Along with the medical field in general, the role of a nurse underwent significant changes over the course of the 20th century, as the field professionalized and the duties of a nurse went from, essentially a non-skilled service to a highly educated qualified, and licensed profession. Over that time, administering medications, checking vital signs, and simply following the directions of the doctor in charge shifted to collecting raw data, interpreting observations, and making diagnoses and treatment plans.
Role and Duties of a Nurse: Professional Nurse Characteristics
Long gone are the days when nurses had few options about where to use that coveted license that recognized them as professionals. Today there are hundreds of options for meaningful careers in nursing, with the role of a nurse determined by the level of nursing education and specialization, the type of facility, and other factors. For instance, a registered nurse may have an associate’s degree or bachelor’s degree, and an RN license, but the duties of a nurse with a BSN will likely be higher than an RN with an ASN – and better paid.
Check out our latest ranking of the best online RN to BSN programs if you’re interested in earning a nursing degree. Specialized certifications may required by law in many areas, but may be used by potential employers as a measure of competence – so you have a better chance on the job market with a certification than without.
Types of Nursing Jobs and Salaries: How They Relate
Know yourself. The title labels this ranking as “best nursing careers.” Because “best” is so subjective, it is vitally important to know, among other variables, which is more important, a higher salary or fulfillment and job satisfaction. Related to job satisfaction is job location and mobility. Salaries and projected income vary incredibly, as does demand. The salary of a nurse practitioner, for instance, may be much higher for nurse practitioners who have more responsibility and autonomy. Location and demand make an enormous difference in types of nursing jobs and salaries available. For example the Department of Labor based Bureau of Labor Statistics reports that generally registered nurses may earn a mean annual wage of about $69,000. However, if you are nursing in California you might top out at $141,000; on the other hand, in Puerto Rico a nurse might earn as little as $25,000.
Having a valid nursing license opens doors to a wonderful variety of possibilities for both work and advancement. This listing will help you discover those doors, from basic staff positions to advanced nursing practice, education, and research – any of which may be “best” depending on what invigorates you. There are areas in the United States that have an acute nursing shortage, and others where there is no need. Identifying specific locations with a demand is beyond the scope of this ranking, but this ranking does provide job descriptions and median salaries as indicators of demand.
The Bureau of Labor Statistics is the source for the information that follows. Click on the links provided if you want more information.
1. School Nursing
What to expect: If what looks like the lowest salary in the ranking scares you off, consider that school nurses only work 9 to 10 months a year, have weekends and evenings off, and a have fall and spring vacation. Generally a school nurse works without a lot of direct supervision from a nursing coordinator. School students are the main clients for school nurses who do wellness screenings as well as providing basic first aid and referral of students discovered to be ill. Medication administration will probably be included in your tasks. A couple of years experience following graduation and licensure will probably be a basic requirement.
Challenges you may face: You may be faced with having to report child abuse and neglect and may have to deal with the effects of poverty and dysfunctional families. Children with special needs, both physical, and emotional, will probably form part of your clientele; knowing how to respond both personally and professionally may challenge you. Because you are responsible to a nursing supervisor or coordinator for health concerns, as well as the school principal for educational concerns, you may find a conflict of interests based on goals that each of them has for your students.
Median salary: $45,500.
2. Nursing Home – staff nurse
What to expect: Interestingly the two lowest median salaries in this ranking also reflect the two opposite sides of human experience, the very young and sometimes the oldest members of society. Nursing home nursing requires independent thinking and good assessment skills since generally speaking physicians may not be present physically. Medications and patients with special feeding and elimination needs will probably be included. RNs often supervise staff who perform basic care of clients. Several years of experience in acute care may be required.
Challenges you may face: Persons who either through age or disabilities require nursing care in a nursing home also require a great deal of patience and understanding. Communication with persons whose ability to communicate has been lost through illness or accident may be a major challenge. Demonstrating caring and compassion when it is not returned or understood may be difficult. Your case load may be disproportionately high.
Median salary: $55,200
3. Nursing Home – head nurse
What to expect: If you need a bit more of a challenge and just over $5000 more annually, consider being the head nurse in a nursing home. You will be expected to have additional, beyond staff level, experience in acute care and a background in management may be required in your resume. In this position you will probably do much less hands on care, but be involved in assuring that policies, services, and procedures are done as specified by the persons you are supervising. If you staff is primarily paraprofessional you will be assessing, evaluating, and following up the care needs of your clients. Caring for the staff will also be part of your role as you make certain that professional care is happening at all levels within your place of employment.
Challenges you may face: Maintaining a team spirit when staff members are feeling overworked and stressed may be difficult. Paraprofessionals may need the job, but not feel especially inspired to be on the job. Communication with family members who may have distanced themselves from long term needs of a loved one may be stressful.
Median salary: $60,700
4. Burn Unit – staff nurse
What to expect: Even with all the challenges that a staff nurse may feel in working with clients who often have to deal with excruciating pain and bodily disfigurement, staff nurses on a burn unit still earn a median salary well below the median overall salary. As a specialized work site, additional understanding and assessment in specific areas will be needed. While working more closely with other professions than in some areas of nursing, assessment skills and independent thinking are still crucial. Prior experience in acute care is part of the preparation.
Challenges you may face: Whether the client is a small child with large areas of the body burned, or a soldier recovering from chemical warfare burns, psychological shock and dealing with projected trauma may be hard. Maintaining a positive and restorative attitude when hoped for results don’t happen is not easy. Knowing how to provide self-care is crucial because of (pardon the pun), burn out.
Median salary: $61,900
5. Geriatrics – staff nurse
What to expect: Unlike a nursing home staff nurse, a geriatric staff nurse will not have a range of ages in the clients being cared for. Thus learning to know the peculiarities of older persons via both experience and specialized study will make this job much more meaningful. Diseases related to age and deceased bodily function are part of the big picture in this field. A generalized slow down, especially compared to acute care may make it seem easy and less stressful, but there are other stresses. Medications may need to be crushed or liquefied; food needs and elimination needs will take much longer to address.
Challenges you may face: Being patient when you know you have an hour of work and only half an hour to complete it requires a lot of skill and lots of care and compassion. Work colleagues who share neither your compassionate spirit nor the respect and honor you want to offer your geriatric clients for whom they once were, if not the person they are now, may also stress you.
Median salary: $62,400
6. Pediatric Home Care – staff nurse
What to expect: Practicing nursing outside of an institution is unique in many ways. Feeling comfortable about assessing needs, and responding to them, especially when your clients are children, can be challenge when there are no professional peers close with whom to consult. Following orders and paying attention to details, while at the same time taking initiative and responding to the unexpected is part of what this job is about. Institutional experience as a nurse, and maybe even as a parent, will help to make you feel secure about your role in a non-traditional setting.
Challenges you may face: Pediatric clients needing on going care often have complex health needs, and although some may be in an acute state, others may be chronic and it may be difficult to keep a positive and encouraging attitude. Not having peers close by will mean becoming comfortable with making decisions and assessing challenging realities. Becoming attached to your client may make it hard to be objective depending on what their situation is.
Median salary: $62,700
7. Hospice Care – staff nurse
What to expect: Hospice care, providing respect and dignity to a person in the final stages of life may seem to be in contraction to the role of healing often associated with nursing or medicine. Some of the persons you care for will have come to terms with their end of life reality; others may still be resisting giving up hope, even when there is no hope. Significant others who have not been part of the picture for years may suddenly show up, and challenge what other family members have decided, leaving you to mediate between persons at a very difficult time in the life cycle. Following orders and assessing will be part of your role, but so will having a compassionate and loving spiritual and psychological base.
Challenges you may face: If you have not come to terms with your own finite being, you may find it too difficult to deal with caring for those who have “made their peace” with that aspect of reality. Mediating, reinterpreting, listening, caring, and providing support for those present may feel like a heavier load than you bargained for. You may provide care in an institution and have support at hand for yourself, or may be in a home setting and feel overwhelmed.
Median salary: $63,600
8. Phone Triage – staff nurse
What to expect: As the name implies, this career puts you squarely in the role of a good listener and interpreter of what your client describes without you actually seeing them. You will need to know how to ask probing, but not leading questions if you wish to get an accurate awareness of what is happening. Even though you may have clear guidance about how to respond, or to discover what is happening, non-scripted reality will always break through. Persons calling may be in a panic, and your response will determine whether an ER visit is warranted, or whether waiting at home, or making an appointment “in the morning” is the best option.
Challenges you may face: Feeling comfortable with independent judgment is crucial. Depending on your location you may field questions from very inexperienced minors or older confused persons who simply want someone to talk to. Treating all persons with dignity and respect, and knowing when to follow up may call for discovering a “sixth sense” within you that knows more than you are being told or asked.
Median salary: $64,200
9. Home Care – head nurse quality improvement
What to expect: Although this nurse, like many head nurses, will not be involved in direct health care, the guidance and planned activities to promote quality of care provided by the home care service will ultimately improve the what the organization provides to it’s clients. Being aware of current best practice and expectations that persons who utilize the service expect is a starting point. Carrying out the tasks and successfully motivating changes will be the test of leadership you practice. Because of government regulations that cover most health care professions an awareness of regulations, and successful adherence to those are vital to this nurse’s success. Minimally you will need a bachelor’s degree and more than a few years’ experience, as well as strong leadership and self-starting skills with creativity to lead.
Challenges you may face: As regulations seem to become ever more tedious and requirements for documentation, not to mention, in this case, geographic factors, your staff nurses may feel frustrated and disconnected from their clients. If you have successfully done a practical “internship” in this area, and learned from it, you will be better equipped to help your staff face the challenges they now face. Standardization is good, and will make your work easier, but there are always cultural and religious factors that may require you to be flexible and understanding. Work as an ally, not an enemy, and you will be more successful.
Median salary: $67,100
10. Oncology – staff nurse
What to expect: Once more it seems ironic that like the preceding careers, oncology nursing also calls for a profound depth of character and personal strength, but provides a salary at the lower end of the scale. Caring for persons who are facing the reality of cancer, who may consider that word to be synonymous with death, makes this career one requiring a lot of fortitude. On the physical side, being a skilled phlebotomist, starting and maintaining intravenous lines is crucial, but so is sensitivity and compassion for persons coming to terms with the meaning of their lives. This job has aspects that no course material can provide and you alone will know if you have what it takes.
Challenges you may face: Although there will probably be other professional and lay persons (clients) present, you will still be alone in needing to provide support and care for your clients. If you can only do the physical aspects well, but can’t relate to the reality your clients face, oncology nursing is probably not for you. Finding support and ways to care for yourself is crucial, i.e., it’s probably not optional if you want to last long in the job.
Median salary: $67,200
11. Clinical Nurse Specialist – home care
What to expect: While this career has almost the same title as one based in an institution, the salary is almost $30,000 less. You will need an advanced degree, certification, and more than a few years of experience as you assess, plan, and follow up professional and paraprofessionals caring for persons in their home. Direct patient care is probably not part of this job, rather you will be responsible to make certain those under your supervision are providing it appropriately. Managerial and relational skills are vital for success in this specialty.
Challenges you may face: Persons who are open to working more independently may not necessarily have all the skills required to complete their tasks appropriately, so you will be caring for your clients and orienting and following up on your care providers as well. Your clients may be scattered over many miles, and depending on your geographic location weather hazards may be a challenge for you and your employees.
Median salary: $67,600
12. Nurse Recruiter
What to expect: If you are excited about being a nurse, and want to find other nurses of any level of competence to work in your preferred place of employment, being a nurse recruiter is the way to go. Answering questions at job fairs, making nurses aware of openings and options, and interviewing candidates who pass your required level of confidence is part of what you will do, but in order to do that you need to be highly competent yourself both educationally (with at least a bachelor’s degree and experientially, that is, being knowledgeable about the details of the job you are recruiting for.
Median salary: $71,900
13. Flight Transport – staff nurse
What to expect: Handling emergencies with firm ground under your feet, both literally and figuratively, is part of being a professional nurse. Doing the same when you are thousands of feet above the ground, and possibly dealing with acutely or severely ill clients will identify your level of competence. Accurate and ready assessment of the unexpected as well as simply handling the crisis you faced on beginning the transport to a major medical center, will call for your best effort. Sometimes you will need to do much more than simply follow orders that anticipated almost every potential issue as you respond to the demand for your best effort.
Challenges you may face: If your patient, or patients, are acutely ill you may not be alone in caring for them, but don’t count on not being struck by the nursing shortage. Being able to keep your balance intact, and your stomach in place, during air turbulence may be harder than you imaged when being recruited Long hours, stress, and relatively low pay are also part of what a flight nurse may experience.
Median salary: $72,000
14. Renal Dialysis Unit – staff nurse
What to expect: Of all the nursing careers we have considered, being a renal dialysis nurse requires less formal or advanced education in order to begin a career than most. Much of the work is routine with specific guidelines for assessing and determining what goals need to be met during the time a client spends using an “artificial kidney.” While the work in itself may be more routine, clients who have, or are in the process of coming to terms with their reality and needs may not see their reality as routine. Being a compassionate, understanding, and encouraging person will probably give both you and your clients a lot more satisfaction.
Challenges you may face: Machines that beep when they malfunction, and demand intervention may be difficult. So too, clients who are angry about their loss of freedom and limitations of independence may be a challenge to deal with in a compassionate manner. Creativity in the midst of routine and disappointment and despair will help make this a meaning job.
Median salary: $72,000
15. Home Health Care – staff nurse
What to expect: Having the self-assurance to assess, plan, and carry out professional care without someone looking over your shoulder may sound simple, but needing to cover physical needs is probably far from the only need you will respond to. Care may not be complex, but persons who have recently become home-bound may have expectations that are not realistic, or may be angry about what they are experiencing and blame the nurse for not fixing all that they have to face. Working without professional peers close by, or having a physician readily available means taking initiative, but also knowing when person knowledge and understanding for making a decision is not enough.
Challenges you may face: Clients who are alone much of the time may feel apathetic and uninvolved or caring about their well-being. Their needs may be complicated by their reality. For example, a person who has diabetes may have recently had a limb amputated, but also has very special dietary needs, rehabilitation needs in learning how to care for self, spiritual and psychological needs in dealing with the loss of function and independence. Home health care may challenge your creativity and patience, compassion and understanding.
Median salary: $72,200
16. Long-Term Care – nurse manager
What to expect: Knowing a bit about long-term and institutional care of persons will not cut it for this career. Advanced education, managerial skills, and five or more years of clinical experience will prepare you for assessing, planning, and organizing those who actually provide the care. You will be responsible for both professional and paraprofessional care-givers, and advocating for their needs will be an important part of this job as you strive for maintaining a competent staff in what may be routine work, but challenging in the terms of work load and certain monotony.
Challenges you may face: Keeping up staff morale may be a challenge; paraprofessionals who accept a position because of the need for employment, but resent a heavy, literally and figuratively speaking, work load will look to you to keep a positive environment. Clients may feel abandoned, and may have lost touch with reality, so knowing how to motivate and encourage persons who don’t even realize your good intentions may be difficult. Maintaining and recruiting staff will probably be part of this managerial task as well.
Median salary: $73,500
17. Industrial Health – head nurse
What to expect: As the title implies, this nurse practices in an industrial setting and must be prepared with more than a few years of experience in assessing and responding to emergencies and providing for outpatient surgery. Industries that are dangerous in and of themselves want to keep down time at a minimum, so hiring a nurse to provide care as well as teaching preventative measures is an important part of what they may seek to offer employees. Functioning with basic guidelines and appropriate responses still requires a lot of initiative and self assurance, so in every way this job will be demanding.
Challenges you may face: Industrial employees are not known for their tenderness and compassion. The job may entail social isolation and “tough characters” known for their rough language and manners. Maintaining a professional approach and treating persons with respect may be difficult, but is vital for being effective.
Median salary: $74,800
18. Research – staff nurse
What to expect: As part of on-going research. pharmaceutical firms and health related industries rely on human subjects for evaluating the effectiveness of their products. Belief in patient safety, strict adherence to guidelines and policies, and an investigative spirit supported with at least a bachelor’s degree and at least four or five years of experience will equip you for this job. Being skilled at assessing what is happening in any given moment, and responding to emergencies is vital for work in research of this type.
Challenges you may face: Some persons struggle with the ethics of “human guinea pigs” (or even natural ones for that matter); if you are one of those persons, this is not for you. Some research may go on for extended periods of time, so not giving in to monotony, or to compromise that may invalidate the research, is crucial. Study participants are expected to be healthy, but as humans they may test your patience and make you question just how healthy they are.
Median salary: $74,900
19. Charge Nurse
What to expect: The term “charge nurse” is a catch all phrase which as been used for decades as synonymous with “head nurse”, “nurse coordinator” and other terms. However, it generally refers to a nurse who overseas other staff persons, both professional and paraprofessional, and makes certain that all clients receive quality care, are duly assessed, and that there is continuity between the institution and community. Coordination of continuing and in-service education is also part of the charge nurse’s role. A charge nurse will necessarily be based and focused on a specific aspect of human reality, for example medical-surgical, OB-Gyn, orthopedics, or pediatrics.
Challenges you may face: Keeping abreast of all the advances in medicine, changes in procedures, documentation requirements, and legal issues (to name a few) will truly be a challenge. Some years of experience as a staff nurse give the impression that responsibility as a charge nurse is not unduly complicated, but becoming aware of all that is happening on a unit, and maintaining a professional milieu at all times will not be easy. Valuing the gifts of both experienced nurses, and young and naïve ones, to use the best of both perspectives is important.
Median salary: $75,000
20. Occupational Health – staff nurse
What to expect: In some ways this job is similar to that of a school nurse, except in an adult setting. Providing both assurance and referrals to employees and their families as well as doing basic health screening to help maintain the well-being of the employee will provide structure and guidelines for work. You will probably not need an advanced, or maybe not even a bachelor’s degree, but a compassionate heart and listening ear for challenges individuals and their families face are vital for your success.
Challenges you may face: Whenever families and children form part of a nurse’s clientele, the possibility of complicated and dysfunctional families, with domestic violence a present danger, may challenge your sense of well-being. Knowing how to connect families with community resources, and helping your employer to understand the reality of their employees is crucial if you are to provide integral health to those you serve. Being a “people person” is a must; if you find people and their problems boring or offensive, this job is not for you.
Median salary: $75,200
21. Recovery Room – staff nurse
What to expect: As technology advances and surgical procedures take advantage of new processes, the amount of time a patient spends post-operatively in the hospital will continue to decrease for some patients, as will their time in recovery. For others, however, the unheard of complex procedures requiring total control of body functions will make recovery room much more than a “wake up room.” Assessing all aspects of what is or may be happening with a post-operative patient and responding appropriately and in a timely manner is obviously at the very core of this profession.
Challenges you may face: Although as a staff nurse you will have direct and frequent contact with clients, most of the time they will hardly be aware of your presence, so if relating is important, this job probably won’t be gratifying. Experience and good judgment, often independently, may make or break you in recovery room. Judgment and assessment will be more important than tasks, and of course, documentation will be crucial.
Median salary: $75,500
22. Nursing Home – nurse practitioner
What to expect: Nursing homes are not synonymous with geriatric care facilities. In some areas, a nursing home provides care for persons who are no longer acutely ill and therefore do not require hospitalization, but are not well enough to be discharged to home care. As a practitioner in this setting your independence may be simplified in the sense that clients will be fairly stable, but will also probably be a larger group. Both preventative care (especially infectious disease possibilities) and curative response are part of this job. An advanced degree as well as certification as a Certified Registered Nurse Practitioner (CRNP) is required to get started. Of course for both of those a prior requirement, even if not a legal requirement, might be a few years of experience to be familiar with the principals and practices you could, or do encounter, will make you an important part of the health team.
Challenges you may face: Because of compromised brain function, either from dementia or accidents, your clients may not be able to express clearly, or quickly, what they are experiencing. Sensitivity to all your clients, and staff who look to you for modeling quality care, is very important. That sensitivity of course includes practicing and teaching understanding, compassion, and going the extra mile. Knowledge alone will not be sufficient to make you a successful nurse practitioner in this area of nursing.
Median salary: $75,600
23. Nursing Services Instructor
What to expect: Having the heart of an educator, being able to plan, organize, and carry out “in service” programs that will keep the nurses on your unit excited about what they are doing, and eager to do it better, will make you successful in this field. Nurses who are stressed out, or burned out, may be experiencing that reality because of the work load, but possibly because of not being adequately prepared for changes that have occurred in approaches and technology. An educator tuned in to current reality can make a world of difference by being relevant, and sensitive to colleagues. Expect to take a lot of initiative and use your own experience to make a difference for others. Having a background in education will help you be successful.
Challenges you may face: No matter how “wise” the input you provide, if you are unable to relate to the stresses your colleagues face, or come across as insensitive, your teaching moments will be diminished in value. Nurses may resent having to participate in educational experiences at the end of a shift that has stretched them to the limit, or being required to show up early when it means juggling outside schedules. Discovering the reality your colleagues face, and demonstrating sensitivity and compassion will be crucial if you want to connect.
Median salary: $79,200
24. Transplant Nurse Coordinator
What to expect: As skills and technology improve and awareness of how to deal with rejection of a transplanted organ or tissue increases, a transplant coordinator will need to maintain current as well as have a firm base with experience and awareness of how vital coordination of both donors and recipients intentions is. You will be working with clearly limited deadlines in time for organs and some tissues to be viable, feel a lot of pressure from persons involved (families that is, in the case of a donor), and will need to know how to handle grief, and joy, and all the emotions in between as a voice for those who made the decision to share life. More than an educated heart you may need a realistic and compassionate heart.
Challenges you may face: Persons who have waited, literally, for the death of a person so that they may live (although this may not be true in the case of some transplants), may feel guilt about feeling grateful. Families of donors may be struggling with giving up part of their loved one to a stranger. As you coordinate donors and recipients being sensitive and caring is absolutely essential. Handling your own disappointment when things don’t work out, and great effort and expense seems to have been wasted, is crucial for continuing in this role.
Median salary: $79,800
25. Infection Control – staff nurse
What to expect: “Hospital acquired infections” have become the challenge for providers and care-givers and tragically, the salary of persons who thrive on other person’s misfortune. Being very knowledgeable about specific transmission of given diseases, and the precautions required to avoid their spread is a must. Even though you may know the basics of epidemiology, you will need to constantly upgrade your knowledge of new and dangerous bacterial strains and viruses. Monitoring and discovering breakdown in the system that allows for infection to spread from one part of a facility to another is an absolute necessity. Educating, and insisting on compliance is also vital. From initiative based on assessment skills, knowledge and awareness, to testing premises and responding, you will be a very vital part of the future well-being of your institution.
Challenges you may face: Discovering faults in technique, or nurses who are stressed and understaffed taking shortcuts will probably not make you a popular person. Knowing how to guard each person’s dignity and pride, without compromise, will make the difference. Being able to involve ancillary personnel in control of disease and infection may be a test of your character and personality. If you fail the test, you may need to reconsider your participation in this vital area.
Median salary: $79,900
26. Occupational Health – head nurse
What to expect: If you found working as a staff nurse in occupational health invigorating, discovered that you enjoyed assessing and planning your own work, and at the same time thought about how you could help others be more relevant and fulfilled, you may be ready for a head nurse position. Don’t plan on doing it for the salary increase, a mere $2.00/hour more than you made, but the job fulfillment may be worth it. Large companies who are concerned for the well-being of their employees will expect you to provide continuity of care so that what is good in one area is also available in another area of the business. Employees will always be sharing their experiences so your goal will be to provide equally good care, follow up, and preventative nursing and teaching to all by way of a dedicated, unified staff working under your guidance.
Challenges you may face: Nurses who have been part of an organization for a long time may resent a new person asking them to change their way of doing things. Learning how to gain the trust and confidence of others, without demeaning or failing to value “the way we always did it” will make you successful. Assuring your colleagues that you care about their personal reality just as much or more than you expect them to care for their clients will have to be more than verbal.
Median salary: $81,000
27. Surgical First Assistant – staff nurse
What to expect: As in some other settings, the need prompts the expansion of roles. A staff nurse working as a surgical first assistance may perform some surgical procedures under the direction and supervision of a surgeon. Typically surgical nurses work as scrub (helping to prepare the client for surgery and assisting the surgeon) and circulating nurses (providing supplies and support without being in the actual “operating field,” but this role may go beyond that. Due to the increased responsibility, additional certification will be required, and at least two years of experience in the OR. Specialization in a given area of surgery to understand foundational practices and procedures and the concepts behind them will make you more effective. Wise judgment and experience are crucial.
Challenges you may face: If you find working with a few specialists in a given area of expertise, rather than relating to, and caring for many clients who can respond to you, this may be your field. Routines are very much a part of this job even though the clients will be changing, the basics will not change drastically. Being creative, and keeping up with new trends and challenges as you provide good self-care will make an important difference in how long you stay in this specialty.
Median salary: $84,300
28. Nursing Education Coordinator
What to expect: As median salaries increase, the complexity of the role, as well as the demand reflected by the law of supply and demand in the salary, so too the education and experience required increases. One step up from the education instructor, and about $3.00/hour more pay, this job has the additional challenges of using resources wisely between difference services, coordinating education that has common aspects, and adapting what is not common. Although the coordinator may not do the actual teaching, sensitivity and insight based on additional years of experience and education (at least a bachelor’s degree), will help you to be successful. Being a successful leader means having the respect and admiration of those you lead; expect that to happen.
Challenges you may face: Just as an instructor may face challenges from people who are used to a certain MO, so too the coordinator must be sensitive to learning from others. For example, knowing why an alternate way of doing things seems too much is just as important as teaching the alternate way. Overworked nurses will be resentful of instructors who demand their time and attention. As a coordinator, you will need to be sensitive to the instructors, and supportive of the reality they face too. Providing a win-win set up may be a challenge, but in the long run clients and staff will benefit with better care, better job satisfaction, and less stressed staff.
Median salary: $85,200
29. Psychiatric Unit – head nurse
What to expect: As head of a specific unit, you will be expected to delegate care of clients to professional and paraprofessionals working there. In addition to care provided, an awareness, both mental and written, of what is happening on the unit will mean good feedback and documentation of care provided, equipment and supply inventories, and following institutional guidelines for keeping tabs on all controlled substances. The degree of responsibility you shoulder will have to be supported with a minimal five years of experience and possibly an advanced degree. For the unit to function as a well-oiled machine, your personality skills, care for personnel working there, and team-building activities and attitude are crucial.
Challenges you may face: Maintaining professional objectivity is a challenge for some nurses who work with mental health clients. Being aware of the dynamics of how caregivers may be immobilized by their own issues is vital. Both staff persons and clients will benefit from continuity of care, and good professional judgment that may be compromised when adequate self-care is not provided either for you or your staff. Professional judgment in both actions and words, especially in words, are more vital here perhaps than on those units where physical care and intervention play a stronger part in return to wellness.
Median salary: $88,800
30. Obstetrics – head nurse
What to expect: Although some websites that pretend to provide job descriptions for head nurses assigned to different units change only a word or two, a truly professional nurse will recognize that the dissimilarities may be as numerous as the similarities. The routine basic responsibilities of documentation, inventory, reporting,, staffing, controlled substance inventory, and provision for staff maintenance, are, of course, very similar. However, a head nurse on an obstetrical unit can expect to be ready to respond to a wide range of emotions from both clients and staff, and will need to provide creative care and understanding for the unexpected. Furthermore, the degree of preparation for caring for a newborn will vary a great deal, and so staff must also be gifted and sensitive educators. If stress is to be reduced to a minimum, awareness and understanding of roles and expectations is crucial. Team leadership, and team building is a vital part of this role.
Challenges you may face: In some geographic areas, gynecological services may be combined with obstetrical services. If this is the case, clients and staff may face fears, anger, and challenges of moral and ethical dilemmas not usually faced on an obstetrical unit. For example, caring for a client with a botched abortion, and follow up care of a parent of a healthy new born child may stretch all involved. Still births, and premature births that separate parents either permanently or long term will need sensitive, compassionate nursing care not required on other units. Facing one’s own issues and dealing with one’s own history may be life giving or exacerbate past pain. Self care for all is vital.
Median salary: $91,700
31. Psychiatric Nurse Practitioner
What to expect: As the awareness of the degree of mental health challenges both in diagnosing, and providing care increases, many mental health care facilities have realized the importance of adding nurse practitioners who can cover some of those needs. Among the “non-nursing” tasks are diagnosis of mental illnesses and prescribing medication, but as a nurse dedicated to client advocacy, you will be involved with not only the client but significant others as well who will become part of the expected wellness. Use of counseling skills will also be part of what you are expected to provide, a task often delegated by psychiatrists to others.
Challenges you may face: Diagnosing illness is not a traditional role for nurses and there may be persons both professional and lay who resent your presence or question your credentials. Knowing your own limitations, as well as your preparation and gifts, is vital for your job security. Because nurses have long functioned in traditional ways of seeing the big picture and involved the family in the well being of ill persons, you are uniquely prepared to carry on that role. Use it and take advantage of what you know and do well. Remembering to delegate follow up care to social workers, and other community oriented persons will make you more successful and increase your ability to provide positive restoration of health.
Median salary: $91,900
32. Home Health – nurse practitioner
What to expect: The degree of independence you experience, as a home health care nurse practitioner can be invigorating and exciting. As a practitioner, because you are able to diagnose and provide for the immediate medical needs of your home bound clients, you will also be able to use an important short cut to health improvement. As in all nursing care, documentation and use of other medical and medical related services is crucial. Being independent is not synonymous with providing all the care that is provided for your client, nor is it synonymous with caring for only elderly persons. Depending on your actual agency, you may provide for both families and pediatric clients.
Challenges you may face: Even though nurse practitioners are not new in their area of expertise, they may not be known or valued where you are working. Needing to prove yourself capable and connecting with all parts of the picture is vital. Having clients spread out over a considerable geographic area, rather than located centrally, means having organizational and mobilization skills as well. Utilizing other providers, both lay and professional, will expand your provision of care.
Median salary: $92,300
33. ER – head nurse
What to expect: As a head nurse on a unit where very little is scripted, competence is a key word. Having your staff prepared mentally, emotionally, and educationally to respond to the unknown based on their awareness of anatomy and physiology will help make your ER function successfully. Reviewing, via documentation of both procedures carried out and best practice outlines, as well as keeping a valid and up to date inventory of everything ever used or needed, will avoid unexpected dilemmas. Years, at least five, of experience as an observant and model staff nurse on a unit like you expect to direct will help to prepare you. But preparation is insufficient if you lack relational and motivational skills to equip your team. Only rarely may you be involved in hands-on care, more likely your will delegate almost entirely the care and compassion you may wish to provide. Maintaining a solid professional relationship with the other services, such as radiology, laboratory, and an array of specialized providers is crucial. If you are not a team player, or aware of group dynamics, this job may not be for you.
Median salary: $92,500
What to expect: Although a certified nurse midwife has far fewer years of preparation than a OB/Gyn physician, a midwife often has the time and experience necessary to be much more involved in the care of an expectant mother. But the role does not stop with the delivery as many nurse midwives also are involved in follow up care of the mother and newborn infant. Usually midwives have a working relationship with a qualified OB/Gyn physician and have both the knowledge and practical skills necessary to know which pregnancies are beyond their scope of practice. In some geographic areas, you may function with a great deal more latitude than others; if you desire, you may find working directly under the direction of a board-certified physician an option.
Challenges you may face: No matter how gifted you are, there will still be surprises, some with a happy ending, and others with devastating negative outcomes. Knowing yourself, and your limits, and your gifts, and more particularly how you deal with the unexpected is crucial for taking on this role. Providing adequate support and self-care is really up to you if you are largely independent. Avoiding and prevention is not necessarily a sign of weakness, but rather a sign of awareness and professional judgment.
Median salary: $94,000
35. Critical/Coronary Care unit (CCU) – head nurse
What to expect: As median salaries mentioned in this listing increase one may conclude two things: 1) that the demand is higher, and the supply lesser (which may or may not be true), and 2) that the stress and responsibility, as well as the required preparation, is greater than in other areas. As noted earlier the demand is not correlated to the salary in this listing, but it can be an indicator. Being in charge of a critical/coronary care unit demands a great deal of stamina and preparation. Providing optimum care in situations that literally involve life and death decisions is part of the oversight, but just as important is making certain that all areas are fully functional, from technology to sustain life to technology to document all that is taking place. As a team leader knowing how to get the best possible service with the least stress and highest sense of responsibility, you will need at least five years of experience and advanced study, if not an advanced degree, to head up this unit. Wise judgment and knowing when to be flexible and when to draw a firm line will help you be successful as a CCU head nurse.
Challenges you may face: Because of the high stress nurses face in this setting, turn over may be greater than other units. However, to provide the best of care, permanency on the job will make the unit safer and smoother functioning. Leading your team in a way that provides safety, stimulus, and security on the job will help make you successful. Relatives of acutely ill persons may be demanding and unsympathetic to following expectations or depending on cultural differences may want to introduce ideas or customs that seem inappropriate in western medicine. Knowing how to distinguish between what may seem to be harmful, but in the long run facilitate wellness in a culture unknown to you will probably be a challenge.
Median salary: $94,200
36. MD Office – nurse practitioner
Challenges you may face: Clients who are generally insecure, and expect to be able to pay for a more highly educated, and in their perception a more qualified provider, may reject you. Knowing your limitations, and providing consultation and follow up for your clients is not a sign of weakness or insecurity, but rather of wisdom and responsible practice. Some more highly qualified professionals may also be threatened by your capability and understanding gained through experience that they might have missed because of longer academic preparation. Reassuring those persons, by words and actions, that your role is not to compete but to complement will go a long way to improve your acceptance.
Median salary: $94,300
37. OR – head nurse
What to expect: As one of the areas where absolute attention to an aseptic (germ free) environment is most crucial, you will face the task of supervising both professional and paraprofessionals, and also providing and maintaining an environment that provides the ultimate safety of your clients. Surgeries that are both invasive, and employ deep anesthesia cannot compromise or take short cuts in attention to details. Documentation, of course, will include all of these areas, and evaluation of how all of the above are functioning as they should and must is also part of the task. Both theory and practice are important: knowing what is expected, and seeing it fulfilled, be it by staff personnel or by equipment will require your best effort. Maintaining professional judgment and not compromising care because your client “won’t know the difference” will make the difference in who you are at the end of the day. As in other nursing professions with high expectations, your years of experience, five at least, and continually keeping up to date professionally are required.
Challenges you may face: Clients undergoing surgery and spending most of the time without being able to indicate what they are experiencing or their doubts and questions should not in any way decrease your own self criticism. Expecting, and practicing the most professional stance possible at all times may be difficult when staff is stressed, but it is crucial. Long and tedious hours with high stress form part of this role, so providing for self-care and renewal for your staff is not optional. To avoid burnout you must have leadership skills and practice them.
Median salary: $95,000
38. Clinical Nurse Specialist
What to expect: A clinic nurse specialist has a role that in some ways is like that of a head nurse, or nursing director of a facility in the sense of oversight, and attention to the care that is being provided in a clinic setting. However, rather than being involved with interpersonal relationships, and maintaining a good team approach, a clinical nurse specialist will make certain that clinic competency is achieved and maintained. In order for that to happen, clinical competency will be more important than staff relationships. No matter what the area of clinical specialty, the nurse specialist will be familiar with, and insist on following best practice and procedures that adhere to recognized concepts in the field. Knowing what is inflexible, and what can “bend” to adjust to cultural or religious values will make you a true specialist if this is your choice of nursing expertise. Both an advanced degree, and certification in your specialty area, plus, of course, experience gained over five years or more, will make you a true professional.
Challenges you may face: As a specialist you will be aware of trends and advances before most other staff. Being able to motivate change, if required, and adapting procedures may be a challenge. Presenting requirements in a way that they are valued and accepted, rather than questioned and time consuming is crucial for you to be the true specialist you prepared to be. Communication skills are vital; maintaining professional roles will be facilitated by your presentation in a manner that calls out the best of persons rather than provokes them to question why change is important.
Median salary: $95,800
39. Nurse Practitioner
What to expect: If you are not certain of the role you may play as a nurse practitioner, or uncertain of the area you will want to specialize in, you may find employment working independently on a limited basis, but still dependent on the professionals with whom you are linked. There are family practice physicians and others who see a wide range of clients and who may want a nurse practitioner to care for, and follow up some of those clients. Your general knowledge will be greater as you work in both preventative and curative care. Diagnosing, treating, prescribing medications, following up to see the effectiveness of what you have ordered will be part of this role. Even if you don’t have a specialized certification, you will still need to be certified as a nurse practitioner (which may require an advanced degree), and have a minimum five years of experience as a registered nurse.
Challenges you may face: Every professional is unique, and that includes you, so knowing how much latitude you need or desire, and finding a match with a professional with whom to collaborate and who has the same ideals may be a challenge. Paraprofessionals and even registered nurses who are not certified may feel intimated or resentful of the role you fill, so earning trust and having a good working relationship is vital. In areas where the role of a nurse practitioner is still new, you may have to prove yourself to your new colleagues.
Median salary: $96,000
40. Medical Surgical – nurse practitioner
What to expect: Unlike the nurse practitioner who possibly has not determined what area of specialty is most attractive, a “med-surg” practitioner will have decided to focus on this area of care. An advanced degree, experience, and certification in your specialty are part of the requirements. As other nurse practitioners, a nurse practitioner dealing with both surgical and medical clients will function much more independently than a clinical nurse in the same area. Small practices may combine services, like this one, in order to attract a greater number of clients or to be able to address more of the needs that may present in a given geographical area. Diagnosis, treatment, prescribing care and medicines, and follow up, along with proper documentation will be part of this role. In some clients the need for specialized care that encompasses both specialties may also be a reality. For example, persons recovering from a serious accident who are diabetic, or have other chronic health issues, will do well to have a nurse practitioner who understands and can address all their needs. Knowing one’s limits and gracefully referring those clients who are out of scope of practice from the nurse practitioner’s perspective is crucial.
Challenges you may face: Being the first nurse practitioner in a given practice may require a lot of stamina and a strong sense of self-worth and dignity. In some areas nurse practitioners, like physician’s assistants, must be linked to a given provider. If that is your only option, having the humility and courage to continue to gain experience and hope for greater independence at a future date will, in the end, make you a stronger and better prepared professional. Knowing how to deal with disappointments, and “failure” that is usually not part of a nurse’s role may be a challenge for you.
Median salary: $98,900
41. ER – nurse practitioner
What to expect: While the degree of latitude a nurse practitioner in ER experiences will be greater than that of a staff nurse in ER, you will probably not have the same level of independence that a nurse practitioner has in a family clinic. Doing triage duty, and ordering initial tests, providing input, and interpreting results are part of this role, but may involve other professionals. Keeping current of advances in technology in both goods and services is vital. You may work closely with social services in providing support to families who have to deal with significant stress, loss, and grief. Your extensive knowledge in advocating for the appropriate care and knowing your own limitations is a vital part of being an ER nurse practitioner. An advanced degree as well as more than a few years of experience will help you to deal with the unknown and the unscripted life of an ER.
Challenges you may face: Families facing devastating news about a loved one who was healthy just hours ago and is now gone, or barely hanging on or dealing with “frequent flyers” who somehow don’t seem to be able to care for themselves adequately to prevent their return for your services will challenge you. ER is fast paced and demands are often not flexible. Knowing how to keep calm in the midst of a crisis or mass casualty situation is part of the reality you will face. Self-care, before burn out happens is vital. By being tuned in to reality of professionals who are where you were a few years ago will make you a welcome mentor for others. Continuing humility, rather than a haughty attitude will go a long way in making you known as a team player.
Median salary: $100,000
42. Specialty Care – nurse practitioner
What to expect: Nurse practitioners who chose specialties rather than to work as “generalists” can expect to earn a higher salary, although the difference is not as great as one might expect. You will still be assessing, interpreting, ordering meds and tests, and recording results to plan initial and on-going care. An advanced degree in and of itself may not fully equip you for the specialty of your choice, but will provide the foundation, and the final part of that degree will prepare you for certification in the specialty care most important to you. Knowing and keeping tabs on advanced practices and procedures is part of this role also. The concept of once a professional, always a professional simple is not valid. Your wise judgment and on going education will keep you fine-tuned to continue the specialty in which you are engaged. Being creative and imaginative will give you the ability to pass on your knowledge and skills to professionals and paraprofessional colleagues.
Challenges you may face: Nurses who have worked on a specialty unit for years and have not had the luxury of obtaining an advanced degree or certification may resent you, or feel jealous. Maintaining an attitude and environment that fosters cooperation rather than competition will be healthier for all concerned, both staff and clients. Being willing to learn from others, not presenting yourself as the ultimate gift on a specialty unit will aid that link you hope to achieve. Unless health is compromised, or there is danger to clients, you may need to choose your battles for the ultimate good of all.
Median salary: $100,000
43. ICU – head nurse
What to expect: With the possible inclusion of other high risk units, nursing services on ICU are among the most stressful and have the highest staff/client ratio. As director of nursing service in ICU you will have a firm understanding of staffing needs and options of placement for the professionals and paraprofessionals on your unit. Maintaining documentation of performance both from equipment, supplies, (including medications and controlled substances) and personnel is vital if the unit is to be a safe and healing and wholeness unit. Having all the supplies you could possibly need, and readily available and inventories is also part of this daunting task. You will need to be constantly upgrading your own knowledge as well as making certain, in collaboration with nurse educators, that your staff is fully competent for whatever reality they may face. Knowledge about creativity in leadership and maintaining a good team spirit is part of part of your task; carrying it out is just as, or more important. You will probably need an advanced degree and specialized certification to be considered for this role.
Challenges you may face: the constant pressure to make wise and appropriate decisions based on information from technology input as well as having staff who share your competence may be very wearing, and result in burn out and tensions and tempers flaring. Knowing how to deal with issues before they happen, or if they happen, will be crucial for the mental health of all on the unit. Knowing the limits of what you and your staff can take, providing self-care and well being with time away from the stress is very important. Keeping staff abreast of all that is required and changes needed in approaches means constant learning and awareness.
Median salary: $100,500
44. Neonatal – nurse practitioner
What to expect: Because of the high risk neonatal clients face you will probably work with a fully qualified physician in this role which will include assessments, planning, ordering laboratory and other tests, ordering medications and planning accordingly. The fragility of the lives of neonatal clients calls for at least at advanced degree and certification in this specialty. Naturally some years of direct experience will be required as well. Being aware of and able to use advanced technology for both care and documentation is an absolute essential. Acute sensitivity, based on knowledge and experience, will make you competent in this area. Because your clients will not communicate with any precision what is happening or not working, you will need greater sensitivity to realize that intervention is indicated if that is the case.
Challenges you may face: Learning to distinguish nonverbal communication variances from your clients will be a major challenge. Learning to cope with the impossible, and shattered hopes, is part of this job. However, not becoming jaded and unable to keep hope when it seems hope is lost is also important. Forming a closely knit team that works with precision and understanding, with mutual trust, is crucial. Being aware is important, but also second guessing yourself and others will not increase confidence.
Median salary: $106,500
45. Grant Services – nurse practitioner
What to expect: Although this job is not clinical in the sense of caring for clients directly, an acute and up to date awareness of clinical practice and hopes for improvement is crucial. Grants for improving services, educational input to both staff and clients, both in house and beyond, are part of the role you may fill. Seeing the big picture, the needs that could be met with further evaluation of what is now best practice, and responding with proposals that address those issues, but lack funding, can empower and motivate you to find funding and solutions. An acute awareness of how the health industry works, and how funding can be obtained calls for knowledge and expertise beyond assessing, planning, carrying out plans, re-evaluating, and planning anew that you may have practiced prior to being involved in grant services.
Challenges you may face: Being creative enough to note new options or to reduce the thoughts and ideas of other professionals into highly desirable and fundable projects may not be easy. Research in grant services goes beyond what is already happening to the field of dreams and possibilities. Having faith in yourself and colleagues in crucial for this role. Not giving up when grant requests are denied, or for whatever reason you fail to impress must be met realistically, and new visions sought and obtained.
Median salary: $107,400
46. Specialization – nurse practitioner
What to expect: Specialization as a nurse practitioner will require more experience, a lot more education (advanced degrees and certification) and an area of nursing that has both high demands and is unique in the field. As you learn to know your interests, particularly in regard to independence, and the acute awareness what you can offer that is not frequently offered by nurse practitioners, you will be able to provide your own job description as you tailor your specialty to what you can offer. Nurse practitioners freedoms to assess, plan, provide, test, and carry on do not vary a great deal from one general area to another, but a specialized field gives you latitude for creativity and spontaneity.
Challenges you may face: If you are a team player, you may not find many nurse colleagues in a highly specialized field, but undoubtedly your health profession colleagues will be present. Being humble enough to welcome others of lesser preparation, and to challenge them to become all they can be is a gift you will be able to offer. Clients who have unique needs that are both frightening and uncommon will welcome a knowledgeable and sensitive compassionate person to accompany them. Continuing your education is crucial; don’t ever consider yourself to have “arrived” but carry on learning and specializing.
Median salary: $109,900
47. Director – nursing education
What to expect: If you loved being a nurse, and loved teaching, this might be a good fit for you. As the nurse responsible for planning and leadership in the functioning of a nursing school, you will be able to duplicate yourself over and over. Leading and motivating your faculty to be the highest quality nurses they can be, overseeing operations that have to do with government regulations, and maintaining enough contact with the students in the nursing school to hear their concerns are three basics for being a successful director. The gap between reality and ideals can quickly become clouded if nurses who are teaching are too disconnected from technological advances and challenges their students face. A couple of advanced degrees plus years of experience are vital for being a successful director.
Challenges you may face: Halls of learning can quickly become tombs of frustration as students may experience too many virtual classrooms and patients to be in touch with the painful or joyful human reality that is part of successful nursing. If you are to lead successfully humbly admitting that you aren’t up to date may be acceptable on rare occasions, but after that, staying one step ahead of your colleagues is crucial. Being a leader means being human, being sensitive, compassionate, and strong, but also knowing your limitations and providing for your own self-care.
Median salary: $110,200
48. Director of nursing
What to expect: The median salary posted at the end of this entry is generic. While the term “Director of Nursing” may be the same, the position will not be the same in either expectations or salary if you are located in a hospital, or a nursing home, or some other facility. You will be the primary link to other departments–such as physicians and providers, and heads of departments in other areas that relate to nursing in the institution where you are employed. When nursing, as practiced in your institution, is questioned, or praised, you will be the voice and interpreter of what you expect(ed) and what policies are in place. Advanced nursing degrees and years of experience must accompany your RN license as well. Your creativity in leading and directing the nursing staff, as well as having a “well-oiled” setup to provide the optimum care is part of what you will be about.
Challenges you may face: Many areas of the country are facing an ongoing shortage of nurses. For that reason, your institution may employ nurses from many parts of the world, including those who speak English as a second language. If you do not have an adequate voice in human resources, you may become frustrated and upset with the staff you have to deal with, especially if they are already in place when you are hired. The diversity in staff, not only educationally, but also in core beliefs and politics may make forming a team a challenge. Your creative team work will make the world smaller, or failure to do that, may blow your world apart.
Median salary: $131,200
49. Certified Nurse Anesthetist
What to expect: A certified nurse anesthetist is a highly specialized nurse, and takes home one of the higher salaries in the field, but also may experience a much higher demand for safety and care for persons unable to communicate their needs. An acute awareness of safety in both the preparation and administration of anesthesia forms the core of this role. Evaluating clients thoroughly pre-operatively for what unexpected and undesirable events may result from the client’s current anatomy and physiology, as well as post-operatively for what has or may occur is a vital part of this profession. An advanced degree as well as certification as a nurse anesthetist is required. Knowing and understanding current practice expectations and limitations, as well as knowing how to respond to the unexpected is vital.
Challenges you may face: Being secure in your own capability to deal with emergencies, as well as your assessment skills and prompt intervention is very important in this job. Trusting that someone will rescue you if things go wrong is not a valid expectation. Know yourself, and how you respond under pressure, in life and death situations, and your ability to handle failure. You, of course, will be a ready target for litigation, so knowing how to deal with that at a personal and professional level is vital. Self-care is important too.
Median salary: $164,000
50. Chief Nurse Anesthetist
What to expect: While a certified nurse anesthetist is directly involved in the preparation of pre-, actual, and post-operative care of clients, the chief nurse anesthetist will probably not be involved in the care of clients, but rather in the care of colleagues. Providing both educational and professional oversight, by way of planning and maintaining equipment and supplies as well as personnel, the head of the department will need to have broad understanding and preparation. An advanced degree as well as seven years or more of experience along with the required certification is the minimum requirement. Skills in team leadership are also vital, and must include ways to provide self-care for all those in the department.
Challenges you may face: Short-cuts are not an option in the operating room. Although not directly concerned with providing a sterile environment at all times, maintaining an unbroken chain of safety is absolutely required. This is true even more so because of the nature of anesthesia as a gas, or intravenous medication that acts quickly and may not be readily reversible. Providing safety for all concerned, which is everyone present in the department, demands that all persons respect and honor the leadership of the chief nurse anesthetist. Maintaining that respect is vital; losing it may be equivalent to the loss of the role completely. Providing for the emotional and psychological well-being of persons in this stressful environment will be a challenge, but it will make or break you.
Median salary: $186,000