The health care profession is one that can be rewarding both financially and in terms of job satisfaction. Most people who choose to become a nurse do so because health care appeals to them, and they want to do a job that makes a difference. Financial rewards are a nice bonus, and there is the potential for senior nurses to command a high salary.
The average earnings of people in the health care profession can vary significantly. At the entry-level, nursing assistants and orderlies who have completed a short certificate in nursing care but are not entitled to call themselves nurses can expect an average income of around $14.25 per hour.
Licensed Practical/Vocational Nurses, who have completed a one-year program of study and passed their licensing exam can expect to earn around 50% more than nursing assistants, with an average income of $22.83 per hour, or $47,480 per year.
Salaries continue to increase as the education requirements increase, with Registered Nurses enjoying a higher pay band than LPN and LVNs. Time in service, level of education, and specialization all influence the income of a registered nurse.
If you’re considering becoming a nurse, you may be wondering which specializations offer the highest salaries. The earning potential between a nurse educator, psychiatric nurse practitioner and certified nurse-midwife can vary dramatically.
Of course, when you’re planning a nursing job, compensation should be just one consideration. It’s true, for example, that a flight nurse usually earns more than an ADN-holding registered nurse working in a clinic, but that extra salary is to compensate them for long hours and difficult working conditions.
In addition, nurses who work in the highest-paying parts of the profession have usually spent at least 2-4 years longer in education than those in more entry-level positions. They may be able to recoup some of the cost of that education via bursaries or nursing student loan forgiveness programs, but there’s still some cost in terms of lost working time and study expenses to consider.
If you’re looking for maximum earnings, choose your nursing career progression path carefully.
Highest paying nursing careers with the fewest educational requirements
The standard route into nursing is to take a degree in nursing and then pass the NCLEX-RN licensing examination. This confers the right to call yourself a Registered Nurse.
It’s possible to become a registered nurse after studying for an associate’s degree in nursing, but an increasing number of hospitals are aiming to have at least 80% of their registered nurses be holders of a Bachelor’s degree. In New York, there is a new law requiring all nurses to pass their BSN within ten years of licensure, and some other states are debating introducing similar rules.
Given this trend towards requiring a BSN, anyone who is considering entering the nursing profession in the next few years should treat the BSN as a qualification baseline. Someone who holds a BSN and has extensive clinical experience has the opportunity to move into a number of specialization areas that could boost their earning potential.
What are the highest-paying jobs with a degree in nursing?
For a nurse to qualify for the jobs with the highest salaries, they will need to be educated to a postgraduate level. Those who earn a Doctor of Nursing Practice and work as a nurse practitioner, for example, can command salaries of $115,800 per year.
It’s possible for nurses to command above-average salaries without taking their education all the way to the doctoral level, however. A Nurse Practitioner, or Advanced Practice Nurse, who holds is educated to the MSN level can expect to earn far more than a registered nurse.
There are also career progression options open to nurses who hold a BSN and who have significant clinical experience. The American Nurses Credentialing Center offers a huge variety of certifications aimed at nurses at various levels of their careers.
Some of these certifications are aimed at nurses who have postgraduate qualifications, but others are offered to early-career RNs who are looking to move into specific areas of practice. Nurses who commit to building up a significant number of clinical practice hours and who take the time to earn certifications and engage in continuing education will have the opportunity to advance their careers that way.
Some of the higher-paid jobs that a nurse could pursue include:
Nurse educator
A nurse educator is an experienced nurse who works in hospitals or in an educational setting, overseeing training and education for younger nurses. The average salary of a nurse educator is $76,591 per year. Nurse educators are responsible for the continuing education of nurses in the facility in which they work, and are expected to have many years of clinical experience themselves.
Nurse anesthetist
A nurse anesthetist works with anesthetics in a variety of settings, including critical care, operating theaters and private clinics. Nurse anesthetists are classed as Advanced Practice Registered Nurses and can command salaries of $115,800 or more as a result of their qualifications and training.
Psychiatric nurse
A psychiatric nurse educated to the RN level can expect to earn around $66,611 per year. Psychiatric nurses work with people who are living with various mental health conditions such as anxiety, depression, ADHD, trauma or eating disorders. A psychiatric nurse who holds the Psychiatric Mental Health Nursing Certification is limited in their scope of practice since they’re not classed as a Nurse Practitioner, but can deliver some mental health services.
Nurse administrator
Salaries for nurse administrators vary significantly from state to state. To qualify as a nurse administrator, you’ll need a Master’s Degree with a specialization in nursing administration, and to complete the NE-BC certification or an equivalent from another recognized awarding body. Nurse Administrators manage the day-to-day operation of care facilities and are in charge at a strategic level. This position is popular with experienced nurses who want to move out of patient-facing roles and into a background position but don’t want to retire entirely from health care.
Pediatric nurse
Pediatric nurses are trained to care for children and have an understanding of how some medical conditions present differently in younger patients. A registered nurse who works in pediatrics can expect to have a salary of around $62,607. Those who are qualified to the advanced practitioner level can expect higher salaries. The entry-level qualification for pediatric nurses is the Pediatric Nursing Certification (PED-BC), which is valid for five years.
Informatics nurse
The informatics specialization is a broad one. In general, informatics nurses use technology to inform nursing practice. Informatics nurses may be skilled in data analytics and statistics, computer programing, or the use of specialist medical software. The Informatics Nursing Specialization (RN-BC) is open to newly-qualified RNs who are interested in moving into informatics. The average salary for someone who has specialized in this field is $84,804.
Forensic nurse
Forensic nurses care for patients who have suffered trauma, violence or abuse. They serve two job roles, providing medical care and emotional support for the victim and serving as a liaison between the victim and law enforcement. They record evidence of the injuries the victim suffered, interview the victim and report the injuries to the correct authority. The average salary of a forensic nurse is $63,263. This specialization is open to Registered Nurses with a bachelor’s degree.
What are the typical nursing career educational requirements?
As mentioned earlier, the Bachelor of Science in Nursing is rapidly becoming the baseline for registered nurses. It’s possible to start your nursing career with a two-year associate’s degree, and many nurses do enter the profession with that degree then complete their BSN part-time, but progression options for ADN holders are limited.
Nurses who have a BSN produce better patient outcomes, including shorter hospital stays and lower mortality rates than their less-educated counterparts. The extra two years of study can genuinely be the difference between a nurse being able to save a life or not.
After earning a BSN, a nurse has the option of studying a Master’s of Science in Nursing, with a focus on a specific area such as psychiatric mental health, informatics, or pediatrics. Once they’ve completed those studies, they’ll be expected to engage in a program of continuing education to keep their skills current.
The most in-demand nursing careers with high salaries
Demand for qualified health care professionals is increasing at a rate far higher than the rest of the job market. This is true for nurses at all levels of their careers. The number of jobs available for Licensed Vocational Nurses is expected to increase by 9% by 2029 and the number of openings for Registered Nurses is expected to grow by 7% over the same time period.
Nurses with post-graduate qualifications are even more in demand, with the Bureau of Labor Statistics predicting the demand for positions such as nurse anesthetists, nurse practitioners, and certified nurse-midwife to grow by 45% by 2029. For those who are seeking job security, it truly appears that nursing and other related health-care professions are a good choice.
Why are so many nursing jobs in demand?
Nursing jobs are in high demand because of the level of skill and training they require, and the nature of the job itself. Health care will always be needed, and as our population grows and the average age of the population increases, the number of people needing medical care increases too.
The nursing profession is a demanding one. Nurses who work in hospitals, especially in the ICU or emergency department, often find themselves working long hours in a stressful environment. Nurses, nurse assistants, and orderlies have physically demanding jobs, needing to lift, prone, or otherwise move patients who are unable to move.
The physical and mental toll that is put on Registered Nurses means many nurses retire from the profession fairly quickly or move into areas such as administration and informatics, where they’re not dealing with patients on a day-to-day basis. This, plus the expense of postgraduate education, means the number of nurses who progress to higher-level patient-facing jobs is low compared to the number of people who enroll on an ADN.
The nursing shortage is compounded by the plans many states have to increase the requirements for RN licensure from an associate’s degree to a bachelor’s degree. Currently, only 64.2% of RNs are bachelor’s degree holders.
There’s a shortage of new nurses entering the profession, and approximately 1 million nurses currently in the workforce are nearing retirement age. This means the existing skills shortage is set to get a lot worse, leading to a requirement for nurses at all career levels.
What influences the salary of a nursing job?
There are many different specializations within the field of nursing, and pay varies dramatically between them. Salaries can even vary for nurses with the same job title, depending on where they work.
Factors influencing nurse salaries include:
- The level of qualifications required
- The seniority of the position
- Working hours and conditions
- Whether the nurse is working for a private clinic, corporate, or non-profit
- Scope of practice
- Whether the position offers other benefits
The nursing jobs that require the most study, such as Nurse Practitioner and Certified Nurse Midwife, which require someone to have completed an advanced nursing program, tend to have higher average salaries than jobs that are open to ADN or BSN holders. However, there are some nursing specialty options that are open to those with lesser academic qualifications that still pay more than the salary of an RN working in a small, rural clinic.
Nurses who take the time to earn certifications can usually expect to have the door opened for higher-paying positions. So, a nurse who earns clinical experience and certifies as a dialysis nurse, physician’s assistant or trauma nurse can expect an increase in their salary from that.
Someone who wants to move away from patient care could consider qualifying as a legal nurse consultant or using their experience to move into a position as a nursing administrator. Those with a background in a different skill, such as IT or business, can use that to strengthen their position for such job applications.
The pay difference between hospitals and private care providers and clinics should not be overlooked. A care nurse working at a luxurious care home could command a higher rate of pay than someone in a mainstream hospital setting and have a smaller patient caseload too.
Even moving to a different state can make a significant difference to income, although any pay difference should be weighed against a change in the cost of living. In some cases, a nurse could enjoy a higher standard of living by moving, even if doing so meant taking a pay cut.
Highest-paying nurse specialties
There are dozens of different nursing specialties. If you’re unsure which field to go into, it’s well worth considering the varying salaries available, especially if you’ll be self-funding your education and want to find a field where the five or six-figure investment in a degree will pay off.
What are the different nursing specialties?
Some of the most popular nursing specialties include:
- ICU Nurse
- Nurse midwife
- Family nurse practitioner
- Orthopedic nurse practitioner
- Trauma nurse
- Oncology Nurse
- Dialysis Nurse
- Pediatric nurse
- Psychiatric Registered Nurse
- Neonatal Nurse
- Flight nurse
- Pain management nurse
- Nurse researcher
- Nurse educator
- Nurse manager
- Travel nurse
- Informatics nurse
- Nurse leader
- Nurse administrator
- Public health nurse
The above is not an exhaustive list. There are many other potential job roles for nurses to move into, depending on their interests, academic background, and the sort of work they’re hoping to do long-term.
The beauty of the nursing profession is the level of flexibility it offers. Whether you’re looking for a busy, challenging, and fast-paced job, a steady stream of patients at a clinic, the chance to work with a smaller number of patients or a specific age group, or you want to steer public policy and work in health care at a managerial level, there are options for you.
Which nursing specialties are the highest paying?
The highest-paying nursing specialties are usually the ones that require postgraduate qualifications. For example, nurse anesthetists are some of the highest-paid nurses, with an average salary of $174,780.
At the time of writing, some of the nursing professions with the highest average salaries are:
- Certified Registered Nurse Anesthetist
- Neonatal Nurse Practitioners
- Cardiac Nurse Practitioners
- Clinical Nurse Specialist
- Nurse Midwife
- Pain Management Nurse
How can you get certified as a nurse in different specialties?
The American Nurses Credentialing Center awards certifications in a variety of specialisms for nurses at different levels. It offers nurse practitioner and clinical nurse specialist-level certifications, as well as entry-level certifications for newly licensed registered nurses.
Eligibility requirements for certifications vary. Typically, to apply for a certification a nurse will be expected to have a valid RN license, a minimum number of hours of supervised clinical practice in the field for which they’re applying for specialization, and a certain level of academic qualification.
For example, to earn the Adult-Gerontology Clinical Nurse Specialist certification, a nurse is expected to have 500 supervised clinical practice hours and a Master’s Degree in Nursing, plus graduate-level courses in physiology, pharmacology, and health assessment.
Once these eligibility requirements are met, the nurse can take the exam. If they pass the exam, they’ll be awarded the certification, which is valid for five years. Nurses are then required to re-certify every five years and submit proof of continuing education.
At the time of writing, certifications cost an average of $395 for ANCC members. Some hospitals will cover the cost of certifications for nurses who are contracted with them.
How to earn a higher salary as a nurse
The pay gap between an entry-level nurse working at a not-for-profit hospital and a nurse who has specialized in a field requiring significant expertise can be as much as $100,000 per year. If you’re a newly-licensed registered nurse and you’d like to earn a higher salary, there are a few things you can do to unlock higher-paid roles.
Invest in your education
If you earned your ADN and went straight to work in the nursing field, the next logical step is to focus on completing the BSN. This will unlock more nursing roles, and most likely lead to an increase in pay too.
Don’t be put off by the thought of student debt from the BSN. There are many student loan forgiveness programs, bursaries, scholarships, and other forms of financial assistance available to help nurses improve their qualifications. If you go the loan forgiveness route you will need to make payments to your loans for a few years, but many nurses who follow that path still end up with higher take-home pay simply because the BSN makes them more appealing to employers.
Entry-level certifications still have value
The majority of the ANCC’s certifications are aimed at nurses who have at least a master’s degree, but there are some qualifications such as the Nursing Case Management Certification (CMGT-BC) that are open to newly-qualified RNs.
These certifications demonstrate to your employer that you’re serious about advancing your career, and give you the basic skills required to work in the area covered by the specialization. This means you can start building up supervised practice hours sooner, making the path to higher-level certifications easier.
Even if they don’t choose to pursue a career as an Advanced Practice Registered Nurse immediately, a Registered Nurse with certifications that show competency in more specialist areas has the chance to progress up the career ladder.
Be flexible and take opportunities to improve your skills
If you’re unsure what you want to specialize in, take every chance you get to learn a new skill, whether that’s through conferences, certifications, short courses, or time in a new department.
If you find something that appeals to you, invest some time in that. Some departments, such as the ER and ICU, require nurses for shifts around the clock and may struggle to fill their schedules. If those departments appeal to you then finding a place in them could be a positive mark on your C.V.
Look outside the typical hospital settings
Hospitals, primary care physician offices, and clinics are the most common places for nurses to seek employment, but they’re not the only places you can work. Home health care agencies, care homes, and private health care facilities all need nurses too.
There are also opportunities in education, corporate settings, private air ambulance companies, and also in the public health and local government sectors. There are benefits and downsides to each of these sectors, in terms of working conditions, resources, promotion opportunities and pay.
Do some research into each type of employer and weigh up your own priorities. Would you rather be a Registered Nurse enjoying a reasonably high salary for steady work in a private care home, but with limited exposure to other areas of nursing and therefore limited future promotion opportunities? Or, does the idea of working long hours in challenging conditions as a trauma nurse appeal to you, knowing that you can move into nursing administration if you decide those long hours are too draining?
Whatever you decide, continuing education is a must
All nurses are required to engage in continuing education and provide records of the work they’ve done when they come to re-certify. In most cases, you’ll receive a reminder of the continuing education requirements around one year before your certification is due to be renewed.
One year sounds like a long time, but the continuing education requirements for nurses are very high, and you’ll find it hard to meet those requirements while also working and studying for your Master’s or DNP if you wait until you’ve had the reminder to start work.
Try to do a little bit of continuing education every year. Remember that there’s no such thing as ‘too much study’. The body of scientific knowledge nurses have to draw on is huge and is growing every year. Continuing education is the way you can keep up to date with the latest knowledge and best practices in your field.
When you come to apply for entry into a new study program as a nurse, your clinical experience, current certifications, and study history will be taken into account. Post-graduate programs are competitive and highly selective. Your chances of acceptance onto an MSN or DNP will be much higher if you can show that you’ve proactively invested in your skills during your early RN career.
The nursing field has many options for sideways and upward movement, giving you the option to experiment, try new fields, and change paths many times throughout your nursing career. No decision you make is set in stone, and if you study something and decide you didn’t like it, that study wasn’t wasted since it will help you become a more knowledgeable and well-rounded member of the profession.
