The healthcare industry is always on the lookout for new talent to meet the challenges of the nursing profession. Today, nurses can choose from a seemingly endless number of medical specialties, including following a career that focuses on mastering traditional patient care. Nursing salaries vary by location, and in many places nurses can earn a comfortable income while enjoying the satisfaction of helping other people.
Personal Qualities Required for Nursing
The daily duties and responsibilities of nurses require certain personal qualities that must complement their education and training. Nurses working in clinical settings must have the physical stamina to work long shifts on their feet, with constant activity such as bending at the waist and repositioning heavy patients.
Compassion, communication skills and interpersonal skills rank high among the qualities that nursing requires. Working at a hospital or clinic, you must deal with patients in pain and frightened by their medical conditions. You also must work closely with the patients’ families, who often feel as fearful and frustrated as their sick loved ones do. By showing patients and families that you understand their feelings, you can help them relax and accept their difficult situations. Attention to detail will play a pivotal role in your nursing career and in the lives of your patients. A patient’s condition can change for better or worse at any time, so you must pay close attention to indicators such as level of alertness, skin color and breathing. Equally important, you must have the ability to document your observations and share details with other medical staff.
Nursing Work Schedules
Nurses do not work bankers’ hours. Healthcare facilities such as hospitals, hospices and nursing homes operate around the clock, 365 days per year, which requires nurses to work days, nights, weekends and holidays. In some medical facilities, nurses work three 12-hour shifts per week, while other employers offer traditional five-day work weeks.
Hazards of the Nursing Profession
Working in close quarters with sick patients puts nurses at risk of contracting all types of infectious diseases. Accidental needle sticks can transmit blood-borne diseases such as syphilis, HIV and hepatitis B. Healthcare workers sustain up to 1 million needle sticks per year, according to the National Center for Biotechnology Information. Because nurses spend their work shifts standing, walking, lifting and bending, they also run the risk of sustaining injuries such as pulled muscles, joint damage and back injuries.
Types of Nurses and Salaries
Licensed Practical Nurse (LPN) and Licensed Vocational Nurse (LVN)
“LPN” and “LVN” refer to the same job, but the titles vary depending on the state in which you work. LPNs and LVNs serve on the front lines of patient care, performing tasks such as collecting urine and blood samples, changing bandages, inserting catheters, feeding newborns, and taking temperatures and blood pressure. They also help patients bathe, dress and remain comfortable in beds and wheelchairs. LPNs and LVNs also must provide verbal and written reports of patients’ conditions to other medical staff.
In 2016, the United States had more than 700,000 LPNs and LVNs, of which nearly 40 percent worked in nursing homes and other long-term care facilities, according to the U.S. Bureau of Labor Statistics (BLS). Around 30 percent worked in hospitals and doctors’ offices, and the remainder worked for the government or home healthcare companies.
To become an LPN or LVN, you must complete a certificate program, often offered by community colleges and technical schools. Some hospitals and high schools also have LPN or LVN programs, which typically take about one year to complete. Coursework includes subjects such as pharmacology, biology and nursing. Once you complete your education program, you must pass the National Council Licensure Examination before you can work as an LPN or LVN. The duties you perform may depend on guidelines established by the state where you work. To expand your duties and advance your career, you can complete certification programs given by professional medical associations in areas such as cardiac life support, gerontology and palliative care.
In 2017, LPNs and LVNs earned a median salary of around $45,000 per year, according to the BLS. The median salary represents the wage in the center of an occupation’s pay scale. The lowest earners took home about $33,000, while the highest earners made about $61,000. LPNs and LVNs working for government healthcare facilities earned the highest salaries, followed by those working for nursing homes, home healthcare companies and hospitals. The BLS projects the LPN/LVN job market to grow by around 12 percent through 2026. Low-income communities and rural areas will see the greatest need for all types of healthcare professionals.
Registered Nurse (RN)
RNs handle responsibilities such as distributing medications, assisting in medical tests, administering treatment, and explaining medical conditions and treatment to patients. They maintain patients’ medical records, devise medical plans, administer protocols ordered by doctors and operate medical equipment. RNs can choose to work in general medicine or specialize in a particular type of medicine. The different kinds of nursing jobs available to RNs include cardiovascular, trauma, critical care, public health, neonatology, genetics, nephrology, oncology, pediatric and psychiatric nursing, to name a few.
In 2016, the healthcare industry employed about 3 million RNs in the United States, according to the BLS. More than 60 percent work in hospitals, while nearly 20 percent work for ambulatory care providers. The remainder work for nursing homes, government healthcare facilities and as educators.
To become an RN, you must complete an Associate’s Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program. Some programs offer a path for LPNs and LVNs to become RNs. Likewise, RNs with an ADN can enroll in a program to earn a BSN. ADN programs typically take two years to complete, while BSN programs take four years. All nursing programs include coursework in chemistry, anatomy, nutrition, microbiology and physiology, along with clinical work. Bachelor’s programs provide more clinical experience, along with coursework in areas such as communications and administration. Many healthcare facilities require you to have a BSN to advance to administrative positions. You can also earn master’s and doctoral degrees in nursing, which may enable you to conduct medical research.
After graduating from a nursing program, you must pass the National Council Licensure Examination to obtain your nursing license – a requirement in all states. Some states also require you to pass a background check during the licensing process. If you choose to work in a particular area such as oncology or cardiac nursing, you can earn a certification through various professional associations. Certifications can help boost your career, and some medical facilities require them to work in certain medical specialties.
In 2017, RNs took home an annual median salary of around $70,000, according to the BLS. RNs at the top of the pay scale made around $104,000, while the lowest earners made nearly $49,000. RNs employed by the government earned the most, followed by RNs working in hospitals.
The BLS expects RN job opportunities to increase by around 15 percent, through 2026. The aging baby-boomer population, along with a shift toward home health care and outpatient care, fuels the need. RNs who hold at least a BSN have the best chances for employment and advancement.
Advanced Practice Registered Nurses (APRNs)
APRNs include nurse midwives (CNMs), nurse anesthetists (CRNAs) and nurse practitioners (NPs). CNMs work in areas of obstetrics and gynecology delivering babies, administering gynecological examinations, assisting doctors with cesarean deliveries, and responding to delivery and post-delivery emergencies and complications such as hemorrhaging. In some practices, CNMs serve as the primary health provider for pregnant women and newborn babies, along with offering guidance on issues such as sexually transmitted diseases and neonatal nutrition.
CRNAs work in operating rooms, administering anesthesia and monitoring vital signs during surgery, and provide pain management for surgery patients during recovery. The CRNA’s job begins before surgery, as she assesses the patient’s medication regimen and potential complicating issues such as allergies or medical conditions.
NPs often act as primary healthcare providers for their patients, diagnosing and treating illnesses and medical conditions. Often, NPs work in a particular specialty, such as psychiatric or geriatric care. For instance, many nursing homes employ NPs to care for their elderly patients.
Duties of NPs can depend on the regulations established by the state in which they practice. In many states, NPs handle many of the duties and responsibilities of RNs and medical doctors. They perform medical examinations, diagnose illnesses, order tests, prescribe medications, evaluate treatments, maintain patients’ medical records, operate medical equipment and analyze test results.
APRNs may work on their own or in partnership with a doctor. In 2016, nearly 204,000 APRNs practiced in the United States, according to the BLS. More than 150,000 APRNs work as NPs, along with nearly 42,000 CRNAs and more than 6,000 CNMs. Nearly half of APRNs work in doctors’ offices.
To become an APRN, you must complete your RN education and licensing requirements, before enrolling in a master’s degree NP, CRNA or CNM program. APRN coursework includes advanced study in subjects such as pharmacology and anatomy, along with classes in the specific APRN area in which you plan to practice. Most APRN programs require candidates to have a BSN. APRN licensing and certification varies by state. Most states require you to pass a national certification examination and obtain certification from a qualified organization such as the American Midwifery Certification Board or American Nurses Credentialing Center.
In 2017, APRNs earned a median wage of more than $110,000, according to the BLS. APRNs at the bottom of the pay scale made around $77,000, while those at the top took home more than $180,000. CRNAs earned the highest incomes. Hospitals paid the highest salaries, while educational institutions paid the lowest.
The BLS estimates APRN positions will increase by around 31 percent, through 2026. The explosive growth is rooted in the needs of the aging baby-boomer population, along with changing state laws that allow APRNs to perform services traditionally administered by physicians.
Nurse Educator (NE)
NEs teach nursing courses in nursing schools and facilitate medical research. They also work in healthcare facilities to devise nursing processes, maintain standards and conduct training programs. NEs in school settings must work closely with students to evaluate their comprehension and understanding of nursing practices. Some write grants to continue or expand educational programs, while others offer tutoring services.
Nurses often become NEs late in their careers. To become an NE, you must complete all of your nursing education and work for a designated period as a licensed RN. Most NEs have earned a Master’s Degree in Nursing, followed by a Doctor of Nursing Practice or Doctor of Philosophy in Nursing degree. After completing your education, you must pass the Certified Nurse Educator Examination to qualify as an NE.
According to PayScale, NEs earn an average salary of around $72,000 per year. NEs at the bottom of the pay scale make around $53,000, while top earners take home nearly $100,000. Nurse Journal estimates the need for NEs to grow by as much as 19 percent through 2020.
Highest Paid Nurses
Although sources such as the BLS offer comprehensive statistics about the salaries of certain types of nurses, factors such as state-level wages make it difficult to determine a “highest paid” nursing career. For example, nurse educators in New York earn an average salary of $75,000, while their counterparts in Hawaii make just $39,000. If your dream nursing career involves a certain type of nursing, research the market to see if relocating might improve your income.
Nursing Salaries Vary by Area
According to a 2017 Nightingale College study, California nurses with a BSN degree earn the highest incomes among nurses, taking home an average of nearly $103,000 per year. On the other hand, South Dakota nurses made the lowest average salaries, earning just $57,000. But salaries do not paint a complete picture, because you must also consider the cost of living. For example, nurses in Hawaii earn an average annual income of nearly $97,000, but the high cost of living in the islands gives them less spending power than nurses in West Virginia, who earn an average of $60,000, but enjoy a significantly lower cost of living.
Politics of Health Care
The American healthcare system has been a political hot potato for decades. The Affordable Care Act offered healthcare coverage to millions of Americans, but proposed funding cuts to Medicaid and Medicare could dramatically reduce healthcare access for elderly and low-income citizens, as well as decrease opportunities for healthcare workers. If you plan to enter the healthcare industry, research the political climate carefully to determine how potential policy changes might affect your job prospects.