courses in registered nursing

How to Become a Nurse

Every state and the District of Columbia has a board of nursing with a mission of protecting the public from harm. Governance of the practice of nursing includes:

• Establishing requirements for initial licensure and retaining: basic education, continuing education and/or competency
• Interpreting scope of practice parameters, defined by state statute (nurse practice act)
• Investigating complaints of licensees and disciplinary actions

There is more than one educational pathway leading to eligibility to take the standardized National Council Licensure Examination (NCLEX)-RN.

Undergraduate Diploma in Nursing, once the most common route to RN licensure and a  nursing career , is available through hospital-based schools of nursing

Associate Degree in Nursing (ADN) is a two-year degree offered by community colleges and hospital-based schools of nursing that prepares individuals for a defined technical scope of practice.

Bachelor of Science in Nursing (BS/BSN) is a four-year degree offered at colleges and universities:

• Prepares graduates to engage in the full scope of professional nursing practice across all healthcare settings
• First two years often concentrate on psychology, human growth and development, biology, microbiology, organic chemistry, nutrition, and anatomy and physiology.
• Final two years often focus on adult acute and chronic disease; maternal/child health; pediatrics; psychiatric/mental health nursing; and community health nursing.
• Is intended to result in a deeper understanding of the cultural, political, economic,  and social issues that affect patients and influence healthcare delivery
• Includes nursing theory, physical and behavioral sciences, and humanities with additional content in research, leadership, and may include such topics as healthcare economics, health informatics, and health policy

Graduate Offer additional routes to advancing the expertise of registered nurses:

• Master’s Degree (MSN) programs offer a number of tracks designed to prepare Advanced Practice Nurses, nurse administrators, and nurse educators.
• Doctor of Philosophy (PhD) programs are research-focused whose graduates typically teach and/or conduct research
• Doctor of Nursing Practice (DNP) programs focus on clinical practice or leadership roles

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How To Become An RN: A Step-By-Step Guide

Updated: May 2, 2023, 6:41am

During the Covid-19 pandemic, the importance and dedication of essential workers became even more clear. Registered nurses (RNs) are among the most crucial frontline workers in healthcare. Along with receiving relatively high pay and strong job security, many nurses find their careers meaningful. These professionals care for patients and help save lives in hospitals and other healthcare facilities.

Requirements for RN licensure vary by state but always include earning a degree and passing a national examination. Read on to learn more about how to become an RN.

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What Is a Registered Nurse?

Registered nurses typically provide bedside care and patient education alongside a team of healthcare professionals. RNs can become licensed after earning an associate in nursing (ADN) or a bachelor of science in nursing (BSN). All RNs must also pass the National Council Licensure Examination (NCLEX).

Role and Responsibilities

Typical daily tasks for nurses include observing and caring for patients at the bedside, keeping detailed records of patient symptoms and information, administering medicine or treatments, and collecting blood and urine samples for lab analysis.

RNs work in physician offices, hospitals, schools and other medical facilities. RNs provide care and education to patients across the lifespan, including the elderly, children and people experiencing medical emergencies or acute trauma.

Work Environment

Registered nurses work in nearly every healthcare setting, including hospitals, community clinics, urgent cares and nursing homes. Nurses’ schedules depend on their work environment. Emergency room and intensive care unit (ICU) nurses generally work eight- or 12-hour shifts, sometimes overnight, while nurses in other healthcare facilities can work typical business hours.

Although their work environments and schedules can be stressful and fast-paced, nurses benefit from above-average salaries and economic demand.

RN Specialties

As a nurse, you can focus your career on a specific type of patient care. Specialties allow nurses to work with particular populations, departments or settings. The right specialization for you depends on your interests, preferred work environment, schedule and desired patient population.

RNs can specialize in critical care, treating patients in ICUs, or neonatal care, which involves caring for premature and sick newborns. Other RN specialties include public health, pediatrics , gerontology and perioperative care.

How to Become an RN

Get an education.

While licensure requirements vary by state, completing a nursing education is the first step to becoming a registered nurse.

In most states, the minimum education requirement for an RN license is a diploma from an accredited RN program; however, many aspiring nurses earn an ADN or a BSN .

A BSN degree is not required to become an RN, but many healthcare employers now prefer to hire nurses with BSNs, as this degree provides broader knowledge and stronger competency in foundational nursing skills.

Nursing programs should be accredited by either the Commission on Collegiate Nursing Education, the Accreditation Commission for Nursing Education or a state-specific accrediting body, if applicable.

Pass the NCLEX

While examination requirements vary by state, RNs must pass the NCLEX-RN to earn licensure. Beginning in April 2023, prospective nurses must pass the Next Generation NCLEX. This test uses new question types drawn from case studies to better measure clinical judgment.

Test-takers can take up to five hours to finish the NCLEX. In 2022, the NCLEX pass rate for first-time test takers was 79.9% . We recommend that you make an NCLEX study plan and review NCLEX prep resources well ahead of your test date.

Obtain State Licensure

After passing the NCLEX, nurses apply for RN licensure in the state where they want to practice. Requirements for RN licensure vary by state; check your state’s nursing regulatory board for up-to-date requirements.

In most cases, RN licensure requirements include at least an accredited RN diploma and a passing NCLEX score.

Do You Need a BSN to Become an RN?

A BSN is not technically required to earn licensure and become a nurse. However, many employers prefer to hire nurses with BSN degrees. Research shows that BSN-prepared nurses lead to better patient outcomes, including lower patient mortality rates, according to the American Association of Colleges of Nursing (AACN). AACN reports that over 77% of employers prefer or require nurses to hold at least a BSN.

BSN programs prepare nurses with more extensive knowledge than associate degrees and RN diplomas. This higher education can set you up for further career and educational advancement down the line should you choose to pursue a master’s in nursing .

Salary and Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS), registered nurses earned a median annual wage of $77,600 in May 2021. The top 10% of nurses made more than $120,250 annually, while the bottom 10% made less than $59,450. Higher pay, however, is often correlated with higher living costs.

The BLS projects employment for nurses to grow by 6% from 2021 to 2031, which is comparable to the national growth average.

Frequently Asked Questions (FAQs) About How to Become a Registered Nurse

Is becoming an rn hard.

Becoming an RN is challenging for many students since licensure requires multiple years of study and a mastery of technical and scientific concepts. However, the rewards for pursuing a nursing career are significant as well. In addition to high salaries, nurses also benefit from job stability and career mobility.

How many years does it take to be a nurse?

The time it takes to become a nurse depends on your education route and state licensing requirements. Nursing students can complete certain accelerated RN diploma programs in 16 months. Associate programs usually take around two years of full-time study to complete, while BSN degree programs take around four years. You can apply for nurse licensure soon after completing your education.

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15 Common Courses In RN Programs

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• Nursing Fundamentals
• Introduction to Psychology
• Microbiology
• Gerontology
• Psychology Mental Health
• Pharmacology
• Women and Infant Health
• Leadership Management
• Community and Environmental Nursing
• Care Transitions
• Population Health
• Clinical Theory
• Clinical Study

The class requirements for RN qualifying degrees will differ slightly depending on the level of education you plan to pursue. Most nursing programs will cover a wide array of material from math and chemistry to psychology and physiology. Some nursing students will choose electives based on their desired specialty, such as pediatrics , oncology , or geriatrics .

For a glance into 15 of the assorted common courses that an RN will see throughout their academic career, read on below.

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1 | Nursing Fundamentals

This is one of the first classes you can expect to take in a nursing program, often required during your first semester. Nursing fundamentals courses give you an overview of what it means to be a nurse, how healthcare works, and potential careers and roles for nurses. The focus is on the basics of patient care and fundamental nursing skills. Your nursing fundamentals course also prepares you for more advanced topics in particular areas. This course may have different names at different schools, such as “Nursing 101” or “Introduction to Nursing,” but it will cover the same topics.

This is one of the most important RN courses because it sets the foundation for all other nursing school classes and clinicals. It also provides you with a clearer understanding of nursing and different nursing roles, which helps you confirm whether nursing is the right career for you.

2 | Physiology

Physiology is the study of the human body and how it functions. You’ll learn about the names and functions of different parts of the body and how they all function together, both in a healthy person and throughout different types of illnesses and injuries. This is usually one of the earlier required classes, since many subsequent courses rely on your understanding how the body works.

Physiology also includes topics that are important for your own health and safety, such as how to safely lift and move patients. Physiology also ensures that you and other healthcare professionals are using the same terminology to describe the body and how it functions, so mastering this helps ensure effective communication and medical notes. This makes it a vital part of patient safety and positive health outcomes.

3 | Introduction to Psychology

Introductory psychology is typically a prerequisite course needed to enter nursing programs. It covers principles and practices of psychology and helps nurses understand both psychology as a medical discipline, and how to use applied psychology as a nurse and communicator. Topics include cognition (how people think and make decisions), personality and behavior, organizational psychology, and the psychology of illness.

Studying psychology can help you communicate better , understand your own personality and those of others, and make better decisions individually and as part of a group.

4 | Microbiology

Microbiology is the study of microorganisms, any organism too small to see without a microscope, including viruses, bacteria, and certain types of fungi. This is also a prerequisite course often taken before entering nursing school, because understanding the role that microorganisms play in human health is necessary to understand many other aspects of healthcare. Topics include microorganisms that cause and help prevent disease, including the emerging field of the human biome, and the microorganisms that are part of the human body. This course generally includes lab work as well as classroom work.

This is one of the most important nursing prerequisite classes because of how important microorganisms are to human health. It sets the groundwork for infection control, population health, clinical theory, and nursing practices.

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5 | Gerontology

Gerontology is the studying of aging. RN classes in gerontology include topics such as conditions associated with aging, the psychology of aging, how to effectively communicate with aging adults, and end-of-life concerns for nursing. Gerontology is included in nursing major classes because of the important role nurses play in providing care to aging patients. Because it is a specialized class, most nursing students take it during or after their second year.

This is a foundational course for nurses who plan to specialize in gerontology but vital for all nurses because of the aging US population. Aside from pediatrics and obstetrics, older adults make up a large and growing proportion of general and specialty care patients, so the ability to understand their needs and provide effective nursing care is vital.

6 | Psychology and Mental Health

While introductory classes on psychology cover all aspects of psychology, including organizational psychology, RN classes on psychology and mental health focus on providing mental healthcare. Because understanding the psychological aspects of health is important to many other nursing school classes, this course is usually included in the first or second years. These courses cover mental health conditions and their treatment, as well as the special legal and ethical considerations associated with caring for patients with mental health conditions.

Physical and mental health are closely related, and so this course and other RN courses on mental health are vital to understanding patient well-being. Because nurses provide so much hands-on care to patients and are a vital communications link for patients, their ability to understand mental health directly affects the quality of their nursing.

7 | Pharmacology

Pharmacology is the study of medications. Nursing courses in pharmacology focus on the safe administration of medications, including opioids and other substances with the potential for abuse; different methods for administering them; how to watch for medication errors; and potential drug interactions. In addition to learning about medications and how they work, you will learn about the major pharmacology reference sources, including databases and texts.

While nurses (other than advanced practice nurses) do not prescribe medications, they must understand the fundamentals of pharmacology in order to ensure patient safety and answer patients’ questions.

8 | Women and Infant Health

Women and infant health covers women’s health, reproductive health, pregnancy, delivery, and infant development. Nursing school classes in this subject emphasize the nurse’s role in patient education and communication, as well as their role in providing direct nursing care. Generally, this is a foundational course that students take earlier in their nursing school curriculum. Some schools offer this topic in two courses, one in reproductive health and the other in infant health.

This foundational course covers general nursing concepts, as well as preparing nurses who specialize in women and infant health for advanced courses. These courses can include pediatrics, gynecology, or obstetric nursing.

9 | Leadership Management

Leadership management is typically offered later in RN curriculum since it requires broader knowledge of the scope of nursing. These classes include management and administration, staff leadership and motivation, legal and ethical aspects of leadership, nursing strategic planning, and healthcare administration. The curriculum combines management theory and case studies of how that theory applies to real-life nursing situations.

In addition to preparing nurses for leadership roles , these nursing school classes prepare nurses to understand nursing leadership functions so that they can understand their own role in their organization. While there’s no substitute for real-world experience to teach leadership, leadership management courses also provide a theoretical underpinning to understanding organizational behavior and management theory.

10 | Ethics in Nursing

Ethics in nursing is a core class because of the many difficult ethical situations that nurses face, no matter where they practice. RN classes in ethics cover topics such as professional conduct, conflicts of interest, health equity, diversity and inclusion, and appropriate responses to unethical behavior. Like leadership classes, ethics classes combine theory and, so be prepared to critically analyze ethical issues.

Throughout their career, nurses will face ethical dilemmas that might not have an obvious right or wrong answer. No matter how ethical you may be as an individual, nursing major classes in ethics provide you with the mental framework to think through dilemmas and find the best resolution.

11 | Community and Environmental Nursing

Community and environmental nursing is a branch of public health . These courses, which are typically offered in BSN programs, look at how the community and environment affect health and how to promote health in different communities and environments. Students will study factors including community safety, pollution and its impact on health, and community design for health in urban, suburban, and rural settings. As part of this course, you are likely to study your own community and the factors impacting its health.

As frontline health workers, nurses are among the first individuals to be in contact with individuals in need of information on environmental hazards or communicable diseases. An understanding of the influence of community and environmental factors on health can allow nurses to better communicate with local leaders and organizations. This may be especially critical for at-risk or underserved populations.

12 | Care Transitions

Care transition programs teach students about the process of transferring patients from one health environment to another, changing treatments, or discharging patients. The course covers other subjects such as health promotion, risk reduction, safety standards, and healthcare interventions.

Transferring medically complex patients between healthcare settings can have a significant impact on patient comfort or even health outcomes. Transition processes are especially at-risk for human error. Nurses must understand how to transfer important patient information including health records, medication information, and adverse reactions between settings.

13 | Population Health

Population health is sometimes offered as a capstone course to include a clinical intensive or synthesized experience within the public health industry. This course explores information and processes within complex healthcare systems and social-ecological theories within the public health system. It covers topics such as epidemiology, promoting healthy behaviors, health equity, and increasing access to health care. During this course, you’ll learn about the social factors that affect health and the healthcare system, including government, employment and income, media messaging about health and disease, and public health initiatives such as vaccinations.

While much of your career as a nurse will be responding to individual patients, those patients and their nursing needs are affected by population health factors. Understanding these factors and how they work helps you promote health at a different level. This is also a vital subject if you plan to go into nursing administration or healthcare strategy.

14 | Clinical Theory

Clinical theory teaches you the theoretical underpinnings of medicine and nursing, and how medical and nursing practices are designed, tested, and applied. It is typically one of the later RN classes, as it requires some familiarity with nursing and healthcare theory and practice. In these courses, you will learn about how different models of medicine, health, and healthcare apply to nursing. You will also learn how to apply these theories to your daily work in nursing as you encounter different parts of the healthcare system. For an ADN degree, nursing school classes may include elements of clinical theory rather than having a separate class, while at the BSN level, this is more likely to be a separate class.

Clinical theory courses help you think more strategically about health and healthcare, and are particularly important for nurses preparing for roles in healthcare management and leadership or advanced practice nursing.

15 | Clinical Study

Clinical study (often abbreviated as “clinicals”) is a vital part of becoming an RN , since it requires fieldwork hours in a clinical setting such as a hospital, physician’s office, health clinic, or other healthcare facility. During this course, you will apply both the skills and the theory you learned, under the guidance of a preceptor. These courses usually start with theory, move on to simulations, and end with you working with your own caseload.

Clinical study is a vital test of how ready you are to become a nurse, as well as a chance to learn hands-on about different healthcare settings and specialties. This makes it one of, if not the most important, of the classes required for nursing.

Frequently Asked Questions About Nurse Classes

What subjects are covered in nurse courses.

Nursing courses generally cover subject matter relating to biology and chemistry. Biology courses focus on anatomy, epidemiology, microbiology, and physiology. Chemistry courses include biochemistry, organic chemistry, pharmacology, and pathophysiology. Outside of the life sciences, nursing courses include study in mathematics, psychology, and sociology.

Are nursing classes hard?

Programs are intended to prepare nurses for a rigorous profession; therefore, they can be intense and challenging, but not impossible. Courses teach the complicated practices necessary for nurses to provide the best care to their patients. To ensure nurses can perform to the best of their ability, programs need to make sure students are up to the task of committing themselves to a difficult yet rewarding profession.

What is the easiest class in nursing school?

Some of the easiest classes in nursing school tend to be general education courses. These often focus on the memorization of key terminology or the development of soft skills, such as collaboration and communication. Some courses that are considered easier than others include the social sciences, introduction to speech, and information technology.

What is the shortest nursing program?

The shortest programs typically focus on becoming a practical nurse. Learners can become certified nursing assistants (CNAs) or licensed practical nurses (LPNs) in the shortest amount of time. CNA programs take 4-12 weeks to complete and prepare students to assist RNs in helping patients with daily functions. LPN programs take approximately one year to complete, preparing them to provide basic nursing tasks. Unlike CNAs, LPNs are licensed nurses.

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Online Nursing Degrees

Southern New Hampshire University answered the call in 1995 to begin making higher education more accessible to working adults. And in the early 2010s, it did the same for nursing education.

A pioneer in innovative online education, our programs meet the demands of the nursing profession and address the needs for prepared nurses in such areas as:

• Administration
• Quality improvement
• Patient care
• Clinical leadership
• Evidence-based practice
• Global health
• Equitable care

Our online nursing programs, developed by doctoral-prepared nursing faculty, feature curricula based on new standards for the 21st-century healthcare industry as defined in the Institute of Medicine report ''The Future of Nursing: Leading Change, Advancing Health.''

Heroes Behind the Scrubs: SNHU Nurse Leaders Share Their Stories

Nurse leaders at Southern New Hampshire University participated in a roundtable discussion about the role nurses play in transforming healthcare. With 7% job growth projected through 2029 - that's over 221,000 registered nurse roles that could be filled - there's quite the demand to change the lives of others. 1 And yours, as well.

Our Nursing Philosophy

At Southern New Hampshire University, we view the students in our online nursing programs as respected colleagues who come to the learning environment with their own unique views of the world and nursing.

Students are valued for the contributions they bring to the learning environment and are appreciated for their diverse values and beliefs. Students are viewed as both learners and learning resources.

Mission of the Department of Nursing

The mission of the Department of Nursing programs flows from the mission and vision of Southern New Hampshire University.

Our mission is to empower students to be successful nurse leaders, prepared to promote a culture of health within a diverse society and responsive to meet the challenges of an ever-evolving healthcare system. This mission is fulfilled through innovative programs responsive to the needs of adult learners in an online environment.

The program provides the nursing professional with the knowledge, attitude, skills and behaviors to lead patient-centered collaborative healthcare. Graduates are prepared to apply theory-guided, culturally competent, evidence-based professional nursing practices to improve the well-being of diverse populations within complex healthcare systems at the local, national and international levels.

Nursing Curriculum Conceptual Framework

• Builds upon prior nursing knowledge to provide a broad knowledge base for evidence-based, clinically competent, professional practice in the care of individuals, groups, families, communities and populations
• Prepares nursing leaders in professional roles and attributes
• Develops nurses into empowered change agents ready for successful integration into the dynamic, complex healthcare system within a global context

CCSNH Nursing Partnership

Our nursing partnerships include a seamless academic pathway for transferring community college credits , a tuition discount and financial aid.

If you are a graduate of a New Hampshire community college nursing program interested in learning more about the online BSN  and online MSN programs  or the accelerated RN to MSN , contact an SNHU admission counselor for more information.

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The baccalaureate degree program in nursing and the master’s degree program in nursing at Southern New Hampshire University are accredited by the Commission on Collegiate Nursing Education , 655 K Street NW, Suite 750, Washington, DC 20001, 202.887.6791.

ANCC Accredited Provider

At Southern New Hampshire University, we’re committed to your success — even beyond graduation. That’s why we’re committed to delivering accredited continuing education for nurses and healthcare professionals. From one-hour webinars to multi-day conferences and more, these opportunities are built to help you continue to meet the needs of communities across the globe.

Visit our SNHU continuing education page to learn more.

Southern New Hampshire University is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's (ANCC) Commission on Accreditation.

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Specially designed for learners in healthcare and nursing, HEaRT (Higher Education and Real World Training)  is a powerful experiential learning opportunity at SNHU. These online, asynchronous, voluntary experiences help connect students with employers to help solve real-world business problems – so you can be ready to make an impact in your field.

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RN to Bachelor of Science in Nursing

Earn Your Bachelor's of Nursing Online with Ohio State

Elevate your confidence and competence to care for your patients and develop the skills to advance the field of nursing.

The online Registered Nurse to Bachelor of Science in Nursing program provides the academic foundation for licensed nurses to keep pace with change, as well as to shape the profession of nursing. Graduates will be well-equipped to work in a variety of healthcare settings and prepared to pursue graduate degrees in nursing.

Ohio State’s RN-BSN program was ranked No. 7 in U.S. News & World Report’s Best Online Bachelor’s Programs in 2024.

"The online RN-BSN program fits the needs of a full-time nurse, and the understanding faculty worked with me to make sure that I got the support I needed."

"There's so many connections you can make that will have a really meaningful impact on you and provide you with a rich education. The opportunities that exist at Ohio State feel limitless."

Frequently asked questions, does the rn to bsn program require prerequisites.

No, the RN to BSN program no longer requires prerequisite courses for application or admission. Any prospective student who meets the other admission requirements will be eligible for admission.

Is the program fully asynchronous?

Yes, the online RN to Bachelor of Science in Nursing program is fully asynchronous, meaning you can log in to view instructional materials and complete your work when it is best for your schedule.

Is the program 100% online?

Yes, this program is 100% online, offering flexibility for working RNs to study from wherever they are.

Official Recognition

Ohio State’s RN-BSN program is ranked #7 in  U.S. News & World Report Best Online Bachelor’s Programs .

Academic Calendar

For the convenience of online students, multiple start dates are offered during the academic calendar year for the RN to Bachelor of Science in Nursing program.

Spring 2025

Application Deadline October 30, 2024

Term Start Date January 6, 2025

Summer 2025

Application Deadline March 31, 2025

Term Start Date May 6, 2025

Autumn 2025

Application Deadline June 30, 2025

Term Start Date August 26, 2025

Admission Criteria

• An associate degree in nursing or a nursing diploma
• An active and unrestricted RN license
• A cumulative undergraduate degree GPA of 2.0 on a 4.0 scale

Application decisions are made on a rolling basis. Most applicants will receive a decision on their application within one month of completing the full application process.

The State Authorization Reciprocity Agreement, also known as  SARA , establishes uniform standards for distance education for all participating states and institutions. Ohio State joined SARA in 2015, which means Ohio State can offer most online and on-ground courses and programs in  SARA member states, districts and territories without seeking authorization in each state.

Career Outlook

With a BSN, you’ll be eligible for a wider range of nursing roles such as nurse managers, clinical nurse specialists, and nurse educators.

Whether you’re looking to grow in your current career or make a career change altogether, Ohio State’s online programs can help you achieve your goals. Learn what the outlook is for your current or next career move using O*Net’s My Next Move tool.

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Experience top-tier curriculum in our online bachelor’s in nursing program, structured to provide graduates with comprehensive knowledge and practical expertise to advance their careers in nursing.

NRSADV 2440 – Foundations and Contemporary Issues for RNs

Provides the framework for exploration of professional issues in contemporary nursing and health care for nurses pursuing a baccalaureate degree.

NRSADV 4240 – Concepts in Community Health Nursing

Study of community health nursing theory and principles applied to the nursing care of individuals, families, groups, communities, and populations.

NRSADV 4780 – Evidence Based Practice: Transforming Healthcare

Study of concepts, application and implementation of evidence based nursing for transforming quality health care.

NRSADV 4402 – Evolving Concepts in Leadership and Management

Exploration and application of leadership and management concepts as applied to nursing practice and the health care environment.

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As you research the right online program for you, you likely will come across the terms “asynchronous” and “synchronous.” Learn what these terms mean and how they’re important to consider when understanding how a program will fit into your life.

Program Faculty

RN-BSN students will experience unparalleled learning from our world-class faculty within The Ohio State University College of Nursing.

Wendy Bowles, PhD, RN, APRN-CNP, CNE

Dr. Wendy Bowles has been a nurse since 1994 and a Pediatric Nurse Practitioner since 1998. In addition to a fulfilling career as a nurse, she began her journey in nursing education in 2005 and realized the importance of educating future nurses for current practice environments. She is committed to advancing the science of evidence-based pedagogies of teaching and learning in nursing education.

Jessica Reuter, DNP, RN, CCRN

Amy Jauch, DNP, RN, CNE

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Party Like It’s 1999: RN Residency Celebrates 25 years

The party began at 6 a.m., but this crowd is more than accustomed to early starts.

Above the din of voices enthusiastically connecting, “Doo Wop” by Lauryn Hill plays overhead on the speakers. Streamers with 90s pop culture references adorn the ceiling while folks page through a collection of yearbooks, occasionally pausing to marvel at throwback photos of their friends and colleagues.

It’s an alumni reunion of sorts—marking 25 years since CHLA launched its RN Residency in Pediatrics , then called the RN Internship Program. In 1999, the RN Residency was one of the first initiatives of its kind. It has since welcomed 50 cohorts and more than 2,100 participants to train at CHLA.

“It’s hard to imagine the impact of these 25 years,” remarked CHLA President and Chief Executive Officer Paul Viviano at the event. “As one of the first to start this great legacy of developing postgraduate nurses for pediatric specialty care, this program is a model for the entire country.”

The RN Residency experience

The ultimate goal of the American Nurses Credentialing Center-accredited program is to ensure nurses gain proficiency, comfort and confidence working in a high-acuity specialized pediatric hospital setting. Over their first year of practice, participants attend classroom instruction, engage in “action days” via skills stations and simulations, are assigned to preceptorships in a specific hospital unit, and meet with a personal mentor for clinical and professional development.

“Back in 2000, most hospitals’ orientation programs were only six weeks long,” says Senior Nursing Development Specialist Margaux Chan, DNP, RN, who sports a “Party Like It’s 1999” tee. “This program gave me much more time to gain an understanding of what it’s really like to work as a nurse.”

Over the last 25 years, the RN Residency model has expanded to thousands of hospitals across the country—and become increasingly more competitive. Twice a year, anywhere from 500 to 800 new grads from across the country apply to score one of 50 spots in a CHLA RN Residency cohort.

“It’s a very competitive program,” says Chan. “You’ll be working alongside the best of the best. As an accredited program at one of the top pediatric hospitals in the country, according to U.S. News & World Report, applicants choose CHLA to gain experience with an incredibly wide range of patients and health conditions they won’t see anywhere else.”

Twenty-five years ago, Beth Zemetra, MHA, RN, was one such applicant, joining a cohort of 24 for the inaugural RN Residency.

Today, she’s a Clinical Services Manager for the Thomas and Dorothy Leavey Foundation Cardiothoracic Intensive Care Unit (CTICU) and oversees a team of 150.

“The RN Residency program is truly what made me successful,” Zemetra says, citing how mentors and colleagues empowered her to be successful and encouraged her to challenge herself. “It gave me a sense of belonging and confidence.”

Specialized training for stronger retention

A key driver behind the creation of the RN Residency was to address the high turnover rate for first-year nurses nationwide. In complex care settings, nurses can often feel like they’ve been thrown into the deep end and ultimately choose to leave the profession early.

Today, the program celebrates a 92% one-year retention rate. Additionally, 50% of CHLA staff with RN licenses were past RN Residents.

“It would have been difficult for me to succeed in a very high-acuity, detailed critical-care environment without this training,” says David Romberger, RN, MSN, a 2003 residency graduate who started his career in the CTICU and is now Executive Director of the Heart Institute . “The program provided a more intensive, structured way to build my skills. My mentors showed me where I could end up someday and sent me in a better direction.”

As part of the team charged with selecting new Heart Institute hires and guiding decisions to support new grads, Romberger has witnessed how RN Residency ensures long-term success for nurses in real time. “It can be really hard to pick the right people, but this program sets them up well.”

While today Romberger spends most of his time leading administration for 300 Heart Institute team members, the family legacy of nursing excellence continues: In March, his daughter Tatum graduated from the RN Residency and now works as a nurse in the Cancer and Blood Disease Institute .

“Working in a great field and making a daily difference in kids’ lives are all the things you want for your child,” Romberger says.

A legacy of next-level care

Over the next year, 100 more nursing graduates will embed themselves in the CHLA campus for their year-long residency and emerge equipped to excel in pediatric specialty.

Zemetra emphasizes that while the nursing profession can be filled with challenges, it's also incredibly rewarding. She reflects on how overwhelmed she felt stepping into the CTICU as a new graduate. “Take it one day at a time,” she says. “Know we’re here to support you in becoming your best professional self.”

While music choices, hairstyles and color options for scrubs have certainly evolved in the last 25 years, a key theme has remained from 1999 to today: the collective dedication to CHLA’s mission of creating hope and building healthier futures.

“Everyone across the organization is so committed to providing next-level care to patients and families—whether they’re at the bedside, in the main lobby or housekeeping,” says Zemetra. “It’s truly a special environment.”

The CHLA RN Residency in Pediatrics will welcome its 51st cohort this September.

Learn more about the RN Residency in Pediatrics . 

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