The healthcare industry in the United States is currently navigating through a period of significant transition, especially in the nursing field, after the pandemic. Nurse practitioners are advanced practice registered nurses (APRNs) who provide primary, acute, and specialty healthcare services. Among these, the growing demand for nurse practitioners (NPs) stands out as a critical factor that affects healthcare delivery nationwide.
This trend won’t change soon, as the Bureau of Labor and Statistics reports that until 2031, there will be 30,200 new jobs annually in the nursing field. Understanding the key drivers behind the escalating demand for NPs is essential for healthcare planning and policy-making. The demand is not only reflected in job growth but also in salary increments and expanded opportunities in various healthcare settings. Today, we’ll break it down and look at the career opportunities for nurses.
The job outlook of nurse practitioners in the United States
As we have seen, the healthcare landscape in the United States is ever-evolving, with the demand for skilled and advanced healthcare professionals on a consistent rise. The U.S. Bureau of Labor and Statistics reports that the employment outlook for nursing jobs is 40% higher than for other occupations. Nurse practitioners work in a variety of settings, including hospitals, physicians’ offices, outpatient care centers, and educational services. They also serve in specialized roles such as family practice, gerontology, pediatrics, psychiatric mental health, and women’s health. The job outlook in each specialization reflects the broader trends in healthcare needs and policy changes.
The proliferation of educational programs for nurse practitioners has facilitated a steady flow of professionals into the field. These programs, including Doctor of Nursing Practice (DNP) and MSN degrees, focus on advanced clinical skills, healthcare policy, leadership, and evidence-based practice, preparing NPs to meet complex healthcare needs. While the overall demand for NPs is increasing, there are regional variations in the job market. States with more liberal scope-of-practice laws tend to have higher demand and better pay for NPs. The BLS data and reports from the American Association of Nurse Practitioners (AANP) suggest that states like New York, California, Texas, and Florida, which have large and diverse populations, exhibit a robust demand for NPs.
The median annual wage for nurse practitioners was $124,6870 in May 2022, according to the BLS. Wages can vary greatly depending on geographic location, experience, specialty, and setting. According to data from the Bureau of Labor Statistics (BLS), California, with a high cost of living, especially in metropolitan areas like San Francisco and Los Angeles, often tops the list for high salaries to compensate for the expense of living. Alaska, Massachusetts, New Jersey, Washington, and New York also offer competitive salaries.
Factors influencing the demand for nurses in the US
Increase in the aging population
One of the most potent drivers of demand for NPs is the aging baby boomer population. As per the U.S. Census Bureau, by 2030, all baby boomers will be over the age of 65. By 2040, the population of people over 85 years old is expected to quadruple. This demographic shift results in a higher prevalence of chronic conditions and a consequent increase in the need for healthcare services. Health conditions such as heart disease, diabetes, arthritis, Alzheimer’s disease, and other ailments require ongoing medical care. They make more frequent visits to healthcare providers, have longer hospital stays, and require more home health care and long-term care services. NPs are trained to manage these chronic conditions, making them invaluable in caring for an aging population. Nurses with expertise in geriatric care are crucial for assessing the complex health status of elderly patients, managing multiple disease conditions, and providing age-appropriate care.
Primary care provider shortage
The Association of American Medical Colleges (AAMC) forecasts a shortage of between 21,100 and 55,200 primary care physicians by 2033. With their ability to provide many of the same services as physicians, including diagnosis and prescribing medications, NPs have become a pivotal part of the solution to this shortage, especially in primary care settings.
Additionally, as the current nursing workforce ages and retires, there’s a compounding effect on the already existing nursing shortage. A study by the National Nursing Workforce in 2022 revealed that 800,000 RNs—about 20% of RNs in the US—are likely to retire by 2027. It underscores the urgency of training and recruiting new nurses to care for the increasing number of older adults. The Affordable Care Act (ACA) also expanded health insurance coverage for millions of Americans. With more people having access to healthcare services, there is a corresponding rise in demand for providers. NPs have been integral in filling the increased need for care providers, especially since they are more cost-effective than physicians.
Rural health disparities
Rural areas are particularly affected by healthcare provider shortages. The National Academy of Medicine reports that rural regions have only 62 RNs per 100,000 people, compared to 84 per 100,000 in urban areas. NPs are more likely to practice in rural and underserved areas than their physician counterparts. With fewer nurses to cover the needs, the quality and timeliness of care can be compromised. Nurses’ presence helps mitigate the disparities in access to care for these populations. State and federal policy initiatives, such as funding for rural health clinics and incentives for healthcare providers to practice in underserved areas, are critical. In addition, expanding and supporting local community college and university nursing programs in rural areas can increase the supply of local nurses. Offering scholarships, loan forgiveness, and other incentives for nursing students who commit to working in rural areas can also help.
Increased demand for mental health nurses
The ongoing opioid crisis and increasing attention to mental health have created a demand for healthcare professionals who can provide integrated substance abuse and mental health services. Nurses working in emergency settings have seen a marked increase in patients suffering from opioid overdoses, necessitating quick and often complex life-saving interventions. Nurses are pivotal in coordinating long-term care for patients recovering from opioid addiction, including follow-ups, rehabilitation services, and mental health support. NPs, especially psychiatric-mental health nurse practitioners, are playing a crucial role in addressing this need. Federal funding has been increased to combat the opioid crisis, some of which is directed toward training healthcare professionals. Programs like the Substance Abuse and Mental Health Services Administration (SAMHSA) offer grants to support the education of nurses in substance use disorder treatment and prevention.
Telehealth and other technological advancements have expanded the reach of healthcare providers. NPs have adapted quickly to these technologies, which has increased their accessibility and the demand for their services, particularly in telemedicine. According to the U.S. Department of Health and Human Services (HHS), during the early months of the pandemic, there was a 63-fold increase in Medicare telehealth visits, from approximately 840,000 in 2019 to 52.7 million in 2020. Nurses often serve as telehealth coordinators, managing patient schedules, ensuring technology is working correctly, and acting as the first point of clinical contact in telehealth appointments. As new technologies are adopted, nurses are not only required to learn to use these tools but also often take part in training other healthcare team members.
Increased demand for nurse educators
According to the AACN’s report on 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, US nursing schools turned away 91,938 qualified applicants from baccalaureate and graduate nursing programs in 2021 due to an insufficient number of faculty, clinical sites, classroom space, and budget constraints. The same report indicates a 7.9% vacancy rate for nursing faculty across the country. Clinically experienced nurses may be less inclined to pursue educator roles, which often offer lower salaries than clinical positions. The Bureau of Labor Statistics (BLS) notes that the median annual wage for nursing instructors and teachers was $75,470 in May 2020, compared to higher salaries for nurses working in hospitals and outpatient centers.
Scope of practice regulations
Changes in the scope of practice (SOP) laws that allow NPs to practice independently in many states have also contributed to the growing demand. As of April 2023, many states have full practice authority, meaning NPs can assess, diagnose, interpret diagnostic tests, and initiate treatment plans, including prescribing medications. As NPs provide cost-effective care with comparable outcomes to physicians, this is a significant advantage in a healthcare system concerned with cost containment. Insurance companies and healthcare institutions are increasingly relying on NPs to deliver high-quality, cost-effective patient care.
Top career paths for nurses
Within this dynamic environment, nursing remains a cornerstone profession, critical to the delivery of care. As we enter 2024, nursing continues to offer a wide spectrum of career opportunities, many of which command substantial salaries due to their expertise, complexity, and demand. Let’s explore some of the most rewarding nursing jobs in the United States, examining the factors driving their compensation and the qualifications required to pursue these rewarding career paths.
Certified registered nurse anesthetist (CRNA)
Anesthetist nurses continue to hold the top spot as the highest-paid nursing professionals. CRNAs play a vital role in the administration of anesthesia, working closely with surgeons, anesthesiologists, and other medical professionals. With an aging population and the expansion of surgical procedures being performed, the demand for CRNAs remains robust. To become a CRNA, one must have a master’s degree or doctor of nursing practice (DNP) in nurse anesthesia and pass the National Certification Examination.
Family nurse practitioner (NP)
Family nurse practitioners (FNPs) are highly versatile and valued for their ability to provide comprehensive care across all age groups. In many states, FNPs have full practice authority, allowing them to diagnose and treat patients independently.
If you’re asking yourself where do Family Nurse Practitioners work, well, they can work in outpatient clinics, community health clinics, telemedicine, and other primary care settings. A Master of Science in Nursing (MSN) FNP program or a DNP is required, along with passing the national board certification exam relevant to their specialty. Many institutions, including Texas Woman’s University, offer online MSN-FNP programs that equip nurses with the skills to become primary caregivers.
Pain management nurse
With an increasing focus on responsible pain management and the complexities of treating chronic pain, they work closely with the healthcare team to diagnose the cause of pain and develop individualized pain management plans. It may involve coordinating with physicians, pharmacists, physical therapists, and other specialists. They have advanced knowledge of pharmacological and non-pharmacological pain management techniques. It includes administering medications, understanding drug interactions, monitoring for side effects, and evaluating the effectiveness of pain interventions. These nurses often have an MSN with specialized knowledge in pain management, often certified through the American Nurses Credentialing Center (ANCC).
Psychiatric/mental health nurse practitioner
Psychiatric nurse practitioners specialize in mental health and are essential in addressing the growing need for mental health services. They are trained to provide a wide range of mental health services, including the assessment, diagnosis, and management of psychiatric disorders. The role of a PMHNP is multifaceted and crucial to bridging the gap in mental health services.
Certified nurse midwife (CNM)
Certified nurse midwives (CNMs) are advanced practice registered nurses (APRNs) who specialize in primary and reproductive care for women across their lifespan. It includes gynecological exams, family planning services, preconception care, prenatal care, labor and delivery support, postpartum care, and sometimes newborn care. They are trained to provide comprehensive, holistic care and to support women through all stages of pregnancy and childbirth, as well as offer well-woman health care.
Neonatal nurse practitioner (NNP)
NNPs specialize in the care of newborns, particularly premature or ill infants. NNPs work in neonatal intensive care units (NICUs), delivery rooms, emergency rooms, specialty clinics, and during patient transport. Their specialized skills command higher salaries. NNPs can expect a median salary of about 136,000, according to ZipRecruiter.
An MSN or DNP with a neonatal focus and certification from a recognized accrediting body are required.
Orthopedic nurse practitioner
They provide comprehensive care to patients with a variety of musculoskeletal ailments, such as fractures, sprains, arthritis, osteoporosis, and sports injuries. ONPs may work in a range of settings, including hospitals, orthopedic clinics, rehabilitation facilities, and private practices. Their role encompasses a blend of clinical, surgical, and therapeutic aspects tailored to the needs of orthopedic patients. With the rise in sports injuries and age-related musculoskeletal issues, their expertise is increasingly sought after. They typically earn between $115,000 and $131,700, and an MSN or DNP, along with orthopedic nursing certification, is often required.
Nurse informaticists stand at the crossroads of nursing and information technology, playing a critical role in the management of health information systems to improve healthcare outcomes. It is a professional who integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. The mean salary is about $97,795.
The demand for nurse practitioners in the United States is a multifaceted issue driven by demographic shifts, healthcare shortages, legislative changes, and economic factors. It is essential for healthcare systems and policymakers to recognize and support the expanding role of NPs in order to fully address the healthcare needs of the nation. The data suggest that not only is there a need for more NPs, but there is also a need for systems that can fully integrate them into the healthcare team, maximizing their impact on patient care and health outcomes.
As demand continues to grow, competitive salaries and benefit packages are likely to improve to attract and retain these professionals. For those considering a career as an NP, the future looks promising with abundant opportunities, competitive salaries, and the ability to make a significant impact on the health and well-being of the community.