Where do I start?

I'm a senior in high school interest in a career in nursing. I've always wanted to go to a 4 year right out of high school but after reading up on everything I'm SO confused. Should I start with an ADN or so straight into a BSN. What schools are best? I live in Southern CA. My GPA and test scores are competitive. I'm so confused on where to start. What are prerequisites? Am I completing them now in high school (chemistry, biology etc.) or do they need to be done in college? what is the TEAS and when do I have to take it? Any suggestions as to which school to start with and which road to take? Thank you!

- a confused student

First off, good for you for thinking ahead! Being that you're a HS Senior, you have a range of options, limited only by a few things. i'm going to answer things a little out of sequence to hopefully make things easier to understand. Since you have "competitive" scores, that will make it easier to get accepted to a College or University. What's the difference? While both do post-secondary education, a University can confer Bachelors and higher degrees. A College can confer an Associates degree and very rarely (if specifically authorized) a Bachelors. We'll get back to that, much of what I'll discuss applies to both unless specifically stated otherwise.

Once in school, you take courses that generally will broaden your knowledge in a variety of subjects. While the specific courses will vary from person to person, the way they broaden your knowledge is that they have certain courses that cover different types of content, and you must choose courses from each area of content. Now here's where things do get a little confusing and interesting. Some of those courses you can take a test for placement directly into those courses. Others have classes that you must pass in order to "qualify" to take the class. A "prerequisite" course is a course that you must take before you're allowed to take the next course. In short, if you have to take class "C" to graduate, you often have to take class "A" and "B" in sequence before you can take class "C." Sometimes, if you demonstrate sufficient knowledge through prior coursework or testing, you may be allowed to bypass class "A" or even class "B" and go directly to class "C" and knock that out as a graduation requirement. Nursing school is full of prerequisite courses as the next course in the series has specific course requirements, effectively making it so you take each class in a very defined sequence.

Different schools and programs within each school have entry requirements. You can be accepted to a school but not a given program. In that case, you take your general education requirements along with program prerequisites for entry (acceptance) to the program. The TEAS exam is often taken right before applying to a nursing program and AFTER completing most, if not all, of the prerequisites. By waiting until then, you maximize your chances of scoring high on the TEAS test because you will have recently been exposed to the material you'll be tested on.

Now, you must look further down the line, after graduation from school, passing the NCLEX, and getting your license. When you're at this point, you'll be looking for a job. Employers know that the core of nursing is essentially the same with both Associates Degree and Bachelors Degree programs. They also know that the higher degree requires a broader general education and has more of an emphasis in critical thinking. Therefore they know that, all things being equal, an applicant with a higher degree will usually be able think through issues that arise and come up with a scientifically sound solution. It usually also means that same person will be able to continue to expand their knowledge and stay more current by going through the literature and apply that knowledge to their practice. That can mean fewer lawsuits lost because the nurses were doing the correct, up-to-date practice. Various regulatory/advisory bodies know that too, so they recognize that by telling employers that if you have a certain percentage of nurses educated to a certain level, we'll bless you with status you can use to market yourself. That can mean more money...

What does that mean to you? It means that you should strive to earn a Bachelors Degree in Nursing at some point in your career, and the sooner, usually the better. I'm an Associates Degree Nurse and while I did find a job, it took me longer than I'd have liked because not having the BSN kept me from realistically applying to one major employer locally and likely pushed me towards the bottom of the pile of applicants for other jobs.

Now the question for you is how you want to get there. You could go directly to a University (4 year) school and apply for their nursing program. If you have the grades, scores, and are a little lucky, you can also attend that University's nursing program. You can go to a University directly, get your nursing school prerequisites done, and apply to multiple University level nursing programs and transfer over to that University and earn your BSN from there. You could attend a College (2 year school) and get all your Lower Division (Freshman/Sophomore) Gen Ed done and nursing school prerequisites done, apply to a University's BSN Program and transfer there after you're accepted. Lastly, you could attend a College, get all your LDGE and nursing school prerequisites done, and go through their nursing program. Later, you can then attend a program that will take you from RN to BSN.

Those options are generally presented to you from most expensive to least expensive. I would suggest that if you have all those open to you, choose the one or ones that will result in you earning a BSN quickly and without a crushing amount of student debt. Private colleges and universities can teach you all the same stuff but their tuition will generally be very high and can crush people with debt that cannot be wiped away.

I'm a bit of an oddity in that I have a Bachelors degree in an allied health field, but an Associates in Nursing. Employers generally won't recognize my Bachelors precisely because it isn't in Nursing, though I have some very advanced education in healthcare and many, if not all, of the qualities they attribute to the BSN also apply to me. Having that Bachelors also kept me from going for a second Bachelors, which would have been Nursing as the Universities were closed to students like me at the time. I also earned my degrees (BS and ADN) with zero student debt. The faster you can get to the BSN, with an amount of debt you can handle comfortably, is your best option, IMHO. It is possible to do that even going straight to a 4 year school and graduating with a BSN. You just have to have the financing lined up, and I'm nowhere near qualified to advise you how to pull that off because I don't do school finance stuff.

Very much lastly, the program design can limit where you can work. Most US programs are set up so that what you learn in class, you also experience in clinical in the same Quarter/Semester. This means you'll be able to get licensed in basically any state without too much fuss. If you go outside the US, you could potentially have problems getting a license in the US if you do. Simplest way to figure that out would be to look at California programs, and if the program you want to attend looks like how a California program is set up, chances are you'll be OK. Why California? They've got the strictest rules for initial licensing.

thank you SO much! That answered a lot of my questions! Just to be clear, when you say college are you referring to a community or junior college? And also to clarify, I can graduate from HS, get my prereqs done at a Community College and then apply for a school to get my ADN?

Also, if anyone else sees this, are all nursing prerequisites the same or do they vary by program? Are all Cal State school nursing prerequisites the same or do they also vary? What are the prerequisites? Can I complete them at a community college and then apply for a BSN or ADN (whichever I decide on doing)?