Nursing Careers & Specialties for RNs
Nursing is not for everyone. It takes a very strong, intelligent, and compassionate person to take on the ills of the world with passion and purpose and work to maintain the health and well-being of the planet. No wonder we're exhausted at the end of the day! Donna Wilk Cardillo
One of the greatest aspects of nursing as a profession is the ability to work in many types of environments and in many different roles. It is a field which is constantly evolving.
Registered Nurses (RNs) can work bedside with the sickest patients or opt to care for those who are mostly well. They can work directly with patients or indirectly by collaborating with the interdisciplinary team or others involved in healthcare to help patients.
For every individual temperament and personality exists a nursing specialty. The pace of a working environment can be fast and full of adrenaline, or a slower pace with lots of time to spend bonding with patients and families, or somewhere in between. RNs can have a great amount of pressure to do everything perfectly and quickly with extremely high stakes or may work in an environment that is more relaxed with basically "well" patients who want to chit-chat while they wait for their physician's appointment. RNs can work with every age and population from very sick premature newborns to the elderly at the end of life from school children to adults who are undergoing elective plastic surgery. The options are nearly endless.
RNs have the option of working in hospitals, long-term care facilities, clinics, physician's offices, prisons, from home, as a traveling nurse in hospitals across the country, and in many other specialty roles.
And, as the political healthcare environment continues to grow and evolve, RNs are finding that the options are growing quickly. The nursing specialty options for RNs are many and they just keep growing!
Nurses work in many different areas of healthcare and the roles often vary within each environment. All of them basically can be differentiated by either direct or indirect patient care areas.
Direct Patient Care RN
The RN works "at bedside" in collaboration with the interdisciplinary team and his/her primary role is to work "hands-on" with a patient. This RN works "hand-on" with patients.
Indirect Patient Care RN
The RN works in collaboration with the Bedside Nurse and interdisciplinary team to support the care of patients. This RN may not be as "hands on" as a direct patient care RN.
RNs can work in a variety of healthcare settings, including:
- Skilled Nursing Facilities
- Outpatient Settings
- Physician Offices
- Insurance Companies
- Community Health
- Elementary or High Schools
- Correctional Healthcare Facilities
A variety of non-hospital nursing career opportunities are also available for RNs who don't want to work in the fast-paced hospital environment. Typically, these jobs require at least a few years of hands-on, clinical nursing experience. Nurses in an alternative environment may travel, provide in-home care, or work in an office setting. More of these alternative nursing opportunities will be available to nurses who hold a BSN or higher. Career options include:
- Clinical Nurse Educator
- Public Health Nurse
- Informatics Nurse
- Medical Writer
- Nurse Case Manager
- Forensic Nurse Consultant
- Patient Advocate
- Hospice Nurse
According to the US Bureau of Labor Statistics the 2015 median salary for a RN was $67,490. However, the 5 highest paying States in the US pay an average of $83,800 - $101,260.
Many factors affect the salary of a RN. These include location, experience, specialty, certifications and education.
The State in which the RN lives will affect salary greatly. The top 5 highest paid States in May 2015 were California, Hawaii, Massachusetts, Alaska, and Oregon.
Median annual salary for each of the highest paid States in May 2015 was:
Experience in nursing is irreplaceable. Usually the most widely accepted experience for employers is as a direct patient care RN, or Bedside RN, at least at the beginning of the RNs career. It is essential the New Graduate RN get at least 1 year of Bedside experience. I'll caveat this statement by saying that there are always some exceptions! But, for the most part, this is true even for RNs who wish to work in indirect patient care roles. Therefore, finishing school and getting that first Bedside RN job as fast as possible is the best way to improve lifetime earning potential. And besides, working closely with patients in a Bedside RN capacity is why most nurses chose the profession!
Specialties with the highest need and skill set tend to pay more and be in higher demand. It is not a coincidence that the US Bureau of Labor and Statistics ranked the highest paying RN healthcare environment as "General Medical and Surgical Hospital."
The top 5 highest paid places to work for RNs in 2015 were:
- General Medical and Surgical Hospitals
- Physician's Offices
- Home Health Care
- Skilled Nursing Facilities
- Outpatient Care
Employment is expected to grow by 16% from 2014 to 2024. This is well above the national average for all occupations of 7%. Driving factors for this include the aging population, changing political environments regarding insurance coverage, RNs reaching the retirement age, or RNs changing careers both within nursing or leaving the field.
Types of Nursing Specialties
Some nursing specialties are only available to RNs with a Bachelor's of Science in Nursing (BSN)
- Infection Control
- Quality Control
- Case Management
- Healthcare Informatics
- Assistant Nurse Manager
- Charge Nurse
- Nurse Educator
- Clinical Development Specialist / Training & Development Specialist
Research available RN jobs.
Salary Comparison Tool
This tool will allow you to easily search and compare the average salaries of various careers in nursing for many cities and locations across the U.S. You can search by city and state. Salary data is provided through the BLS.
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Ambulatory care nurses provide high quality nursing care in an outpatient setting. This type of nurse may work in a clinic, medical office, university health center, government institution or other healthcare settings where patients are not required to stay overnight. They perform a variety of tasks including assessing symptoms, providing care for injury or illness, taking vital signs, and any number of general nursing duties for patients.
Learn more about how to become an Ambulatory Care Nurse >>>
Burn care nurses care for patients who have suffered physical wounds as a result of burns. This includes the immediate stabilization of acutely burned patients, cleaning and dressing of burn wounds and assisting in pain management and rehabilitation. Burn care nurses, who often work in the ICU or Burn Care Units (BCUs) of hospitals, also play a critical role in the assessment of a patient’s emotional and psychological wellbeing and ensure patients receive compassionate care as they recover physically and emotionally from their injuries.
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Camp nurses provide care to campers and staff in both residential and day camps. They often work solo or independently, so camp nurses must have excellent clinical and managerial skills. Camp nurses complete pre-camp health assessments, and treat everything from colds to bug bites to allergies. RNs with a background in pediatrics, emergency care, or trauma are best suited for this role, as providing care to children with both urgent and non-urgent medical needs is a large part of the job.
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Cardiac care nurses treat patients with heart diseases or conditions. They may provide cardiac and vascular monitoring, administer medication, perform stress test evaluations, and/or help with pain management in cardiac patients. They may also tend to post-op patients recovering from bypasses, pacemaker implants, or other heart surgeries. Cardiac care nurses work in hospitals, cardiovascular centers, and other healthcare environments and work with patients of all ages.
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Cardiac Catheterization Lab nurses are highly qualified nurses who meet the challenges of their patient load and procedures in order to help save lives. They assist in specialized cardiac and vascular procedures like angiograms, stent placements, and heart monitoring, while informing patients and families of lifestyle, exercise and dietary changes that could prolong or improve patient outcomes. Most cath lab nurses work in hospitals and outpatient clinics and see regular patients as well as emergency cases.
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Case management nurses work with patients and their medical teams to develop, coordinate and implement comprehensive medical care plans over the course of an illness. An especially rewarding field of nursing that allows RNs to develop long-term relationships with their patients, case management nurses coordinate doctors’ appointments and surgeries, educate patients and their caregivers on their treatment options and have the opportunity to work in a variety of healthcare settings, ranging from hospitals and clinics to hospice facilities and nursing homes.
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Certified nurse midwives (CNMs) provide care for women before, during, and after low-risk pregnancies. They perform examinations, educate parents-to-be on prenatal care and birthing options, and assist in childbirth. After delivery, they monitor the new mom and baby and even help with breastfeeding. CNMs might work alongside physicians in a hospital setting, or they can work in private physician practices or alternative birthing centers. In some states, they can provide independent services. Aside from maternity care, some CNMs offer other gynecological health services to non-pregnant women.
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Charge nurses manage and supervise the staff nurses in hospital wards and busy medical facilities. They provide staff guidance, set schedules, maintain supplies, and oversee patient education and care. Charge nurses also typically treat patients themselves, and often take control when a medical emergency is presented. A mix of clinical and managerial leadership skills are needed to excel in this role.
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Clinical nurse leaders are master’s level educated nurses who focus on improving treatment outcomes and the quality of care for their patients. Often directly managing nursing staff, clinical nurse leaders analyze treatment results, assess patient risk and develop best practices and procedures for improving patient care. Clinical nurse leaders work in a variety of healthcare settings and serve as knowledgeable resource to the entire care team.
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Clinical nurse specialists are expert clinicians with advanced education and training in their respective specialty field, such as oncology, pediatrics or critical care. In addition to providing direct patient care, clinical nurse specialists educate, mentor and supervise nursing staff and are responsible for improving the quality of nursing care within their particular clinical department.
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Correctional nurses are a highly valued part of the corrections team. A demanding role, corrections nurses are the front-line response for patient/offender healthcare needs. With extensive training that spans triage and medical/surgical, as well as a holistic approach to treating the patient - but within the firm boundaries of the penal system, the correctional nurse is concerned for patient health as well as the overall safety and security of themselves, their fellow corrections employees, inmates and the general community.
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Experts on developmental disabilities and delays, Developmental Nurses work with patients and their facilities to understand a patients' immediate and lifelong abilities, physical, cognitive, social and emotional traits that are associated with developmental disabilities and other special needs and assistive devices that may need to be accommodated for. Many Developmental Disability nurses are fierce advocates of patient rights and the Americans With Disabilities Act.
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Domestic violence nurses combine compassionate healthcare and forensic techniques to care for domestic abuse victims. These nurses examine domestic violence patients for physical, mental, and emotional wounds, and work with doctors and law enforcement officers to report injuries. Domestic violence nurses must be patient, empathetic, and observant, as many patients may be too traumatized to speak about their experiences readily. They must also keep meticulous records and collect evidence for use in court, and they may even be called to testify in domestic abuse cases.
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ER or ‘Emergency Room’ nurses are efficient, effective and calm. Their prescences and skills are both general – as the Emergency Room admits all kinds of patients with all kinds of trauma – and highly specialized to assess, triage and care for those who have been a victim of a sudden accident or illness. With a varied intake, which depends on the day and sometimes on the hour, the ER nurse is responsible for continuously prioritizing the needs of the patients in the emergency ward in order to ensure everyone remains stable as doctors move to treat, admit, or refer to ancillary care. A leader with a strong ethical sense and calm demeanor, ER nurses have equal parts strong stomach, efficient pace, and assertive personality.
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Enterostomy therapy nurses, often referred to as ET or stoma nurses, treat patients before, during, and after enterostomy procedures. Once a patient has an ostomy, ET nurses monitor the ostomy site and teach a patient and their family how to properly care for the ostomy to prevent infection and other complications. They also assist in cleaning and changing ostomy appliances and are a valuable resource in identifying problems, recommending supplies, and suggesting care techniques.
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Family nurse practitioners, or FNPs, are highly educated and skilled nurses who treat patients of all ages and perform many of the same tasks a physician would perform. They examine patients, diagnose illnesses and diseases, and prescribe medication. Many patients see an FNP throughout the course of their lives, from childhood to adulthood and beyond. FNPs emphasize prevention and general wellness and can form lasting relationships with patients.
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Flight nurses, also referred to as transport nurses, provide critical care to patients en route to a hospital or medical facility on board an aircraft, such as a helicopter or rescue flight. They assess patients, administer first aid, perform resuscitation or ventilation procedures, and monitor vital signs to keep patients stable until arrival. They also assist in getting patients into and out of the aircraft and ensure that they are secured safely once onboard. Upon arrival at the hospital, flight nurses update the onsite medical staff to ensure a smooth hand-off.
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Intensive Care nurses, sometimes called 'Critical Care' nurses or simply ICU nurses are a highly specialized and trained subsection of the nursing profession. With a low patient to nurse ratio, the ICU nurse is responsible for the individual tasks and subtasks that are involved in caring for a patient in order to stabilize their condiiton. Frequently, intensive care nurses work with patients out of surgery, post-trauma, during complicated phases of disease, and those who are transitioning to end of life care measures. ICU nurses can choose to specialize by patient population or by affliction; common specializations include neo-natal ICU (NICU nurse), pediatric ICU (PICU nurse), surgical ICU or medical ICU to name but a few.
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The Labor and Delivery (L&D) RN ensures the safety of both mother and baby during the childbirth process. They work with the interdisciplinary team to bring life safely into the world. The L&D nurse must think and act quickly while constantly assessing for emergencies and initiating appropriate interventions. This RN may assist with caesarean sections, initiate and monitor fetal heart rates, monitor and assist with epidurals, induce labor, and ultimately work to find the safest and most effective ways to healthy childbirth. The L&D RN works closely with the interdisciplinary team including obstetricians and anesthesiologists to provide mothers and newborns with the best possible outcomes.
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As the single largest population of nurses, Medical-Surgical nurses work mostly in caring for adult patients who have an acute condition or illness, or who are recovering from surgery. While Med-Surg nursing used to be viewed as an entry-level position for nurses looking to gain experience after graduation and licensure, perspective has shifted somewhat in that to be competent and effective requires mastery of so many different specialties that med-surg has become something of a specialty in itself. Still viewed as foundational, most nurses will find their practice greatly enhanced by a position on the med-surg ward, regardless of where their career path takes them afterward.
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Oncology nursing care is sometimes referred to as Hematology/Oncology or 'Heme/Onc' nursing. These nurses specialize in caring for individuals who have been diagnosed with a bloodborne cancer (like leukemia) or a solid cancer (like a tumor). Oncology nurses are the first line of communication, care and education that patients learn to lean on as they undergo a scary and often challenging path to remission. Working with both adult and pediatric populations, the Oncology nurse helps patients and families track results and studies, inform about next steps, and manage symptoms throughout treatment.
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In every aspect of pre-surgery, intra-surgery and post-surgery, there's an OR nurse to help navigate the process; assisting the surgical team, providing care for the patient, and educating the patient's family. The OR nurse promotes the health and welfare of the patient under a variety of conditions. With the promotion of a supportive, care-focused and positive environment, the OR nurse is a valuable addition to many hospitals, doctor's offices and clinics.
Learn more about how to become an Operating Room Nurse >>>
Organ procurement coordinators are registered nurses who oversee and assist in the process of organ transplant surgeries. They help prepare the deceased body for transplant, help to match a donor to a recipient, and coordinate with doctors and surgeons regarding transportation of the organ. Most coordinators are RNs who have a surgical background and complete the Certified Procurement Transplant Coordinator examination.
Learn more about how to become an Organ Procurement Coordinator >>>
Orthopedic nurses deal with musculoskeletal issues including broken or fractured bones, arthritis, joint replacements, and more. They monitor patients before, during, and after orthopedic surgeries and assist in casting and wound dressing. Orthopedic nurses also help patients get on a pain management schedule and help administer pain medications. Most orthopedic nurses are RNs with a BSN who have passed the Orthopaedic Nurses Certification exam.
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Palliative care nurses provide compassionate nursing care to patients with chronic or terminal illnesses. They help patients with pain and symptom management to ensure that they carry out their final days in comfort. These nurses work in hospitals, nursing homes, assisted living facilities, and private homes, or wherever a patient requires this type of care. They also often provide emotional support to the patient and their friends/family.
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Postpartum nurses provide physical and emotional care for mothers and newborn babies following a delivery. They work in hospitals and birthing centers and often work alongside lactation consultants and labor and delivery nurses to ensure that a new mother recovers from the birth properly and is educated on caring for an infant. They also provide important pain management and postpartum monitoring for the new mother.
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Psychiatric nurses care for patients who suffer from mental health illnesses as well as those struggling with addiction and substance abuse problems. They assess and monitor patients, work with an interdisciplinary team including psychiatrists and social workers, and help administer medications. Psychiatric nurses work in hospitals, medical offices, mental health facilities, schools, correctional facilities, and in community settings where mental healthcare is needed.
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School nurses attend to the physical and mental health of children on a school campus. They treat and assess illnesses and injuries, and alert parents and emergency services when a health issue is severe. School nurses provide health education to students and work with teachers, parents, and administrators to promote health in the school system. They work in a variety of educational institutions and may travel between schools in a district.
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Telemetry nurses care for patients with heart problems who have moved out of the ICU. They specialize in monitoring the readings of electrocardiogram, or EKG, machines and alerting the doctor to any dangerous changes. They also monitor other vital signs including blood pressure and breathing patterns and may assist the doctor with diagnoses, treatments, or procedures. Telemetry nurses also educate patients on cardiac health and may recommend lifestyle or diet changes to promote a healthy heart.
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Wound care nurses treat patients with ostomies and serious wounds. This includes wound debridement, cleaning, and bandaging, amongst other things. Wound care nurses also help doctors assess whether further treatment such as antibiotics or surgery is necessary. This type of nurse also helps care for bedridden patients who have bedsores, people suffering from complications of diabetes, and may work in a hospital, nursing home, or other long-term care setting.
Learn more about how to become a Wound Care Nurse >>>