The current serious shortage of nurses is expected to continue, partly due to medical advances. Put simply: people who would have died now live, but need nurses to continue to recover. Registered nurses (RNs) constitute the largest healthcare occupation in the United States, at 2.6 million jobs—only 60 percent of which are in hospitals.
According to a recent report by the American Association of Community Colleges,
There will be 581,500 new jobs for registered nurses by 2018, representing a 22% increase in employment. The number of available jobs will soar even higher when factoring in retirements, resulting in 1,039,000 available jobs that will need to be filled by 2018, according to the Bureau of Labor Statistics and the Employment and Training Administration.1
A million jobs ….
There are several schools of thought on the subject of credentials in booming fields like nursing: One is, get the best nursing degrees you can right now, for a chance at the top job offers and career growth potential. The other is, if you get in at the start of the boom with any available credentials, you will be carried upward by your experience and can upgrade later (through an online RN to BSN or RN to MSN program) — while getting paid, maybe even with financial assistance from your employer. You must decide which is the best strategy for you.
Another consideration: It is much easier to get in at the start of a boom; if we wait until demand levels off, we may find entry barriers such as formidable, expensive credentials, whereas before the system would accept and train a hardworking, sensible person of good character. Currently, many stepping stones to advancement are in fact certificate programs that can be taken as adult education or online. That’s important because early career nursing usually involves shift work, so you need flexibility for your education (and online schools offer more flexibility for working professionals).
Most nurses graduating in 2005 or later (nearly 57%) have associates degrees from nursing schools. Certain specialties, of course, such nurse anesthetist, nurse midwife, and nurse practitioner, need a master’s degree from an accredited nursing school. If you are interested in a a specialty that includes serious risk as a normal part of the job, you should want these qualifications for your own protection, of course.
Due to nurse shortages, you may be able to get attractive financial assistance to complete any nursing degree at an accredited nursing school, and can often apply your certificate credits toward more advanced degrees. You certainly needn’t worry much that you won’t find a job that will enable you to pay back loans. You may not even need to borrow much money. As one source puts it,
In order to encourage more students to enter into the nursing profession to help fill the shortage, numerous organizations, private sources and the government are now supplying scholarships, grants and other gifts of money to help pay for students educations. The HRSA or Health Resources and Service Administration, which is a division of the Department of Health and Human Services, offer numerous valuable grants either tangentially or specifically applicable to nursing in the United States.2
Check out these scholarships; your name could be on one of them.
Compensation for nurses is quite promising; the main factors that determine salary are, of course, level of qualification and need. The United States Bureau of Labor Statistics reports the average annual salary for a registered nurse as $62,450, with the top 10% making over $92,000 a year. Also, because most nurses work for institutions (hospitals, government health care programs, schools, agencies, et cetera), the benefits are usually attractive.
You may hear references to “diploma” programs in nursing; these usually older programs have typically been offered by teaching hospitals; the trend today is toward degree or certificate programs based in educational institutions.
The most remarkable thing about nursing is how varied it is. Below we’ve listed different types of nursing jobs and nursing degrees you can get in no particular order. Instead, we’ve taking a look at some nursing specialties in relation to the strengths of the particular online schools:
(Note: Degree Wizard , below, means that you can find a convenient online degree program toward this career in the Wizard box at left by selecting “Certificate Programs”, then “Health and Medicine/Nursing”, then “Nursing”. For best follow-up results in any research, note your university choice.)
I can’t decide between …
“ … nursing and teaching.” Be a Nurse Educator (certificate) (Kaplan University, Degree Wizard) With your Bachelors or Masters degree in nursing, you can complete an online certificate program in nursing instruction, and can also use the credits toward a Masters in Nursing. Here, as with all teaching, some experience as a nurse is expected. This career offers regular hours in a field where many other careers require shift work.
“ … nursing and teaching, but I want advancement as well” Consider a Graduate Certificate in Nursing Education (Degree Wizard: U Mass Online, Lewis University). After getting a Masters in Nursing, you are well placed to help set up programs as well as teach.
“… nursing and teaching, but must I get a Masters first?” Consider a Certificate – Contemporary Nursing (Degree Wizard: Drexel University) You need a Bachelors of Nursing for this program. Courses are chosen from the MSN in Contemporary Nursing Faculty curriculum. Upon completion of this online certificate program, the student will have 12 graduate credits from an NLN/CCNE approved Masters in Nursing Program, which can be used towards a Masters at Drexel or any other university, so it should be easy to get a Masters later.
“ … nursing and police work.” Nurses can get a Certificate in Forensic Nursing (Degree Wizard: Kaplan University). Get your RN first, then study to become a crime solver and victim counselor. Your focus would be collecting evidence (of criminal or auto accident injuries, for example), giving testimony, and supporting survivors of violent crimes and accidents. You would work primarily with medical examiners, crime scene police units, or hospitals, which usually means you get standard government benefits. In addition to acquiring some experience as a nurse, you can earn recommendations through volunteer work at shelters, a good place to learn about the variety of patients you will be working with.
“ … nursing and law, but there wasn’t money for law school.” Consider the Legal Nurse Consulting Certificate (Degree Wizard: Post University Online, Kaplan) After you’ve got your RN and some experience, you can work with lawyers to help determine whether a patient received adequate care. You need some knowledge of law and health care regulations as well, so consider online paralegal courses (Degree Wizard, 5 offers) on your own schedule. You are in line for a well-paying, highly regarded career where you probably know more than the lawyers about the “balance of probabilities” (the key civil law concept) as to what happened in a health care situation.
“… nursing and human resources” Because of the sheer number of nurses in the work force and constant innovation in health care, human resources for nurses is a growing field. You’d need an MA in nursing, but not necessarily in Human Resources. That’s because you can get a post-Masters certificate in Nursing Leadership and Management (Degree Wizard: Walden University), for example. It would be a challenging job, as you are responsible for work force development, resource management, integration of technology, and the maintenance and improvement of quality care.
“… nursing and administration.” So do both. Consider the Certificate – Nurse Administrator (Kaplan University, Degree Wizard) This online certificate helps prepare nurses for advanced positions in hospitals, community health, long-term care facilities such as nursing homes , and other health care systems. Contrary to what some may suppose, one can rise to high administrative rank starting as a nurse, and it is a great advantage to know what conditions nurses face. Also, a quiet move into administration may be convenient when starting a family.
… nursing and Masters in Administration (for career advancement) Consider a Graduate Certificate – Nursing Administration (Lewis University, Degree Wizard) This certificate requires a Masters in Nursing and is aimed at those who are either currently practicing in nursing management or interested in a career change to this specialty.
“But Ireallywanted to be a doctor …” Are you sure? If what you want is to do what some believe only a doctor can do, look at these nursing careers before you decide:
Nurse obstetrician (sometimes called “nurse midwife”) While having a nurse midwife is considered trendy in some circles, the profession was established as a discipline of scientific medicine in the 1920s. The nurse midwife cares for the mother and child during the pregnancy, and during and after childbirth. Most nurse midwives deliver babies in hospitals, but, with appropriate backup, some deliver at home. You need to be an RN, then a course (degree or certificate) acceptable to the American College of Nurse Midwives (ACNM), and must write a certification exam. Some worry that the outlook for midwifery is poor due to declining birth rates, but keep in mind these facts: The United States’ birth rate (two children per woman) is much lower than it was fifty years ago but has changed little in the last decade — and the population is much larger now than it was back then. In census year 2005, 4,138,349 babies were born. In addition, many older mothers are now choosing motherhood, and statistically, they often need more help than the average. So obstetrics staff are hardly going out of business.
Obstetrics nurse Here, you do everything except the actual delivery – which means getting everyone and everything ready, keeping everyone calm no matter what, and helping out with baby’s first peek at the world. You could be a Licensed Practical Nurse or an RN, with special obstetrics courses as part of your education, and must pass a licensing exam. You may not need to work at a hospital; obstetrics nurses also work in clinics and doctors’ offices. (Note: The comments regarding the birth rate, under “Nurse obstetrician,” apply here as well.)
Neonatal nurse This is a newer specialty for a stark reason; neonatal intensive care became available only in recent decades, and is associated with a decline in infant mortality. As a neonatal nurse, you look after babies in the critical first twenty-eight days (the point at which trouble, I any, will usually show up). You may need to do anything from encouraging breastfeeding to rescuing infants who have stopped breathing. You’ll need your nursing degree, followed by some certifications in neonatal care. (Note: The comments regarding the birth rate, under “Nurse obstetrician,” apply here as well.)
Pediatric nurse Here, you not only look after young children in medical need, but you play a key role in helping their parents understand and adapt to their needs. You are their advocate as well as their nurse, because they often do not understand clearly what is happening and cannot explain things for themselves. Many are frightened, angry, and confused to a degree beyond what most adults would experience. After your RN, your best bet is to qualify as a Certified Pediatric Nurse. (Note: The comments regarding the birth rate, under “Nurse obstetrician,” apply here as well.)
Intensive care unit (ICU) nurse You’ve seen life and death medical drama on TV. Are you up for it in real life? Consider being an ICU nurse, trauma nurse, or triage nurse (decides which ER cases are most urgent). These are rewarding careers in all senses, but not easy ones. Your observations and actions may spell life or death for a medically unstable patient, or you may need to help a family come to terms with very difficult decisions following an accident or medical emergency. After your nursing degree,you may wish to consider some course work in counseling, to give you a head start in dealing with such issues. You’ll be well paid, but it can be high stress work.
Cardiac nurse This field is booming partly because older people have more heart problems and partly because today’s medical science can do much more about them. The American Heart Association notes, for example, that, among the more than 1.2 million Americans who have heart attacks each year, 460, 000 die – of those, 300,000 could not get medical treatment in time.3 In short, most people who get treatment live, and most people who do not get treatment don’t. As a cardiac nurse, you will work with the cardiologist (heart doctor) to care for patients with congestive heart failure, angina, and similar problems. Part of the job is routine pre- and post-operative care, but another part is working with defibrillators, cardio revert, and life support (your patient is made “clinically dead” for treatment purposes but can be brought back). And another part is encouraging the patient to team lead the recovery after discharge. After your RN, try to get jobs in cardiac units, especially those that help you keep up with the latest treatments and technologies. You’ll need that because, for certification, you must log 2,000 hours working as a cardiac nurse as well as attend continuing education.
Surgical nurse Not only do you assist the surgeon before, during, and after the operation, but you’re often the one who must explain matters to patients and families and sometimes advocate for the confused or inarticulate patient. For best career chances, after your nursing degree, get certified as a Certified Medical-Surgical Registered Nurse (CMSRN) offered through the Medical-Surgical Nursing Certification Board. Note: If you are uncertain about the level of stress this may involve, cosmetic surgery is also a growing field; it offers regular hours in a low stress environment.
Oncology nurse In this career, you specialize in helping the oncologist (doctor) care for cancer patients treated, usually, by surgery, radiation, and chemotherapy. You prepare patients, help administer treatments, and help them recuperate. Our society is making progress against cancer: The Centers for Disease Control says that in 2007, 11.7 million Americans had a history of cancer; but in 1971 it had been a mere three million4 (principally because a much greater proportion back then had simply died). Your challenge is to care no matter what the outcome, but not take it personally, so you are ready for the next battle for a patient’s life. After your RN, you should seek certification as an oncology nurse.
Hospice nurse (sometimes called palliative care nurse) If aggressive medical treatments are simply not reversing a patient’s decline, and death appears inevitable, the medical goal is too make their last days as comfortable and meaningful as possible, using many available methods. Hospice nursing is a newer field; although there are specialized hospices, many hospitals provide palliative care services, sometimes discreetly choosing to describe them another way. Some patients prefer to spend their last days at home. The hospice nurse needs to know how and when to administer treatments, supervised by a palliative care physician. The nurse must also act as the patient’s advocate when faced with a variety of the patient’s friends, relatives, and other caregivers in a stressful emotional situation, and here your distance learning psychology courses may help. You have a great advantage if, after your nursing degree, you have oncology credentials, as many hospice patients are suffering from cancer. You should also work for certification from the Hospice and Palliative Nurses Association, for best career results.
“This is a bit off the wall, but …”
“I love the caring aspect of nursing, yet I love computers too! A computer can alert the cardiac nurse six rooms away if a patient goes into arrest.” You may wish to consider the Nurse Informatics Certificate (Degree Wizard: Kaplan University) after your RN (Bachelors). You could go on to the American Nurses Credentialing Center’s Informatics Nursing certification exam. The integration of computers into health care has been increasing steadily for several decades, and nursing shortages will drive future growth.
“To combine nursing and computer science, I would hang in there for a Master’s” Consider a Post-Masters Certificate – Nursing Informatics (Degree Wizard: Walden University) Nurses can learn to integrate data and information to support decision-making processes for patients and practitioners.
“I’m reallyinterested in helping people with medical challenges live in the community. How does this fit with nursing?” Consider a Certificate – Life Care Planning (Degree Wizard: Kaplan University). If you are a registered nurse who wants to help people with significant disabilities or chronic health problems live as independently as they wish, the Life Care Planning Certificate can help you to the CLCP credential. You don’t in fact need to be a nurse; a variety of professionals gain entry. However, if you choose to specialize in issues around chronic illness, nursing might be the best entry career.
“I have a great idea for much-needed health care changes in my community, but everyone says, just be a nurse …” Consider the Certificate – Innovation Entrepreneurship (Degree Wizard: Drexel University) after your nursing degree (Bachelors is best here.) Essentially, you learn how to make changes effectively within or beyond an organization. It could be a good start to running your own health care business.
I’d be happy as a nurse except I don’t like hospitals, operations, etc. Is that a contradiction in terms? Forty percent of nurses do not work in hospitals or, if they do, are mainly providing counseling, etc. Here are some non-hospital nursing careers:
Public health nurse Here you work mainly with education and sometimes with intervention, to prevent or remedy disease, disability, or injury in your community. After you receive your nursing degree you can probably just seek work as a public health nurse, especially if your ambition is to work in an existing program in a community challenged by chronic health problems such as alcohol, obesity, or illicit drug use. However, if you acquire enough experience to dream of designing your own program, look at graduate certificates to build your resume and make the contacts who can get funding for your ideas. The trend toward prevention in health care, rather than treating existing disease, should mean more positions in public health.
Private duty nurse Working through a service provider such as a hospital, hospice, or social agency, you provide in-home care for patients who prefer that option. Sometimes, you are the patient’s private nurse at a hospital (for example, if the patient is a prominent person, publicity might otherwise disrupt the regular work of other staff). If the patient is not especially demanding medically, you could be a Licensed Practical Nurse or Licensed Vocational Nurse (starting with a high school diploma). But for seriously ill patients, you may need your RN, especially if certain treatments may only be legally provided by RNs in your state (injections of scheduled narcotic painkillers, for example). This is a well-paying field because those patients who choose this option are paying only for your time and supplies, not for a hospital’s maintenance. However, you must be prepared to deal with your patient’s friends and family (or fans) tactfully, with limited institutional backup.
Mental health nurse Caring for people in a fragile mental state, you could, of course, be working in a hospital, but increasingly, such care is provided in the community on an outpatient or day patient basis, or in the home. Although care can be provided at all levels from high school diploma on (as in Licensed Practical Nurse, high school diploma), your RN is key to advancement. At higher levels of responsibility, you may need to administer mood-altering medical drugs, sign legal paperwork, or testify in court as a skilled professional. A promising newer area is geriatric psychiatry: At one time, older patients were considered only marginally treatable, but today, many treatment approaches are offered to seniors.
I want adventure! Show me some! Your RN can be a ticket to adventure too.
Frontier nurse Have you considered nursing in an adventurous, but still American, locale? Try Alaska, where there is a persistent shortage of nurses, due possibly to the fact that nursing has traditionally primarily attracted women and as of the 2000 census, there were 109 Alaskan men for every 100 women. Alaskan RNs are well paid and, and can easily find help getting a job and getting settled in a unique American environment.
Flight nurse If a seriously ill person must be transported by air, the flight nurse steps in. Starting with an RN, you had best work up to nurse practitioner because, in flight, you are the medical team. Because more people who have health problems travel by air these days, there is a growing need for flight nurses and they are well compensated. It’s also a great way to travel, if you don’t mind being surprised by your next destination – perhaps so exotic that your travel agent has never heard of it.
Military nurse Are you up to this much adventure? You may not be a battlefield nurse, of course, you could be working with wounded veterans or helping deliver babies at a US Forces base hospital. The Armed Forces will pay for you to get your RN/BSN through ROTC (Reserve Officers’ Training Corps) and for any further courses you need while serving. Demand is high, and benefits are great. However, be aware that as a military nurse you have a rank in a vast hierarchy and must play the game by the rules.
[Check out our new ranking of the best accredited nursing schools online!]