How to Get Into Nursing School in St. Louis

Revised September 5, 2026

Danielle works the opening shift at a coffee counter in Arnold and has wanted to be a nurse since she was nineteen. She is twenty-six now. Last spring she finally sat down, filled out an application to a nursing program, hit submit, and felt like she had done the big scary thing. Six weeks later a polite email arrived explaining that her file could not be scored, because she had not completed the prerequisite science sequence. Nobody had ever told her the application was the last step rather than the first one. She had spent seven years waiting to be brave about the wrong task.

She is not alone, and the people around her in the metro are standing at slightly different doors. A CNA in Florissant has three years on a busy floor and wants the license to match the work she already does. A thirty-eight-year-old in O’Fallon has a marketing degree collecting dust and just learned there is such a thing as an accelerated second-degree BSN. A senior at a high school in Union is trying to decide whether to start at a community college or head straight into a four-year program. A mother of two in Belleville is going back at forty-four and quietly wondering whether she is too old and too rusty at chemistry to pull this off.

All four of them want an answer to the same question: what actually decides whether I get a seat? This guide walks through it in order. The real first step, how to choose between an ADN, a BSN, and an accelerated route, the prerequisite list and why one C is worth more attention than your essay, the entrance exam and how people under-prepare for it, the points formula programs use to rank applicants, the paperwork that quietly knocks people out late, an honest conversation about the science and the math, and what to do if the first cycle does not go your way.

What is the first step to get into nursing school?

The first step is not the application. It is choosing your route, ADN or BSN, and starting prerequisites at a school whose credits transfer where you plan to apply. Prerequisite grades are the long pole and the main thing that ranks you. Most applicants begin those courses a year later than they should.

Here is why the timing matters so much. Anatomy and physiology I and II are usually taken in sequence, one semester after the other, so you need two terms minimum before you hold both. Microbiology frequently wants chemistry finished first. Stack those dependencies end to end and you are looking at three or four semesters of prerequisite work before your file is even scoreable, and that assumes nothing fills up, nothing gets dropped, and no semester goes sideways on you.

So the honest first step is one unglamorous afternoon at the kitchen table. Pick two or three programs you would genuinely attend. Open each program’s nursing admissions page. Write down the exact prerequisite list, the exact entrance exam they require, and the exact application deadline. Then find the overlap. The courses that appear on all three lists are the ones you register for first, at a school whose credits you have already confirmed will transfer.

Confirm that transfer question out loud, by course number, before you pay tuition on anything. “If I take this anatomy course at this college, does it satisfy your prerequisite?” A four-minute phone call has rescued more nursing careers than any admissions essay ever written. If you are still weighing schools in general, our guide on how to choose a college or trade school in St. Louis covers the accreditation and transfer questions worth asking before you enroll anywhere.

ADN, BSN, or accelerated: which route fits the life you actually have?

There is no best route, only the one that matches your money, your calendar, and your starting point. An ADN is an associate degree, roughly two years of nursing coursework at a community college. A BSN is a bachelor of science in nursing, roughly four years. Graduates of both sit for the same NCLEX-RN licensure exam.

That last sentence surprises people, so sit with it a second. Missouri RNs are licensed by the Missouri State Board of Nursing, part of the Missouri Division of Professional Registration, and graduates must pass the NCLEX-RN to be licensed. The route in front of the license changes. The exam at the end does not.

The ADN route tends to fit people who need to be earning as an RN sooner, who have a household depending on that timeline, and who want community college pacing and cost while they work. Plenty of nurses finish an ADN, get hired, and complete an RN-to-BSN bridge later, often with employer support, while drawing a nursing paycheck the whole time. That is a completely normal way to arrive.

The BSN route fits the high schooler in Union who can go full-time for four years, and anyone aiming at units or career tracks where a bachelor’s is preferred or required. You get more coursework in leadership, research, community health, and public health along the way.

The accelerated or second-degree BSN exists for people who already hold a bachelor’s degree in something else, like our marketing graduate in O’Fallon. It is compressed and intense, and it is genuinely hard to hold a full-time job through one. And the CNA in Florissant has her own on-ramp: LPN programs and LPN-to-RN bridges are built for people already working in care who want to climb without starting from zero.

Whatever route you pick, every one of them puts you in clinical rotations, in real facilities, with real patients who are having a bad week.

Soon you’ll be the one in scrubs, not the patient choosing a specialist.

What are the requirements to enter the school of nursing?

Requirements vary by program, but the shape is remarkably consistent across the metro. You will need a prerequisite course block, an entrance exam score, a criminal background check, a drug screening, and current immunization and CPR certification records. Some programs add an essay or an interview on top of that.

The prerequisite block typically includes anatomy and physiology I and II, microbiology, chemistry, statistics, a psychology or human development course, and English composition. Some programs also want nutrition, a lifespan development course, or a general education spread on top. Write the list down per program. Do not assume the school across the river wants the identical set, because it often does not.

The entrance exam is usually the TEAS or the HESI A2. The background check and drug screen are non-negotiable, because clinical sites require them before they will let a student on the floor. Immunizations and CPR certification are the same story. These are not admissions preferences. They are the conditions your clinical partners impose, and the program cannot waive them for you.

Now the part almost nobody does, and the part that changes outcomes most. Shortlist two or three programs and go interview them. Attend the information session. Sit down with an advisor. Say plainly what you want out of the program and what your actual situation is: I work thirty hours a week, I have a seven-year-old, I have a C in chemistry from 2019, I need evening clinicals. Then listen to what that program is prepared to provide. The gap between what you need and what they can offer is the signal. It tells you where to apply, and it tells you what to fix first.

Why is retaking a C often the highest-leverage move you can make?

Because prerequisite grades usually carry the heaviest weight in the ranking formula, and a single science C can quietly cost you more points than anything else in your file. You cannot rewrite your essay into an acceptance. You can retake anatomy. One course, one semester, and your score moves.

Most applicants resist this. Retaking a class you already passed feels like going backward, like admitting something. It is not. It is the cheapest, most controllable point gain available to you, and the people who get in have usually done it without advertising it.

Before you register, ask the program two specific questions. First, do you replace the original grade or average the attempts? Second, is there a limit on how many times a science prerequisite can be repeated? Those two answers decide whether the retake helps you or hurts you, and they differ by program. Ask them by name, in writing if you can, and keep the reply.

How do people under-prepare for the entrance exam?

They treat it like a formality. The TEAS and the HESI A2 are not pass or fail hurdles in most admissions formulas. They are scored inputs, and your number becomes points that get compared directly against every other applicant in the pool. A rushed sitting is a permanently weaker file.

The second mistake is scheduling the exam for a week you are already drowning, right at the end of a term, on top of finals. The third is skipping the sections outside your comfort zone. Nursing entrance exams sample reading, math, science, and English usage. People who love the science content lose points on grammar and reading comprehension they never studied, because they assumed those parts would take care of themselves.

Ask the program how many attempts they allow, how long they make you wait between sittings, and which score they use if you test twice, the highest or the most recent. Then build backward from the application deadline so you have room for a second attempt if the first one lands soft. Give it real study weeks, not a weekend.

What does the points formula actually reward?

Nursing programs generally admit by a points or ranking formula rather than a single cutoff. Prerequisite grades, entrance exam score, and sometimes an essay or interview each convert into points, the pool gets sorted, and seats go down the list. You are not being measured against a bar. You are being measured against everyone else who applied that cycle.

This is why the published minimum misleads so many people. A minimum is the floor to be considered, not the profile of who actually got in. The competitive average in a given cycle typically sits well above the published minimum, and it moves year to year with the applicant pool. There is no statewide number, and anyone who quotes you one is guessing.

So get the real figure from the only place it exists. Call or email the nursing admissions office and ask, in these words: what was the score range or admitted-student profile for your most recent cycle? Many programs will tell you. That number tells you whether you are a strong applicant, a borderline one, or someone who needs another semester of work before applying. Guessing costs you a whole year. Asking costs you an email.

What you control is short and worth taping to the fridge: which prerequisites you take and where, the grade in each one, how hard you prepare for the entrance exam, and whether you apply to more than one program in the same cycle.

What paperwork quietly disqualifies people at the last minute?

The boring documents, every time. Background checks, drug screening, immunization records, CPR certification, and deadlines. These do not reject applicants for being unqualified. They reject applicants for being late, and that is the most painful way to lose a seat you had already earned on the merits.

Immunization records are the classic. People need childhood shot records they have not seen in twenty years, or a titer drawn to prove immunity, and they start looking for the clinic in the same week the file is due. Some vaccination series take weeks to complete. Start that folder the month you start prerequisites, not the month you apply.

Criminal history deserves a straight answer rather than a rumor. Licensure through the Missouri State Board of Nursing includes a criminal history review, and certain convictions can affect eligibility. Those situations are decided case by case by the Board, not by an internet forum and not by your cousin who heard something. If you have something on your record, ask early, ask the Board and ask the program, and get the answer before you spend two years and real money on prerequisites. Knowing sooner is always better than hoping longer.

Is the science and the math really as hard as people say?

It is hard in a specific, survivable way. Nursing science is heavy on volume and memorization rather than abstraction, and nursing math is arithmetic under an accuracy standard rather than higher mathematics. People are asking “is it really hard to get into nursing school” when the honest strain is the sustained pace, not the ceiling of the material.

Anatomy and physiology is a vocabulary marathon. Microbiology is detail work. Chemistry is the one that scares returning students most, and it is usually the one that responds best to a tutor, a study group, and a lighter course load in that particular semester. Nobody is expecting you to enjoy all of it. They are expecting you to get through it while paying attention.

The math is dosage calculation, unit conversion, ratios, and drip rates, plus a statistics course as a prerequisite in most programs. What makes it feel heavy is not the difficulty. It is that a decimal in the wrong place is a patient safety problem, so programs hold you to a precision standard that ordinary math classes never did. That standard is learnable. Repetition builds it.

If you are forty-four in Belleville and your last chemistry class was in another century, take one prerequisite alone in your first semester back. Prove to yourself that you can still do this, get a strong grade, and then add load. Starting with four science courses at once is how confident people talk themselves out of the whole plan by October.

What should you do if you are not admitted the first cycle?

Apply again, but not with the identical file. Programs rank applicants against a pool that changes every cycle, so resubmitting the same numbers is a coin flip with the same coin. Change something measurable first, then reapply. Most people who get in on a second attempt did exactly that.

Start by asking the program where your file fell short. Some will tell you your score, your rank band, or the component that dragged you down. That single conversation replaces a year of speculation. Then pick the fixable item: retake the science course with the weakest grade, sit the entrance exam again with real preparation, finish an outstanding prerequisite, or apply to more programs in the same cycle instead of just one.

Meanwhile, get closer to the work. Becoming a CNA, taking a patient care tech role, or working in a clinic puts income in your pocket, tells you whether you actually like bedside care before you borrow money for it, and gives you something real to talk about in an interview. If you are mapping out earning options while you wait, our St. Louis career roadmap is a reasonable place to look.

And give yourself the honest reframe. A denied application is not a verdict on whether you will be a good nurse. It is a ranking outcome in one competitive pool in one particular spring.

For nursing programs and healthcare employers in the metro

If you run a nursing program or hire clinical staff, the applicants above are your pipeline, and most of them are losing a year to information they could not find. The programs that publish a plain prerequisite list, an admitted-student score range, a retake policy, and a real deadline calendar get stronger applicants, not fewer.

The same goes for employers. Candidates who know that tuition assistance, RN-to-BSN support, or a CNA-to-nursing pathway exists will apply for the entry role today. Say it in the job posting. A clear listing that spells out the pathway does more recruiting than a career fair table, especially in North County, Jefferson County, and the Metro East where people are weighing commute against schedule.

Frequently asked questions

Is it really hard to get into nursing school?

Yes, admission is competitive, but it is competitive in a way you can plan around. Programs rank applicants by a points formula built on prerequisite grades and entrance exam scores, then fill seats from the top down. That means the difficulty is comparative, not fixed. Strong prerequisite grades and a well-prepared exam score move you up the list more than anything else in your file.

Does it take 2 years to be a nurse?

Roughly, for the nursing coursework in an ADN, but that number leaves out the prerequisites. Most people spend two to four semesters finishing anatomy and physiology, microbiology, chemistry, and the rest before nursing courses even begin. A BSN runs about four years. Accelerated second-degree BSN options are shorter for people who already hold a bachelor’s degree. Then you still have to pass the NCLEX-RN.

What disqualifies you from nursing school?

Incomplete prerequisites and missed deadlines knock out more applicants than anything else. Beyond that, programs require a criminal background check, drug screening, and current immunization and CPR records, because clinical sites demand them. Licensure through the Missouri State Board of Nursing also includes a criminal history review, and certain convictions can affect eligibility. Those cases are decided individually by the Board, so ask early rather than assuming.

What is the lowest GPA to be a nurse?

There is no single statewide answer, and be suspicious of anyone who gives you one. Each program publishes its own minimum, and the competitive average of admitted students usually sits well above that published floor. The only reliable source is the nursing admissions office at the program you want. Ask them directly for the minimum and for the most recent admitted-student profile.

Is math for nursing hard?

It is more demanding than difficult. The math is dosage calculation, unit conversion, ratios, and IV drip rates, plus a statistics course as a common prerequisite. None of that is advanced mathematics. What makes it feel hard is the accuracy standard, since a misplaced decimal is a safety issue, so programs test precision far more strictly than a general math class ever did.

Can I be a nurse if I don't like science?

Plenty of excellent nurses were never the science kid in high school. You cannot skip it, though. Anatomy and physiology, microbiology, chemistry, and later pharmacology are all part of the path. Many people find they disliked how science was taught rather than science itself, and applied clinical context changes that. Try one prerequisite before you decide the whole field is not for you.

More St. Louis guides

• How to Choose a College or Trade School in St. Louis
• How Long It Really Takes to Become a Doctor
• Trade Schools and Apprenticeships in St. Louis

About the Author: The St Louis Near Me Directory Team
Written by a dedicated team of St. Louis locals who live, work, and play right here in the St. Louis metro. Founder Lane Forman and team are committed to building the region’s most trusted directory by verifying listings and connecting local businesses with loyal customers across Missouri and Illinois.

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