The Best and Worst Specialties for Nurses in 2024
Choosing a nursing specialty can be a challenge, especially right now. The best specialty for obtaining the highest level of job satisfaction will depend on various factors, including salary, autonomy, and the potential for career growth. Read on to find out the best and worst specialties for nurses.
The Best Specialties for Nurses in 2024
| Best Specialties Based on Salary | Best Specialties Based on Satisfaction Ratings | Best Specialties Based on Autonomy | Best Specialties Based on Potential for Career Growth |
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As you can see, there are some clear patterns among the best nursing specialties: CRNAs, Nurse Practitioners, Nurse Educators, and Certified Nurse Midwives consistently ranked on the lists of the best nursing specialties.
Best Nursing Specialties Based on Salary
- CRNA
- NICU Nurse
- Nurse Practitioner
- CNM
- ICU Nurse
Certified Registered Nurse Anesthetist (CRNA) - $203,090
CRNAs are the highest-paid nursing specialty by a long shot! The annual median salary for CRNAs, according to the U.S. Bureau of Labor Statistics (BLS), is $203,090 or $97.64/hr.
Neonatal Intensive Care Unit Nurse - $135,949
ZipRecruiter reports that the annual median salary for Neonatal ICU nurses in the U.S. is $135,949 or $65 per hour. Like all nursing specialties, income can vary widely depending on factors such as location, hours worked, and the facility. But ZipRecruiter found that some of the highest-paid NICU nurses earn as much as $205,000 annually.
Nurse Practitioner - $121,610
Becoming a nurse practitioner (NP) is a great stepping stone for nurses who want to earn a significantly higher salary. The BLS reports that NPs earn an annual median salary of $121,610 or $58.47/hr. However, top earners make as much as $165,240 or more.
>> Show Me Online Nurse Practitioner Programs
Certified Nurse Midwife - $120,880
RNs who love working with new moms and infants will also love the salary certified nurse midwives (CNMs) earn annually! According to the BLS, CNMs earn a median annual income of $120,880 or $58.87 per year.
Intensive Care Unit (ICU) Nurse - $92,568
ZipRecruiter reports that ICU nurses are another highly compensated nursing specialty, earning a median annual salary of $92,568 or $45/hr. Income ranges widely depending on location and hours worked per week; however, top earners across the country earn as much as $178,000!
Best Nursing Specialties Based on Satisfaction Ratings
There are countless nursing specialties that one can choose from, especially given the ongoing nursing shortage. The 2023 State of Nursing report revealed the highest nursing job satisfaction rates for nurses in non-bedside jobs. Among these practitioners, nearly 50% reported feeling happy in their positions.
Other specialties that reported high satisfaction rates include the following:
- Community Health Nurses
- Ambulatory Care Nurses
- OR-Perioperative Nurses
- Pediatric Nurses
- Critical Care Nurses
>> Show Me Online Nurse Midwife Programs
Community Health Nursing
Community health nursing is among the most rewarding specialties registered nurses and APRNs can assume. Focused on community-oriented and community-based nursing practice, these nurses can step away from stressful acute care environments and build strong connections to fortify public health in local areas.
Community health nurses largely hold BSN degrees and earn around $65,013 a year (Zippia). Their job satisfaction rate is 43%.
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Ambulatory Care
Nurses in ambulatory care settings report a 39% job satisfaction rate. Ambulatory care refers to outpatient medical environments like physician offices or urgent care clinics. Nurses in these roles perform routine tests, educate patients on their conditions, and provide treatments under the supervision of an APRN or physician.
Ambulatory care settings are often less stressful than hospitals or critical care environments. They also offer more predictable schedules, making it easier to manage your work-life balance.
OR-Perioperative Nurses
OR and perioperative nurses, also commonly referred to as surgical nurses, also reported higher levels of job satisfaction compared to the average. These are registered nurses who have been trained to assist during surgeries. They care for patients before, during, and after surgical procedures and work on everything from life-saving procedures to elective ones.
Pediatric Nurses
31% of pediatric nurses also reported being happy in their current role. Pediatric nurses are registered nurses and advanced practice registered nurses who work with newborns, children, adolescents, and teenagers. Their specialized education and skillset make them uniquely suited to handle various conditions specific to children.
Critical Care Nurses
Critical care nurses work with patients of all ages who suffer from emergent, life-threatening conditions and injuries. Because their patients' conditions often make communication difficult, critical care nurses frequently advocate on their behalf. Additionally, these nurses often only handle a few patients at a time and work in teams with doctors, other nurses, and healthcare professionals.
Critical care nurses are well-paid, earning a median annual salary of $83,789 (Salary.com). 25% of critical care nurses report feeling satisfied with their jobs.
Best Nursing Specialties Based on Autonomy/Responsibility
A healthy mix of autonomy and work responsibility can help provide nurses with a higher level of job satisfaction. Here are the nursing specialties that offer the highest level of autonomy and responsibility.
- CRNA
- Nurse Educator
- Nurse Practitioner
- CNM
- Home Health Nurse
CRNAs
CRNAs have far more autonomy than the average registered nurse. Although CRNAs often work under the guidance of anesthesiologists, they are qualified to make independent judgments regarding various aspects of a patient’s anesthesia care. Thirty states across the US allow CRNAs to practice independently, and other states allow CRNAs to practice under the supervision of a physician.
Nurse Educators
Nurse educators typically work in clinical settings alongside many other nurses. However, they don’t spend very much time, if any, providing patient care at the bedside. Nurse educators are mostly responsible for training and educating nursing staff and improving their clinical competency so they can provide the highest possible standard of patient care.
This master's or doctoral degree-level role requires a high level of autonomy that allows the nurse educator to work uniquely with nurses of different skill sets, levels of education, and experience.
>> Show Me Online Nurse Educator Programs
Nurse Practitioners
Nurse practitioners are APRNs with master’s or doctoral degrees. Their higher education allows for significantly higher responsibilities, such as providing primary care, assessing, diagnosing, prescribing medications, and collaborating in the care of patients alongside physicians and other healthcare professionals. Nurse practitioners also have specialized certification and training in a specialty such as family practice, gerontology, neonatal, pediatric, or women’s health.
The autonomy that NPs have allows them to practice within a much greater scope of practice than most other nursing specialties.
>> Show Me Online Nurse Practitioner Programs
Certified Nurse Midwives
As APRNs, CNMs also have a wider scope of practice and autonomy. According to the American College of Nurse-Midwives, as of 2023, 27 states in the US and the District of Columbia have “full practice authority,” which means CNMs can practice autonomously. Twenty states require a signed collaborative practice agreement with a supervising physician, and three states require physician supervision.
>> Show Me Online Nurse Midwife Programs
Home Health Nurse
Some nurses move into home health nursing due to burnout from working in a hospital providing bedside care. In fact, as many as 81% of nurses feel burnt out and frustrated with working with administrators in the hospital setting.
Home health nurses provide ongoing care to patients outside of the hospital setting. Many home health nurses enjoy the responsibility and autonomy of caring for patients in their own homes.
Best Nursing Specialties Based on Potential for Career Growth
When considering which specialties are the best, it's also important to consider that specialty's potential for career growth: how in demand is that specialty? These are the specialties that are predicted to have the greatest growth in demand:
- Nurse Practitioner
- Nurse Administrator
- CRNA
- Nurse Educator
Nurse Practitioner
The nursing shortage and aging population in the US continue to create a need for advanced-practice nursing professionals. Nurse practitioners, especially those specializing in adult gerontology, will be in-demand positions in the next decade.
The BLS predicts that NP jobs will grow by a staggering 45% from 2022 to 2032, which equals 118,600 new NPs. In contrast, registered nursing jobs will only grow by 6% over the same period.
Nurse Administrator
There is a huge opportunity for medical and health service managers, including nurse administrators, in the coming years. According to the BLS, the job outlook for nurse managers will grow by 28% between 2022 and 2032.
>> Show Me Online Nurse Admin Programs
CRNA
The BLS predicts that CRNAs will grow by 9% by 2032, adding 4,500 new jobs in the coming decade. Additionally, the AANA reports increasing opportunities for CRNAs to find employment all over the country. They also note that CRNAs represent more than 80% of the anesthesia providers in rural counties.
Nurse Educator
One of the reasons that nurse educators have a higher potential for career growth is that they may enjoy their specialty more than many other nurses. The BLS predicts that postsecondary teachers, which include nurse educators, will grow by 8% from 2022 to 2032.
Nurse educator positions are a promotion from working as a bedside nurse, where they learn valuable teaching skills that have a huge impact on hospital performance ratings. If moving into an administrative nursing position interests you, this may be a great route to take!
The Worst Nursing Specialties in 2024
All nursing specialties have their pros and cons, but these are the so-called worst specialties for nurses based on salary, satisfaction, autonomy, and career growth.
| Worst Specialties Based on Salary | Worst Specialties Based on Satisfaction Ratings | Worst Specialties Based on Autonomy | Worst Specialties Based on Potential for Career Growth |
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The Worst Nursing Specialties Based on Salary
It is important to remember that there are many factors at play when it comes to nursing specialty salaries, including your city and state, your facility, and whether you work full-time or part-time.
- School Nurse
- Home Health Nurse
- Nurse Educator
- Research Nurse
- Charge Nurse
School Nurse - $65,048
Many nurses love the idea of moving out of the clinical setting and into an environment where they can help children in an educational setting. If this is you, school nursing may be a perfect fit. However, school nursing is also one of the lowest-paid nursing specialties.
ZipRecruiter reports that the median annual salary for school nurses in the US is $65,048. However, this range also ranges widely -from as low as $36,000 to as much as $90,000 per year.
Home Health Nurse - $74,329
ZipRecruiter reports that as of August 2022, home health nurses earn a median annual salary of $74,329 or $36/hr. However, despite a potentially lower salary, many home health nurses enjoy the flexibility this specialty offers and enjoy caring for people in their homes.
Nurse Educator - $82,219
Payscale reported that the average median nurse educator salary in the US is $82,219. However, income ranged from as low as $61,000 for the lowest 10% to $111,000 for the top 10%.
Nurse educators teach and instruct nursing staff in clinical settings on maintaining clinical competencies, improving nursing practice, and providing the highest standard of patient care.
Research Nurse - $83,747
There are many types of research nursing positions. However, ZipRecruiter reports that the national median average income for clinical research nurses is $83,747 or $40/hr.
Charge Nurse - $96,662
Charge nurses earn a median annual income of $96,662, according to Salary.com. The site notes that charge nurse salaries range from $83,512 (10th percentile) to $117,300 (90th percentile).
The Worst Nursing Specialties Based on Satisfaction Ratings
Based on our survey, nurses in the following specialties reported the highest levels of dissatisfaction, burnout, discomfort, and other negative feelings:
- Emergency Room Nurse
- Acute Care Nurse
- Long-term Care Nurse
- Float Nurse
- Obstetric Nurse
Of the surveyed nurses, only 28% reported feeling satisfied with their current job, while 39% reported dissatisfaction. Simultaneously, 91% of nurses cite reasons like burnout, poor working conditions, and inadequate pay as reasons why they believe the nursing shortage is worsening. It's no coincidence that nurses who report understaffing are in the exact same roles as these least satisfied positions.
Emergency Room Nurse
23% of emergency room nurses reported feeling happy in their current role. Additionally, 82% of emergency room nurses reported feeling unsafe at work in 2021
Throughout the pandemic, ER nurses were on the frontline and generally were the first nurses that encounter COVID patients. They dealt with countless struggles, including PPE shortages as well as overrun emergency rooms. Now, as the number of ER cases stabilizes, ER nurses are struggling with caring for unvaccinated patients.
Acute Care Nurse
Acute care or trauma nurses also report a mere 23% job satisfaction rate. Trauma nursing is one of the most demanding and stressful roles a nurse can assume. RNs and APRNs on trauma units work under overwhelming pressure with patients in critical conditions. They must think and act quickly, juggle multiple tasks, and remain calm in chaotic situations.
On top of the demands of the job, 84% of acute care nurses report understaffing as an issue.
Long-Term Care Nurse
Long-term care nurses often work with elderly, disabled, or other types of patients with specific conditions that require continual support. They complete many routine nursing tasks like administering medications, checking vitals, and providing treatments.
However, the population they work with presents unique challenges due to their complex conditions. These challenges, paired with inadequate staffing and pay (80% of long-term nurses feel they aren't paid well enough), may contribute to the lack of satisfaction in this role.
Float Nurse
Float nurses are roving RNs who work on multiple units in a hospital or healthcare system. The role addresses staffing needs throughout a medical facility, and those in it must be adaptive, skilled nurses. Despite being a position created to fill vacancies left by the nursing shortage, 90% of float nurses report staffing shortages.
Additionally, 61% feel underpaid by employers. The stress of wearing many hats at work, combined with staffing shortages and too little pay, makes float nursing one of the least satisfied specialties. Only 23% of these nurses report feeling satisfied in their roles.
Obstetrics Nurse
Obstetrics nurses reported the lowest satisfaction ratings in the 2023 State of Nursing Review. A mere 15% of obstetrics nurses feel satisfied at their jobs. Like other nursing professions with low satisfaction ratings, OB nurses also report feeling understaffed and underpaid at work.
Worst Nursing Specialties Based on Autonomy/Responsibility
Unfortunately, many nurses report that they are dealing with increased workloads and have fewer resources than ever before. This means that nurses are taking on more patient responsibility, which sometimes translates into unsafe patient ratios.
In fact, in Nurse.org’s 2023 State of Nursing Review, 79% of nurses say their units are inadequately staffed. This puts the nurse’s license and the patient's safety at risk. Some nurses reported that they felt they were increasingly running tasks, making it exceedingly difficult to provide adequate patient care.
- Emergency
- Long-Term Care
- Surgical
- Obstetrics
- Pediatrics
Emergency Room
The emergency room is well-known for being a high-stress environment. To top that off, 87% of ER nurses in the Nurse.org survey reported that they were facing staffing shortages, and 83% felt underpaid for the amount of work and responsibility they had during shifts.
Long-Term Care
80% of long-term care nurses said that they felt underpaid for the amount of work and responsibility they had. In addition, 88% reported they experienced staffing shortages and felt unsupported in their roles.
Surgical
Despite their comparatively higher satisfaction rates (31%), surgical nurses also feel the burden of increasing responsibility, with 78% reporting feeling underpaid in their roles.
Obstetrics
Many OB nurses enjoy their jobs because they enjoy providing care to women and families during the most vulnerable and memorable points of their lives. However, 83% also state that they face staffing shortages, and 79% report feeling underpaid, which may explain the low satisfaction rate.
Pediatrics
Peds nursing is an emotionally and mentally fulfilling career. It offers plenty of variety, as pediatric nurses work with children of all ages. Additionally, treating and caring for young patients can be emotionally rewarding.
Despite its merits, peds nursing also has deficits like lack of pay and staffing shortages. The increased burden of juggling many duties paired with unsatisfactory pay makes pediatrics one of the worst nursing specialties based on autonomy and responsibility.
Worst Nursing Specialties Based on the Potential for Career Growth
Career growth can come in many forms. Most commonly, nurses find career growth opportunities by advancing their education or finding higher-paying nursing roles that require more responsibility, better critical thinking skills, and more work.
It may also help to acknowledge that burnout may prevent nurses from staying in a position that may have eventually offered some career growth opportunities. In fact, 90% of nurses practicing in a clinical setting report a high level of burnout, versus 78% of nurses not working in a clinical setting. In contrast, 65% of NPs and APRNs reported job burnout.
The jobs listed below include nursing specialties based on the potential for career growth without simultaneously also earning advanced education or applying for higher-paying nursing roles. In other words, staying in a lower-paying position that also has little upward potential indefinitely throughout your nursing career will also limit your overall career growth. But that doesn’t mean these are not great careers!
However, if career growth is important to you, you may want to look at other options at some point.
- School Nurse
- Home Health Nurse
School Nurse
School nurses make a tremendous difference in students' lives by providing health education and supporting those with chronic healthcare conditions, such as diabetes or Crohn’s disease. Unfortunately, aside from increased pay from years of service, there is not a lot of potential upward mobility in a school nurse career.
Home Health Nurse
Some nurses move into home health nursing to get away from working at the bedside. While home health nursing is typically much less stressful than working in a hospital, some nurses may lose some of their bedside nursing skills, which may prevent upward career growth if they decide to move back into a hospital role.
How to Choose the Right Nursing Specialty for You
There are many pros and cons to every nursing specialty. In many cases, knowing what is best for you is impossible until you’ve worked as a nurse for a period of time.
For example, one person may have desperately wanted to work in the ICU after graduating from nursing school, but after their first year on the job, they realized they hated it. Instead, they decided their passion was working with children, so they applied for a pediatric nurse position and moved to a different unit. At the same time, an ICU position opened up for a nurse who loved working in the ICU.
In other words, everyone has their own idea of what makes a specialty better or worse. Here are a few questions to ask yourself when deciding on the best specialty for you:
- Do you want to work with adults, children, or infants?
- Do you want to work in a hospital, a university, a school, or other health facilities?
- Do you thrive under pressure or want to work in a low-stress environment
- Are there specific specialties that you enjoyed in nursing school, such as psychiatric care, ER, or med/surg?
- Do you want to work directly with patients or in an administrative role
- What are your financial goals?
- Do you want to earn higher education to take on more responsibility and have more autonomy?
- Are you open to relocating for your dream position or earning more money?
- Have you considered travel nursing?
It may also help to reach out to other nurses to ask about their experiences working in different specialties.
