What is this job?
Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may remain healthy.
Nursing is a large sector, representing a significant fraction of the entire workforce within developed countries and is the largest group in the medical system.
Broadly, the career progression is:
- Nurses assistants – Nurses without a nursing degree who assist registered nurses with simple tasks.
- Registered nurse – Nurses with a nursing qualification, who make up the majority of nurses.
- Advanced practice nurses – There are a number of advanced masters degrees or specialist qualifications that can raise responsibility and salaries significantly.
What are the pros of this job?
Registered nurses are in high demand in most countries and the course of study required to become one is not very competitive. In the US, on average nursing students scored around 500 on their Math and Verbal SAT components, which corresponds to about the median result.
In some countries, in particular the USA, nursing is a quite high paying job, permitting earning to give. US nurses have a median income of $66,000. Adjusting for the initial ability of students, nursing degrees in the US raise earnings almost as much as any other qualification. We expect salaries to continue to rise because demand for nurses is growing more quickly than other professions, and the work is hard to automate.
Furthermore, someone who went on to do a specialist master’s degree permitting them to work as nurse practitioners or nurse anaesthetists could see their salary rise 50-100% (see occupations similar to registered nursing). However, these courses are significantly harder and quite competitive – though probably a bit less difficult than medicine itself. Unfortunately we haven’t yet found a concrete measure of this difficulty.
Although nurses suffer from a high rate of burnout due to the psychological challenges of caring for the sick, often with limited resources, they also report high level of meaningfulness and satisfaction from their work. The work also offers reasonable levels of autonomy and variety. In the UK nurses report somewhat above average job satisfaction. A US survey found 29% of nurses were extremely satisfied with another 52% reporting being moderately satisfied; extreme satisfaction was significantly higher among those with higher qualifications.
Both at school and work, nursing offers flexibility in the number of days of study or worked in a week; nurses suffer a lower penalty in career progression for taking time away from nursing than most professionals.
Because the SAT scores of people becoming nurses are relatively low for a graduate profession, someone with stronger results could do significantly better job than their replacement, be promoted to a senior role, make systematic improvements to their ward and thereby have more direct impact.
A nurse could also probably have several times more direct impact by working in a developing country, for example in international development organisations, if they have the necessary institutional support.
What are the cons?
The skills, contacts and credentials you gain from nursing do not open up many opportunities for advancement outside of the health sector. We are concerned that someone studying nursing as their first undergraduate degree may significantly limit their later options before they have done enough exploration to find the career that fits them best. The most common exit options according to LinkedIn are: medical assistant, clinical research specialist, social worker and administrative employee. A nurse wishing to study medicine will have to start the course from the beginning like anyone else.
Nonetheless, nurses can be promoted to a wide range of management positions within the healthcare system, or non-clinical work in ‘quality improvement’ and health policy. So if you are set on working in the healthcare system it can be quite a flexible qualification and requires less upfront investment than medical school.
As with other medical careers in the developed world, we think the direct impact of the work is limited and less than generally believed. (Nonetheless, due to the complementary nature of the work, registered nurses probably have a significant fraction of the impact of physicians. Nurse physicians are close substitutes for the physicians they work with, and so probably have a similar impact. Some studies suggest they provide equally good care in some situations.)
Working as a registered nurse also fails to create many opportunities for advocacy, as few nurse build a public profile or have the opportunity to discuss important issues with their patients. Nurses are not afforded the same high credibility as physicians.
As noted above we could not find a concrete measure of the difficulty of advanced nursing qualifications relative to other qualifications.
We were not able to investigate every nursing specialty because there are literally dozens. It is possible that some provide a particularly good income relative to their difficulty.
One person suggested that nursing could actually be the best and most flexible starting place for a career in medicine, but we did not have time to check this.
One person also suggested that we were underrating the advocacy potential of nurses but we are not yet convinced about this.
Who should consider taking it?
As always, if you can’t imagine being satisfied in another job you should consider being a nurse.
If you live in the US, want to earn to give, think you could handle the challenging courses required to become a Nurse Practitioner or Nurse Anaesthesiologist, and don’t want to pursue a medical degree or other earning to give career, nursing may be a good option.
We recommend young people (those under 23) study a more general degree and explore what jobs are a good fit for them before committing to an applied qualification that then limits their options.
If you are considering becoming a nurse in order to earn to give, we suggest looking at our profile on the allied health professions, particularly pharmacy, podiatry and optometry. They normally have more say over how to treat their patients, many are higher paid, and they have less shift work. Most, like nursing, have good job growth prospects and a high rate of employment following university. There are a wide range of salaries and levels of competition over the many options, so see our full profile for more.