Choosing a career in nursing might have been easy, but settling on a nursing specialty or changing one specialty for another is not so simple. There are so many settings where nurses may work: hospitals, long-term care facilities, outpatient care centers, correctional facilities, rehabilitation centers, schools—and the list goes on. Furthermore, even if nurses have identified a nursing setting and a population that they enjoy working with—for example, infants and children—at each facility, there are different roles that nurses can carry out. In the hospital setting alone, nurses can work in labor and delivery, mother and baby, neonatal intensive care, pediatrics, pediatric ICU, pediatric OR, pediatric ER, and pediatric telemetry, among others.
To help nurses navigate seemingly limitless information on this topic and to help them decide on the best specialty for them, we have created the most comprehensive yet straightforward guide to nursing specialties, starting with a summary of the most popular specialties.
Table of Contents
Which Are the Best Nursing Specialties for Me?
What Nursing Specialties Are in Demand?
Highest-Paying Nursing Specialties
Which Are the Most Stressful Specialties?
Which Are the Least Stressful Specialties?
Which Nursing Specialties Have the Lowest Burnout Rates?
Nursing Specialties for Each Personality Type
Nursing Specialties: Continuing Education
How Many Types of Nurses Are There?
Master’s in Nursing Specialties
Nursing Specialties: PhD Programs
How to Try Out Different Specialties
Which Are the Best Nursing Specialties for Me?
By now, you should have a preselection of the specialties that seem the most interesting to you. Perhaps, you know which facilities you would like to work in, which populations you enjoy caring for, or which responsibilities you would like to take on—or avoid altogether.
However, there are also some practical aspects that you should consider before making such an important career choice as choosing a nursing specialty.
What Nursing Specialties Are in Demand?
With the ongoing nursing shortage, which the COVID-19 pandemic has only exacerbated, nurses are always in demand. That said, here are the nursing specialties in highest demand:
- Nurse anesthetists
- Nurse midwives
- Nurse practitioners
According to the U.S. Bureau of Labor Statistics (BLS), these three nursing specialties are projected to grow by a whopping 45% from 2020 to 2030. To put this growth in context, the increase in registered nurses (RNs) in general is expected to be a more moderate 9% during the same period.
Another group of nursing specialties for which demand can only increase includes those specialties that focus on older adults. According to the U.S. Census Bureau, people over sixty-five will outnumber children for the first time in US history by 2030. In fact, by that year, one in five Americans will be of retirement age. This is why, these types of nursing specialties will be needed the most.
Each of the nursing specialties on this list focuses on or provides excellent knowledge, experience, and skills to work with older populations:
- Long-term care
- Assisted living
- Home health
- Hospice care
- Case management
- Skilled nursing
- Wound care
Highest-Paying Nursing Specialties
According to BLS, the highest paying nursing specialties are nurse anesthetists, nurse practitioners, and nurse midwives. The following were the median salaries for these nursing specialties in 2021:
- Nurse anesthetists: $195,610
- Nurse practitioners: $120,680
- Nurse midwives: $112,830
It is interesting to note that there are even salary variations within each specialty depending on the settings or industries where nurses work.
Here are the average annual salaries of nurse anesthetists in different settings:
- Outpatient care centers: $254,180
- Specialty hospitals except psychiatric and substance abuse hospitals: $219,540
- General medical and surgical hospitals: $212,340
- Colleges, universities, and professional schools: $200,340
- Offices of physicians: $194,240
- Offices of other health practitioners: $179,220
The following average salaries show pay variation among nurse practitioners:
- Home health care services: $133,170
- Psychiatric and substance abuse hospitals: $131,830
- Outpatient care centers: $129,190
- General medical and surgical hospitals: $122,960
- Offices of physicians: $114,870
- Offices of other health practitioners: $108,890
Finally, here is the breakdown of average annual salaries for nurse midwives across industries:
- Outpatient care centers: $146,430
- General medical and surgical hospitals: $119,900
- Offices of physicians: $113,920
- Colleges, universities, and professional schools: $107,130
- Local government, excluding schools and hospitals (OEWS designation): $104,670
- Specialty hospitals except psychiatric and substance abuse hospitals: $80,440
- Offices of other health practitioners: $68,430
Which Are the Most Stressful Specialties?
Naturally, some nursing settings are more stressful than others. ER and ICU nurses work in fast-paced settings caring for patients who are generally in critical condition. Furthermore, patients in these settings often die due to the severity of their health conditions, which adds another layer of stress to these types of nursing work.
That said, there are many sources of stress—some quite unexpected—and different settings come with their own challenges. For example, hospice nurses also see a high number of deaths, leading to stress in a specialty that isn’t generally considered stressful. In addition, LTC settings, such as assisted living facilities and nursing homes, experience serious understaffing, which also leads to stress and nursing burnout. Furthermore, Med-Surg nurses experience even more stress than ICU nurses regarding work overload and understaffing.
As we can see, stress is a complex issue that can be caused by several factors. Therefore, instead of choosing a specialty based on the perceived general levels of stress associated with a particular specialty, nurses should consider which sources of stress might be more detrimental to their well-being based on their unique personality profiles and life experiences. Are you very affected by death? Avoid hospice care and intensive care units. Do you find it hard to multitask? Steer clear of Med-Surge.
Which Are the Least Stressful Specialties?
Although we have acknowledged that stress is complex and that different specialties all come with their own challenges. Thankfully, multiple nursing specialties are as stress-free as nursing can be. Here are some of most slow-paced nursing specialties:
- Nurse educator: Nurse educators work for academic institutions, training nursing students, or for healthcare systems, providing continuing education for licensed nurses. The catch is that nurses need extensive clinical experience in order to work in this role, so they can see this nursing specialty as a well-earned respite after years of sweat and tears.
- Nurse administrator: Granted, managing budgets and staffing issues can be stressful. However, this is an excellent option for nurses who crave the predictability and the nine-to-five schedule of an office job. Just being able to sit down for hours at a time and drink coffee while it’s still hot is daydream material for many nurses.
- Clinical research nurse: This nursing specialty is another heavily administrative one, which also comes with the benefit of regular work schedules. However, clinical research nurses also interact with patients, which is the main reason nurses choose to study nursing in the first place. In other words, this type of work offers a balance between an office job and a clinical position.
- Clinic nurse: Working as a clinic nurse in a physician’s office is also relatively stress-free. Although nurses see many patients every day, these positions offer predictability, and patients are rarely in critical condition.
- Mother and baby: This specialty is an excellent option for nurses who love working with new moms and newborn babies without the intensity of working in labor and delivery or the stress of a neonatal ICU.
Which Nursing Specialties Have the Lowest Burnout Rates?
A 2007 study analyzed the perceived control and burnout rates among different nursing specialties and found that nurse practitioners had the highest levels of control and the lowest levels of burnout.
These findings can be further generalized to identify other specialties with low burnout rates since control was a determining factor in levels of burnout. For example, the study found that ER nurses have very little control and very high burnout rates; therefore, ICU nurses must also experience high burnout rates due to their low levels of control. On the other hand, other specialties, such as nurse management, offer nurses high levels of control and, therefore, relatively low levels of burnout.
Nursing Specialties for Each Personality Type
According to the Big Five Model, there are five main aspects of personality, each representing a spectrum of possibilities for each person. Identifying where nurses are on each spectrum can help them view their personality profiles as a whole, which in turn can help them determine in which nursing specialties they can feel the happiest:
- Extroversion: Highly extroverted nurses are energized by social interaction, whereas more introverted nurses are tired by it. Therefore, extroverted nurses would enjoy specialties that allow them to develop deep relationships with patients, as is the case in long-term care settings or specialties that involve significant nurse-patient interaction, such as labor and delivery or mother and baby. On the other hand, the best nursing specialties for introverts would be nursing administration or clinical research nursing, which require less social interaction.
- Agreeableness: More agreeable nurses are cooperative, empathetic, sympathetic, and compliant, which makes them excellent team workers. However, these nurses struggle with individual proactivity. Therefore, a highly agreeable nurse would do well in settings that require significant teamwork and collaboration, such as ICUs and Med-Surg units, but nurses with low agreeableness would flourish in roles that provide more autonomy, such as nurse practitioners.
- Openness: This factor is directly related to nurses’ ability to adapt to and enjoy change. Nurses with low openness would benefit from specialties that allow them to have predictable schedules and routines, such as in physicians’ offices or assisted living. On the other hand, nurses with high openness should consider working per diem, which would allow them to work at different facilities every day.
- Conscientiousness: This factor is a predictor of overall job performance since people with high conscientiousness are organized, disciplined, and careful, whereas people with low conscientiousness tend to be disorganized and impulsive. That said, nurses with more impulsive tendencies would also benefit from the added flexibility of per diem work, which would allow them to go on spontaneous road trips whenever the need emerges but also find work whenever financial needs are pressing.
- Neuroticism: Neuroticism affects nurses’ job performance similarly to agreeableness in that nurses with high neuroticism work better in teams but don’t thrive in autonomous roles. However, high neuroticism would also cause nurses to be prone to negative thoughts, which means these nurses should avoid highly stressful specialties to avoid burnout.
Nursing Specialties: Continuing Education
Naturally, nurses who work in specific facilities or units for many years become specialized in those areas of nursing. For example, after years of working in Med-Surg, a nurse would be very knowledgeable and skilled in medical-surgical nursing, but they would still not be a certified Med-Surg nurse. To become certified, nurses must fulfill a minimum number of hours of continuing education and pass a test by a recognized board of nursing certification—in addition to a minimum of clinical hours in the area of interest. The American Board of Nursing Specialties (ABNS) encourages nurses to continue their education since certification and accreditation contribute to professional excellence, higher ethical standards, and greater confidence, leading to better patient outcomes.
How Many Types of Nurses Are There?
According to a 2020 survey by the ABNS, at least forty-four nursing certification boards are currently offering at least 148 credentials in fifty-three different specialties. Of these 148 credentials, 106 are accredited, meaning the certification programs meet industry standards. The Accreditation Board for Specialty Nursing Certification (ABSNC), which is solely focused on nursing certification programs, accredits sixty-seven of these; the National Commission for Certifying Agencies (NCCA), which accredits programs for professions and occupations in many fields, accredits fifty-three of these, and both the ABSNC and the NCCA accredit fourteen.
Furthermore, from the total of 148 credentials, seventy-six are available for both RNs and Advanced Practice Registered Nurses (APRNs), twenty-nine are available only for RNs, and forty-three are only available for APRNs.
Master’s in Nursing Specialties
APRNs are the most respected, demanded, and competitive nursing specialties. Becoming an APRN implies completing a master’s degree, a post-master’s degree certification, or a practice-focused doctor of nursing practice degree program in one of the following roles:
- Nurse practitioners
- Clinical nurse specialists
- Certified nurse midwives
- Certified nurse anesthetists
Due to the nature of their work, nurse midwives work with infants and women during pregnancy and throughout the rest of women’s lives. Nurse anesthetists can work with all patient groups but may decide to focus on a particular population.
In the case of nurse practitioners and clinical nurse specialists, their particular certifications further define their roles in one of the following areas:
- Family/Individual across the lifespan
- Adult-Gerontology
- Women’s health
- Neonatal
- Pediatrics
- Psychiatric/Mental health
Nursing Specialties: PhD Programs
Nurses may also obtain PhDs in nursing if they are interested in working in academic or research settings. Nurses go the PhD route if they want to focus on research and education instead of pursuing leadership roles in clinical practice. They primarily work in academic institutions teaching and doing research.
Online Resources for Nurses
Online resources for nurses are practically limitless. Nurses not only can continue their education online, but they can also use the Internet to find nursing jobs, reach fitness goals, make friends and find support networks through social media and other online platforms, and even learn tips for using social media adequately—and the list goes on.
An all-around excellent online resource for nurses is Nursa’s per diem nursing blog, which covers a wide range of topics from taxes to nutrition to reaching goals.
How to Try Out Different Specialties?
When debating nursing career paths, reading about different nursing specialties is an excellent first step. However, nothing beats hands-on experience. Once you have narrowed down your areas of interest, per diem or PRN nursing can help you get that practical experience without committing to a specialty or type of facility before being sure that you absolutely love it. Pick up shifts in as many settings and roles as possible to help you find the perfect one.
Furthermore, PRN work is an excellent way to boost your career opportunities as a nurse.
