Can You Apply for Nursing in the U.S. Right After High School? What Families Need to Know
Last Saturday, I was hauling my recycling bin to the curb, still in the sweatpants I’d slept in, when I heard Lila call my name from next door. The 17-year-old senior was perched on her porch steps, a crumpled state university brochure spread across her lap, a half-eaten strawberry Pop-Tart oozing filling onto the paper. “Can I ask you something?” she said, patting the step next to her. “I want to be a pediatric nurse. Can I actually apply for nursing here in the States right after high school, or do I have to do something else first?”
I’ve done part-time college advising for local high schoolers for 10 years, and this question comes up at least twice a semester. Most of the time, kids and their parents have only heard the generic “go to college for four years” line, and they aren’t sure if nursing fits that timeline right after graduation. Lila’s case was pretty typical: she’d volunteered four hours a week at the same clinic where her mom works as a nurse aide for the past two years, had a 3.7 GPA, and knew exactly what she wanted to do. She just didn’t know how to get there.
First thing I told her: Yes, you absolutely can apply for nursing right after high school. There are two main paths that open to you immediately after you walk across your graduation stage. The first is a direct-entry Bachelor of Science in Nursing (BSN) program, which is what most people picture when they think of four-year nursing degrees. You apply as a high school senior, get accepted straight into the nursing program, and graduate four years later ready to take your licensing exam.
I also told her these programs are competitive, way more competitive than most other undergraduate majors. When my oldest cousin applied six years ago, she had a 3.8 GPA and 100 hours of hospital volunteer work, and she got rejected from six out of the eight direct-entry programs she applied to. If you’re set on this path starting in your junior year of high school, there are concrete things you can do to boost your application: take AP Biology and AP Chemistry, if your school offers them, or sign up for a dual enrollment statistics class at the local community college. Most direct-entry programs require these prerequisites, and checking them off before you apply means you don’t have to cram them in during your first two years of college. It also shows admissions teams you’re serious about the track.
If direct-entry doesn’t work out, that doesn’t mean you have to put your nursing plans on hold. The second path open to high school grads is an Associate Degree in Nursing (ADN) at a local community college. Almost all community college ADN programs accept applications straight from high school, and most have open enrollment policies that are less competitive than four-year BSN programs. My cousin ended up taking this route after her second rejection, and she graduated two years later for less than $8,000 total tuition. She passed her NCLEX (the national licensing exam for nurses) on the first try, got a job at a children’s hospital right away, and finished her BSN online three years later while working full time, with most of the tuition covered by her employer.
By this point, Lila’s mom had joined us, leaning against the porch rail with a mug of lukewarm coffee. Her big question was cost, which is the top concern for almost every family I talk to about this. ADN programs are almost always a fraction of the cost of four-year BSN programs, and a lot of local hospitals and clinics offer tuition reimbursement for new RNs who agree to work there for 2 to 3 years after graduation. That’s what happened with my cousin—her hospital covered 100% of her online BSN tuition once she started. I told her even if you have your heart set on a BSN, it’s not a requirement to start working as a nurse, and starting with an ADN doesn’t close any doors long term.
There are a few things most families miss when they start looking into nursing programs after high school, though. First, always check the program’s NCLEX pass rate on your state’s nursing board website. Any program you’re considering should have a pass rate of at least 80% for first-time test takers. I had a student a few years ago who picked an unaccredited ADN program that advertised a 12-month fast track, and their NCLEX pass rate was 52%. She failed twice, had to retake half her classes at a different school, and ended up wasting two years and $5,000. It takes 5 minutes to look up the pass rate, and it’s the easiest way to avoid bad programs.
Second, if you’re an international student applying from a high school outside the U.S., there are a few extra steps. Most programs require a TOEFL iBT score of at least 80, a transcript evaluation through a service like WES, and you’ll need to confirm the program accepts F-1 student visas before you apply. Many smaller community college ADN programs are happy to accept international students, but competitive direct-entry BSN programs often have very limited spots for non-U.S. students.
Third, if you get accepted, don’t wait to get your paperwork in order. Almost all nursing programs require a current CPR certification, a full background check, and a full set of immunizations including the three-dose hepatitis B series, which takes six months to complete. I’ve seen students put this off and almost miss their program start date because they didn’t plan ahead.
Lila wrote all this down in the notes app on her phone, crumpled up her Pop-Tart wrapper, and said she’s going to ask her high school counselor to change her senior schedule this week to add that dual enrollment chem class she needs. She’s applying to three in-state direct-entry BSN programs, and got the application link for the local community college’s ADN program to keep as a backup. Her mom already sent a text to the HR manager at her clinic asking about their tuition reimbursement program. We don’t know how it’ll go yet, of course. Lila might get into her first-choice program, or she might end up taking the community college route. Either way, she’s on track to become a nurse right after high school, which is all she wanted in the first place. There’s no one right path to nursing, and that’s the thing most families don’t learn until they start digging. It’s okay if your path isn’t the straight one everyone talks about.
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