Getting Paid to Become a Nurse: How RN Apprenticeships Work

How RN Apprenticeships Work

“There’s a little bit of a misunderstanding with apprenticeship,” says Dr. Mullinax. “A lot of people think that we can admit students and just let them work as an apprentice to get their nursing education, but the student has to already be admitted to our nursing program.”

Once students are enrolled, the apprenticeship becomes a separate hiring process that runs alongside their nursing coursework. At Gadsden State, students are eligible to apply after successfully completing their first semester of the nursing program, and the apprentice jobs themselves come from healthcare employers rather than the college.

Hired students sign an apprenticeship agreement and commit to working at the same healthcare facility for the rest of their nursing program, which includes the last four semesters at Gadsden State. In Alabama, apprentices must also apply to the Alabama Board of Nursing for a student nurse apprentice permit, which costs $50 and remains valid until the student graduates or leaves the program.

“If they get hired as an apprentice, they continue through the nursing program, and nothing about the nursing program changes,” says Dr. Mullinax. “The difference is each nursing course that we teach has a required number of clinical hours, so the student who gets hired as an apprentice is able to get their required clinical hours working at the employer that hires them.”

What an RN Apprenticeship Looks Like

“With the registered nurse apprenticeship, they have to work one-on-one with what some facilities call a journey worker,” says Dr. Mullinax. “It’s a licensed RN who works for that hospital, and the student usually works very closely on that person’s schedule. They work together, and they’re trained one-on-one as they work when they’re at the facility.”

In Alabama, apprentices may only perform nursing skills from a Board-approved list, and the nursing program or supervising nurse must validate their competency before they perform each one independently. Board rules also specify that a licensed practical nurse may not supervise an RN apprentice.

“In a traditional clinical group, you have eight students to one instructor,” says Dr. Mullinax. “If there’s only one opportunity to start an IV on a patient, that instructor’s got to decide which one of her eight students is going to get to do it. An apprentice working one-on-one with a nurse might be able to start five or six IVs in one day, so they don’t have to share those skills with other students.”

Apprentices meet the same clinical requirements as every other student in their nursing program. “Those students cannot be counted in staffing numbers for the hospital because it’s an educational experience,” she says. “They can’t say, ‘Okay, you’re going to work as a nursing assistant today and do all the baths.’ When they are there as an apprentice, they’ve got to be working with their journey worker, and it’s all about learning while they’re working.”

Balancing Work and Nursing School

RN apprentices are employees of the facility that hires them and earn an hourly wage for the clinical hours they work there, though they are not paid for on-campus classes, skills labs, or simulation. At Gadsden State, apprentices can start working in the second semester of the five-semester nursing program, so they may balance a job and coursework for four of their five semesters.

The schedule is heavier than traditional students’. A traditional student might complete about 65 hours of med-surg clinicals, usually split into nine-hour shifts two days a week, while apprentices in Gadsden State’s competency-based model, set up through the Alabama Office of Apprenticeship, work about 96 hours a month, or at least two 12-hour shifts every week.

“They are working even when the traditional students are off for break,” says Dr. Mullinax. “If they have spring break week, the apprentice student is still expected to show up to their shifts during all of the normal downtime.”

“They know when we start them in apprenticeship that they’re making a huge commitment to their employer, but they’re also making a salary,” she says. “We set up a wage scale based on what the facility is willing to pay, and as the student progresses through the nursing program, that wage can be increased a little bit as they move along.”

The Role of Employers in RN Apprenticeships

“The spots are limited,” says Dr. Mullinax. “It’s all based on the employer. The whole apprenticeship is really built around the employer’s needs.” Each employer decides how many apprentices to hire based on its own requirements and open positions, and every apprentice signs an apprenticeship agreement with that employer.

“In the beginning, it was like, ‘Oh yeah, we’re going to hire as many as we can. We need staff,’” she says. “But the employers have learned that they can’t take large numbers of apprentices because of the nursing shortage. They don’t have enough employed nurses to train the apprentices, so over the past couple of years, they’ve backed off on the numbers. I have some employers who will hire maybe two or four each hiring period.”

Who Should Consider an RN Apprenticeship

Apprenticeship is not for every student,” says Dr. Mullinax. “It requires a very self-motivated student, someone who doesn’t struggle academically, who can still study and make really good grades, and then know how to balance that with the required work hours.”

In Alabama, an apprentice’s permit is automatically invalidated if they withdraw from the nursing program or don’t make satisfactory progress in it. “Because they do have to work more hours as an apprentice, it could interfere with their ability to be successful in their nursing course,” she says. “So some students wind up failing a nursing course.”

“If they’re struggling academically, I would probably not promote apprenticeship for them as much,” she adds. “I tell them in our information sessions that it’s like taking on another responsibility. Nursing school is usually very different from any other academic courses they’ve had because it is so time-intensive, and they have to learn a different way of studying.”

How RN Apprenticeships Vary by State

“Alabama has an office of apprenticeship, which not every state has, I’ve learned,” says Dr. Mullinax. “The Alabama Community College System, the Alabama Office of Apprenticeship, and the Alabama Board of Nursing worked together to develop the initial guidelines for this competency-based apprenticeship.”

Under Alabama’s rules, a nursing program that wants to offer an apprenticeship must submit its curriculum or clinical training plan changes to the Board of Nursing and notify the Board in writing when an apprentice withdraws from the program.

“What I’m seeing now is a lot of states don’t have the resources that we were able to use when all this started,” she says. “In a lot of states, their board of nursing is not even involved. There may not even be a college involved. It may just be a hospital that’s starting an apprenticeship program.”

Other states are still testing the model. In Minnesota, for example, the Department of Employment and Economic Development funded a pre-licensure nurse apprenticeship pilot at the University of Minnesota that ran from 2024 to 2025. “It’s being done many, many different ways, but I’m thankful for the way that we started it,” says Dr. Mullinax.

How to Find an RN Apprenticeship

“A lot of people call because they see on our website that we have an apprenticeship program, and they think that they can just apply for the apprenticeship program,” says Dr. Mullinax. “You have to apply to our nursing program first and be admitted before you can even think about apprenticeship.”

For students outside Alabama, the US Department of Labor’s Apprenticeship Finder lets users search open apprenticeship jobs by career path and location and apply directly with the employer. Its Partner Finder lists organizations that support apprenticeship programs, which can help students learn when those programs accept new apprentices. Because many RN apprenticeships are built through partnerships between schools and local healthcare employers, prospective students can also ask the nursing programs they’re considering whether they offer one.

“For the general public, apprenticeship is a really good thing,” says Dr. Mullinax. “If you’ve got really good nurses that are doing the training, I think it’s really good for students to have that one-on-one.”