Employment & Job Outlook for Registered Nurses
As the largest health care occupation, registered nurses held about 2.6 million jobs in 2008. Hospitals employed the majority of RNs, with 60 percent of such jobs. About 8 percent of jobs were in offices of physicians, 5 percent in home health care. services, 5 percent in nursing care facilities, and 3 percent in employment services. The remainder worked mostly in government agencies, social assistance agencies, and educational services.
Overall job opportunities for registered nurses are expected to be excellent, but may vary by employment and geographic setting. Some employers report difficulty in attracting and retaining an adequate number of RNs. Employment of RNs is expected to grow much faster than the average and, because the occupation is very large, 581,500 new jobs will result, 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 by 22 percent from 2008 to 2018, 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:
|Offices of physicians||48|
|Home health care services||33|
|Nursing care facilities||25|
|Hospitals, public and private||17|
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 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 older persons, many of whom require long-term care. Many elderly patients want to be treated at home or in residential care facilities, which will drive demand for RNs in those settings. The financial pressure on hospitals to discharge patients as soon as possible should produce more admissions to nursing and residential care facilities and referrals 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 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.
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.
Qualified applicants to nursing schools are being turned away because of a shortage of nursing faculty. The need for nursing faculty will only increase as many instructors near retirement. Despite the slower employment growth in hospitals, job opportunities should still be excellent because of the relatively high turnover of hospital nurses.
To attract and retain qualified nurses, hospitals may offer signing bonuses, family-friendly work schedules, or subsidized training. 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.
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.
Median annual wages of registered nurses was $63,000 as reported a few years ago. The middle 50 percent earned between $52,000 and $77,000. The lowest 10 percent earned less than $43,000, and the highest 10 percent earned more than $94,000.
Many employers offer flexible work schedules, child care, educational benefits and bonuses. About 21 percent of registered nurses are union members or covered by union contract.