As you might expect from the largest healthcare profession in the US, Registered Nursing offers a wide variety of different career paths. Read on below, for descriptions of the various parts of the nursing profession, and links to our directories of each type of nursing degree program.
According to the US Department of Labor, approximately 59% of all registered nursing jobs are in hospitals. The specific tasks performed by hospital RNs really run the gamut, from patient/family education to administering medication and maintaining IV lines, to supervising lower level nursing and medical employees - Licensed Practical Nurses (Search for LPN/LVN Degree Programs), Nursing Assistants, etc.
You should think about career paths in terms of the following dimensions: care type/work setting, condition, body part, or population. Many times, they’re combined (for example, Adult Critical Care). In addition, specialization means different things at the BSN versus the MSN level.
BSN nurses (Search for Four-Year BSN Programs, Search for RN-to-BSN Degree Programs, Search for LPN/LVN-to-RN Degree Programs, Search for Second Degree Accelerated BSN Programs) can certainly have specialties, but they typically receive on-the-job training in them, as opposed to MSN nurses (Search for Masters in Nursing Programs, Search for Direct Entry MSN Programs) or nurses with doctorate degrees (Search for DNP or PhD Degree Programs), whose specializations are based on formal study over a longer period. There are, of course, corresponding differences in pay and job responsibilities.
The Department of Labor page on Registered Nurses is a good resource to check out: http://www.bls.gov/oco/ocos083.htm.
Nursing Career Specialties Based on Care Type / Work Setting
Hospitals and other care environments are divided into sections with highly specific functions. You have operating rooms, emergency rooms, ambulatory care (outpatient) wings, intensive care units, radiology departments, and so on. Hospices outside of hospitals may focus on palliative (end of life) care. Rehabilitation clinics focus on helping patients recover from injuries and/or surgery. Home health care agencies send nurses to visit patients at home to provide follow-up care.
Each of these settings has its own unique rhythms, tasks, patient types, and technologies, and each requires nurses with specialized skills.
Nursing Career Specialties Based on Conditions
There have been amazing advances in the medical field in the past few decades in the treatment of certain common, chronic conditions. These can be mental conditions (developmental issues, etc.), physical conditions (cancer, diabetes, HIV/AIDS, etc.), or a mix (like alcohol and drug addition). Nurses who specialize in areas like these can find positions either in hospitals or in specialized clinics that cater to patients who suffer from one of these conditions.
Nursing Career Specialties Based on Body Parts
The major systems of the human body all have their own special needs and their own field of study. These include the skin (dermatology), the heart (cardiology / cardiovascular), the kidneys (nephrology / urology), the lungs (respiratory / pulmonology), the female reproductive system (gynecology), the digestive system (gastroenterology), and others. The hospital departments and other settings that specialize in the care of these various systems all require nurses who are specially trained in the area.
Nursing Career Specialties Based on Populations
The process of providing medical care to patients can be quite different for different types of patients. Specializations exist in the care of adults, women, families, children (pediatric, school nursing), infants (neonatal), the elderly (geriatric / gerontology), the mentally ill, rural populations, and other distinct groups with their own distinct backgrounds and types of health challenges.
If you’re looking for degree programs in any of the Masters-level specialties, here are some of the most popular types:
Nurse Practitioner (NP)
Nurse Practitioner Programs
Family Nurse Practitioner Programs
Psychiatric/Mental Health NP/CNS Programs
It’s often said that Nurse Practitioners are the primary care physicians of the future. This specialty requires a Master’s degree in nursing, but in return, it brings with it substantially more pay and more independence. Nurse Practitioners are able to prescribe medication in all 50 states, and in just under half of the states they can even practice independently, without a physician’s supervision. As a result, many retail clinics are opening up inside chain stores, grocery stores, and drugstores, staffed entirely by Nurse Practitioners. Researchers expect that there will be thousands of these clinics across the country within 5 years. Common specialties for Nurse Practitioners include occupational health, school nursing, mental health, family practice, pediatrics, neonatal care, emergency/acute care, and women’s health. You can find more information on the American Academy of Nurse Practitioners website.
Certified Nurse Midwife (CNM)
Nurse Midwife Programs
Certified Nurse Midwives help deliver babies and provide care for women both at homes and in hospitals. A Certified Nurse Midwife is an RN who has completed a program in midwifery certified by the American College of Nurse-Midwives, and then passed a national certification exam. While the majority of Certified Nurse Midwives have a Master’s degree, it is possible to become a CNM without one. This specialty experienced a rebirth (no pun intended) in the 1970s and has been growing ever since. In 2004, midwives attended over 300,000 births, compared to half that number in 1990. As another sign of the profession’s growth and respect, Medicaid reimbursement for a Nurse Midwife’s services is mandatory in all 50 states. You can find more information on the American College of Nurse-Midwives website.
Certified Nurse Anesthetist (CRNA)
Nurse Anesthetist Programs
Certified Registered Nurse Anesthetists are graduates of accredited Master’s programs in nurse anesthesia (typically 2-3 years long) who have also passed the national certification exam. CRNAs play a vital role in providing health care services to groups like the US military and rural residents, in addition to the population at large. According to the American Association of Nurse Anesthetists, CRNAs are the sole providers of anesthesia in more than 2/3 of all rural hospitals in the US. This is the highest paying nursing specialty in the market. You can find more information on the American Association of Nurse Anesthetists website.
Clinical Nurse Specialist (CNS)
Clinical Nurse Specialist Programs
Clinical Nurse Specialists hold Master’s degrees and can choose from a very broad array of specialties based on diseases, populations, types of care, and so on. There are many similarities between the Clinical Nurse Specialist and Nurse Practitioner training and roles. However, the CNS career is more geared towards providing specialist/expert patient care, and mentoring of other staff, within hospitals, whereas the Nurse Practitioner’s focus tends to be on primary care, often outside of hospitals. You can find more information on the National Association of Clinical Nurse Specialists website.
Nurse Educator Programs
It’s no secret that nursing schools are in desperate need of additional faculty to teach and train the next generation of nursing students. Over 40,000 qualified applicants were turned away from nursing programs in 2007 because the schools did not have enough professors to teach them. The Nurses’ Higher Education and Loan Repayment Act, recently introduced into the House of Representatives, would offer loan repayment of up to $40,000 for Master’s degrees and $80,000 for PhDs as long as the graduate commits to teach full time at an accredited school for four years.
Nurse Managers and Supervisors are the glue that holds nursing teams together. They are responsible for hiring, training, evaluating, scheduling, and motivating nursing staff, among many other things. In an era where staff nurse turnover can reach into the double digits, they play a critical role. It can be a difficult job at times, because it has similar hours and pressure to a staff nurse position but typically does not offer overtime pay. However, it is an interesting and rewarding job for people who are interested in the business side of how a hospital or a clinic functions, and it is excellent preparation for higher level management jobs in healthcare organizations.
Clinical Nurse Leader
Clinical Nurse Leader Programs
The Clinical Nurse Leader is a new role created by the AACN. The Clinical Nurse Leader helps coordinate the team’s care activities at the point of care, to improve clinical and cost outcomes. This is an attractive specialty for nurses who want to progress in their careers, but still stay at the bedside. CNL programs require 2-3 years of study after the completion of a bachelor’s degree. There is an informative white paper on the AACN Website that describes the CNL role.