What Are the Different Career Paths in Nursing?

It takes a whole team of professionals to tend to the nation’s healthcare needs, and nurses are the keystone that keeps the healthcare system running. After all, they make up the nation’s largest healthcare profession. America has more than 3.8 million licensed registered nurses (RNs), 84.5 percent were active in nursing in 2019.

The nursing profession has always been about caring for patients. Still, as high service costs, poor patient outcomes, a physician shortage, and other issues prompt a revision of the nation’s current healthcare model, nurses are rising to the challenge to help healthcare organizations save money and improve care. The result has been a push to shift more responsibility to nurses, a trend that requires more nurses than ever to pursue advanced degrees and high-level training.

Technology has also transformed nursing. Some changes in the profession are a result of the healthcare industry’s increasing ability to use big data to make care more personalized and efficient. Other advancements in medical science, telecommunications, and even robotics have created many new opportunities for nurses to become more tech-adept.

Nursing is becoming a broader field—and deeper, too. The opportunity to pursue nursing specializations—like psychiatry, obstetrics, and gerontology, among a seemingly endless list of other specialty areas—is growing fast. In turn, opportunities for nurses to practice beyond traditional bedside care are more accessible than ever.

As nursing continues to encompass new responsibilities, fancier gadgets, and greater educational preparation, employment is also on the rise across a range of specializations and work settings. But with more career possibilities than ever, how do nurses find the best path?

Since knowing your options is the first step, here’s an overview of some of the most common nursing career paths along with others that stray from the expected. You’ll notice that many of these positions require RN licensure, while others call for additional training or an advanced degree.

Direct care

According to the BLS, 60 percent of the RNs employed in 2018 worked at state, local, and private hospitals, while another 7 percent were employed by nursing and residential care facilities. Given the data, it’s fitting that the majority of nursing jobs are in direct patient care settings.
Outside of hospital settings and residential and nursing care, RNs who practice within the scope of direct care can find work in doctors’ offices, assisted living facilities, and home health care services.

No matter their employer, RNs in this field typically provide and coordinate patient care, educate patients and the public about various health conditions, and offer advice and emotional support to patients and their family members. They may also operate medical monitoring equipment and administer medications.

All states require RNs to earn at least an associate’s degree from an accredited nursing program and gain licensure by passing the NCLEX-RN exam, but some employers prefer candidates with a bachelor of science in nursing (BSN) degree and licensure.

Additional board certification allows RNs to specialize in such crucial health disciplines as:

• Cardiology
• Dialysis
• Hospice care
• Military
• Neonatal care
• Neurology
• Oncology
• Rehabilitation
• Surgery

Many nurses decide to continue their education through a master of science in nursing (MSN) degree. These programs help students gain the advanced knowledge and sophisticated clinical skills necessary to become nurse practitioners (NPs) and fill both established and emerging roles in direct care.

Direct care specializations for nurse practitioners include:

• Adult-gerontology
• Critical care
• Dermatology
• Emergency care
• Family health
• Midwifery
• Pediatrics
• Psychiatric mental health
• Women’s health

Leadership

Leadership roles in this profession come in a variety of shapes, sizes, and titles, but all provide nurses with the ability to lead their fellow nurses through higher titles and responsibilities. In most cases, nurses in leadership positions are less task-oriented and hands-on than those providing direct care.

They focus instead on setting standards, spearheading advancements in their field, and inspiring and motivating their teams. They also work with their organization’s management and executive teams to cement the organization’s overall mission, vision, and strategic long-term plans.

Here are some leadership opportunities that allow nurses to take on greater responsibility and make a greater impact on the communities they serve. Many require an MSN in addition to a BSN degree:

• Nurse manager
• Head nurse
• Clinical nurse leader
• Nurse executive
• Nurse administrator
• Nursing director
• Chief nursing officer

Innovation

From monitoring devices that safeguard patients at high risk for falls to technology that allows parents to see their sick newborns in the NICU, nurses are developing solutions to work smarter and safer—and change the future of care.

Today’s healthcare workplaces require that nursing and technology go hand-in-hand. It’s all around, all the time—whether it’s electronic health records, computerized infusion pumps, digital drug delivery systems, or any of the other technologies that are now being used in hospitals and other healthcare settings.

These technology-focused careers present nurses with opportunities to use their skills in innovative ways and transform what it means to be on the frontlines of care:

• Forensic nurse
• Hyperbaric nurse
• Informatics nurse specialist
• Medical esthetics nurse
• Nurse anesthetist
• Radiology nurse
• Telemedicine nurse

Education

Some nurses aspire to educate an incoming generation of professionals in the field. Nurse educators are instrumental in shaping the future of healthcare by providing nursing students with the technical skills that they need to be successful, and also the skills and expertise that will help advance patient care.

As the healthcare industry increasingly emphasizes prevention, a growing number of nursing professionals are focusing their practice on health education and community care. These practice areas include community and public health, and allow nurses to educate specific populations on any health issues they may encounter, and how to prevent those issues.

Other specializations, like school nursing, require nurses to carry out care plans for students who need additional healthcare support to be successful in school. They’re also responsible for educating staff and students about healthcare, and in some cases, finding healthcare for students beyond school.

Research

Research is essential to developing new tools and techniques to use in nursing practice, and nurse researchers are the brains behind the investigation. Generally, you can find them at academic medical centers, educational institutions, pharmaceutical companies, and private research foundations.

Nurse researchers undertake a broad range of responsibilities. For example, some may assist patients through drug testing while others may observe sick individuals in the hopes of discovering new findings concerning a particular illness or disease. No matter their focus, their work is geared to improve health, health care services, and health care outcomes at the local, regional, national, and international levels.

Advocacy

In caring for the underserved, nurses work with populations that may be below the poverty level, have a significant amount of chronic health problems and medical disabilities, reside in geographically isolated areas, or don’t have a sufficient number of health care providers to meet their needs. They may also be uninsured or underinsured or face language and transportation barriers when accessing health care.

Other professionals in this realm act as the voice for patients and families who feel particularly lost in the healthcare system. They work to maintain a proper quality of care by educating patients about their medical conditions and their rights as patients, and help them make informed decisions about potential treatment.

They also operate as liaisons between patients, healthcare providers, and healthcare organizations and insurance companies. When a recommendation from a doctor differs from their patient’s wishes, they act as a representative of the patient to land on the best possible treatment option.

These nursing careers are geared toward improving the health and wellbeing of underserved patients:

• Charity nurse
• Managed care nurse
• NGO nurse
• Nurse advocate
• Nurse for at-risk populations
• Rural nurse

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