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Nursing Career Outlook

Registered nurses (RNs) work to promote health, prevent disease, and help patients cope with illness. While state laws govern the tasks that RNs may perform, it is usually the work setting that determines their daily job duties.

Advanced practice nurses – an umbrella term that refers to registered nurses prepared at the master’s level or higher – can deliver as much as 80% of the primary and preventative health care services traditionally provided by primary care physicians, including prescriptive privileges in 48 states. Possessing an in-depth knowledge of one or more specialty areas, advanced practice nurses care for patients in a variety of settings that include acute care, critical care, intermediate care, long-term care, ambulatory care, and home care.

The U.S. is facing a widespread nursing shortage. The shortage is fueled by an aging population which requires more medical care over extended periods of time; by technological advances in medicine and treatment, which permit a greater number of medical problems to be treated; and by an increasing emphasis on preventive care.

Nursing vacancies are increasing rapidly as baby boomers begin to retire. Registered nurses constitute the largest health care occupation, with 2.4 million nurses employed in 2004, the latest year for which data are available, according to the U.S. Department of Labor, Bureau of Labor Statistics. The agency reports that more than six percent of nursing jobs nationwide are vacant, and it forecasts more demand for registered nurses than any other job through 2014.

Hospitals, health clinics, and other health facilities are grappling with how to address the shortage. The job outlook for nurses is exceptionally promising: employment of registered nurses is expected to grow faster than average for all occupations through 2014, and because the occupation is very large, many new jobs will result. In fact, registered nurses will create the second largest number of new jobs among all other occupations, according to the Bureau of Labor Statistics.

In particular, rapid growth in demand for nurses is expected in hospital outpatient facilities – such as those providing same-day surgery, rehabilitation, and chemotherapy – as a growing number of procedures are done on an outpatient basis and hospitals face financial pressures to discharge patients quickly. Demand for home care is also expected to rise as the population ages and medical advances enable more patients to be cared for in the home.

The gap is beginning to close on the shortage: enrollment in nursing schools has increased by more than 10 percent per year since 2002.

Read about career changers at the MGH Institute.

Working Conditions

Nurses work in hospitals, physicians' offices, home care settings, nursing homes for the elderly, occupational settings, and public health settings (schools, government and private agencies, clinics, and retirement communities).

Many nurses say they chose nursing in part because of the scheduling flexibility that enables them both to pursue a career and have a family. In settings that require round-the-clock care, nurses are needed to work days, evenings and nights. The profession can be physically and emotionally demanding, depending on the environment.

Earnings

According to the Bureau of Labor Statistics, median annual earnings of registered nurses were $52,330 in 2004. The middle 50 percent earned between $43,370 and $63,360. The lowest 10 percent earned less than $37,300, and the highest 10 percent earned more than $74,760. The median annual earnings of nurse practitioners were higher: $74,800 in 2005, according to Advance for Nurse Practitioners' most recent survey in 2005. Nurse practitioners owning their own practice, and those working in emergency departments earned an annual salary of more than $90,000 and $84,000 respectively. Many employers offer flexible work schedules, childcare, educational benefits, and bonuses.

Training

Nursing students must graduate from an approved nursing program and pass a national licensing examination to obtain a nursing license. Nurses may be licensed in more than one state, either by examination, endorsement of a license issued by another state, or through a multi-state licensing agreement. All states require periodic renewal of licenses, which may involve continuing education.

The major educational paths to registered nursing include an associate degree in Nursing (ADN), a bachelor’s of science in nursing (BSN), or a master of science in nursing (MSN), which can include advanced certification as a nurse practitioner. In addition, post-professional programs exist for RNs with a bachelor's degree in another field.

Further information

US Department of Labor Bureau of Labor Statistics Occupational Outlook Handbook 2004-2005

Discover Nursing

American Association of Colleges of Nursing

Massachusetts Center for Nursing
National Health Service Corps

National Health Service Corps

For more than three decades, the National Health Service Corps (NHSC) has been recruiting caring health professionals to serve in rural areas where the closest clinic could be miles away, and in inner-city neighborhoods, where economic and cultural barriers prevent people from seeking and receiving the health care they deserve.

NHSC delivers a workforce of caring and culturally competent clinicians dedicated to serving the underserved. Through a combination of programs, including an educational loan repayment program, scholarship program and summer clinical opportunities in select areas, NHSC deploys a cadre of primary care clinicians who are motivated by an extraordinary desire to serve, along with a commitment to improve the health of underserved communities.

For more information about National Health Service Corps opportunities, email Clinical Assistant Professor Patricia Reidy.