Registered Nurse Careers and Salary Outlook 2020

The U.S. Bureau of Labor Statistics (BLS) projects the registered nurse (RN) profession to grow by 12% from 2018-28. The current landscape calls for even more RNs, as the American Association of Colleges of Nursing (AACN) warns enrollment of prospective nurses in training programs may not meet this demand, citing a current shortage of RNs. Our guide provides answers to questions like "what is a registered nurse," "how do I become a registered nurse," "what does a registered nurse do," and "how much does a registered nurse make?"

What is a Registered Nurse?

RNs care for patients in many different medical settings. They may take patient medical histories, check vital signs, and perform diagnostic tests under the direction of medical doctors. Nurses also educate the public on healthy living, ensuring that patients and families understand treatment directions and concerns.

Each state sets registered nurse requirements, including education, exam, and licensing standards. Prospective nurses must complete a state-approved nursing program. Many nurses begin by earning associate degrees in nursing and continue their education with a bachelor's degree. In some cases, these professionals also obtain graduate and doctoral degrees for advanced nursing positions.

What Do Registered Nurses Do?

RNs provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their families. RNs must possess specialized knowledge to assess, plan, and intervene to better promote health and prevent disease. Nurses often observe, assess, and record vital health information while providing direct patient care. This work provides other healthcare professionals with a basis for care planning and intervention.

RNs also carry out elements of the care plan, such as drawing blood or other biological samples for lab testing, preparing patients for medical procedures, or changing wound dressings. These nurses also need excellent communication skills to efficiently and effectively relay information to their supervisors, physicians, or patients. Technical skills also benefit RNs, as they use electronic medical records and computerized medication dispensers.

Duties can vary by nursing specialization, particularly for advanced practice nurses. With proper training, certification, and licensure, some nurses administer anesthesia, prescribe medications, and diagnose and treat medical conditions. They may also carry out administrative duties, like scheduling or quality assurance.

Where Do Registered Nurses Work?

RNs work in healthcare organizations like hospitals, outpatient clinics, residential care facilities, physician offices, and patient homes. They work with doctors, nursing assistants, allied healthcare providers, and administrators. Most nurses work full-time schedules. RNs working in facilities providing 24-hour care may work overnight hours, along with weekends and holidays.

Hospitals employ the greatest number of RNs. The BLS reports that 1.6 million RNs work in hospitals across the country, with a mean annual salary of $77,730. Their medical expertise makes them valuable employees in related industries, as well. Some nurses find employment in pharmaceutical manufacturing, the top-paying industry for nurses with an average wage of $95,400.

Skills That Could Affect Registered Nurse Salaries

RNs benefit from excellent listening and communication skills. They may sometimes need to question patients to learn more about their symptoms and assess their care needs. Nurses use their extensive medical knowledge and clinical training to analyze patient needs and excellent reading comprehension to follow physician orders correctly. RNs often build strong interpersonal relationships with other members of the care team, and they may deliver instructions or directions. Excellent writing, speaking, and teaching skills help carry out these duties.

Each nurse cares for multiple patients over a single work shift. They need strong time management abilities to ensure that they provide people with high-quality care and complete their notes and charts before turning a patient's care over to another provider. RNs must demonstrate dependability, cooperation, and compassion to treat the patients in their care.


How to Become a Registered Nurse

RNs enjoy strong employment opportunities and continued career advancement with ongoing education and training. However, many nurses choose their careers for the fulfilling nature of the work. A 2011 study found that many students choose to become RNs primarily to care for others. Many also cited job flexibility and the variety of available specializations.

States set rigorous standards for nurses to ensure patients receive care from knowledgeable RNs who adhere to a set of professional rules and meet high moral standards. Every state requires each nurse to complete an approved nursing program with classroom and hands-on learning, followed by a comprehensive exam. The sections below provide more information on the education, training, and licensing processes.

Education

A two-year degree with a focus on clinical education meets the minimum education standards for most states. These programs often include 60 credits in general education and nursing, with courses in anatomy and physiology, medical terminology, and application of pharmacology. These programs allow prospective nurses to begin work quickly.

Some students choose to earn a bachelor's degree in nursing. This four-year degree also includes extensive clinical education but incorporates leadership and administrative skills throughout the curriculum. Some states, such as New York, have moved toward requiring all nurses to earn a bachelor's degree within 10 years of becoming RNs. Many schools offer accelerated online programs that allow RNs to earn a bachelor's or master's degree while continuing to work.

No matter which educational path you choose, always ensure that your school holds accreditation from the AACN, along with approval from the state. These designations ensure that your degree meets licensing standards and allow you to continue your education later.

Training and Certification

Once you earn your registered nurse degree, you must apply to your state board of nursing to become an RN. The application typically includes verification of your education using transcripts. Many states conduct background checks and require applicants to disclose any criminal history, particularly regarding substance abuse or abuse of a child, partner, or adult. Most states charge an application fee to process your paperwork.

The national council licensure exam for RNs (NCLEX-RN) is a comprehensive exam of RN knowledge and clinical skills. It features multiple choice and short answer questions using an adaptive online test. The RN exam includes at least 75 questions but may ask test-takers as many as 265 questions. You have up to six hours to complete the exam. Pearson VUE charges $200 to register for the NCLEX-RN.

Once you pass the NCLEX-RN exam, you may begin working as a nurse. Your license requires continuing education credits, and many nursing organizations offer these learning opportunities. A nurse can choose to earn a certification in a specialty area, such as critical care or emergency nursing. Professional credentials require continued study and exams, but they are voluntary. They can enhance your resume and employment options.


Registered Nurse Salaries and Job Growth

The median registered nurse salary came out to $71,730 in 2018, with a projected 12% job growth through 2028, according to the BLS. RN salaries vary by education, experience, location, and skills. New York City reports the highest wages for RNs ($79,463), according to PayScale. According to the BLS, California holds all 10 of the top-paying metropolitan areas, but RNs can find lucrative positions across the country, with Hawaii, Massachusetts, and Oregon among the top-paying states for RNs.

Nursing salaries grow with experience, as well. PayScale reports an almost $20,000 gain in salary from entry-level jobs to late-career nurses. Some of the skills employers seek include telemetry, critical care, intensive care unit, and labor and delivery. Acute care and emergency room skills may also boost registered nurse salaries.

Highest Salary Locations for Registered Nurses
National Median $63,393
Los Angeles, California $75,296
New York, New York $79,463
Houston, Texas $69,235
Dallas, Texas $63,893
Chicago, Illinois $66,685

Source: PayScale


Median Salary for Registered Nurses by Career Experience

  • Entry Level: $53,580 yearly
  • Early Career: $57,100 yearly
  • Mid Career: $63,130‬ yearly
  • Experienced: $68,680 yearly
  • Late Career: $72,470 yearly

Source: PayScale


Related Job Salaries
Certified Nurse Assistant Licensed Practical Nurse Office Manager Medical Assistant Operations Manager
$27,891 yearly $43,528 yearly $47,349 yearly $32,840 yearly $64,341 yearly

Source: PayScale


Registered Nurse Resources

  • Association Society of Registered Nurses This national organization provides awards, grants, fellowships, and scholarships to RNs. It offers access to leading journals related to the nursing profession and scholarly research, including the Journal of Nursing and Journal of Advanced Practice Nursing. Members can take advantage of the career center's virtual job fairs, instant interviews, and career board.
  • TravelNursing.org This site helps match RNs willing to take short-term assignments around the country. Hospitals facing staff shortages or seasonal staffing needs rely on travel nursing companies to supply highly trained nurses to provide excellent patient care. The site welcomes nurses from all specializations for assignments ranging from a few weeks to six months or more.
  • Doctors Without Borders This global nonprofit organization provides medical aid in more than 70 countries around the world. Founded in 1971, the organization responds to humanitarian crises caused by disease, famine, and war. They offer some volunteer and internship opportunities at their New York headquarters and through field projects. The organization also offers medical and non-medical staff positions, with a need for qualified medical staff.
  • Nurse.com Job Search This online career board offers more than 200,000 job listings in many different nursing specialties. RNs can search for new jobs by specialty, location, salary, contract type, or hours. RNs can register on the site for free and gain access to career planning tools, such as email alerts and job tracking.
  • Association for Nursing Professional Development This organization promotes the professional development of RNs through education and certification. It offers a professional development center with recordings of convention sessions and webinars. It also provides a bookstore, live webinars, and an annual convention. The organization's certification prep course prepares RNs for the American Nurses Credentialing generalist exam.