How Hard Is Nursing School in 2023?

Here's how hard nursing school is, the general skills different degrees and program types require, and five expert tips for success. Education

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Just as it's crucial to understand what a nursing career entails, it's equally important to understand the real-life challenges of nursing school and what it takes to succeed. Considering that, here's everything you need to know regarding how hard nursing school is, the general skills different degrees and program types require, five expert tips for success, and more.

How Hard Is Nursing School?

Nursing school can challenge students in various ways, often depending on personal factors and the strengths of individuals. Some of the challenges include:

  • Academic Rigor: Nursing programs require substantial knowledge and understanding of biology, anatomy, physiology, chemistry, pharmacology, and psychology, which may pose different difficulty levels to students based on previous studies and interests. Developing a deep understanding of hands-on, technical skills is essential for patient care, so these skills will be tested during nursing school in the practice lab and during clinical experiences.
  • Time Commitment and Management: Nursing schools require many hours of studying, class time, and clinical rotations, each of which may occur during early mornings, late nights, and weekends. Combining this with juggling other commitments such as work, family responsibilities, or other possible obligations may challenge nursing students. Add in the time commitment and ability to manage time well, and the perfect storm to cause burnout may exist.
  • Physical Demands: Most people know that RNs spend long hours on their feet. However, knowing that long hours and hard work begin in nursing school is essential. Clinical rotations often start in the early morning hours and go into the afternoon. Nursing students are on their feet providing nursing care to patients with lots of required bending, squatting, and lifting. It's recommended that nursing students invest in a good pair of nursing shoes and many pairs of compression socks. These items can enhance their comfort and productivity and keep their legs and feet healthy and strong while completing their rotations.
  • High-Stakes: Many nursing students may encounter high-stakes situations that increase stress, which are inherent to the pressures of the healthcare setting. These include situations with complex patients or families, death, and other high-acuity and critically ill patients. Other stressors may consist of education costs, the importance placed on succeeding, or preparing for and taking the state licensure exam (NCLEX-RN).

Although nursing school has many challenges, students often find the time rewarding and worthwhile as the profession enables them to make a significant impact on the lives of others. Nursing also comes with job security and offers many specialization and career advancement opportunities. Additional resources are available to students who struggle during their nursing education, including academic tutors, counseling services, study groups, time management resources, test prep centers, and career placement.

How Hard Is It to Get Into Nursing School?

Generally, nursing school is accessible to all students who have graduated from high school or achieved their GED. However, institutions will vary in the prerequisites and requirements for acceptance, considering factors such as:

  • Type of Program: Each nursing program creates individual admission criteria. For example, acceptance into a Bachelor of Science in Nursing (BSN) program may prove to be more difficult than acceptance into an Associate Degree in Nursing (ADN) program, as the former is a more advanced level of education. Graduate-level programs are also subject to this, as a Master of Science in Nursing (MSN) program or Doctor of Nursing Practice (DNP) program may be even more selective.
  • The reputation of the School: Highly reputed schools often have more applicants and are therefore more competitive than lesser-known institutions.
  • Prerequisites and Requirements: Most nursing schools will require that students have a minimum GPA and have taken subjects such as anatomy, physiology, Microbiology, chemistry, and statistics. They often additionally require entrance exams such as the TEAS or HESI, an interview, letters of recommendation, and demonstration of desirable qualities through extracurriculars.

Which Year of Nursing School Is the Hardest?

A student's experience in nursing school will depend on their strengths and weaknesses and the institution and program they take. However, the years spent entrenched in the nursing curriculum are challenging. Whether students take an ADN or BSN program, they'll likely spend two solid years taking primarily nursing-related subjects.

The first year can be the most challenging as it may be an adjustment for students entering more intensive education than their previous experience. In the second year, coursework can become more specialized, with classes becoming more challenging due to complexity while clinical hours increase, demanding more time and energy from students.

General Skills Required for Nursing School

Technical nursing skills will be taught during nursing labs and clinical rotations. These are not skills students need to have before beginning nursing school.

However, they must possess soft or durable skills, which are personal attributes that can help nursing students work with others and succeed. Some of the key skills that will help a student excel in nursing school include:

  • Critical thinking and problem-solving
  • Time management
  • Communication
  • Compassion and empathy
  • Attention to detail
  • Technical skills
  • Endurance
  • Resilience
  • Adaptability
  • Teamwork

Although these general skills can help students excel, each nursing program will have specific requirements and expectations.

What Type of Personality Makes a Good Nurse?

Nursing isn't a one-size-fits-all profession. However, a few personality traits will be useful during nursing school and beyond. Not only will these traits help nurses succeed when caring for patients, but they'll also help them be excellent members of the nursing team.

A few personality traits of good nurses include:

  • Emotional Stability: Helps nurses control their emotions and responses during challenging situations to remain in control.
  • Communication Skills: Nurses use verbal, non-verbal, and written communication skills during every shift and must know how to use each skill well.
  • Problem-Solving: The ability to solve, analyze, and create an action plan quickly. This skill helps nurses during standard patient care and emergent situations that arise.
  • Work Ethics: Nurses determine right and wrong when dealing with challenging situations. This skill might also be called a moral compass and allows nurses to make decisions in the best interest of the people they care for at work.

What Are the Different Types of Nursing Schools?

The most common nursing programs include:

  • LPN
  • Nursing Diplomas
  • ADN
  • BSN
  • MSN
  • DNP
  • Bridge programs such as RN to BSN, etc.


Licensed practical nursing (LPN), also called licensed vocational nursing (LVN) in certain states, is an entry-level healthcare role. LPNs are instrumental in fostering communication between the medical and nursing staff, patients, and their families working under the guidance of registered nurses (RNs) and physicians. Coursework typically includes:

  • Biology
  • Chemistry
  • Anatomy
  • Physiology
  • Psychology
  • Medical Terminology
  • First Aid
  • Physical Education
  • Food and Nutrition
  • Child Growth and Development

Nursing Diploma

Nursing diplomas provide training and enable students to become RNs. However, they are different than ADNs and BSNs in that they're hospital-based nursing schools rather than offered at community colleges or universities. These programs do not end with the nurse earning a degree but rather a diploma. Nursing diploma coursework includes:

  • Anatomy and Physiology
  • Chemistry and Microbiology
  • Nursing Science
  • Psychology and Sociology
  • Nutrition and Diet Therapy
  • Pharmacology
  • Pediatrics and Obstetrics
  • Medical and Surgical Nursing
  • Community Health Nursing
  • Critical Care Nursing


An ADN focuses on core nursing principles and provides hands-on experiences while requiring general education courses for a degree program. The rigorous curriculum readies students for the NCLEX-RN and prepares them for a career as an RN. Typical coursework includes:

  • Fundamentals of Nursing
  • Nursing Care of Adults
  • Community Health Nursing
  • Behavioral Health
  • Microbiology
  • Psychology
  • Anatomy and Physiology
  • Chemistry
  • Pharmacology


Most healthcare institutions highly seek BSN-prepared nurses in comparison to ADN-prepared nurses. BSN nurses receive higher-level training focusing on research, nursing theory, leadership skills, and evidence-based practice. Coursework often includes:

  • Biology; lab and lecture
  • Chemistry; lab and lecture
  • Human Anatomy and Physiology
  • Microbiology; lab and lecture
  • Nutrition
  • Pathophysiology
  • Sociology
  • Genetics and Genomics
  • Health Assessment
  • Nursing Pharmacology
  • Public Health Nursing
  • Mathematics
  • General Psychology


MSN programs blend nursing theory, research, evidence-based clinical practice, leadership, and healthcare management and offer specialization tracks, including advanced practice nursing, nursing leadership, nursing education, and nursing informatics. Coursework will vary based on which specialization is taken.

It's essential to know that MSN programs require that the nurse has earned a BSN before beginning advanced practice nursing school.


The DNP is the beacon of advanced skills and in-depth nursing knowledge, uniquely positioning students to profoundly impact the healthcare industry through their roles in organizational leadership, healthcare administration, health policy implementation, and more. DNP school requirements vary. However, the nurse must have earned a BSN at a minimum.

How to Survive Nursing School

Surviving nursing school will be different for every student. Those who are genuinely passionate about the career may liken their experience as closer to thriving. Nonetheless, much effort will be required by all who attend nursing classes.

Here are five tips to help you succeed through a rigorous nursing school curriculum, simulation labs, and clinical experiences.

  1. Study Smart: Discover your learning style and the best study routine to optimize your studying. Consider joining a study group or working with one study buddy who learns the same way you do.
  2. Organize Yourself: Plan and ensure you can take on all the responsibilities required by nursing school. Create a study schedule that works with your personal life and work schedules, and don't forget to pencil in downtime too.
  3. Stay Healthy: A healthy lifestyle and routine can differentiate nursing school success and burnout. Exercise, eat well, and get enough sleep. Don't neglect your self-care amid a busy schedule.
  4. Seek Help When Needed: Many resources, such as academic tutors, counseling, and career placement, are available to students in need. Reach out to a nursing faculty member or student support services as soon as possible if you start feeling overwhelmed or stressed during nursing school.
  5. Remain Positive: Attending nursing school out of genuine passion will help students stay positive during difficult times. If you start feeling stressed or questioning if you can succeed, take a minute to remember your "why.” This means you should sit down and think about why you chose this career. Maybe it was inspiration from a family member or healthcare experience that caused you to want to become a nurse. No matter what your "why" may be, it's essential to remember it often during the tough times of nursing school.

Is Nursing School Worth It?

Becoming a nurse is a rewarding career for many due to having the opportunity to make a meaningful difference in the lives of others, excellent job security, opportunities to advance your career and specialize, and much more. Ultimately, whether or not nursing school is worth it will depend on an individual's personal and career goals.

One thing is for sure, and that is that nurses make a good living. According to the Bureau of Labor Statistics (BLS), RNs in 2022 made an average annual wage of $81,220. Average salaries vary based on location, education, years of experience, and the facility or employer pay scale.

Top Paying State for RNs:

  • California: $133,340
  • Hawaii: $113,220
  • Oregon: $106,610
  • Massachusetts: $104,150
  • Alaska: $103,310

Frequently Asked Questions

Is an accelerated program better than a standard program?

Accelerated BSN, ADN, and MSN programs aren't better or worse than taking a standard nursing program. These programs deliver the same nursing curriculum. However, the program length is shorter so that you graduate quicker. Because of the shortened length, these programs tend to be more rigorous and challenging.

Can you earn a nursing degree entirely online?

Most nursing programs cannot be earned entirely online. Nursing students must attend in-person labs and clinical experiences. However, many schools offer blended learning formats, where students complete didactic courses online and only participate in in-person labs and clinicals when needed.

The exception to this rule is for some bridge programs where clinical experiences aren't required, such as with RN to BSN programs, because the nursing student is already a nurse.

How can I tell if I'll be able to deal with the real-world stress of nursing school and a career in nursing?

There's no foolproof way of knowing if you'll succeed in nursing school or as a nursing professional. The best advice we can give is that successful nurses are passionate about helping others but realistic that nursing is a challenging and tiring career. They understand the current industry climate and are dedicated to finding the best nursing job for themselves so they can be successful and happy with their career choice.

Workforce Development Columnist

Melissa Mills has 26 years experience as a BSN and specializes in Workforce Development, Education, Advancement.

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