As the largest healthcare occupation, registered nurses held about 2.7 million jobs in 2012. The industries that employed the most registered nurses in 2012 were as follows:
| Hospitals; state, local, and private | 61% |
| Nursing and residential care facilities | 7 |
| Offices of physicians | 7 |
| Home health care services | 6 |
| Government | 6 |
Registered nurses work in hospitals, physicians' offices, home healthcare services, and nursing care facilities. Others work in correctional facilities, schools, clinics, or serve in the military.
Most registered nurses work in well-lit, comfortable healthcare facilities. Home health and public health nurses travel to patients' homes, schools, community centers, and other sites.
Some nurses move frequently, traveling in the United States and throughout the world to help care for patients in places where there are not enough healthcare workers.
Injuries and Illnesses
Registered nurses may spend a lot of time walking, bending, stretching, and standing. They are vulnerable to back injuries, because they must often lift and move patients.
In addition, the work of registered nurses may put them in close contact with people who have infectious diseases, and they often come in contact with potentially harmful and hazardous drugs and other substances. Therefore, registered nurses must follow strict, standardized guidelines to guard against diseases and other dangers, such as radiation, accidental needle sticks, or the chemicals used to create a sterile and clean environment.
Work Schedules
Because patients in hospitals and nursing care facilities need round-the-clock care, nurses in these settings usually work in rotating shifts, covering all 24 hours. They may work nights, weekends, and holidays. They may also be on call.
Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to work regular business hours.
In 2012, about 1 out of 5 registered nurses worked part time.
Registered nurses usually take one of three education paths: a bachelor's of science degree in nursing (BSN), an associate’s degree in nursing (ADN), or a diploma from an approved nursing program. Registered nurses also must be licensed.
Education
In all nursing education programs, students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology and other social and behavioral sciences, as well as in liberal arts. BSN programs typically take 4 years to complete; ADN and diploma programs usually take 2 to 3 years to complete. All programs also include supervised clinical experience.
Bachelor's degree programs usually include additional education in the physical and social sciences, communication, leadership, and critical thinking. These programs also offer more clinical experience in nonhospital settings. A bachelor's degree or higher is often necessary for administrative positions, research, consulting, and teaching.
Generally, licensed graduates of any of the three types of education programs (bachelor's, associate’s, or diploma) qualify for entry-level positions as a staff nurse. However, some employers may require a bachelor’s degree.
Many registered nurses with an ADN or diploma choose to go back to school to earn a bachelor’s degree through an RN-to-BSN program. There are also master’s degree programs in nursing, combined bachelor’s and master’s programs, and programs for those who wish to enter the nursing profession but hold a bachelor’s degree in another field. Some employers offer tuition reimbursement.
Certified nurse specialists (CNSs) must earn a master’s degree in nursing. CNSs who conduct research typically need a doctoral degree.
Licenses, Certifications, and Registrations
In all states, the District of Columbia, and U.S. territories, registered nurses must have a nursing license.
To become licensed, nurses must graduate from an approved nursing program and pass the National Council Licensure Examination, or NCLEX-RN.
Other requirements for licensing vary by state. Each state's board of nursing can give details. For more on the NCLEX-RN examination and a list of state boards of nursing visit the National Council of State Boards of Nursing.
Nurses may become certified through professional associations in specific areas, such as ambulatory care, gerontology, and pediatrics, among others. Although certification is usually voluntary, it demonstrates adherence to a higher standard, and some employers may require it.
CNSs must satisfy additional state licensing requirements. They may choose to earn certification in a specialty.
Advancement
Most registered nurses begin as staff nurses in hospitals or community health settings. With experience, good performance, and continuous education, they can move to other settings or be promoted to positions with more responsibility.
In management, nurses can advance from assistant unit manager or head nurse to more senior-level administrative roles, such as assistant director, director, vice president, and chief of nursing. Increasingly, management-level nursing positions require a graduate degree in nursing or health services administration. Administrative positions require leadership, communication skills, negotiation skills, and good judgment.
Some nurses move into the business side of healthcare. Their nursing expertise and experience on a healthcare team equip them to manage ambulatory, acute, home-based, and chronic care businesses.
Employers—including hospitals, insurance companies, pharmaceutical manufacturers, and managed care organizations, among others—need registered nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance.
Some RNs choose to become nurse anesthetists, nurse midwives, or nurse practitioners, which, along with certified nurse specialists, are types of advanced practice registered nurses (APRNs). APRNs may provide primary and specialty care, and, in most states, they may prescribe medicines. For example, clinical nurse specialists provide direct patient care and expert consultations in one of many nursing specialties, such as psychiatric-mental health.
Other nurses work as postsecondary teachers in colleges and universities.
Registered nurses (RNs) typically have an interest in the Helping and Organizing interest areas, according to the Holland Code framework. The Helping interest area indicates a focus on assisting, serving, counseling, or teaching other people. The Organizing interest area indicates a focus on working with information and processes to keep things arranged in orderly systems.
If you are not sure whether you have a Helping or Organizing interest which might fit with a career as a registered nurse (RN), you can take a career test to measure your interests.
Registered nurses (RNs) should also possess the following specific qualities:
Critical-thinking skills. Registered nurses must be able to assess changes in the health state of patients, including when to take corrective action and when to make referrals.
Compassion. Registered nurses should be caring and sympathetic, characteristics that are valuable when caring for patients.
Detail oriented. Registered nurses must be responsible and detail oriented because they must make sure that patients get the correct treatments and medicines at the right time.
Emotional stability. Registered nurses need emotional stability to cope with human suffering, emergencies, and other stresses.
Organizational skills. Nurses often work with multiple patients with various health needs. Organizational skills are critical to ensure that each patient is given proper care.
Physical stamina. Nurses should be comfortable performing physical tasks, such as helping to lift and to move patients. They may be on their feet for most of their shift.
Speaking skills. Registered nurses must be able to talk effectively with patients to assess their health conditions. Nurses need to explain how to take medication or to give other instructions. They must be able to work in teams with other health professionals and communicate the patients’ needs.
The median annual wage for registered nurses was $65,470 in May 2012. The median wage is the wage at which half of the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $45,040 and the top 10 percent earned more than $94,720.
In May 2012, the median annual wages for registered nurses in the top five industries in which they worked were as follows:
| Government | $68,540 |
| Hospitals; state, local, and private | 67,210 |
| Home health care services | 62,090 |
| Nursing and residential care facilities | 58,830 |
| Offices of physicians | 58,420 |
Many employers offer flexible work schedules, childcare, educational benefits, and bonuses.
Because patients in hospitals and nursing care facilities need round-the-clock care, nurses in these settings usually work in rotating shifts, covering all 24 hours. They may work nights, weekends, and holidays. They may be on call, which means they are on duty and must be available to work on short notice.
Nurses who work in offices, schools, and other places that do not provide 24-hour care are more likely to work regular business hours.
In 2012, about 1 out of 5 registered nurses worked part time.
Employment of registered nurses is projected to grow 19 percent from 2012 to 2022, faster than the average for all occupations. Growth will occur for a number of reasons.
Demand for healthcare services will increase because of the aging population, since older people typically have more medical problems than younger people. Nurses also will be needed to educate and to care for patients with various chronic conditions, such as arthritis, dementia, diabetes, and obesity. In addition, the number of individuals who have access to healthcare services will increase, as a result of federal health insurance reform. More nurses will be needed to care for these patients.
The financial pressure on hospitals to discharge patients as soon as possible may result in more people admitted to long-term care facilities, outpatient care centers, and greater need for home healthcare. Job growth is expected in facilities that provide long-term rehabilitation for stroke and head injury patients, as well as facilities that treat people with Alzheimer's disease. In addition, because many older people prefer to be treated at home or in residential care facilities, registered nurses will be in demand in those settings.
Growth is also expected to be faster than average in outpatient care centers where patients do not stay overnight, such as those that provide same-day chemotherapy, rehabilitation, and surgery. In addition, an increased number of procedures, as well as more sophisticated procedures previously done only in hospitals, are performed in ambulatory care settings and physicians' offices.
Job Prospects
Overall, job opportunities for registered nurses are expected to be good. Generally, registered nurses with at least a bachelor’s degree in nursing (BSN) will have better job prospects than those without one. Employers may prefer candidates who have some related work experience.
Job opportunities should be good because of the need to replace workers who retire over the coming decade and because of the growing number of people with access to healthcare services.
For more information about registered nurses, including credentialing, visit
For more information about nursing education and being a registered nurse, visit
For information about undergraduate and graduate nursing education, nursing career options, and financial aid, visit
American Association of Colleges of Nursing
For information about the National Council Licensure Examination (NCLEX-RN) and a list of individual state boards of nursing, visit
National Council of State Boards of Nursing
For information about clinical nurse specialists, including a list of accredited programs, visit