Highest-paid nursing roles in America

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January 8, 2021
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Highest-paid nursing roles in America

If there was ever a time the United States needed more nurses, it's now. The latest forecasts received Dec. 30 by the Centers for Disease Control and Prevention (CDC) suggest as many as 21,000 new confirmed COVID-19 hospital admissions by Jan. 25. As COVID-19 hospitalizations continue to rise, the country faces significant nurse and doctor shortages, with demand for travel nurses climbing 44% between November and December 2020. While Health Affairs reports some immediate steps to help fill the COVID-19 nurse gap, the ultimate resolution is for more nurses to enter the workforce.

Nursing roles are as diverse in pay as in specialty, with primary and preventative nurses often obtaining specializations in a wide variety of fields that includes nurse-midwives, flight nurses, and correctional facility nurses. The American Association of the College of Nurses (AACN) health care employers prefer nurses with a bachelor's degree or a minimum associate's degree.

NursingEducation.org used data from the U.S. Bureau of Labor Statistics Occupational Employment Statistics (May 2019 data released in March 2020) to compile a ranked list of the seven highest-paid nursing roles in the United States based on average annual salaries. For each occupation, the U.S. average annual and hourly wages are provided, as well as 2019 employment numbers, and which states pay workers in this profession the most based on state average salary.

The American Association of the College of Nurses (AACN) anticipates more than 200,000 newly registered nurse roles forming annually between 2016–2026. The industry growth, which is faster than most occupations, is based on nurses' needs in acute and community settings.

Keep reading to see which nursing roles command the highest salaries.

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#7. Nursing assistants

- Average annual salary: $30,720
- Average hourly wage: $14.77
- 2019 employment: 1,419,920 (9.7 per 1,000 jobs)
- Highest-paying states based on average salary: Alaska ($40,320), New York ($38,810), Hawaii ($37,710)

A certified nursing assistant (CNA) isn’t mandated to hold a degree to perform on-the-job duties. Tasks for CNAs, performed under licensed nurses' supervision, include feeding, bathing, medication administration, and other health-related services.

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#6. Licensed practical and licensed vocational nurses

- Average annual salary: $48,500
- Average hourly wage: $23.32
- 2019 employment: 697,510 (4.7 per 1,000 jobs)
- Highest-paying states based on average salary: Alaska ($63,850), Massachusetts ($60,340), California ($60,240)

Licensed practical nurses (LPN) and licensed vocational nurses (LVN) provide specific services based on the health care setting. Primary care includes taking vitals, changing bandages, inserting catheters, keeping patient records, and reporting patient status to physicians. A practical or vocational nurse must graduate from an approved educational program offered through community colleges or technical schools. The field is expected to grow at 9% from 2019 to 2029, 5 percentage points higher than the national average.

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#5. Registered nurses

- Average annual salary: $77,460
- Average hourly wage: $37.24
- 2019 employment: 2,982,280 (20.3 per 1,000 jobs)
- Highest-paying states based on average salary: California ($113,240), Hawaii ($104,060), Washington D.C. ($94,820)

Registered nurses (RNs) have far-reaching responsibilities that include everything from assessing a patient's condition and administering medications to conducting tests and consulting with physicians. There are multiple education pathways to becoming an RN, with associate, bachelor's, and master's degrees all ways to enter the field. While the amount of practical and clinical hours and course credit requirements vary from state to state, all RN's must be licensed and maintain current certifications to practice.

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#4. Nursing instructors and teachers, postsecondary

- Average annual salary: $83,160
- Average hourly wage: data not available
- 2019 employment: 59,680 (0.4 per 1,000 jobs)
- Highest-paying states based on average salary: Washington D.C. ($157,560), Florida ($122,050), California ($101,930)

With roughly 60,000 nurses retiring annually, nursing educators are in high demand. The role requires at least an RN license and several years of work experience.

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#3. Nurse midwives

- Average annual salary: $108,810
- Average hourly wage: $52.31
- 2019 employment: 6,930 (0.05 per 1,000 jobs)
- Highest-paying states based on average salary: California ($154,500), Minnesota ($121,980), New York ($120,380)

A certified nurse-midwife (CNM) must either hold a masters of science in nursing (MSN) or a doctor of nursing practice (DNP) degree, most often part of an advanced degree program that includes a midwife specialty track. Most CNMs work in doctor’s offices, hospitals, outpatient care centers, and colleges and universities.

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#2. Nurse practitioners

- Average annual salary: $111,840
- Average hourly wage: $53.77
- 2019 employment: 200,600 (1.4 per 1,000 jobs)
- Highest-paying states based on average salary: California ($138,660), Washington ($126,920), Hawaii ($124,000)

Health nurse practitioners provide comprehensive care in several health care settings, including hospitals, doctors’ offices, employee health centers, research centers, or teaching in universities and colleges. Some nurse practitioner specialties include acute care, which entails working in emergency rooms and intensive care units, and adult-gerontology that involves tasks such as managing chronic elderly conditions and ordering diagnostic tests.

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#1. Nurse anesthetists

- Average annual salary: $181,040
- Average hourly wage: $87.04
- 2019 employment: 43,570 (0.3 per 1,000 jobs)
- Highest-paying states based on average salary: Wyoming ($243,310), Montana ($239,380), Oregon ($234,750)

A certified registered nurse anesthetist (CRNA) works in operating rooms, plastic surgery centers, public health facilities, and dental offices. These professionals are required to have a bachelor's degree in nursing science (BSN) and master's degree from an accredited anesthesia educational program, a current license, and a minimum of one year RN experience in an acute care setting.

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