The many types of nursing form a critical component of the medical profession. Nursing assistants support other health professionals and provide basic care to patients. Registered nurses direct patient care and communicate with doctors and families to ensure that patients receive appropriate medical attention. Nurse practitioners often diagnose patients and provide treatment.
An aging U.S. population drives the growing demand for nurses. The Census Bureau projects that the number of Americans aged 65 or older will double by 2050. The Bureau of Labor Statistics (BLS) projects the nursing profession to grow 15% through 2026 -- a rate much faster than the national average for all occupations.
A recent recent BLS report names healthcare as one of the most important industries in Missouri, which means graduates of nursing colleges in Missouri can expect ample job opportunities in the field.
How to Become a Nurse in Missouri
The Missouri Board of Nursing oversees nursing licensure in the state. All nursing professionals follow the same general process to obtain licensure, but costs and procedures vary by license type and candidate background. Missouri follows procedures associated with the Enhanced Nurse Licensure Compact (eNLC), set by the National Council of State Boards of Nursing (NCSBN). Nursing professionals licensed in eNLC states can practice in all states that adopt these licensure standards.
1. Choose the Path That's Right for You
Applicants for nursing licensure need to complete a recognized nursing program. Candidates can apply for registered nurse licensure with an associate degree in nursing (ADN) degree or a bachelor's of science in nursing (BSN) degree, offered by most nursing colleges in Missouri. After obtaining an online nursing degree and licensure, registered nurses (RN) may aspire to specialized or advanced nursing roles, such as nurse practitioner or nurse midwife, which require master of science in nursing (MSN) degrees. Experienced nurses who want to train nursing students at the college level should pursue a doctor of nursing practice.
2. Earn Your Nursing Degree
Admission and program requirements vary by online nursing degree. Basic RN programs in Missouri granting ADN degrees generally require high school transcripts and ACT scores. Most ADN programs take two years to complete, but some accelerated nursing programs in Missouri allow students to graduate in one year. Practicing nurses who wish to continue their studies can complete online RN-to-BSN programs in Missouri. Advanced MSN and doctor of nursing practice (DNP) degrees require previous nursing training and take two to four years to complete. All online nursing programs require students to participate in clinicals, and some programs place candidates in fellowships and internships.
3. Pass the Licensing Exam and Earn Your License
Nursing candidates in Missouri must take the National Council Licensure Examination (NCLEX), developed by the NCSBN. The NCLEX tests for competency in basic standards of care and treatment, costs $200, and takes five hours to complete. Online RN programs in Missouri prepare students to pass the NCLEX, but most candidates spend additional time familiarizing themselves with the test format. Although a nursing license does not guarantee a job, passing the NCLEX proves necessary to obtaining RN licensure and applying for nursing positions.
Nursing Licensure in Missouri
The Missouri Board of Nursing oversees nursing licensure in the state and follows licensing standards set by the NCSBN. After completing an online nursing degree, candidates must pass the NCLEX, which ensures that nurses possess the knowledge and skills needed to work in entry-level nursing roles.
Candidates must earn an ADN or BSN degree to qualify for the NCLEX. While ADN and BSN programs in Missouri prepare students for the exam, most candidates dedicate several weeks to additional studies.
Since Missouri adheres to nationally accepted nursing license standards, RNs with Missouri licenses can easily apply for licensure in other states. Although each state possesses the authority to set its own nursing regulations, the movement toward standardization allows RNs to work in other states.
State Requirements By Nursing Type
To attain an RN in Missouri, nurses need to graduate from an accredited nursing program. The Missouri Board of Nursing reviews each school every five years to ensure that schools properly educate students. Students should enroll in a nursing program that passed an assessment from the Missouri Board. Missouri expects prospective RNs to learn the state's Nurse Practice Act.
Once students complete their degrees, they must pass the NCLEX-RN. Several states use the NCLEX to test prospective nurses. The exam covers several topics, including health promotion and maintenance, psychosocial integrity, and physiological integrity. The test also assesses whether nurses know how to safely use medical equipment. Additionally, future RNs should study concepts like alterations in body systems, medical emergencies, and hemodynamics. Students can take the NCLEX anywhere in the U.S., even if they plan to apply for licensure in Missouri. To apply for the license, candidates submit their test registration along with a completed application and a $45 application fee.
Nurses who originally earned their license in another state can apply for licensure in Missouri by endorsement.
Registered nurses need to renew their license every two years. RN licensure expires on April 30 during an odd-numbered year (e.g., 2019). The Missouri Board sends postcards reminding RNs about licensure renewal two months before expiration. Nurses can also enroll at the NURSYS website for online reminders.
To become a certified nursing assistant in Missouri, students must enroll in a training program certified by the Missouri Department of Health and Senior Services. The program teaches CNA students how to work under the supervision of a licensed nurse in long-term care facilities. Certified nursing assistant trainees must spend 75 hours in the classroom in addition to 100 hours of on-the-job training.
They must also take a certification exam that involves two parts: a written component and a practical component. The test assesses students' basic nursing skills and covers topics like the rights of long-term care residents and how to care for residents with psychological problems such as dementia. Students need to know basic safety skills, like fire safety and disaster training. If students fail the exam, they can retake it twice within 90 days. If they fail all three times, however, they must re-enroll in the full course. In some cases, aspiring nursing assistants submit a challenge to take the exam without enrolling in the course. Only candidates who meet certain criteria can submit a challenge, like RN or LPN students who completed their degrees but did not take -- or pass -- their licensure exams.
CNA certification remains active as long as nursing assistants work eight hours a day without a two-year break. After two years without work, the CNA certification deactivates. After five years, it expires. If CNAs move to Missouri from out of state, they can transfer their credentials if they appear active on another state's registry. To transfer, certified nursing assistants need to submit an out-of-state certificate, a social security card copy, and work verification.
Licensed registered nurses in Missouri need to complete a nursing program approved by the Missouri Board of Nursing. Graduates must then apply for licensure by registering for the NCLEX-PN exam, submitting a notarized application, and paying the $41 fee. They must also submit transcripts and undergo a background check. LPNs can work as graduate nurses without licensure for up to 90 days without registration; however, they must take the NCLEX within that 90-day threshold.
The NCLEX exam tests candidates on topics like creating a safe and effective environment for patients, understanding patient rights and ethical practice, and supporting the health and well-being of patients. Exam content mirrors the RN exam in many ways. However, the PN exam focuses more on the coordination of care than on care management. Since several states recognize and administer the NCLEX, candidates may take the exam outside of Missouri. If they pass, they possess multistate licensure applicable in compact states. Like RNs, LPNs moving to Missouri from another state can apply for license by endorsement.
After LPNs receive licensure, they must enroll at www.nursys.com. This website notifies nurses before their license expires. LPNs must renew their nursing licenses by May 31 of years ending in even numbers (e.g. 2020). Renewal takes three to five business days, so nurses should not wait until the last possible day.
Unlike other types of nursing, nurse practitioners are given more independence and responsibility. They can work without the supervision of a doctor, making diagnosis and prescribing medications. As such, NPs must complete a higher level of education than other nurses. In Missouri, advanced practice registered nurses must complete both a bachelor's and a master's degree in nursing. They must then pass a certification exam from one of the following agencies: the American Academy of Nurse Practitioners, the American Association of Critical Care Nurses, the American Nurses Credentialing Center, the National Certification Corporation, the Pediatric Nursing Certification Board, the American Midwifery Certification Board, or the National Board of Certification for Nurse Anesthetists.
Missouri recognizes several areas of specialization, including adult acute and critical care, adult psychiatric and mental health, women's health, neonatal acute and critical care, family care, and gynecological care. Nurse anesthetists and midwives also qualify as advanced practice nurses in Missouri.
In order to confirm their NP status, nurse practitioners need to possess a registered nursing license in Missouri, hold a national credential in advanced practice nursing, and maintain recognition from the Missouri Board of Nursing. NPs can confirm their status by uploading all of these documents to NURSYS. Since nurse practitioners must hold a Missouri RN license, the procedures for renewal match the requirements for registered nurses. NPs must renew their licenses by April 30 of every odd-numbered year. If they move to Missouri from another state, they can apply for nursing licensure through endorsement.
Career Outlook for Nurses in Missouri
Graduates of nursing programs in Missouri enter several related career paths, but most online nursing degree holders work as registered nurses. More specialized roles command higher pay, but often require additional nursing degrees. Online MSN programs in Missouri prepare students to fill advanced roles, such as nurse midwife, nurse practitioner, and nurse anesthesiologist.
The Missouri Economic Research and Information Center reports a high demand for healthcare professionals throughout Missouri, especially in the Kansas City and St. Louis metro areas. Demand for qualified nurses is projected to grow, so for students attending nursing school online, Missouri will continue to offer employment opportunities.
Employment Data for RNs in Missouri
According to BLS, the number of nurses in the U.S. may increase by 15% in the next 10 years. Nearly three million nurses worked in the U.S. in 2017, and over 72,000 of those nurses worked in Missouri. Nursing ranks as one of the most common occupations in Missouri. The state actually holds the fourth-highest "location quotient" for registered nurses, according to the BLS. As such, job seekers in Missouri considering a position in St. Louis or in the surrounding suburbs should note that they will face job competition. The St. Louis region employs over 36,000 nurses, and the metropolitan area ranks 10th in the country for employing the greatest number of registered nurses.
The BLS also estimates that American nurses made a mean annual salary of over $73,000 in 2017. Nurses in the U.S. make anywhere from $48,000 to $104,000. In comparison, the mean annual salary for Missouri nurses equaled $63,300 the same year. In the state's two major metropolitan areas, St. Louis and Kansas City, the mean annual salary for registered nurses rose to above $65,000.
Employment Data for CNAs in Missouri
In 2017, over 1.4 million certified nursing assistants worked in the U.S. About 40,000 of those nursing assistants found employment in Missouri. These nursing assistant jobs appear all over Missouri, with the majority employed in St. Louis, Kansas City, central Missouri, and the southern part of the state. BLS also projects that the number of nursing assistant positions will increase by 11% over the next decade.
Certified nursing assistants most commonly find jobs in nursing care facilities. This makes sense in Missouri, where CNAs specifically receive training to work in long-term care facilities.
While the annual mean salary for nursing assistants in the U.S. reached $27,520 in 2017, nursing assistants in Missouri earned an annual mean salary of $25,360. Nursing assistants in the rural part of the state tend to make less than their urban colleagues. In areas like northern and southwest Missouri, the annual mean wage ranges between $22,400-$22,800. In comparison, nursing assistants who worked in the middle of state -- in Columbia and Jefferson City -- earned the greatest annual mean wage: $28,280.
Employment Data for NPs in Missouri
Over 160,000 nurse practitioners worked in the U.S. in 2017, according to the BLS -- a number projected to grow by 31% in the next decade. In 2017, over 4,000 NPs worked in Missouri. Joplin -- a small metropolitan area in southwest Missouri -- ranked as the sixth-highest concentration of nurse practitioners in the entire country. As such, job seekers should recognize that they might face stiff job competition. Nurse practitioners should also look for open positions in physician offices, the most common employer of nurse practitioners.
Compared to other types of nursing positions, NPs received the highest salaries. In 2017, the annual mean wage for nurse practitioners in Missouri equaled nearly $96,500. On average, nurse practitioners in southwest Missouri earned about $111,000 -- greater than the national median wage of $103,880. Nurse practitioners in Kansas City also earned a mean salary of over $100,000. The highest-paying industry for nurse practitioners include personal care services and management and scientific and technical consulting services. NPs in those industries earned a mean annual salary of over $130,000.
Biggest Hospitals in Missouri
The Missouri economy depends on the healthcare industry, and many quality hospitals operate in urban areas and in the central region. Nursing candidates should identify the largest health institutions in Missouri. Larger hospitals need many qualified nurses and hire far higher numbers of RNs than smaller institutions. Online nursing degree candidates can also find valuable internship opportunities at large hospitals, often operated in partnership with local nursing schools and medical colleges.
- Barnes-Jewish Hospital: Located in St. Louis, this 1,365-bed hospital is one of the largest medical facilities in the region. The hospital employs 9,620 people, including 3,347 RNs. Barnes-Jewish serves the St. Louis area with more than 50,000 inpatient visits and 80,000 emergency room visits per year. It also serves as the teaching hospital for Washington University, one of the most respected nursing schools in Missouri.
- St. Luke's Health System: Based in Kansas City, this health system includes ten campuses and serves patients in 67 counties throughout Missouri and Kansas. St. Luke's employs more than 9,500 people and maintains some of the most specialized medical facilities in the region. St. Luke's prioritizes nursing research, making the system an important resource for students attending nursing schools in Missouri.
Additional Nursing Resources in Missouri
- Missouri League for Nursing: This professional organization provides updated information about the nursing field. The organization promotes collaboration among nursing professionals and provides students in online nursing programs with opportunities to earn scholarships and network at conferences and workshops.
- Missouri Nurses Association: This membership-based group promotes the interests of nurses in Missouri through political engagement and education. MONA publishes information about legislation relevant to nursing in Missouri and shapes policy through lobbying efforts. MONA influences public opinion through media outreach efforts and strives to uphold the reputation of the state's nurses.
- Missouri Nursing Students' Association: MONSA strives to enhance the state's quality of nursing education. All students enrolled in nursing schools in Missouri qualify. MONSA shapes nursing education and influences laws related to nursing through lobbying efforts.
- Missouri State Board of Nursing: The Board of Nursing oversees nursing licensure in Missouri. The department's website provides information regarding both obtaining and maintaining nursing licenses and the laws related to Missouri's nursing practices. The Board of Nursing also holds regular conferences to teach best practices.
- National Council of State Boards of Nursing: All students enrolled in nursing schools in Missouri should explore the information and resources available from NCSBN, as these shape licensing policies in the state. NCSBN provides preparatory materials for the NCLEX, which graduates of nursing schools in Missouri must pass to earn licensure.
Accredited Online Nursing Programs in Missouri
Missouri is home to a variety of reputable online nursing degree programs, and students choose the degree and school that best fits their career goals. The following database of Missouri nursing schools details all accredited online nursing programs in the state, including ADN, BSN, RN-to-BSN, MSN, and DNP programs.