By Carol Tice
Not all nurses stick to 12-hour shifts in hospitals. Once they're in the field, many nurses take additional training to become what's known as an advance practice nurse, taking on new challenges in settings from cruise ships to jails. After about five years, most nurses either leave the field or move up, says Michele Kunz, director of nursing education at Mercy Medical Center in Long Island, NY.
Where median annual pay for experienced registered nurses is $56,100, according to online salary database PayScale.com, earning additional credentials often leads to higher salaries. And, in addition to a bigger paycheck, some of these specialties offer the added benefit of work outside the hospital, such as in schools and emergency helicopters. For all nurses, a bachelor's of science degree lays the groundwork for moving up, and a master's degree in their specialty usually follows. Overall, demand for nurses is forecast to rise 22 percent by 2018.
Here's a look at some of the best-paid nursing specialties:
Nurse anesthetist ($144,821). Nurses with critical-care experience may go back to school for this lucrative specialty, Kunz says. Nurse anesthetists combine nursing skills with knowledge of how to safely administer anesthetic.
Nurse practitioner ($86,774). With the ability to treat patients and prescribe medications, nurse practitioners work in pharmacies, doctors' offices and emergency rooms, says Kunz.
Clinical nurse specialist ($82,117). Clinical nurses may care for patients or offer expert consultations in areas such as psychiatric health.
Nursing informatics analyst ($80,596). The economic stimulus bill passed last year requires hospitals to have the ability to share patient records online. As a result, Kunz says, "There's tons of opportunity" for nurses who can combine medical knowledge with computer training, working for medical-records software vendors or hospitals' records departments.
Nurse educator ($71,292). Nurses need ongoing training throughout their careers, notes Kunz, and must re-certify regularly in some specialties. An emerging workplace for nurse educators is mobile simulation labs that tour to hospitals to provide specialized training with lifelike mannequins.
Nurse case manager ($68,032). "A lot of nurses who want to get away from the bedside get into case management," says California-based healthcare recruiting expert Nadia Gruzd. "Here, they're dealing with the families – someone could be running out of insurance, or they need a plan for who will pick the patient up. They're managing the patient's case." Some case managers also work for insurance companies.
Certified dialysis nurse ($63,500). Dialysis nurses love the 9-to-5 schedule they can work at dialysis clinics, says Gruzd, a breeze compared to hospital shifts. Dialysis nurses are also in demand on cruise ships – a far more desirable workplace than a hospital.
Flight or transport nurse ($63,246). In rural areas, a helicopter, small plane or lengthy ambulance ride may be required to get patients to a hospital. A nurse needs to accompany the patient to see to their medical needs en route. Gruzd says some hospitals offer higher pay to transport nurses who work night or weekend hours, or who have Advanced Cardiac Life Support certification.
Certified legal nurse consultant ($62,100). This niche gets nurses out of the hospital and into lawyers' offices, providing medical expertise for lawsuits.
Registered nurses looking for more pay can also forgo the specialized training if they're willing to relocate – at least temporarily – to an area where their specialty is in short supply. Known as travel nursing, it's popular with younger nurses who don't have family they'd have to leave behind, Kunz says. Pay varies depending on the distance traveled and conditions where the nurses will work.
"You can go to Hawaii for a couple months and be a nurse," says Kunz, "plus get a great salary and room and board."
Business reporter Carol Tice contributes to several national and regional business publications.
Source: All salary data is from PayScale.com. The salaries listed are median, annual salaries for full-time workers with 5-8 years of experience and include any bonuses, commissions or profit sharing.