By Jennifer Larson, contributor
February 7, 2014 - As the economy continues to gain strength and demand for health care increases, the job outlook for registered nurses and advanced practice nurses looks good for the foreseeable future. “There is some security in pursuing nursing because there are jobs,” said Judy Honig, EdD, DNP, CPNP, associate dean of student affairs and a professor of nursing at the Columbia University School of Nursing.
Judy Honig, EdD, DNP, CPNP, associate dean at Columbia University School of Nursing, says that RNs need to consider their overall career path when deciding about nursing jobs.
Taking your next career step based on the paycheck potential is one way to select a nursing job. But like many major life decisions, it’s not that simple.
The current RN job market is tighter in some areas of the country than in others, and the cost of living can obviously affect how far a nurse’s paycheck can stretch. Some nursing specialties also pay better than others. And advanced practice nursing jobs typically pay the highest salaries, but not everyone has the qualifications or the desire to pursue that route.
The bottom line: you need to consider what kind of nursing work you want to do, where you want to live, and whether you want to pursue a career path that may require additional education or work but can ultimately lead to higher pay.
The current and future RN job market
Overall, experts expect that the demand for nurses will continue to grow over the next decade. The U.S. Bureau of Labor Statistics (BLS) forecasts a 19 percent job growth for RNs through 2022--that’s an additional 526,800 jobs.
There are pockets of the country where jobs are slightly harder to come by, and some new graduate nurses have reported challenges in getting hospital jobs in certain areas. While there are still nursing jobs out there, experts acknowledge that new nurses may not be able to land their ideal job as quickly or easily as in the past.
A growing number of hospitals are following the Institute of Medicine’s (IOM) call for more nurses to get a bachelor’s degree in nursing by instituting hiring policies that prioritize nurses with BSNs.
“Right now, we’re getting some mixed signals,” said Peter McMenamin, PhD, senior policy fellow for the American Nurses Association (ANA).
And no one is entirely sure when the baby boomers will begin retiring, opening up more nursing jobs.
Many of these nurses put off retirement when the recession began in 2008. The National Academy of Social Insurance notes that baby boomers have a longer life expectancy than previous generations: women in that generation who reach 65 can expect to live 20 more years on average, while men who reach 65 can expect to live an average of 18 more years. Partly because of this, some older nurses may choose to work longer or may need to work longer.
“I think that’s a total wild card,” said Joanne Spetz, PhD, professor at the Institute for Health Policy Studies at the University of California-San Francisco.
Even with those caveats, the nursing profession is expected to add jobs over the next decade--but the jobs may look different or exist in different settings. For example, as increasingly more care is delivered in outpatient settings, those areas are expected to open up new opportunities for nurses.
Top of the nurse pay scale
Typically, nurses in certain advanced practice specialties are the top earners, and that trend is expected to continue.
According to the BLS, the annual median pay in 2012 for nurse anesthetists, nurse midwives and nurse practitioners was $96,460, or $46.37 per hour. As of May 2012, the annual median wage for CRNAs was $148,160, with nurse practitioners earing $89,960 and nurse midwives earning $89,600. By contrast, the BLS reports that the annual median pay in 2012 for registered nurses was $65,470, or $31.48 per hour.
Not only is the pay higher for advanced practice nursing jobs, but the BLS is forecasting a good job outlook through 2022: a 31 percent increase in jobs, which they note is “much faster than average.”
However, a nurse must earn at least a master’s degree to qualify for a job in one of these roles. The best way to begin that journey is to get a bachelor’s degree in nursing, if you don’t already have one.
Spetz pointed out that it is a good idea to pursue a baccalaureate degree in nursing no matter what, because it will give you additional knowledge in policy, community health and other important arenas and give you skills that will prepare you if you want to pursue a leadership role.
“It opens up many opportunities,” she said.
Especially in the wake of the Affordable Care Act, nurse practitioners will be in demand to provide primary care to the people who are gaining insurance coverage, McMenamin said.
“On top of that, I think care coordination is becoming more and more important,” he added. “And who can do that? Nurse practitioners, in particular, are good at that.”
If you truly want to open up doors, consider pursuing even more advanced education, Honig said. It’s not that advanced practice nurses with a doctoral degree earn significantly more than one with a master’s degree, but that extra education has another benefit.
“You have many, many more options, and the sky really is the limit,” she said. “It takes away the ceiling that exists when you only have a master’s degree.”
Decide what matters most and explore your options
Advanced practice nursing is not necessarily for everyone--despite the higher pay rate and expanded career potential. Each nurse has to assess his or her own situation, considering both short-term and long-term plans, as well as other lifestyle priorities.
“[Nurses] need to have a conversation with themselves,” Honig said. “It depends very much on the direction that they’re headed.”
Advanced practice nursing can be a great career path if you are really excited about it, Spetz said.
“Think about your region and what’s happening in your region,” Spetz suggested, adding that some areas of the country will probably have more openings based on current population trends, such as the aging of the baby boomers. “I imagine Florida is going to need a lot more geriatric nurse practitioners than, say, Wisconsin.”
Pursuing specialty certification may boost your nurse pay rate, as well, even if it’s not feasible to return to school for another degree. “If you want to switch jobs or find a new job, it can help,” said McMenamin.
Other strategies to consider: look beyond your immediate surrounding area and use your network to find out what positions may be available elsewhere. Nurses tend to go to school close to home and then look for work in the same area, McMenamin said.
“Sometimes you need to expand your prospects.”
Another option for nurses who want to increase their current pay and gain experience is to take a job as a travel nurse, where the hourly pay rates are often higher than for staff nurses and housing costs are covered during the contract period. Travel assignments, which generally range from 4 to 13 weeks, also allow a nurse to try out new locations before making a permanent move.
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