Nursing is a challenging career — especially during a pandemic — but it can also be rewarding in many ways.
In 2020, nurses and other medical professionals were hailed as heroes during the COVID-19 pandemic. While many people were forced to stay home, many nurses kept going to work.
However, nurses are leaving the workforce in staggering numbers, and demand is rising as fast as people are leaving.
As a profession, nursing can provide you with a reliable and lucrative career with many opportunities for advancement. Find out why you might consider becoming a nurse, and what to expect when you get there.
The salary range for a nurse can vary significantly based on several factors, such as:
- degree or type of nurse (LPN, ADN-RN, BSN-RN, MSN)
- geographic location
- job status (full-time or as needed)
In the United States in 2020, the median pay for registered nurses was $75,330 per year or $36.22 per hour. This represents a range from about $53,410 per year to $116,230 per year.
When breaking this down by practice type, median wages were:
- Government: $84,490 per year
- Inpatient hospital: $76,840 per year
- Outpatient or ambulatory care: $72,340 per year
- Skilled nursing and residential facilities: $68,450 per year
- Educational organizations: $64,630 per year
Salaries can vary based on geographic region and whether you work in a rural or urban area, too.
These figures are based on full-time positions, but nurses who work PRN (standing for “pro re nata,” on an as-needed basis) or to fill particular needs may be paid a premium rate. These nurses don’t work regular hours but are helpful when hospitals need to fill in for employees who are out on leave or when there is a spike in demand.
A good example of this is nursing pay premiums in 2020 during the COVID-19 pandemic. As different parts of the United States — and the world — were hit with surges of the virus, nursing shortages caused some hospitals offered competitive rates to attract the staff they needed. In some cases, nurses could earn $8,000 per week to care for patients with COVID-19.
Sense of purpose
While the compensation in nursing is one perk, most nurses will tell you that it’s not a profession but an art. Nursing is not a career you can do well if you are doing it for the money alone.
You are at a person’s side in their most vulnerable state, and you offer support to families in crisis situations. Many nurses say they didn’t choose their career as much as it chose them, and that nursing is a calling.
Trust me, I’m a nurse
Being a nurse is described by many as a calling that offers a huge sense of purpose and fulfillment. As such, nurses have been ranked as the most trusted profession — even more than doctors or teachers — for nearly 2 decades.
Nursing is a flexible profession with many schedule options.
If you work in outpatient care, chances are your schedule will be more regular — generally 4 or 5 days per week for around 8 hours at a time.
Nurses who work in acute and long-term hospitals or residential facilities tend to work longer hours to help reduce the number of caregivers for each patient. This concept is called continuity of care. In addition to this, longer shifts can help decrease mistakes made during patient handoff from one nurse to another.
Many nurses also like having more flexibility in their scheduled days. Most nurses who work 12-hour shifts work 3 days each week, allowing a few days at work followed by several days off.
Downsides to 12-hour shifts include the fact that longer shifts can be draining and contribute to a decrease in alertness or focus. Nursing is a 24-hour job, so some of these shifts happen overnight. This can be difficult to balance with your personal care needs and home life.
If you need even more flexibility, nursing can offer that, too. Some facilities may offer more flexible shift length, some as short as 4-hour blocks. Or, you may be on call for a 24-hour period, working only a small fraction of that time or not at all if your services aren’t needed.
You can also choose between working full-time, part-time, or PRN, as there are needs for nurses in all shifts and at all hours.
Need for nurses and job stability
The world will always need nurses. Healthcare means helping people live longer lives with chronic health conditions, and a large population of people are reaching their most vulnerable health years.
Even before the COVID-19 pandemic, there were predictions of global nursing shortages, with the American Nursing Association setting a goal in 2017 of adding 1 million nurses to the workforce over 5 years. Along with this increase in demand, a third of the nursing workforce aged into retirement at the same time. And no one expected a pandemic to increase needs even further.
How are we doing?
Here is a look at how many registered nurses have worked in the United States since 2017:
- 2017: 3.8 million
- 2019: 3 million
- May 2020: 2.9 million
More than 26 million Americans applied for unemployment during the pandemic in 2020, with a third of employees working from home during forced lockdowns and beyond.
Demand for nurses, on the other hand, increased during the pandemic, although not in every specialty. Some specialties, like nurses in outpatient facilities or surgery centers, were given time off, as their workplaces closed or were repurposed to serve temporarily in higher demand areas of nursing.
Meanwhile, nurses working in long-term and residential care facilities, inpatient hospitals, and home care have remained in high demand during the pandemic.
If you are considering a career in nursing, you may want to research the demands and needs in your location or desired specialty. Overall, nursing is considered a very stable career, with a need for new nurses each year. In the United States alone, demand for nurses is expected to grow by about 7 percent every year.
If the area where you live doesn’t have enough need for your specialty or if you have a bit of wanderlust, there are many opportunities for travel work in nursing.
Contract assignments are common in healthcare. This is because inadequate staffing levels can result in patient harm and unsafe care. Hospitals have to make sure they have enough people to care for all their patients, even if regular employees leave suddenly or take a medical or maternity leave.
There are many agencies that help nurses find travel jobs that fit their experience and interests. Travel contracts usually last about 13 weeks on average and may center around the area you live — or the other side of the world.
In addition to traveling, the compensation can be a perk. Many agencies offer stipends for travel, room and board, and uniform expenses during a contract. The hourly rate averages about $51 per hour, which is much more than the median nontravel nursing position.
Finding your niche
Working a 12-hour shift in a hospital isn’t the only way to be a nurse. There are many opportunities for nurses, like:
- bedside nursing
- outpatient nursing
- telehealth nursing
- nursing education
- nursing administration
- legal nursing
- nurses consulting for the health insurance industry
- school nursing
- long-term care
- home-based nursing
In each of these categories, there are additional specialties you could pursue based on your interest, including:
- general medicine and family practice
- critical care
- obstetrics and gynecology
- geriatric care
- long-term care
Room for advancement
Most nurses enter the profession with associate’s and bachelor’s degrees. It generally takes 3 to 4 years to earn a nursing certificate. Nursing education is designed to support advancement.
You can earn a certificate as a nursing assistant, then go on to advance your career. Advancements include:
- licensed practical nurse (LPN)
- registered nurse with an associate’s degree
- registered nurse with a bachelor’s degree
- nursing with a master’s degree or certification in a specialty
- doctorates in nursing practice
- advanced practice nursing
- nurse practitioner
Many health systems offer reimbursement for continued education as well.
As much as nursing is a rewarding and beneficial profession, it can take a physical and emotional toll. There are anecdotes about nurses giving up lunch breaks, going without bathroom breaks, and losing sleep. But the physical and emotional cost of nursing can lead to more than an empty stomach or a full bladder.
A balancing act
Working 12-hour shifts, night shifts, weekends, and holidays can be difficult to balance with home life. During the COVID-19 pandemic, some healthcare workers went weeks without seeing family members out of fear of transmitting the virus.
Hours spent working in nursing positions that provide direct patient care can take a physical toll, too. There can be lifting, pushing, and pulling required on every shift. This is especially true when units are running short-staffed.
The increased demand for nurses can be both a blessing and a curse. The vast opportunities for jobs coupled with increased patient loads on nurses can create unsafe care environments and increase nurse burnout.
Reaching a breaking point
Unsafe staffing levels, nursing shortages, and burnout were problems even before the COVID-19 pandemic. Since the pandemic and with increasing nursing shortages, the problem has only gotten worse.
What if you stop caring?
Nurses can develop compassion fatigue as the result of chronic work-related stress. Compassion fatigue increased dramatically in nurses between 2010 and 2019, according to a new study, with nurses working in intensive care units demonstrating the highest levels.
In addition to decreasing job satisfaction and mental health in nurses, compassion fatigue has the potential to negatively impact the level of care patients receive as well.
Mental health and traumatic events
Nurses witness some of the most difficult moments in people’s lives. This applies to both patients and their family members. Dealing with emotionally and mentally difficult tasks is a daily occurrence in nursing, but it has also been taken a step further during the pandemic.
The nursing profession worldwide has entered a perfect storm of nursing shortages, decreased mental health, and pandemic stress, and it’s taking its toll. As many as
The full toll of the heavy workloads, emotional cost, and staffing shortages from the pandemic probably won’t be fully realized for some time.
Physical and verbal assaults are a common experience for nurses. A
The study also found that:
- 24.4 percent experienced physical violence in the past year
- 57.6 percent experienced verbal abuse
Some states have enacted laws to try and help nurses, but this problem is unlikely to go away completely, considering the situations patients can be in when nurses are caring for them.
So, why be a nurse?
We asked some nurses to tell us the good — and bad — about nursing. In the end, they focused on the good:
“I’m 7 years deep, and repeatedly ask myself this question. Am I burned out? Disinterested? Uncaring? Unfeeling? Dispassionate? Yeah, all of that at times. And just when I think maybe I should have [picked another profession], I’ll have an ‘oh so difficult patient’ who can hear what I’m saying when they can’t hear others. And they might smile. Or they might have day that isn’t so bad. And I think, thank goodness I was here. Why be a nurse? Because it reminds me that I can choose kindness.”
— Melissa Bruder, critical care nurse
“Be a nurse because you’ll make a difference in someone’s life. Even if they don’t remember your name, they will remember what you did for them. I know during COVID everyone got burnt out and started questioning their reason for being a nurse. But the truth is, without us, patients would suffer. We make sure they receive the best, even when we are not our best ourselves. We may forget why we do this, but if you’re lucky, every now and then you get a reminder of why you do what you do!”
— Christina Colantuono, surgical nurse
“I choose to be a geriatric nurse because [patients] have all at some point made an impact on someone’s life, no matter how big or small. I feel that they are a completely overlooked population. Some to be left behind and forgotten by their families, and some to have never had a family. They need us to make a difference in their final years.”
— Jeannine Payne Hooley, hospice case manager
“I became a nurse because I had an amazing experience as a sick child with a caring and loving nurse that made my hospital experience tolerable as a youngster at the holidays. I stay a nurse because through all the long, crazy hours, ups and downs of healthcare legislation, and new and old diseases, there runs a silver lining for patient care that keeps me going.
It’s not really quantitative or easily described. I feel it when there is joy in recovery, fear in a new diagnosis, delight at new life, and heartache as last goodbyes are said. It’s the privilege of being asked to participate in these life events of seemingly perfect strangers and knowing that my presence, my care, made a difference in their lives and an impact on their health and well-being. My life’s work has been meaningful for me and hopefully to all the lives that I have touched.”
— Bethany Farrell, nurse practitioner
“Because there are unimaginable situations that can occur in this world: an immeasurable amount of pain and sadness that a family might have to endure, a child who may be at the end of their life way before their time. Someone has to be there to give that child the respect and care and love that they deserve and provide that family a shoulder, an ear, a hug. Reassurance that it’s OK not to be OK. To provide compassion when anything less could make an already heartbreaking time even more unbearable.”
— Trista Chiodini, pediatric intensive care
“Because people will always need someone whose primary focus is their care. We have to stand up for ourselves and each other to make it a job worth coming back to every day, but it’s still true that the driving force behind every decision I make is ‘what’s best for the patient?’ and that makes it easier to speak up and force the [corporate world] to pay attention [and care] what’s happening on the real front lines.”
— Mel Hollis, emergency department nurse and educator
“What other profession is going to let you be a part — sometimes a crucial and vital part — of someone’s life when they need it the most? We have the chance, every single day, to touch someone’s life and help them in ways that sometimes they don’t know they need. Whether it be that shoulder to cry on, or that tough love to get better. I’ve done both and have been extremely privileged to be able to do what I love every day. Yes, there are days when I am burnt out and feel like I have nothing else to give, but then I remember families that need me just a little bit more and what a privilege it is to get to call myself a nurse. It is a title that I do not take for granted.”
— Kristin Weber, trauma outreach and injury prevention program coordinator
“Caring for someone during their most vulnerable time is so rewarding. They trust you — someone they have never met — to be their advocate and caretaker. I’d say one of the most difficult parts of being a nurse is caring for someone with a poor prognosis. However, having the ability to bring comfort or even just a smile to someone in a bad situation is truly special.”
— Amanda Fritz, emergency department nurse
“To care for others and try to make their difficult road easier. There are lifesaving skills we perform, but sometimes it’s the hand-holding that is what is really remembered and makes a difference to patients. Honestly, more often than not, my patients have impacted me more than I may have impacted them. That’s the good and bad about this job that you don’t expect — the impression our patients leave on us.”
— Andrea Grilli Ciulli, nurse practitioner
Nursing is a rewarding career with good opportunities for advancement, stability, and compensation. It’s not without drawbacks, though. Working as a nurse can be both physically and emotionally draining, and the increased demand for nurses has caused staffing problems that increase burnout.
If you are considering nursing as a career, explore the options and career pathways that interest you most and considering shadowing a nurse to see what it’s really like. If you decide nursing is for you, there are many ways to reach your goal, and you can usually find financial assistance for your training.