Nursing Career Trends for 2020 and Beyond
Set your sights on these growing areas of nursing to tee yourself up for success in the coming years.
By Joanna Nesbit
Whether you’re a high school graduate considering a nursing career or a seasoned nurse looking to advance your career, one thing is certain: there is an increasing number of jobs available in nursing. Some positions are in newer areas, such as a nurse navigator, and some are in traditional areas such as a nurse practitioner.
There are a few reasons for the growth: older nurses plan to retire in coming years, the physician shortage is increasing, and the U.S. population is aging. By 2029, in fact, all baby boomers will be 65 or older, according to the U.S. Census Bureau. According to Beverly Malone, PhD, RN, FAAN, and CEO of the National League for Nursing, changes in community demographics are also driving the need. As a result, from 2018 to 2028, registered nursing is projected to experience a 12% growth rate, putting it among the top occupations for growth, according to the U.S. Bureau of Labor and Statistics.
These five nursing careers, especially, are surging in demand and can help position you for success in the coming years.
Community Healthcare Nurse
With advances in technology and telemedicine, as well as an increased focus on preventive and primary care, healthcare is shifting from inpatient (hospital) settings to outpatient settings. That’s partly in response to increased costs of care, and it may become more prevalent in times of public health crises such as the Covid-19 epidemic. “We need more nurses to move into community-based settings to deal with population health and in places where we need primary care,” says Robyn Nelson, PhD, MSN, RN, and dean of the College of Nursing at West Coast University. Nurses will be needed most, says Malone, in the following settings:
• Primary care clinics
• Retail “minute clinics,” like Walgreens or CVS
• Home healthcare agencies
• Long-term care facilities
By 2030, the country will face a projected shortage of 120,000 physicians. With an expanding patient pool, the need for nurse practitioners (NPs) working in community health is going to spike. These healthcare providers are viewed as the professionals to fill the physician gap, particularly in underserved areas, such as rural and low-income communities, Nelson says, where nurse practitioners provide primary and preventive care, including women’s care, pediatrics, and geriatrics. In many states, nurse practitioners operate independently from physicians. “That’s an attractive feature to students considering a career in nursing,” Nelson says.
In the states that allow “full practice authority” (working on their own), nurse practitioners examine patients, prescribe medicines, order tests, and make decisions about patient care. They can establish their own practice or work in urgent care, hospitals, outpatient clinics, schools, nursing homes, and other primary care settings. Other states allow nurse practitioners “reduced” or “restricted” practice, requiring some degree of partnership with a physician. However, as the physician shortage increases, these states might change their practice laws. Research shows that patients do as well under NP care as those who receive care from other providers.
Nurse practitioners are advanced practice registered nurses (APRNs). These professionals have a master’s degree or post-master’s education. Under the umbrella of APRN, you’ll find four specialties:
• Certified nurse practitioner
• Certified registered nurse anesthetist (more on this field below)
• Certified nurse-midwife
• Clinical nurse specialist
Certified Nurse Educator
You might already know that being accepted to a nursing program is competitive, even for qualified applicants. That’s in part because programs don’t have enough faculty to handle the demand. If you’re interested in educating future nurses, you can teach in the classroom or clinical setting. Becoming a certified nurse educator (CNE) or a certified clinical nurse educator (CNEcl) comes with a special credential verifying your competence as an academic nurse educator, and it’s a plus for the institution, Nelson says. Most frequently, teaching requires an advanced degree, though in some states you can provide clinical supervision with a bachelor’s degree and two or three years of experience. “Typically these clinical supervisors have a regular job and then do clinical education one day a week,” Nelson says. “These educators really inspire the next generation.”
The industry also needs faculty with PhD-level education, and it has a vision for growing doctoral degrees in the 2020s, Malone says. All three pathways prepare you to teach future nurses:
• Doctor of nursing practice (DNP), which is a clinical practice-focused or education-focused degree
• PhD of nursing, which prepares you to conduct research, teach and develop policies
• EdD, a specialized degree in knowledge related to teaching overall
As baby boomer nurses retire (some 1 million by 2030), the profession needs younger nurses to take their place in specialty areas beyond critical and acute care. More nurses are needed in all areas of the profession, but the following specialties have the greatest need:
- Psychiatric mental health nurse. A psychiatric mental health (PMH) nurse by training, Malone says the industry needs more psychiatric nurses to address the increase in mental and behavioral health issues. These include anxiety, depression, substance use disorders, bipolar disorder, dementia, or Alzheimer’s disease in older patients. Research shows that 96% of U.S. counties don’t have enough mental-health clinicians, particularly in rural areas. PMH nurses can fill the gap, though in many states they’ll need to work in team-based settings as APRNs do. However, some states have very few PMH programs, according to The American Psychiatric Nurses Association, which is one reason there’s a shortage of nursing students interested in this field. Explore the options.
- Nurse anesthetist. These nurses—nurse anesthetists or certified registered nurse anesthetists (CRNA)—play a key role in patient care during surgery, obstetrical care or dental care, and are important in rural settings that might not have an anesthesiologist. They also enjoy top salaries in their field. To become a nurse anesthetist, you need advanced education, including a bachelor’s of science in nursing (BSN) and at least a master’s degree.
- Perioperative nurse. These professionals assist with surgery, providing patient care prior to, during, and after the surgery in the recovery room. During the procedure, they assist the surgeon, assess patient needs, and monitor patients after they’re awake. Nelson sees a need in this specialty, especially as older nurses retire.
- Geriatric nurse. Experts say gerontology doesn’t draw enough students, but over the next 15 years the aging population will need specialists who understand their needs. Nursing students can study to be a nurse practitioner (APRN) with a specialty in gerontology.
With the next decade’s emphasis on preventive and primary care, nurse navigators will play an important role as a bridge between the hospital and community setting. “A good navigator can assure the patient of the best possible outcome,” Malone says. They provide personalized attention for the patient, family, and caregiver, helping them navigate specialized treatment, such as cancer care. Navigators explain treatment plans, coordinate care across available services, and address barriers that might interfere with access. This could be helping a family understand their insurance or providing paperwork in their native language. Navigators need to have good communication skills to serve as a liaison between medical providers and the family and be open to diverse cultures.
Diversity in Nursing
In addition to the growing need for specialized nurses, emphasizing diversity is an increasingly important factor in nursing, and the healthcare industry needs more of it, Malone says. And that means diversity of all kinds of attributes: race, ethnicity, socioeconomic status, religion, gender, sexual orientation, and more.
“We have patients from all kinds of backgrounds, and we don’t have enough diversity in nurses and nurse navigators who know the community and the needs of our vulnerable populations,” she says. “We also need diverse faculty to attract diverse students.” Being more attuned to the needs of various populations will make the healthcare and educational setting more inclusive and welcoming, Malone says. To attract students to the field, Malone recommends developing a pipeline with scholarships and counseling support that leads to a career in nursing, hiring faculty from a variety of backgrounds, and offering summer opportunities for involvement with universities and other schools of nursing.