Nursing schools in North Dakota: programs, costs, and how to get in

North Dakota is one of the most rural states in the country, and its healthcare workforce gap reflects that. Forty-six of the state’s 53 counties carry a federal Health Professional Shortage Area designation, and roughly half of North Dakota’s critical access hospitals are operating at a financial loss. The state’s healthcare workforce is anchored by Sanford Health and Essentia Health, both large regional systems with significant North Dakota footprints, as well as the VA medical center in Fargo and critical access hospitals scattered across the plains. For nursing students, the state’s workforce gap translates into a practical reality: graduates from North Dakota programs move directly into a market with strong demand, particularly for those willing to work outside the Fargo–Bismarck corridor.

North Dakota is a long-standing member of the Nurse Licensure Compact. The state joined the original NLC on January 1, 2004, and transitioned to the enhanced eNLC framework on January 19, 2018. A North Dakota primary RN license carries multistate authority across the 40 states where the compact is implemented. North Dakota has also enacted the APRN Compact, which would extend multistate practice authority to nurse practitioners and other advanced practice nurses – though that compact is not yet operational. It requires seven enacting states before it can be implemented, and as of mid-2026 only five have enacted it (Delaware, North Dakota, South Dakota, Utah, and Wyoming), so APRNs still need individual state licenses to practice across state lines. Neighboring NLC members include South Dakota, Montana, Wyoming, and Iowa; Minnesota is not a compact state – compact bills have been introduced there but never enacted. This matters for travel nurses working the upper Midwest region.

Types of nursing programs in North Dakota

North Dakota’s nursing education landscape is anchored by two major universities and a network of community and tribal colleges serving rural communities across the state.

LPN programs (12 months) LPN programs are available at several community colleges and vocational schools. The LPN credential allows entry-level nursing work under RN supervision, and LPN-to-RN bridge pathways exist at North Dakota institutions. Tuition typically runs $8,000–$16,000.

ADN programs (2 years) Associate Degree in Nursing programs are offered at Lake Region State College, Dakota College at Bottineau, Bismarck State College, and other community colleges throughout the state. These programs are well-suited to students in rural areas who want to enter the workforce quickly at lower cost. In-state community college tuition typically runs $4,000–$6,500 per year.

BSN programs (4 years) The University of North Dakota (UND) College of Nursing and Professional Disciplines in Grand Forks is the state’s flagship nursing program, ranked #1 in the state by multiple education rankings. North Dakota State University (NDSU) in Fargo and the University of Mary in Bismarck also offer accredited BSN programs. In-state tuition at public universities runs approximately $7,000–$11,000 per year.

Accelerated BSN (12–16 months) UND and University of Mary both offer accelerated or bridge options for career changers with prior bachelor’s degrees. These are concentrated in Grand Forks and Bismarck respectively.

RN-to-BSN and graduate programs UND’s College of Nursing and Professional Disciplines offers an online RN-to-BSN completion program accessible to working nurses statewide. UND also offers MSN and DNP programs, including nurse practitioner tracks. The University of Mary in Bismarck has RN-to-BSN and graduate options with a Catholic health system emphasis.

Admission requirements

North Dakota nursing programs follow a standard prerequisite model, with UND and NDSU setting the most competitive benchmarks in the state.

Standard prerequisites:

GPA benchmarks: UND requires a minimum cumulative GPA of 2.75 for the BSN program, with a February 1 application deadline for fall admission. NDSU’s pre-nursing program requires a 3.2 GPA for progression, with direct-entry requiring a 3.4 high school GPA and a 25 ACT or 1200 SAT. Community college ADN programs typically require a 2.75 GPA across prerequisite courses. Competitive cohorts at UND and NDSU typically carry GPAs above 3.3.

Entrance exams: ADN programs at community colleges generally require the ATI TEAS. UND’s BSN uses its own admission review; NDSU’s pre-nursing program uses ACT/SAT components. See nursing school prerequisites for more on what programs expect.

Background checks and drug screening: All North Dakota nursing programs require a criminal background check and drug screening prior to clinical placement. See nursing school criminal background check for details.

Healthcare experience: Not required for most programs, but direct patient care experience consistently strengthens applications at competitive programs. CNA certification is a practical way to gain this experience while completing prerequisites.

For students concerned about GPA, see nursing school GPA requirements and low GPA nursing schools for alternative pathways.

Costs and financial aid

North Dakota’s public university system is reasonably affordable for in-state students, and community college ADN programs represent strong cost-per-outcome value given the state’s job market.

Typical tuition ranges:

• Community college ADN (in-state): $4,000–$6,500 per year
• University BSN at UND or NDSU (in-state): $7,000–$11,000 per year
• University of Mary (private): approximately $20,000–$26,000 per year

See nursing school cost for a complete breakdown of program costs across degree types.

State-specific financial aid:

• North Dakota Student Loans: The Bank of North Dakota offers the Dakota Education Alternative Loan (DEAL) with competitive rates for students attending North Dakota institutions.
• Nursing workforce incentives: North Dakota has periodically funded loan repayment programs for nurses who commit to practice in rural shortage areas. Check with the North Dakota Center for Rural Health and the North Dakota Board of Nursing for current program availability.
• NHSC Loan Repayment: Federal HRSA loan repayment is available at qualifying Health Professional Shortage Area sites – numerous rural North Dakota facilities qualify.
• Indian Health Service: North Dakota has a tribal health service presence (Standing Rock, Spirit Lake, Turtle Mountain, Fort Berthold); IHS offers scholarship and loan repayment programs for nurses serving these communities.

Students should also complete the FAFSA early – see nursing school FAFSA guide for guidance.

NCLEX pass rates

The North Dakota Board of Nursing monitors first-attempt NCLEX-RN pass rates for all approved programs. State-level data is also available through the NCSBN website.

An 85%+ first-attempt pass rate is the baseline benchmark for a well-performing program.

In 2025, North Dakota posted the highest first-time NCLEX-RN pass rate in the country for US-educated candidates: 92.9% across 647 candidates, against a national figure of 86.7%. The gap between degree types within the state is wide by national standards – baccalaureate candidates passed at 95.4% while associate-degree candidates passed at 87.0%. Nationally that gap is only about 1.5 points, so the ND spread is worth weighing if you are choosing between an ADN and a BSN pathway here.

University of Mary in Bismarck has posted notably strong NCLEX performance, and Dakota College at Bottineau’s ADN program has also posted strong results. When comparing programs, look at pass rate trends over three or more years rather than a single year’s result, and check current program-level figures directly with the North Dakota Board of Nursing – small cohorts in a low-population state make single-year rates volatile.

For a framework for reading NCLEX data, see NCLEX pass rates by state.

Career outlook and salaries

According to BLS OEWS data (May 2025, SOC 29-1141), the median annual wage for registered nurses in North Dakota is $80,730 – about 17% below the national RN median of $97,550, though partly offset by a cost of living below the national average. The state’s percentile spread runs from $65,520 at the 10th percentile to $103,480 at the 90th, with the 25th percentile at $69,620 and the 75th at $93,080. Entry-level RN positions in long-term care or rural outpatient settings sit near the bottom of that range; experienced specialty nurses in Fargo or Bismarck reach the upper quartile. Licensed practical nurses in North Dakota have a median wage of $62,300 (SOC 29-2061), ranging from $50,950 at the 10th percentile to $74,130 at the 90th.

HRSA’s national nurse workforce projections place North Dakota among the states with the largest projected shortfall between RN supply and demand over the coming decade, with the state expected to meet roughly 84% of its RN demand. The shortage is most acute in rural areas, where the combination of geographic isolation, smaller facilities, and compensation pressures creates persistent vacancy rates.

Major employers:

• Sanford Health – the largest health system in both North and South Dakota, with Fargo as a major hub; has publicly described a historic workforce shortage and is actively recruiting at all levels
• Essentia Health – operates in Fargo and across the northern part of the state
• CHI St. Alexius Health – Bismarck’s major health system, serving the south-central part of the state
• VA Medical Center, Fargo – federal pay scale with benefits, serving veterans across the Dakotas
• Critical Access Hospitals – dozens of rural facilities across the state’s plains counties, often with loan repayment and signing bonuses

RN employment growth nationally is projected at 5–6% over the 2024–2034 decade, faster than the average across all occupations, with roughly 189,100 openings per year once retirements and job changes are counted. North Dakota’s trajectory, given its projected workforce coverage gap and rural hospital pressures, is more urgent than that national figure suggests.

How to choose a nursing school in North Dakota

North Dakota’s nursing school market is lean but well-structured. UND and NDSU provide strong university BSN pathways in the state’s two largest cities; community colleges distribute the ADN pathway to students in rural areas who would otherwise face impractical commutes.

Check ACEN or CCNE accreditation. All legitimate programs carry accreditation from ACEN or CCNE. See nursing school accreditation for what accreditation means and why it matters.

NCLEX pass rates from NCSBN: Pull first-attempt pass rate data from NCSBN for any program you are considering. Programs below 80% over multiple years warrant scrutiny. University of Mary and UND both have strong track records.

Rural vs. urban clinical training: North Dakota’s rural shortage is real, and programs that place students in rural clinical settings tend to produce graduates who are more comfortable with autonomous, lower-resource nursing practice. If you want to work in a rural community long-term, a program with rural clinical rotations is a significant advantage.

ADN vs. BSN decision: The ADN-to-employment route is fast in North Dakota – the labor market absorbs ADN graduates readily, particularly in rural and long-term care settings. However, Sanford Health and larger system employers in Fargo and Bismarck increasingly prefer BSN-prepared candidates for hospital roles. If you want to work at a major system, the direct BSN or RN-to-BSN path is worth the additional investment. See ADN degree and BSN degree for a full comparison.

Compact mobility: North Dakota’s long-standing NLC membership means your primary RN or LPN license here carries immediate multistate utility across the 40 implemented compact states. For travel nurses working the Midwest and mountain states, a North Dakota compact license covers a broad footprint. If you are planning an advanced practice career, note that this multistate authority does not yet extend to APRN licensure.

For a full pre-application checklist, see nursing school application checklist and nursing school acceptance rates.

References

1. US Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Registered Nurses (SOC 29-1141), North Dakota,” May 2025 OEWS estimates, 2026.
2. US Bureau of Labor Statistics, “Occupational Employment and Wage Statistics: Licensed Practical and Licensed Vocational Nurses (SOC 29-2061), North Dakota,” May 2025 OEWS estimates, 2026.
3. US Bureau of Labor Statistics, “Occupational Outlook Handbook: Registered Nurses,” national median wage and 2024–2034 employment projections, 2026.
4. National Council of State Boards of Nursing, “2025 NCLEX Examination Statistics,” Research Brief Vol. 96, Table 8: First-time, U.S.-educated Candidates Taking the NCLEX-RN by Degree Type, June 2026.
5. National Council of State Boards of Nursing, “Nurse Licensure Compact: Implementation Status by Jurisdiction,” 2026.
6. National Council of State Boards of Nursing, “APRN Compact: Enactment Status and Implementation Requirements,” 2026.
7. North Dakota Board of Nursing, “Licensure Requirements and Approved Nursing Education Programs,” 2026.
8. North Dakota Center for Rural Health, University of North Dakota School of Medicine and Health Sciences, “Health Professional Shortage Area Maps and North Dakota Health Workforce Data,” 2025.
9. Health Resources and Services Administration, Bureau of Health Workforce, “Nurse Workforce Projections, 2023–2038,” state-level RN supply and demand adequacy estimates, 2025.
10. Health Resources and Services Administration, “Nurse Corps Loan Repayment Program and National Health Service Corps Site Eligibility,” US Department of Health and Human Services, 2026.
11. Indian Health Service, “IHS Scholarship Program and Loan Repayment Program,” US Department of Health and Human Services, 2026.