The Best Nursing Careers and Specialties

by Tanika Johnson
• 5 min read
reviewed by Elizabeth M. Clarke, MSN, FNP, RN, MSSW
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Nurses serve as symbols of strength, courage, and humility in the American healthcare system. They enrich and save the lives of patients and their family members.

Nurses are first responders and innovative leaders in clinical care and professional practice. These professionals instill hope in times of despair — nurses have played a crucial role in the response to the COVID-19 pandemic.

With current nursing shortages, an aging workforce, and the impact of the pandemic, the International Council of Nurses projects that 13 million nurses are needed to fulfill future hiring goals. The nursing career offers a myriad of specialties, ranging from acute care to preventive care. The best nursing specialties may require an advanced degree and additional certifications.

Why Should I Specialize as a Nurse?

Healthcare organizations throughout the world are amping up recruitment strategies to attract a growing number of qualified nurses. According to the Bureau of Labor Statistics, the career outlook for nurses bodes well, with nursing jobs in the U.S. expected to grow by 7% from 2019-2029, faster than the average job growth for other careers.

Registered nurses (RNs) earn median annual salaries of $75,330. However, specialized nurses can earn more than $117,000 a year, depending on their geographic location and advanced qualifications. In addition, the job growth for professionals with certain nursing specialties — such as nurse practitioners (NPs), nurse anesthetists, and nurse midwives — is expected to surpass 45% from 2019-2029.

How Do I Choose a Nursing Specialty?

When considering a nursing specialization, assess your interests, skills, and desired salary in addition to employment trends. Ask yourself the following questions: What kind of setting would I like to work in? Is my passion conducting research or taking care of patients in a hospital setting? What does my job outlook and salary look like?

Certified Nursing Assistant (CNA)

Required Education: Diploma or certificate
Median Annual Salary (2020): $30,830

Certified nursing assistants deliver direct care to patients in hospitals, nursing homes, and their own homes. Daily responsibilities include assisting patients with eating, bathing, dressing, and exercise, and monitoring and recording vital signs. They are supervised by RNs and other medical practitioners.

CNAs are required to complete a state-approved certificate program and pass a competency exam. Specializations include cardiology, gastroenterology, geriatrics, home care, pediatrics, psychiatry, and rehabilitation.

Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN)

Required Education: Diploma or certificate
Median Annual Salary (2020): $48,820

A licensed practical nurse or licensed vocational nurse works under the supervision of RNs and medical doctors. They check vital signs, monitor and report adverse medical and treatment reactions, collect test samples, apply dressings, and monitor catheters. LPNs and LVNs also offer bedside care to sick, wounded, recuperative, and incapacitated patients. Possible specializations include advanced cardiac life support, developmental disabilities, gerontology, and intravenous therapy.

Registered Nurse (RN)

Required Education: Associate degree in nursing (ADN) or bachelor of science in nursing (BSN)
Median Annual Salary (2020): $75,330

An RN is a licensed medical professional who has completed a nursing program and passed the National Council Licensure Examination (NCLEX-RN). RNs work directly with patients, medical doctors, and healthcare providers in hospitals, doctor's offices, nursing homes, and other medical agencies. RNs oversee patient care, document symptoms and medical histories, dispense medicine and treatment, monitor safety and infection, deliver aftercare, and discharge planning. RNs may enroll in a master's or doctoral program to become an advanced practice registered nurse (APRN).

Advanced Practice Registered Nurse (APRN)

Advanced practice registered nurses include nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and certified nurse midwives. APRNs are advanced practitioners delivering specialized clinical care to patients. Having earned a master's degree or doctor of nursing practice (DNP), they are trained and certified to evaluate, diagnose, order tests, prescribe medication, and oversee a patient's chief medical concerns.

Nurse Practitioner (NP)

Required Education: Master of science in nursing (MSN)
Median Annual Salary (2020): $111,680

Nurse practitioners are registered nurses with at least a master's degree and advanced qualifications and training. Practicing NPs may further their careers by obtaining doctoral degrees. NPs may diagnose and treat acute illnesses, write prescriptions, order diagnostic tests and labs, monitor and oversee a patient's medical condition, and act as a primary care provider. Specializations include family nurse practitioner, pediatric nurse practitioner, acute care nurse practitioner, and cardiac nurse practitioner.

Certified Nurse Anesthetist (CRNA)

Required Education: Doctor of nursing practice (DNP)
Median Annual Salary (2020):$183,580

Certified registered nurse anesthetists are APRNs that manage and dispense anesthesia and monitor the patient's recovery phase. CRNAs may deliver care for scheduled and emergency surgery procedures. They complete, at a minimum, a doctoral degree with a concentration in anesthesia, partake in substantial clinical training, and pass an approved National Boards of Certification and Recertification of Nurse Anesthetists certification exam.

Clinical Nurse Specialist (CNS)

Required Education: Master of science in nursing (MSN)
Median Annual Salary (2020):$91,880

Clinical nurse specialists treat and manage acute and chronic diseases. Several states require CNSs to acquire certifications to serve specific populations such as adults, geriatrics, or pediatrics. CNSs may provide psychiatric mental health or rehabilitation care; work in critical care or emergency rooms; or specialize in diabetes, infectious disease, or oncology.

Certified Nurse Midwife (CNM)

Required Education: Master of science in nursing (MSN)
Median Annual Salary (2020): $111,130

Certified nurse midwives deliver professional health and wellness services to women, such as obstetrics and gynecological (OB/GYN) exams and prenatal care. CNMs also prepare mothers for a safe and natural birth experience. Finally, they consult with OB/GYN doctors in cases of cesarean births, high-risk pregnancies, and pregnant patients with chronic diseases.

Common Questions About Nursing Career Paths

true What Is the Highest Paying Nursing Specialty?

CRNAs can earn an annual salary of up to $190,000.

true What Is the Best Nursing Job?

The five best nursing jobs are: certified dialysis nurses, legal nurse consultants, CNMs, CRNAs, and nurse case managers. This list takes annual salaries, workplace environments, and nursing specialty demand into consideration.

true What Is the Most Stressful Nursing Job?

Critical care nurses are often under a lot of stress due to increasing patient morbidity and mortality rates, demanding work schedules, and potential ethical dilemmas.

true Can Nurses Make Six Figures?

Yes. APRNs, such as CRNAs and CNMs, can earn six-figure annual salaries. To enhance their leadership skills and salary, nurses can explore the best online nurse practitioner doctoral programs.

true Do Nurses Have a High Burnout Rate?

Yes. Many nurses retire early from the bedside role due to the physically and emotionally stressful nature of the job. Nurse burnout has been exacerbated by the pressures of the pandemic.

Tanika Johnson is an Education Consultant, Continuing Education Contributing Faculty Member, Licensed Professional Counselor-Mental Health Service Provider, Licensed Mental Health Counselor, National Certified Counselor, Board-Certified Telemental Health Provider, and Certified Clinical Trauma Professional. She holds professional teaching licenses in both psychology and special education. Additionally, she earned her Ed.D. and Ed.S. from Carson-Newman University, MA from Argosy University, BS from the University of Tennessee at Chattanooga, and completed her teacher education program at Freed-Hardeman University. She has a wealth of experience with early childhood education, social and emotional development, education advocacy, and serving the special education community and exceptional needs of children, adolescents, and adults with disabilities.

Elizabeth Clarke (Poon) is a board-certified family nurse practitioner. A native of Boston, MA, Clarke tired of the cold and snowy winters and moved to Coral Gables, FL in order to complete her undergraduate degree in nursing at the University of Miami. After working for several years in the cardiac and ER units of UHealth and Jackson Memorial Medical Systems, Clarke returned to the University of Miami to complete her master of science in nursing. Since completing her MSN degree, Clarke has worked providing primary and urgent care to pediatric populations.

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