Introduction to Nursing Specialties

Most nurses go into the healthcare field with a dream of helping others. You may not have realized what you wanted to do with a nursing degree, you just knew that it must involve direct patient care and your work must benefit patients in some way, whether it is helping the patient heal on a Med-Surg unit, being the friendly face prior to a surgery, caring for sick children or neonates, or helping our fellow nurses through a difficult shift. Luckily for nurses, there are many different nursing specialties for RNs. All offer a lucrative salary, all provide job satisfaction, and most importantly, all benefit our patients in some way.

After you’ve put in a certain amount of time at your first RN jobs, gaining valuable experience and sharpening nursing skills, you’ll be eligible for specialized RN jobs. While healthcare seeks nurses who are a “jack-of-all-trades”, it is also seeking nurses who have skills in one certain area. The face of healthcare is changing and there is much opportunity for nurses to specialize in an area that is interesting to them.

After graduating from a BSN program, you might be setting your sights on future career growth. One of the best places to advance your career is in one of the many nursing specialties for BSNs the nursing profession has to offer. Most employers require that new BSN graduates obtain experience prior to employment in a nursing specialty field. Once time is spent in an entry level position, these RNs have the experience necessary to continue their careers in the direction of their choice.

Some specialties will take the RN away from the patient bedside and allow the nurse to work with the patient in a different context. Some even remove the RN from patient care completely and promote education of nurses, such as the informatics RN or nurse educator. Supervisory roles, while not desirable to all RNs, are also a way to further a nursing career while removing the patient care.

Certified Diabetes Educator (CDE)

An RN employed as a certified diabetes educator can expect to earn about $63,601 per year. This job can be held by a variety of medical professionals such as an RN with a BSN or a registered dietitian (RD). The CDE is a certification obtained after completing a specific amount of hours working with diabetic patients. The CDE provides education to diabetic patients, such as nutrition, insulin and drug therapy, exercise requirements and reducing complications. They may correspond with a patient for a long duration of time, as the nature of diabetes is progressive. Becoming a CDE is typically not an entry level position; an RN most likely requires practical work experience and baseline knowledge of pharmacology prior to obtaining this job.

Charge Nurse

The average Charge Nurse can expect to make about $29 per hour. These RNs typically work in hospitals and long-term-care facilities. A charge nurse is the supervisor during the shift they are working. They are responsible for ensuring that the unit runs smoothly and that patients are satisfied. They monitor admissions and discharges and also monitor the care provided by other RNs and staff on the unit. During the scheduled shift, they will work directly under the unit manager. Typically, an RN is eligible to be a charge nurse if they hold an ADN degree, although certain hospitals may require that the nurse hold a BSN degree.

Clinical Nurse Manager

Of all the nursing specialties, the RN-BSN employed as a clinical nurse manager can expect to earn approximately $75,931 per year; these RNs are typically paid by salary as opposed to hourly. A clinical nurse manager is in a strictly managerial position. This RN does not work at the bedside anymore, but instead is coordinating the staff, creating schedules, fielding complaints from staff and patients, creating policies and working with the budget. A BSN is the minimum education requirement for this position. Prior work experience is absolutely necessary prior to obtaining a position as a clinical nurse manager.

Credentialed Nurse

A credentialed RN typically earns more than their non-credentialed coworkers. There is a credential for almost every type of discipline in nursing. For example, even an RN employed in an entry-level position as a Med-Surg nurse may earn more by obtaining their Medical-Surgical Nursing credential. Credentialing can be provided by a number of different credentialing agencies. The American Nurses Credentialing Center (ANCC) is one such agency. The ANCC provides credentialing for forensic nursing, pediatric nursing, nursing case management, and nurse executive, to name a few. Obtaining a credential is a means to recognize excellence in nursing. Holding a credential not only increases salary but also promotes safer work environments and patient outcomes, which in turn increases patient satisfaction.

Credentialed RNs

Regardless of the specialty, a credentialed RN will most likely have a higher rate of pay. Even an entry level nurse can make more money if they choose to obtain credentials. According to the American Nurses Credentialing Center (ANCC), the purpose of earning a nursing credentials is to, “…promote excellence in nursing and health care globally through credentialing programs… it recognized healthcare organizations that promote nursing excellence and quality patient outcomes, while providing safe, positive work environments.” There are a variety of certifications to select. The entry level nurse that often works on a Med-Surg unit can select the Medical-Surgical Nursing credential. In addition, there are credentials for psychiatric nursing, cardiovascular nursing, home health nursing, and pain management nursing, to name a few.

While one goal when entering nursing school may be to earn a good salary right off the block, this may not be the case. An entry level RN will still make an excellent salary at $26 per hour. However, salary can increase incrementally as more nursing experience is obtained. There are so many nursing specialties available to registered nurses.

Critical Care Nurse

The average Intensive Care Unit (ICU) Nurse can expect to make about $28 per hour. These RNs will work with the critically ill and patients that have a rapidly deteriorating condition. Typically, RNs must have at least a year of experience prior to employment in an ICU. However, many hospitals are offering critical care internships, which prepare new graduates for work in an ICU. For example, UP Health System – Marquette offers a program that is 12-16 weeks and offers both classroom and clinical education. The RNs working in these programs typically have to promise employment to the hospital after completion; for example, UPHS – Marquette requires its interns to commit 6,240 hours post-completion.

Emergency Room Nurse

The average ER Nurse can expect to make about $28 per hour, which is slightly more than the average RN. These RNs will always be in demand – an emergency room is a staple in most hospitals. These RNs take care of patients who have suffered a trauma, injury, experiencing a heart attack or stroke, and other medical emergencies. These RNs must be quick-thinking – they are responsible for triaging patients based on condition so that the most critical patients receive care first. These nurses work side-by-side with other RNs and emergency room physicians to ensure that their patients receive the right care, quickly and safely. In addition, they must be able to work well under pressure, so this type of work environment may not be for everyone.

Forensic Nursing

An RN employed as a forensic nurse can expect to earn about $39 per hour. A forensic nurse may possible hold an ADN, but a BSN is preferred. A forensic nurse may opt to take classes in nursing school that are specific to the forensic field, such as victimology, forensic mental health, and perpetrator theory. In addition, a forensic nurse may choose to become certified from the Forensic Nursing Certification Board (FNCB). According to Criminal Justice Degree Schools, a forensic nurse may “…have a variety of roles, including evaluating and caring for victims of assault, domestic abuse, child and elder abuse, neglect and sexual crimes.”

Informatics Nurse

An RN employed as an informatics nurse can expect to earn about $68,539 per year. An informatics nurse is “…responsible for maintaining medical hardware and software, implementation and training of medical staff, troubleshooting system problems, performing system updates and upgrades, and running reports and collecting data as needed.” Obtaining a job as an informatics nurse requires a BSN degree. However, some employers may even require a master’s degree. The informatics RN is so in-demand due to the majority of healthcare using an electronic health record (EHR) that there are master’s programs specifically for nursing informatics.

Labor and Delivery (L&D) Nurse

The average Labor and Deliver Nurse unit can expect to make about $27 per hour. Rate of pay can increase for L&D nurses if they also are capable of working in the operating room; many L&D units have operating rooms in the event a cesarean section is needed. L&D RNs assist with childbirth, from antepartum to delivery to postpartum care. They are also responsible for the newborn in the initially after childbirth. An RN working on a L&D unit may also eventually work as a NICU RN, potentially earning more money.

Operating Room Nurse

The average Operating Room Nurse can expect to make about $30 per hour. These RNs will always be in demand – surgery is required in many situations and RNs will always have a place in the OR. There are many RNs working in an OR unit, from the preoperative nurse, to the surgical nurse, to the postoperative nurse. There are also typically three RNs present during the surgery – circulating RN, scrub RN and the first assistant. OR RNs typically work Monday through Friday for scheduled surgeries. There is also generally a rotation for on-call RNs for unscheduled, emergent surgeries. RNs have the opportunity to make much more if they are called in for surgery during the evening or weekend.

Neonatal Intensive Care Unit (NICU) RN

The average NICU Nurse can expect to make about $30 per hour. The NICU RN is highly specialized; these RNs take care of critically ill newborns, from premature babies to babies born with illnesses that require intensive care. In addition to the skills necessary for caring for a critically ill newborn, they must also be compassionate and have the social skills to deal with scared and grieving parents and other family members. NICU RNs may require a BSN degree, although many hospitals will allow RNs with an ADN degree to become a NICU RN. For the RN student who seeks to become an NICU RN, joining the National Association of Neonatal Nurses may be the first step in obtaining this job. While many NICUs require at least a year of experience in a related field, such as pediatrics or Labor and Delivery, holding membership with this group and having a strong passion for NICU nursing may actually get the RN the job right out of nursing school.

Nurse Case Manager

An RN employed as a nurse case manager can expect to earn about $66,000 per year. The nurse case manager may work in a variety of settings, such as a hospital, a nursing home or in an industrial setting. They evaluate the patient and determine the type of care that is needed. For example, a nurse case manager working in a hospital may assist with setting up physical therapy on an outpatient basis. They may set the patient up with home health care or aid with transfer to a nursing home after discharge. They may also assist the patient with financial concerns. This position requires an ADN, but a lot of employers require a BSN as the education minimum.

Nursing Educator

An RN employed as a nurse educator can expect to earn about $69,568 per year. The nurse educator is typically employed in a hospital. They oversee a group of nurses to identify their education needs. For example, a nurse educator may be employed on a Med-Surg unit. He or she would be in charge of identifying specific needs of the nurses employed on that unit, such as educating about a new surgical procedure prior to its implementation in the hospital. The nurse educator may also assist with orientation of new nurses, such as implementing an orientation schedule and assigning the new nurse a nurse mentor.

Nurse Executive

An RN employed as a nurse executive (or as a chief nursing officer) can expect to earn about $117,152 per year. According to Villanova University, a bachelor’s degree is required as the minimum education. Many employers may require a master’s degree. Regardless of the type of degree that is held, prior experience in management and leadership is required. The nurse executive manage all of the nursing staff in a given hospital, in addition to managing the budget, preparing plans for emergencies, and communicate with medical and administrative staff. This job undoubtedly has the highest salary of all nursing specialties eligible to a BSN, but they also have the most responsibility.

Oncology RN

The average RN employed as an oncology nurse can expect to make about $28 per hour. These RNs work primarily with cancer patients. These RNs will administer chemotherapy to patients. They must also have strong social skills so that they can effectively interact with the chronically and terminally ill. These nurses not only care for their patients, but their grieving families as well.

Pediatrics Nurse

The average RN employed on a pediatric unit can expect to make about $25 per hour. While this specialty is actually a bit less than the average RN salary, this is a nursing specialty that will not go away; there will always be sick children at clinics and hospitals that need a nurse with this knowledge base. In addition, specializing in pediatrics opens doorways to further nursing specialties, such as NICU nursing. For the nurse that begins with a pediatric nursing specialty, this can also be further specialized, such as pediatric oncology.

Public Health Nurse

An RN employed as a public health nurse can expect to earn about $50,684 per year. The public health nurse typically does not always work on a one-on-one basis with patients. They identify at-risk groups and provide education to individuals, families, groups and communities. For example, a public health nurse may identify that a group of people require smoking cessation education and offer a class to benefit this group of people. The public health nurse is often employed for a large health care provider or for the government. They may reach out to various groups (such as a church) to identify groups that may need their services. Learn more about becoming a Public Health Nurse.

School Nurse

An RN employed as a school nurse can expect to earn about $39,318 per year. The minimum education requirements for the school nurse differ depending on the state of employment. The National Association of School Nurses recommends that the school nurse hold a BSN degree. Johnson & Johnson recommend either an ADN or BSN degree, but for the school nurse to be credentialed as a Certified School Nurse. The salary of a school nurse is less than the salary of an average RN; however, RNs elect to take jobs as a school nurse due to job satisfaction and a sense of purpose. In addition, working as a school nurse is a stepping stone for the RN who seeks to become a family nurse practitioner (F-NP). The school nurse manages the health of chronically ill students, responds to emergencies that may occur during the school day, and promote wellness at school.

Wound Care Nurse

The average RN employed in a wound care setting can expect to make about $27 per hour. These RNs may work in a wound care clinic, in the hospital setting or in a long-term-care facility. These RNs have extra education in wound care and provide this care directly to patients. While often an ADN degree is enough for this type of RN, additional certification may be required for employment. Wound, Ostomy and Continence Nursing Certification Board (WOCNB) provides the necessary certification for wound care RNs. Learn more about becoming a Wound Care Nurse.

Regardless of the direction of specialty nurses choose to take, it is reassuring to know that there are so many nursing specialties for BSNs to choose from. Nursing was once thought of as just at the patient bedside, but as healthcare is evolving, so is the role of the BSN-prepared RN.