How to Become a Registered Nurse in Texas

Registered nurses (RNs) provide a critical link between physicians and patients.  Regardless of specialty or work setting they coordinate and provide care for patients, give advice and offer emotional support to patients and their families, and educate both patients and the general public about a wide variety of health conditions.

Despite a down economy, the healthcare industry is one of the few career fields that is still hiring.  As healthcare advances and people living longer, the demand for registered nurses will continue to rise. For those on the path toward becoming a registered nurse, abundant job prospects and ample opportunities await.

Career Overview

The majority of RNs work directly with patients as staff nurses in hospitals, nursing care facilities, or work for home health care services.  Others hold positions where they do not work directly with patients such as nurse educators, healthcare consultants, public policy advisors, researchers, hospital administrators, salespeople for pharmaceutical and medical supply companies, and medical writers.  Career advancement for RNs includes nursing management and administration positions.

Depending on the facility, the work schedule for registered nurses can be challenging.  Caring for patients in hospitals and nursing care facilities is an around the clock job.  RNs who work in these settings typically work an 8, 10 or 12 hour shift including every other weekend, and rotating holidays.  For those working in doctor’s offices a regular Monday through Friday, 8am-5pm schedule with weekends and holidays off can be expected.

Registered nurses spend considerable amount of time walking and standing. However, regardless of the setting in which they work, RNs need to be able to cope well with stress and pressure, be compassionate, have excellent communication and critical thinking skills, exhibit patience and emotional stability, and be very detail oriented.

The daily duties of a registered nurse typically include the following:

  • Record the medical history and symptoms of patients
  • Perform diagnostic tests and analyze results
  • Administer treatment and medication
  • Operate and monitor medical equipment
  • Help with patient follow-up and rehabilitation

In addition, RNs teach patients and their families how to manage their illness or injury.  They explain post-treatment home care needs such as diet, nutrition, and exercise programs and self-administration of medication and physical therapy.

Education, Training and Certification

There are three educational routes that one can take to become a registered nurse.  Obtain a bachelor of science degree in nursing (BSN), an associate’s degree in nursing (ADN), or earn a diploma from an approved nursing program.  Earning a BSN will typically take four years and an ADN or diploma from an approved program will take between two and three years to complete.  Regardless of the path, courses included in all of the programs above are anatomy, physiology, microbiology, chemistry, nutrition, psychology and other social and behavioral sciences.

Each of the programs includes a supervised clinical experience in a hospital or other worksite.  The clinical provides a very unique learning experience where the instructor supervises the students as they apply the knowledge that they have learned in a real life, hands-on situation. Essentially by the time you graduate from a nursing program you will be fully prepared to enter the workforce and progress quickly.

A bachelor’s degree in nursing will better train you for moving up the ranks to administrative, research, consulting and teaching positions.  A BSN program typically includes greater training in physical and social sciences, communication, leadership, and critical thinking.  In addition the clinical rotations will often include experience in a non-hospital setting such as long-term care facilities and walk-in clinics.

A BSN can also be completed as you work after earning your ADN or diploma by completing a RN-to-BSN program.  This will allow you to take advantage of tuition reimbursement benefits.

According to the Texas Board of Nursing, there are 110 approved professional nursing programs in Texas.  The cost to complete a two-year program to obtain an ADN or diploma ranges from approximately $9,000 to $26,000 depending on resident status (in-state or out-of-state).  A four-year program to earn a BSN from a public school averages $26,000 and from a private institution can cost $100,000 or more.  Tuition includes books, lab costs and administrative fees.  The majority of nursing program websites provide financial aid information for prospective students.

Once you have completed a nursing program, the state of Texas requires that you take and pass the National Council Licensure Examination (NCLEX) to gain an RN license in Texas.  As stated on the National Council of State Boards of Nursing website, the exam “measures the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse.”  Candidates for licensure will have to register for and schedule a time to take the exam on the Texas Board of Nursing website.  It is suggested that this exam be taken immediately after graduating.  The Texas state board of nursing has reported that students who wait more than 6 months to take the exam rarely pass.

Prior to being issued a permanent RN license in Texas, you must also pass the Texas Medical Jurisprudence Examination.  This exam tests understanding of legal issues that affect the delivery of nursing care.

Additional requirements for licensure in Texas include submittal of school transcripts and fingerprints for a background check.

Salary Information

Median earnings of a registered nurse in select regional areas.

Austin $86,244
Dallas/Ft. Worth $85,412
El Paso $75,435
Houston $88,400
San Antonio $83,864

Career Outlook

According to the Occupational Information Network (O*Net) the career field of Registered Nurse has a bright outlook and will grow faster than average through 2020.  Employment for nurses is expected to grow 26% between 2010 and 2020.  Technological advancements that provide wider and better treatment options for a number of health problems, an increased emphasis on preventative care, and a growing elderly population all contribute to this anticipated growth.

In general, excellent job opportunities are expected for registered nurses.  A high turnover rate for RNs working in hospitals has resulted in administrations offering signing bonuses, family-friendly work schedules, and/or training reimbursements.  Due to the regular work hours in a physician’s office, there is typically greater competition for these positions.

Some Advice from the Inside

There is information that simply cannot be found on the internet or in a book.  It is the valuable insight and advice that can be gained only by talking with someone who has gone through the steps necessary to become and held a position as a Registered Nurse.

Rosita Padilla, a self-described “late in life career changer” and registered nurse in Acute Care Trauma Services says, “Be sure that becoming a Registered Nurse is absolutely the career choice for you, because it does require a lot of time and energy to learn all that is required.”  Having always had a passion to do something in the medical field, Padilla strongly recommends using every resource available to interact, research and reach out to medical personnel to gain as much insight as possible before making the decision to become an RN.  Lori Wilson, a registered nurse for 13 years and a Critical Care Clinical Coordinator, agrees that if she were starting over again she would get all of the exposure she could to the healthcare field prior to starting nursing school.  She suggests seeking out a position in a laboratory, pharmacy, or even a hospital.  “There are lots of jobs that you can do in a hospital without a degree.  Many of our Patient Care Techs have minimal experience and go on to nursing school or other healthcare field program.”

“Once in school, don’t just do the bare minimum to get good grades and pass the class.  Go above and beyond the subject at hand to better prepare yourself for the hands-on clinical experience,” says Padilla.  “In the summers during nursing school”, Wilson adds, “look for an internship at a hospital.”  During an internship, a nursing student is paired with an experienced RN mentor.  “The student should feel at ease, be comfortable and respect the RN that they will be working under.  This person will teach the student a lot that the books will not,” says Padilla.  Wilson adds, “You not only learn a great deal from working under a registered nurse, you gain hands-on experience with their supervision.  Interning is a great way to learn how to actually be a nurse, something nursing school doesn’t teach that well.  And if you can intern at a hospital with a promising job after graduation, you will already know the ins and outs of the hospital.  After all, all hospitals have their own way of doing things.”

“Learning as much as you can and gaining experiences before you actually become a nurse will help you decide what kind of nurse you will want to be and where you will want to work.  But do not fret if you still don’t know where to work after graduation.  Nursing is flexible and you can change jobs until you find your forte,” says Wilson.  Padilla adds that if a student already knows which field of nursing they want to work in after graduating, that they try to get into that field when looking for an internship.  “If the field has not been decided upon yet, dabble in a little bit of everything until the fit feels right.”

Wilson shared that “being a nurse is a very rewarding, albeit exhausting profession.  I will never regret my decision to become one.  There are so many avenues that one can take in this profession that I think really anyone could do it.”

Padilla emphasizes that nursing students and RNs should “never be afraid to ask questions. We are taught to always have a questioning attitude and to go with that gut feeling.  If your question does not get answered with one RN, go to the next and the next until your conscience has been satisfied.  Knowledge is power, but remember that we never stop learning.  Listen and learn with enthusiasm.”

Additional Resources

For more information, visit the following sites:

Texas Nurses Association
American Nurses Association
Nurses for a Healthier Tomorrow