Registered Nurse Career Guide

Demand for healthcare workers is growing. According to the U.S. Bureau of Labor Statistics (BLS), employment of healthcare occupations will grow 14% from 2018 to 2028, much faster than the average for all occupations.

The aging baby boomer population (born between 1946 and 1964) is steering increased demand for medical services. The U.S. Census Bureau estimates there were 73 million baby boomers in the nation in 2019, and by 2030, all boomers will be at least age 65. We’ll also see a growing number of existing jobs vacated by retiring baby boomers.

Registered nurses (RNs) are among those healthcare workers needed to take care of the aging population. They are in high demand. The BLS projects that employment of registered nurses will grow 12% from 2018 to 2028, also much faster than the average for all occupations.

What is a Registered Nurse?

A registered nurse is a healthcare provider who has graduated from a nursing program and holds a nursing license. There are many types of registered nurses, mainly defined by their areas of specialization.

However, nurses can enroll in nurse education courses and receive certificates to show prospective employers that they’re trained in an area of specialization.

Types of Registered Nurses

Addiction Nurse

Also known as substance abuse nurses, RNs specializing in addiction may have chosen this career because they or someone they love has suffered from addiction to drugs, alcohol or other substances. Addiction nurses work in recovery centers, hospitals and outpatient care facilities. Certifications for addictions nurses are administered by the International Nurses Society on Addictions (IntNSA).

Cardiovascular Nurse

Nurses who specialize in cardiovascular care work in hospitals, coronary care units (CCUs) and physician practices that care for patients with heart disease. Certifications for cardiovascular nurses are administered by the American Association of Critical-Care Nurses (AACN).

Critical Care Nurse / ICU Nurse

Critical care nurses work in intensive care units (ICUs) and CCUs. Sometimes ICU nurses are referred to as critical care nurses and vice versa. They specialize in caring for patients who are hospitalized for serious conditions and require round the clock observation. Certifications for ICU and CCU nurses are also administered by the AACN.

Gastroenterology Nurse

Nurses who work in gastroenterology help patients who have gastrointestinal diseases involving the stomach and digestive system. They might assist doctors during colonoscopies and endoscopies. Certifications for gastroenterology nurses are administered by the American Board of Certification for Gastroenterology Nurses (ABCGN).

Medical-Surgical Nurse

Medical-surgical nurses typically work in hospital settings and handle heavy patient loads — typically five to seven per day. The Medical-Surgical Nurse Certification Board (MSNCB) and the American Nurses Credentialing Center (ANCC) administers certifications to these nurses.

Neonatal Nurse

A neonatal nurse specializes in the care of infants who were born prematurely or with life-threatening and chronic illnesses. They may work in a neonatal intensive care unit (NICU; pronounced “nick-you”), CCU, ICU, trauma unit or other healthcare setting. The AACN administers a certification for these nurses.

Occupational Health Nurse

An occupational health nurse typically works in a clinical setting but may also work for a large corporation as a full-time nurse. For example, a large manufacturing company might employ an occupational health nurse to help prevent injuries, treat workplace health issues, and administer workers’ compensation and family medical leave. The American Board for Occupational Health Nurses (ABOHN) offers a certification program.

Public Health Nurse

Nurses who work in public health may work for government agencies, nonprofits and other organizations that promote public health through education and screening. Public health nurses focus on providing treatment to a community at large, rather than to individuals in private practices. RNs with five years of public health experience and a bachelor’s degree can apply for the Certification in Public Health that’s administered by the National Board of Public Health Examiners.

How to Become a Registered Nurse

  1. Complete an accredited nursing education program. You will need either a nursing diploma from an accredited RN program, an associate’s degree in nursing, or a bachelor of science in nursing.
  2. Prepared to sit for the nurse licensing exam.
  3. Take and pass the National Council Licensure Examination for registered nurses (NCLEX-RN).
  4. Obtain licensure in the state where you wish to practice. Requirements vary by state. Learn more about state-by-state requirements for RN licensing.

What do RNs do?

The duties of an RN vary, depending on where they work, how long they’ve been a nurse and the area of specialization in which they work. Typically, RNs have clinical and administrative responsibilities.

Clinical Responsibilities of RNs

  • Assessing patients’ conditions and vital signs
  • Giving medications and treatments prescribed by doctors and other healthcare providers
  • Contributing to and setting up patients’ care plans
  • Consulting and collaborating with other healthcare providers
  • Operating and monitoring medical equipment
  • Performing and analyzing diagnostic tests
  • Educating patients and their families

Administrative Responsibilities of RNs

  • Recording medical histories and symptoms
  • Directing and supervising other healthcare professionals, such as LPNs, CNAs and medical assistants

Where do RNs work?

RNs work in doctors’ offices, long-term care facilities, nursing homes, hospitals, clinics, government and education. According to the BLS report on registered nurses, most RNs work in hospitals. Here’s a breakdown of the largest work environments occupied by registered nurses, as of 2018:

  • Hospitals — 60%
  • Doctors’ offices, home health and outpatient care — 18%
  • Nursing care facilities — 7%
  • Government — 5%
  • Education — 3%

Registered Nurse Salary

How much do RNs make? Salaries depend on geography, education, employer type, experience and other factors. On average, RNs in the United States earned $71,730 in May 2018, according to the BLS. RNs who work in government earn the highest average incomes — $78,390 — followed by RNs who work in hospitals ($73,650), ambulatory care services ($68,320), nursing care facilities ($63,990) and education ($61,850).

Here are the top-paying states for RNs, according to the BLS occupational employment and wages for registered nurses, by annual mean wage:

  1. California – $106,950
  2. Hawaii – $98,080
  3. D.C. – $92,350
  4. Massachusetts – $92,140
  5. Oregon – $91,080