (NCANA): NCANA protects and advances nurse anesthesia practice through advocacy and education for the state’s certified registered nurse anesthetists (CRNAs) and student nurse anesthetists.
North Carolina Nurse Practitioner Network (NCNPN): NCNPN supports communication, networking and collaboration among nurse practitioners in the state.