ADN – Associate Degree in Nursing
The Associate's degree in Nursing, or ADN, is a 2-year degree and is the minimum amount of school required to become licensed as a registered nurse, or RN. Once the student graduates, he or she is eligible to take the NCLEX-RN examination which must be passed to become licensed by the State. An RN must be licensed to be able to work.
Many community colleges and vocational schools across the county offer the ADN program. When researching programs, consider these areas:
- Additional Costs
- Waitlists and length of program
- Clinical Hours
- NCLEX-RN Exam and RN Licensure
- Jobs to expect
Checking with local community colleges and vocational schools for tuition cost and what is included with tuition, is a good place to start.
Community college courses for ADN students range from $2,250 for in-state tuition at Northwest Mississippi Community College and up to $12,123 for out-of-state tuition at Red Rocks Community College. Main College of Health Professions in Lewiston, Maine is priced at $9,520 for the 2-year degree. There is a wide price range exists between schools and states.
Reasons for more expensive tuition may include:
- Shorter waiting list than other schools
- All prerequisite courses included within the program
- Additional costs included in tuition, like uniforms and textbooks
- Shorter length of program
Costs which may not be included in tuition include supplies and transportation costs.
Nursing school supplies include:
- Stethoscope, vary in cost and quality, from about $35 up to $500+
- White shoes, most nursing schools require sparkling white sneakers or Dansko clogs
- Pen light, usually just a couple dollars
- Uniforms, 2 or 3 sets of scrubs in required colors and with school's name embroidered, approximate cost $200
- Textbooks, up to $1000 but may be included in tuition
- Meals and incidentals during classes and clinicals
- School and/or clinical location parking permits
Also consider transportation to and from school and clinical locations (if required). The school's location is obvious, but ask the adviser where clinicals might take place. Usual healthcare settings for clinicals are hospitals, especially teaching hospitals, skilled nursing facilities, and long-term acute care facilities.
- How many miles will I have to put on my car?
- How much will gas cost per week?
- Do I need to take public transportation and if so how much will that cost?
Learn more about the cost of RN schools.
Prerequisites and nursing classes make up the ADN. Exact titles and requirements vary but each school must meet the requirements outlined by each state's board of nursing.
Prerequisites for ADN program:
- Anatomy and Physiology
Nursing classes for the ADN program include:
- Foundations in Nursing
- Nursing Care of Adults
- Behavioral Health
- Maternal and Child Nursing Care
Nursing School Waitlists Are Common
Due to the high demand for nursing programs many students find themselves on a waiting list before they can start the actual nursing program.
Some schools will allow prerequisite classes and volunteer hours to be completed while the student is on the waitlist and others require all prerequisites and volunteering to be completed prior to being listed. This is an important distinction when comparing schools because it may take up to a year to complete prerequisite classes for some institutions.
When considering the true value of higher tuition bear in mind that the longer a student waits to graduate the longer it will be before joining the workforce as a RN. RN's have a median starting salary of $27.00 per hour (http://www.payscale.com/research/US/Job=Registered_Nurse_(RN)/Hourly_Rate) which grows rapidly with experience and education or certifications. If the student is not earning more than $27.00 before becoming a RN it may be wise to pay more money and finish school faster. Once the RN is working those experience years begin to add up and more money will be earned over the RN's lifetime. But, this is a personal decision.
ADN programs are about 2 years in length. Many schools allow students to transfer credits from accredited schools which may shorten the program. Vocational schools may be designed to fast-track students by removing breaks, like spring or winter breaks. This make take a few months off of the program.
Clinical Hours for ADN
Clinical hours are required for most ADN program. Each program may slightly vary, so it is important to review the requirements prior to beginning. Clinical hours are faculty-monitored real-world experience which are part of the nursing school curriculum. Each state has a required amount of hours that needs to be completed before the graduate can be eligible to take the NCLEX-RN exam. This exam must be passed for the graduate to be licensed as an RN.
Each facility should have a process for overseeing students and probationary employees which typically includes a checklist of skills. Once the preceptor, or person assigned to orient and train the student, has deemed the student capable of managing skills on their own, the preceptor can act as a resource to the student and no longer needs to oversee each task.
If the preceptor determines that the student is not able to manage the tasks on their own after appropriate instruction over time, the preceptor should consult with the charge nurse or manager so feedback can be provided to the school of the student’s failure to perform at the expected standard level.
Students should refer to their school’s policy or the policies of the institution for further clarification.
The main difference between the two is that the ADN is a college degree while the RN diploma is, well, a diploma. Both programs take about two years to complete, and both are considered “entry-level.” They also both prepare students to sit for the NCLEX-RN exam for licensure. However, RN diploma programs are typically hospital-based and might be offered in technical or vocational schools. Students gain valuable hands-on skills throughout the program and take courses specific to healthcare and nursing.
ADN students also gain clinical experience but are also required to complete general education courses to fulfill associate degree requirements, some of which may or may not include healthcare-related courses.
While both prepare students for licensure as a registered nurse, there are a few considerations one should keep in mind. Students should always check their state board of nursing’s website to determine educational requirements, and they should also find out what minimum education requirements are needed in places of employment. For example, some organizations or facilities prefer a minimum of an ADN, and some even a BSN.
Dispensing of medication can be described as preparing, packaging, labeling, and then providing the medication to a patient or their representative to be taken at a later time. Dispensing is different than administering medication where the medication is provided to the patient for immediate dosing via the prescribed route.
Nurses are responsible and accountable to provide safe, competent, and ethical care to the community and the patients they serve. Each state Board of Nursing determines the Standards of Practice through the Nurse Practice Act. Most states collaborate with the Business and Professions Code to further define, or amend, regulations for dispensing and administration of medications.
For example, in California, the California Board of Registered Nursing and the California Business and Professions Code was amended in 2013 to allow for registered nurses in that state to dispense certain medications under specific circumstances to aid in the distribution of contraceptive medication. A registered nurse may dispense medications such as self-administered hormonal contraceptives once the nurse has been trained and deemed competent in providing the ordered medications.
There are currently 16 states in the U.S. that allow RNs to dispense a limited number of medications under specific criteria. Nurses must refer to their individual state Board of Nursing for direction on dispensing medication in their state.
A 2-year associate’s degree in nursing is the minimum degree requirement to become licensed as an RN. Bachelor’s degree nurses are RNs who have completed a 4-year degree program. BSN nurses work in many of the same roles as ADN nurses. However, they have more career opportunities in areas including leadership.
So, the question remains: What leadership positions are available to ADN nurses?
In reality, it depends on the organization. Many large teaching hospitals prefer BSN-prepared nurses even for just bedside nursing. Some organizations don't have a BSN requirement. Depending on the facility, ADN nurses can work in the role of a charge nurse, which is the first step in clinical leadership. Some employers even allow ADN nurses to take positions in management or as house supervisors. In many cases, it depends on years of experience and work performance.
However, it’s important to note that the pendulum is swinging towards BSN nurses, especially in leadership roles. This does not mean ADN nurses are out of luck when it comes to leadership roles. As stated earlier, some employers hire ADN nurses into leadership and supervisory roles, and some hire into the roles and assist the nurse in earning a BSN.
The required examination for registered nurses is the NCLEX-RN exam. It is a national exam that must be passed in order for the State to allow RN licensure.
Nursing schools teach students what they need to know to pass the NCLEX-RN exam.
NCLEX-RN Pass Rates
NCLEX-RN exam "pass rates" are the percentage of students who graduate from the school and successfully pass the NCLEX-RN. This information is available through both the school and the State's nursing board. Schools with higher "pass rates" are more desirable. These schools may also have higher standards than schools with lower "pass rates" and because of this many students who begin the program fail out of school. See nationwide NCLEX-RN exam pass rates.
Becoming Licensed as an RN
Once the ADN program is complete, the graduate should follow these steps to take the NCLEX-RN exam (https://www.ncsbn.org/before-the-exam.htm):
- Learn about eligibility to take the NCLEX from your state board of nursing or click here (https://www.ncsbn.org/contact-bon.htm)
- Register with https://www.PearsonVue.com and pay the application fee
- Receive the Authorization to Test (https://www.ncsbn.org/1212.htm) from Pearson Vue
- Schedule the NCLEX-RN exam through Pearson Vue at a testing center near you before the Authorization to Test expires to avoid additional fees
The RN license will arrive in the mail from the State Board of Nursing once the graduate passes the Exam. It will also available to employers on NURSYS (https://www.nursys.com/).
The RN can now start to look for jobs! Find an RN job.
For most new graduate RNs the first job is an internship.
These are designed for newly graduated RN's, or New Grad RNs, who need to learn the complexities of a specialty. Specialties in nursing are usually explored during clinical hours while in nursing school so students have an idea of where to work after graduation.
Nursing specialties for New Grad RN Internships include:
- Emergency Room
- Critical Care - meaning Intensive Care Unit (ICU) or Progressive Care Unit (PCU)
- Labor and Delivery
- Neonatal ICU (NICU)
- Operating Room (OR)
- Skilled Nursing Facility
- Long Term Acute Care
- Outpatient Clinic
- Physician's Office
See our complete list of nursing specialties.
Before starting an ADN program it is a good idea to search job requirements for various specialties of interest.
Some employers require a Bachelor's of Science degree in Nursing (BSN). This is especially true for large teaching hospitals, research, and education. However, many RN to BSN bridge programs are available 100% online and have little to no waiting list. Once the RN is completed, clinical hours are not required for a BSN.
The median hourly wage for an Associate's degree educated RN is $27 nationwide with the range being $20.80-$38.52 (http://www.payscale.com/research/US/Job=Registered_Nurse_(RN)/Hourly_Rate ).
The biggest influences on salary are location and experience. See more precise RN salary details.
Nursing salaries, like other professions, tend to align with cost of living. Areas with higher costs of living usually pay more for staff nurses. The exception to this rule is for travel nurses. Travel nurses are contracted RNs who work for a third-party. Many travel nursing contracts in less desirable areas pay more than those in more desirable areas because the hospitals have trouble attracting enough staff to live and work in those areas.
Experience counts for a lot in nursing. In fact, a nurse with less education, like an ADN, may actually make more money than a nurse with a Bachelor's degree. This is because the ADN educated RN has more experience. For this reason, in part, many hospital require ADN educated RNs to obtain a BSN within a certain amount of time after hire.
Once some experience is gained the RN can become certified in his or her specialty. Not only do certifications validate and further education, they also drive up the hourly wage for RNs. For most specialties in nursing a certification is available.
Here are a few popular certifications:
- CCRN, certification for Adult, Pediatric, and Neonatal Critical Care Registered Nurses (http://www.aacn.org/wd/certifications/content/ccrnlanding.pcms?menu=certification)
- RNC-OB, certification for obstetric nursing (https://www.nccwebsite.org/Certification/HowdoIapply.aspx#available-certification-exams)
- RNC-MNN, certification for maternal newborn nursing (https://www.nccwebsite.org/Certification/HowdoIapply.aspx#available-certification-exams)
- RNC-LRN, certifcation for low risk neonatal nursing (https://www.nccwebsite.org/Certification/HowdoIapply.aspx#available-certification-exams)
- RNC-NIC, certification for neonatal intensive care nursing (https://www.nccwebsite.org/Certification/HowdoIapply.aspx#available-certification-exams)
- CEN, Certified Emergency Nurse (http://www.bcencertifications.org/Get-Certified/CEN.aspx)
Becoming a RN is a great career choice and doing it as fast as possible to start working is how most students approach the RN education. Many schools offer the ADN program and with a little research a good fit is bound to happen.
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