Guide to Nursing Careers

Nurses Are in High Demand

As an occupation, nursing is growing at a significant rate in the United States. Currently, registered nurses (RNs) are the largest healthcare occupation in the country, with an estimated 2.9 million nursing positions in the United States. The demand for nurses is expected to increase even more, with an average projected growth rate of 16 percent by 2024, which is much higher than the national average for all jobs.

The Bureau of Labor Statistics (BLS) predicts that more than a million RNs will be needed to fill job openings through 2024 based on both growth and replacement needs, which factor in openings that result from employees retiring or leaving the occupation. In the case of RNs, many who started their careers in the 1960s are expected to retire in the coming years. This creates an enormous opportunity for those interested in working as a nurse in any of the following environments:

• Hospitals
• Clinics
• Private practice
• Universities
• Schools
• The government and the public health sector

While a registered nurse must hold at least an associate degree in nursing or a diploma from a three-year hospital training program, the American Association of Colleges of Nursing names the four-year Bachelor of Science in Nursing (BSN) degree as the primary route into this profession. RNs must also pass the NCLEX-RN exam, which is administered by the National Council of State Boards of Nursing. Other state-specific requirements might apply.

Registered Nurse (RN) Roles

There are many specialties that RNs can pursue. While each requires a slightly different skillset, education, certification, and salary are consistent across all specialties unless otherwise specified. According to the BLS, the median salary for RNs is $68,450, with an upper limit of $102,990 and a lower limit of $47,120.

CLINICAL ROLES

Clinical roles for RNs focus on direct patient care.

ER Nurse

Also known as trauma nurses, ER nurses are responsible for patient care during crisis situations in hospital emergency rooms. Such situations might include serious or life-threatening injuries and illnesses. ER nursing requires working with a wide variety of age groups and demographics. Because emergency rooms are often busy places filled with many sick or injured patients, an ER nurse must be able to assess the severity of a given injury or illness and prioritize it among the other emergencies.

While additional certification for ER nurses isn’t strictly mandated, becoming a Certified Emergency Nurse (CEN) can give an ER nurse an advantage during a job search and can provide valuable knowledge and information.

OR Nurse

OR nurses, or perioperative nurses, provide patient care before, during, and after surgery. They are responsible for assessing patients, creating a sterile environment in which to operate, assisting during surgery, monitoring the patient, and providing patient education both pre- and post-operation.

OR nurses assume a variety of roles during surgery, including the scrub nurse, who works directly with the surgeon during an operation by passing instruments and other needed items; the circulating nurse, who works outside the sterile field, maintaining a broad perspective on the operation and providing a safe, comfortable environment; and the RN first assistant, who assists the surgeon directly by controlling bleeding, suturing, or providing other forms of patient care. Certification is not required in this area of nursing. However, nurses working in this area may choose to become certified as a perioperative nurse (CNOR).

Pediatric Nurse

Pediatric nurses provide care for children of all ages, through their late teens. A pediatric nurse’s practice setting determines day-to-day duties; some might work in a doctor’s office, while others might work in a pediatric surgical unit. Much of a pediatric nurse’s job is assessing a child’s symptoms and working with other pediatric medical professionals to determine a plan of patient care.

Two organizations provide certification for pediatric nurses: the Pediatric Nursing Certification Board and American Nurses Credentialing Center. While certification is not required, the Society of Pediatric Nurses does recommend certification (CPN).

Neonatal Nurse

Neonatal nurses care for infants with health issues related to birth defects, prematurity, surgical issues, and other complications. While the neonatal period is technically considered the first month after birth, neonatal nurses can work with infants up to 2 years old because many of these problems persist after thirty days. Neonatal care typically lasts until the patient is discharged.

While no additional education or certification are required to become a neonatal nurse, nurses working in this area may choose to become certified in neonatal intensive care (RNC-NIC or neonatal CCRN).

Oncology Nurse

An oncology nurse’s responsibility is to care for patients with cancer. This includes administering medications, monitoring a patient’s physical and mental status, collaborating with doctors on a treatment plan, acting as a liaison between patient and doctor, and providing emotional support throughout a patient’s battle with cancer.

Additional certification for oncology nurses is voluntary. The Oncology Nursing Certification Corporation provides several certification options for oncology nurses, and most oncology nurses must have clinical experience working with cancer patients before they can specialize in oncology.

Public Health Nurse

Public health nursing focuses on education, examining health trends, and working with epidemiological data to serve community needs. Public health nurses often participate in disaster service planning, help establish clinics and other services for low-income populations, and address systems within society and government to help prevent the spread of disease.

Nurse Educator

Those who enter nursing education work with students, providing training and education to new and experienced nurses, typically in a clinical environment. Nurse educators must be licensed RNs at a minimum and must have earned a B.S. or M.S. degree. PayScale notes that a nurse educator’s median salary is about $72,000, with an upper range of $97,000 and a lower range of $52,000. There are a variety of environments in which nurse educators can work.

School Nurse

School nurses provide patient care within a school environment. This means not only providing care directly to students when they’re injured or sick, but also working with teachers and administrators to ensure that the learning environment is safe and healthy. In addition to minimizing the spread of communicable diseases within a school population, school nurses are often called on to address other issues that can impact population health within the school, such as creating anti-bullying campaigns or working to improve the emotional health of students.

The National Association of School Nurses recommends a BSN as the minimum standard for a school nurse.

ADMINISTRATIVE ROLES

RNs in administrative roles participate in less hands-on patient care than clinical nurses, because their primary focus is on managing nursing staff.

Nurse Manager

Nurse managers are in charge of a nursing unit at a hospital or other medical facility. These individuals oversee the day-to-day function of the nursing unit. They recruit, train, and supervise staff; work with budgets and create work schedules; liaise with other departments as needed, and perform other duties associated with improving the efficiency and quality of healthcare delivered by the nursing unit.

Most often a BSN is the minimum requirement to become a nurse manager, but many employers prefer a master’s degree. Nurses must obtain sufficient clinical experience before becoming a nurse manager. The BLS reports that the median salary for medical and health services managers in 2016 was $96,540, with an upper limit of $172,240 and a lower limit of $56,970.

Director of Nursing

A director of nursing may oversee several nursing units within a healthcare facility. A director of nursing is responsible for maintaining procedures and policies with current evidence as well as supporting faculty strategic plans at the unit level.

According to PayScale, a typical salary for a director of nursing is around $81,000, with an upper limit of $120,000 and a lower limit of around $61,000. Directors of nursing are often expected to have a bachelor’s or master’s degree and several years of nursing experience.

Chief Nursing Officer

The chief nursing officer is the top nursing official in any medical organization and is ultimately responsible for the function and improvement of nursing within a facility. This usually involves interacting with other medical executives at an administrative level.

Those who reach this level in the nursing career path make a median salary of around $123,000, according to PayScale, and might make as much as $190,000 per year, depending on where they work. A chief nursing officer must be highly educated, with a BSN and a master’s being a typical minimum requirement, and must have seven to 10 years of nursing experience.

Advanced Practice Registered Nurse (APRN) Roles

Advanced practice registered nurses (APRNs) help provide primary and specialty patient care. This nursing career path often involves diagnosing illnesses based on patient histories and symptoms, creating plans for patient care, operating medical equipment, performing diagnostic tests, and analyzing test results, among other responsibilities, such as writing requests for grants. While APRNs may collaborate with a physician, they can also work independently from physicians and can prescribe medications for patients. Scope of practice varies by state.

According to the BLS, the median salary for APRNs was $107,460 in 2016, with an upper limit of $175,170 and a lower limit of $74,300. Becoming an APRN typically requires a master’s degree.

CLINICAL FOCUS

APRNs who focus on clinical work, like clinical RNs, provide direct patient care.

Nurse Practitioner

Nurse practitioners function as primary care providers for patients, operating in a role similar to a primary care physician. They assess and diagnose patients, prescribe medications, perform follow-ups, and work with patients to develop strategies for promoting patient health, to improve patient outcomes and quality of life. Nurse practitioners may work independently of physicians in some states.

Some nurse practitioners choose to earn a specialty certification or pursue a Doctor of Nursing Practice (DNP) degree. The DNP is a terminal degree for clinicians to better serve their patients and advance their careers.

Certified Nurse Midwife

Certified nurse-midwives provide care to women, particularly as it relates to reproductive health and maternal care. In addition to administering gynecological exams and providing prenatal care, a certified nurse-midwife can deliver babies, can manage birth-related emergency situations, and may even act as the primary care provider for a newborn. In addition, nurse midwives can provide family planning care, wellness care, and care for sexual and reproductive issues.

To become a certified nurse-midwife, nurses must obtain the Certified Nurse-Midwife (CNM) credential from the American Midwifery Certification Board and must re-certify every five years.

Certified Nurse Anesthetist

Nurse anesthetists assist with surgical, therapeutic, diagnostic, and obstetrical procedures, providing anesthesia and other care before, during, and afterward. This typically involves discussing the risks associated with anesthetics with the patient before a procedure, safely administering the anesthesia during the procedure itself, and monitoring a patient’s vital signs throughout the procedure and afterward, until the patient has recovered from the effects of the anesthesia.

To become a certified registered nurse anesthetist (CRNA), candidates must successfully complete the exam administered by the National Board of Certification and Recertification for Nurse Anesthetists and must re-certify every two years.

Clinical Nurse Specialist

In addition to the standard duties of an APRN, a clinical nurse specialist (CNS) provides patient care within a chosen specialization, such as pediatrics, women’s health, emergency room care, oncology, or psychiatry. A CNS acts as an expert within this field, providing direct primary patient care and often working in management positions and leading teams of medical professionals. Some clinical nurse specialists also conduct research within their chosen fields.

To become a CNS, a nurse must obtain all of the education and certification required to become an RN and must also complete a two-year clinical nurse specialist graduate degree program. A CNS may need state licensure in order to practice.

RESEARCH ROLES

Nurses focused on research help to advance medical and nursing knowledge or apply for grant funding for research.

Nurse Researcher

A research nurse’s role involves either participating in or contributing to original research. A nurse with a research-focused degree may determine the appropriate research method, as well as identify the appropriate variables to help answer a clinical research question. Depending on the research role, this may include recruiting patients, ensuring participants are giving informed consent, collecting data, and handling various administrative tasks for the study or trial.

University Professor

Some nurses work in colleges and universities. These educators teach classes that students take in pursuit of their nursing degree. Working as a college professor involves teaching classes and labs, preparing lesson materials, evaluating papers and other coursework, advising students and assisting them in understanding course material, and performing other duties associated with teaching nursing students.

College professors teaching nursing must be highly educated; most postsecondary educators are required to hold a doctorate in their field. The median salary opens in a new window for postsecondary nursing instructors was $69,130 in 2016.

Note: Bureau of Labor Statistics salary data is from 2016, while PayScale salary data is from 2017.

Advance Your Nursing Career

Rivier University offers several online nursing degrees to help students in their nursing careers, no matter what nursing career path they choose. Each of the online nursing degrees allows students to learn in a flexible, convenient format and provides the rigor they need to get the skills that will advance their nursing careers. Rivier also offers several on-campus nursing programs at its beautiful university campus in Nashua, New Hampshire.

Online RN to BSN

Rivier’s online RN to BSN is a bachelor’s degree completion program that provides students with all the skills they need to advance their careers as RNs. RNs can complete this program at their own pace, taking as little as 18 months or up to four years. Graduates can pursue careers as medical-surgical floor nurses, pediatric nurses, oncology nurses, and a variety of other specializations.

Online M.S. in Nursing: Nursing Education

Our online master’s in nursing education program provides students with the knowledge and skills to teach others to become nurses. This degree prepares graduates to become educators in academic or clinical settings in universities, hospitals, health agencies, and more.

Online M.S. in Nursing: Leadership in Health Systems Management

Those who want to lead other nurses can do so with Rivier’s online health systems management degree. Skilled nurse leaders are needed to improve patient outcomes and effect positive change in healthcare, insurance, and regulatory agencies. This degree provides the skills needed to assume leadership positions and make substantive contributions to the healthcare industry.

Online M.S. in Nursing: Family Nurse Practitioner

Nurses interested in advancing their careers toward becoming a nurse practitioner can do so with Rivier’s online family nurse practitioner program. Students will learn advanced theory and clinical education to be eligible to sit for the ANCC or AANP Family Nurse Practitioner Certification Exam. Once certified, a family nurse practitioner is qualified to advise patients in the areas of health promotion and routine healthcare visits to improve patient outcomes.

Online Doctor of Nursing Practice

The online DNP is a terminal nursing degree for advanced practice nurses working in the clinical environment. This degree is focused on improving patient care quality and safety in a dynamic, complex healthcare environment. Students are challenged to develop a scholarly project that is designed to improve patient outcomes and population health.

Download a PDF version of the Rivier Guide to Nursing Careers.