Occupation Profile for Registered Nurses

Assess patient health problems and needs, develop and implement nursing care plans, and maintain medical records. Administer nursing care to ill, injured, convalescent, or disabled patients. May advise patients on health maintenance and disease prevention or provide case management. Licensing or registration required. Includes advance practice nurses such as: nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists. Advanced practice nursing is practiced by RNs who have specialized formal, post-basic education and who function in highly autonomous and specialized roles.

Signficant Points

• Registered nurses constitute the largest health care occupation, with 2.5 million jobs.
• About 59 percent of jobs are in hospitals.
• The three major educational paths to registered nursing are a bachelor’s degree, an associate degree, and a diploma from an approved nursing program.
• Registered nurses are projected to generate about 587,000 new jobs over the 2006-16 period, one of the largest numbers among all occupations; overall job opportunities are expected to be excellent, but may vary by employment setting.

Earnings

Median annual earnings of registered nurses were $57,280 in May 2006. The middle 50 percent earned between $47,710 and $69,850. The lowest 10 percent earned less than $40,250, and the highest 10 percent earned more than $83,440. Median annual earnings in the industries employing the largest numbers of registered nurses in May 2006 were:

Many employers offer flexible work schedules, child care, educational benefits, and bonuses.

Job Outlook

Overall job opportunities for registered nurses are expected to be excellent, but may vary by employment and geographic setting. Employment of RNs is expected to grow much faster than the average for all occupations through 2016 and, because the occupation is very large, many new jobs will result. In fact, registered nurses are projected to generate 587,000 new jobs, among the largest number of new jobs for any occupation. Additionally, hundreds of thousands of job openings will result from the need to replace experienced nurses who leave the occupation.

Employment change. Employment of registered nurses is expected to grow 23 percent from 2006 to 2016, much faster than the average for all occupations. Growth will be driven by technological advances in patient care, which permit a greater number of health problems to be treated, and by an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly.

However, employment of RNs will not grow at the same rate in every industry. The projected growth rates for RNs in the industries with the highest employment of these workers are:

Employment is expected to grow more slowly in hospitals—health care’s largest industry—than in most other health care industries. While the intensity of nursing care is likely to increase, requiring more nurses per patient, the number of inpatients (those who remain in the hospital for more than 24 hours) is not likely to grow by much. Patients are being discharged earlier, and more procedures are being done on an outpatient basis, both inside and outside hospitals. Rapid growth is expected in hospital outpatient facilities, such as those providing same-day surgery, rehabilitation, and chemotherapy.

More and more sophisticated procedures, once performed only in hospitals, are being performed in physicians’ offices and in outpatient care centers, such as freestanding ambulatory surgical and emergency centers. Accordingly, employment is expected to grow very fast in these places as health care in general expands.

Employment in nursing care facilities is expected to grow because of increases in the number of elderly, many of whom require long-term care. However, this growth will be relatively slower than in other health care industries because of the desire of patients to be treated at home or in residential care facilities, and the increasing availability of that type of care. The financial pressure on hospitals to discharge patients as soon as possible should produce more admissions to nursing and residential care facilities and to home health care. Job growth also is expected in units that provide specialized long-term rehabilitation for stroke and head injury patients, as well as units that treat Alzheimer’s victims.

Employment in home health care is expected to increase rapidly in response to the growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home. The type of care demanded will require nurses who are able to perform complex procedures.

Rapid employment growth in employment services industry is expected as hospitals, physician’s offices, and other health care establishments utilize temporary workers to fill short-term staffing needs. And as the demand for nurses grows, temporary nurses will be needed more often, further contributing to employment growth in this industry.

Job prospects. Overall job opportunities are expected to be excellent for registered nurses. Employers in some parts of the country and in certain employment settings report difficulty in attracting and retaining an adequate number of RNs, primarily because of an aging RN workforce and a lack of younger workers to fill positions. Enrollments in nursing programs at all levels have increased more rapidly in the past few years as students seek jobs with stable employment. However, many qualified applicants are being turned away because of a shortage of nursing faculty. The need for nursing faculty will only increase as many instructors near retirement. Many employers also are relying on foreign-educated nurses to fill vacant positions.

Even though overall employment opportunities for all nursing specialties are expected to be excellent, they can vary by employment setting. Despite the slower employment growth in hospitals, job opportunities should still be excellent because of the relatively high turnover of hospital nurses. RNs working in hospitals frequently work overtime and night and weekend shifts and also treat seriously ill and injured patients, all of which can contribute to stress and burnout. Hospital departments in which these working conditions occur most frequently—critical care units, emergency departments, and operating rooms—generally will have more job openings than other departments. To attract and retain qualified nurses, hospitals may offer signing bonuses, family-friendly work schedules, or subsidized training. A growing number of hospitals also are experimenting with online bidding to fill open shifts, in which nurses can volunteer to fill open shifts at premium wages. This can decrease the amount of mandatory overtime that nurses are required to work.

Although faster employment growth is projected in physicians’ offices and outpatient care centers, RNs may face greater competition for these positions because they generally offer regular working hours and more comfortable working environments. There also may be some competition for jobs in employment services, despite a high rate of employment growth, because a large number of workers are attracted by the industry’s relatively high wages and the flexibility of the work in this industry.

Generally, RNs with at least a bachelor’s degree will have better job prospects than those without a bachelor’s. In addition, all four advanced practice specialties—clinical nurse specialists, nurse practitioners, nurse-midwives, and nurse anesthetists—will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. Relative to physicians, these RNs increasingly serve as lower-cost primary care providers.

Employment

As the largest health care occupation, registered nurses held about 2.5 million jobs in 2006. Hospitals employed the majority of RNs, with 59 percent of jobs. Other industries also employed large shares of workers. About 8 percent of jobs were in offices of physicians, 5 percent in home health care services, 5 percent in nursing care facilities, 4 percent in employment services, and 3 percent in outpatient care centers. The remainder worked mostly in government agencies, social assistance agencies, and educational services. About 21 percent of RNs worked part time.