The nursing field is on a growth trajectory, with positions projected to grow by 9% between 2020 to 2030, according to the U.S. Bureau of Labor Statistics (BLS). A key reason for this trend is the growing number of nurses exiting the labor force, including those planning to retire. Additionally, people are living longer than previous generations thanks to continued innovation in the areas of life-saving medicines and therapies, which increases demand for nursing professionals to help older patients manage chronic illnesses.
Individuals looking to unlock their potential for career advancement can take advantage of fast-growing employment opportunities and a variety of nursing career paths. In pursuing a nursing career, it’s important to understand the difference between clinical and nonclinical options, from general nursing practice and specialized roles such as adult-gerontology, to nursing education and nursing informatics analysis.
A deeper look into these options can help aspiring nurses choose a path that meets their needs and goals. It’s important to note that regardless of the path chosen, it is typical for employers to require at least a Bachelor of Science in Nursing (BSN) degree for many of these positions, with some preferring candidates with a Master of Science in Nursing (MSN) degree.
Nursing Career Paths to Consider
Among the many different educational paths for nurses, the most common are to earn an associate degree in nursing (ADN), a BSN, or an MSN.
Associate Degree in Nursing
The ADN is a two-year credential that can prepare individuals with core nursing and clinical knowledge useful in entry-level nursing roles. While the ADN does allow graduates to become RNs, many nurses choose to complete an ADN as a stepping-stone to a BSN, which offers the opportunity to earn higher salaries and acquire valuable clinical experience while undertaking BSN coursework.
Bachelor of Science in Nursing
Another path is to enroll in a full- or part-time BSN program without an ADN. A BSN program enables individuals to take general education and prerequisite nursing courses, including electives, and complete clinical rotations in a hospital. The comprehensive curriculum and clinical hour requirements of a BSN program from an accredited college or university prepare individuals to provide safe, effective patient care. They can also participate in more complex procedures under a physician’s supervision. These qualifications typically translate into higher incomes.
To become an RN, ADN and BSN graduates must also pass the National Council Licensure Examination (NCLEX-RN exam), a computerized test that proves a nurse’s competency. Questions in the form of multiple choice, fill-in-the-blank, multiple, and ordered response items test an individual’s cognitive abilities. The test also enables the state nursing regulatory body (NRB) to verify a nurse’s ability and knowledge of safe and effective nursing practice. Before signing up for the NCLEX-RN exam, individuals looking to take the test must first apply with their state’s NRB.
Master of Science in Nursing
The MSN degree offers a path for nurses looking for more responsibility and independence. A master’s education in nursing can lead to more advanced nurse practitioner (NP) and leadership roles, including Family Nurse Practitioner (FNP), Psychiatric Mental Health Nurse Practitioner (PMHNP), and Adult-Gerontology Acute Care Nurse Practitioner (AGACNP). Beyond holding an MSN, NPs must also be licensed by an accrediting agency such as The American Nurses Credentialing Center.
Alternative Nursing Paths
While traditional nursing roles have clinical responsibilities, there are alternative career paths for individuals interested in working beyond health care settings. For example, some MSN careers and DNP careers enable individuals to take on leadership roles, from nurse educator or director of nursing to positions in the executive suite. Despite pursuing nonclinical roles, graduates of advanced nursing programs can still play a pivotal role in advancing patient health and wellness.
BSN Nursing Career Paths
Individuals enrolled in BSN programs typically take coursework in anatomy, microbiology, nursing fundamentals, pharmacology, and ethics. The knowledge and skills obtained from these courses prepares them for various clinical nursing roles. Although some positions may require additional certifications, options within a BSN nursing career path include acute, critical, and pediatric care.
1. Acute Care Nurse
Acute care nurses provide care most commonly in hospital settings for critically ill patients and those with acute conditions such as heart attacks or stroke. Responsibilities vary depending on the type of acute condition, but generally, activities include performing diagnostic, therapeutic, or emergency procedures; managing patient pain relief through pharmacologic and non-pharmacologic interventions; and keeping track of patient records, including diagnostic test results, medications, and changes in the treatment plan as prescribed by a physician. As of August 2022, the annual median salary for acute care nurses was approximately $83,000, according to the compensation website Payscale.
2. Critical Care Nurse
Critical care nurses work in a variety of settings that require urgent care delivery, including hospital emergency rooms and intensive care units. Critical care nurses may also work in specialty departments such as trauma units, burn centers, and cardiac care. Responsibilities vary depending on the work setting, but typical activities include assessing patients’ condition, maintaining treatment regimens, tracking vital signs, inserting IVs, dressing wounds, and administering medications and therapies. Payscale reports the median annual salary of critical care nurses as of June 2022 was around $75,000.
3. Pediatric Nurse
Pediatric nurse care focuses on neonates, young children, and adolescents. Common responsibilities include recording symptoms and medical histories, administering medications, and monitoring vital signs. Pediatric nurses help young patients feel safe, and provide support to parents and caretakers.
Different types of pediatric nurses may have distinct specialties. For example, pediatric oncology nurses care for young cancer patients, while neonatal pediatric nurses provide specialized care to newborns. Pediatric nurses earned a median annual salary of approximately $61,000 as of July 2022, according to Payscale. But salary can vary based on the role. For example, Payscale reports pediatric intensive care unit nurses earned a median annual salary of about $81,000 as of July 2022.
Resources: BSN Nursing Career Paths
The following organizations provide nursing professionals with various resources to learn more about nursing careers and help advance nursing best practices.
- American Association of Critical-Care Nurses: The world’s largest specialty nursing organization focused on supporting acute and critical care nurse communities
- Emergency Nurses Association: Focused on advancing excellence in the global emergency nursing community
- Society of Pediatric Nurses: Provides educational resources, news in pediatric trends, and opportunities to support pediatric nurses in their practice
- American College of Nurse-Midwives: Professional association representing certified nurse-midwives (CNMs) and certified midwives (CMs) in the U.S.
MSN Nursing Career Paths
The MSN nursing career path can open the doors to higher earnings, with Payscale reporting MSN nurses made a median annual salary of $98,000 as of July 2022. The MSN nursing career path also offers opportunities for increased independence in clinical practice. For example, in some states different types of nurse practitioners can prescribe medications just as a physician.
Requirements for an MSN program include earning a BSN from an accredited university. Many schools also require a minimum undergraduate degree GPA. It is also common for MSN programs to require applicants to already have a U.S. state RN license.
When choosing an MSN program, it’s important to keep career choices in mind, as some may offer different specializations. Further, program length may vary depending on whether a student is going to school full-time or part time. Nurses who pursue an MSN can reap the rewards of more independent nursing career options and the possibility of higher pay.
4. Nurse Midwife
Nurse midwives care for women before, during, and after childbirth. They participate in patients’ initial examination and monitor them throughout the course of their pregnancies. Under the supervision of an obstetrician/gynecologist, a nurse midwife provides medical care and treatment to patients during pregnancy and delivery. The role of the nurse midwife also includes educating patients on the proper care of infants. According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary for nurse midwives was $112,830 as of May 2021.
5. Family Nurse Practitioner (FNP)
Family nurse practitioners are NPs who coordinate various aspects of health care for patients across their lifespans, from providing preventative care to treating patients with viral symptoms, injuries, and chronic illnesses such as diabetes and hypertension. Typical FNP activities include diagnosing, planning care, evaluating patients, performing physical exams, ordering diagnostic tests, and prescribing medications in some states. FNPs can work in hospitals, community health centers, and health care systems. They can also work in private practice. For those considering a career as an FNP, the American Association of Nurse Practitioners (AANP) reports a median annual salary of $115,000 for the role.
6. Psychiatric Mental Health Nurse Practitioner (PMHNP)
Psychiatric Mental Health Nurse Practitioners (PMHNP) are APRNs who diagnose and treat patients with mental health issues. PMHMPs manage a wide range of illnesses and disorders, including anxiety, depression, bipolar disorder, PTSD, and substance abuse. In addition to diagnosing and treating patients, PMHNPs plan care, evaluate patients, provide psychotherapy, and in some states prescribe medications.
The patient populations served by PMHNPs include children, adolescents, adults, and geriatric patients. Like other APRN roles, PMHNPs can work in various health care settings, including private practice. The median annual salary for psychiatric nurse practitioners was approximately $114,000, according to July 2022 Payscale data.
7. Adult-Gerontology Acute Care Nurse Practitioner (AGACNP)
The clinical focus of Adult-Gerontology Acute Care Nurse Practitioners (AGACNP) is acute care management. A key focus of AGACNP practice is on preventing complications of patients’ existing complex conditions while improving the health of the patient through disease prevention and education. AGACNPs often work in hospital intensive care units, trauma departments, or critical units. Patient populations primarily served by AGACNPs include young adults, older adults, and elderly patients. Payscale reports the median annual salary for AGACNPs was approximately $96,000 as of July 2022.
Resources: MSN Nursing Career Paths
Advanced practice nursing professionals can use the following resources to learn more about MSN nursing career paths and advancing nursing best practices.
- Gerontological Advanced Practice Nurses Association: Advances evidence-based care, supporting opportunities for leadership, research, advocacy, and networking
- American Psychiatric Nurses Association: Provides tools, continuing education, and evidence-based resources to the psychiatric-mental health nursing community
MSN degree holders can qualify for nursing careers with high earnings, according to July 2022 Payscale data. Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) approximate median annual salary: $90,000. Family Nurse Practitioner (FNP) approximate median annual salary: $99,000. Psychiatric Mental Health Nurse Practitioner (PMHNP) approximate median annual salary: $114,000.
Alternative Nursing Careers
The clinical aspects of nursing, including working with patients and physicians, offer rewarding experiences for nurses. But due to various factors, many choose to take on less traditional nursing careers. For example, about a third of nurses indicated they're likely to leave the nursing profession by the end of 2022. Of those, 44% cited burnout as a reason for their decision, according to a survey by Incredible Health.
The ability to work more traditional hours, which some find less stressful or better suited to their lifestyle, is another reason why some nurses look to alternative nursing career roles. These roles can also offer opportunities to work in different workplaces, including business settings and from home.
According to Health eCareers, Hospital Careers, and SkillGigs, MSN degree holders can pursue various nonclinical and online careers, including Nurse Educator, Nurse Administrator, Public Health Nurse, Nurse Manager, Nursing Informatics Analyst, Telehealth Nurse, and Research Nurse.
Nonclinical Nursing Careers
Nonclinical nursing careers can provide more predictability in terms of schedule and the ability to influence decisions and policies. With a focus on leadership, the MSN can help individuals pursue these types of roles.
8. Nurse Educator
Nurse educators play a critical role in teaching nurses who are working in hospitals and other health care facilities. Nurse educators help nurses perform at their best by identifying the educational and training needs of nursing staff, and by developing programs to help promote skill development and nursing best practices. The median annual salary of nurse educators was approximately $79,000 as of July 2022, according to Payscale.
9. Nurse Administrator
Nurse administrators focus on providing hospitals and clinics what they need to ensure good health outcomes and excellent patient experiences. They possess clinical skills, but focus on administrative and team management activities such as recordkeeping, maintaining nurse schedules, managing budgets, and providing mentorship. Payscale reports the median annual salary of nurse administrators was around $89,000 as of July 2022.
10. Health Services Manager
Health services managers may work behind the scenes, but their contributions are felt throughout all areas of a health care facility. Through their ability to plan, direct, and coordinate health services across an entire facility, a unit, or a medical practice, they help ensure that the delivery of health care services is efficient and high quality. The BLS reports a median annual salary of $101,340 as of 2021 for health services managers.
11. Public Health Nurse
Public health is critical to a well-functioning society. Public health nursing focuses on preventing illness and injury and promoting healthy populations. This can take the form of administering disease vaccinations, setting health standards, promoting wellness, encouraging healthy behaviors, and educating communities about health risks. The median annual salary for public health nurses was approximately $64,000 as of July 2022, according to Payscale.
12. Nurse Manager
The primary responsibilities of nurse managers are to hire, train, and supervise nurses. They also manage nurse department budgets, oversee nursing schedules, and advocate for resources to ensure nursing staff have the tools and equipment they need. Nurse managers also typically monitor state and federal guideline changes, promote best practices to ensure hygienic facilities, and regularly collaborate with physicians and staff. According to Payscale, the median annual salary for nursing managers was around $90,000 as of July 2022.
13. Nursing Informatics
Nursing informatics is a nursing specialty that integrates the science of nursing practice with information technology. Nurses in this role help ensure continuum of care by helping nurses and doctors make decisions based on medical and clinical data. Payscale reports the median annual salary for a nursing informatics specialist was around $85,000 as of June 2022.
Online Nursing Careers
One of the biggest benefits of an online nursing career is its flexibility. Individuals can work from home, which can improve their work/life balance. Online nursing careers also provide opportunities to learn transferable skills, such as using video conferencing tools to work with patients. Here are a few online nursing career options.
14. Telehealth Nurse
Telehealth nursing practice involves assessing patient needs, determining symptoms, developing care plans, and evaluating outcomes using sophisticated telehealth technologies. These can encompass digital patient management platforms, mobile smart phones and tablets, and video conferencing software. The median annual salary for telehealth nurses was approximately $63,000 as of December 2021, according to Payscale.
15. Online Nurse Educator
In the face of COVID-19 restrictions, many in-person nurse educator positions transitioned online. The two roles perform many of the same functions, so they have a similar median annual income. They use their knowledge of health care settings and nursing clinical practice expertise to design program curriculum. They also teach students clinical skills and patient care best practices using virtual learning technologies and platforms.
16. Clinical Research Nurse
Clinical research nurses primarily provide patient care for clinical trial participants. They also design and participate in evidence-based research efforts to investigate nursing practice innovations; new medications, therapies, and procedures; and the efficacy of vaccinations. According to Payscale, the median annual salary for clinical research nurses was $73,000 as of July 2022.
17. Health Coach
Nurses serving in the role of health coach use their clinical knowledge to provide evidence-based interventions and strategies to guide patients toward healthy behavior. They help patients set health goals and offer motivation and guidance throughout their journey.
Resources: Alternative and Online Nursing Careers
There are a number of career options for individuals with nursing degrees, from work-from-home opportunities to working in corporate and government settings. Learn more about alternative and online nursing careers from the following resources.
- Health eCareers, "6 Alternative Careers for Your Nursing Degree": Highlights career paths outside of hospitals
- SkillGigs, "18 Top Alternative Nursing Jobs Beyond the Bedside": Discusses lesser-known nursing specialties, as well as non-traditional roles in nursing
- Wheel, "Alternative Careers for Nurse Practitioners Experiencing Burnout": Provides descriptions of flexible, non-traditional work opportunities in nursing
Start on the Path to Advanced Nursing Roles
The health care field is ever evolving, thanks to the changing nature of medicine, patient demographics, workplace dynamics, and technology. Whether looking to take on a traditional nursing role or an alternative one, it is important to stay up-to-date on the latest nursing practices and innovations.
Advanced nursing education can help individuals who are looking to stay competitive in a constantly changing field. Learn how nursing degree programs can help you gain and apply nursing knowledge in different ways outside of clinical settings, and take on new and exciting roles within the nursing profession.
Infographic Sources:
Health eCareers, "6 Alternative Careers for Your Nursing Degree"
Hospital Careers, "20 Alternative Nursing Careers"
Incredible Health, "The Highest Paying Jobs for MSN Nurses"
PayScale, "Average Adult-Gerontology Nurse Practitioner (AGNP) Salary"
PayScale, "Salary for Certification: Family Nurse Practitioner (FNP)"
PayScale, "Salary for Certification: Psychiatric Mental Health Nurse Practitioner (PMHNP)"