Top Paying RN Specialties and Settings


By Debra Wood, RN, contributor

Overall, nursing pays a competitive wage, but some specialties pay more than others. As a general rule, more education, supply and demand, and relative responsibility contribute to higher salaries, but earning potential should be just one consideration when choosing to specialize.

“What a nurse enjoys is the number one factor,” said Donna W. Cardillo, RN, MA, an author, consultant and recognized expert on nursing careers, based in New Jersey. “Money may draw you into a job, but it will never keep you there. It’s not just doing work you love but working in an environment that is supportive of nurses.”


Donna W. Cardillo, RN, MA
Donna W. Cardillo, RN, MA, reported greater opportunities for nurses to earn more and negotiate salaries, benefits and working conditions at insurance, pharmaceutical and other non-hospital positions.


Nurses should consider the entire compensation package when searching for a new job, Cardillo advised. That includes the benefits available, opportunities for education and personal development, and a workplace with a congenial manager and supportive peers.

“When selecting a job, if you just look at hourly rate or annual salary, it’s short sighted,” Cardillo said.

That being said, the U.S. Bureau of Labor Statistics reports the median wage for registered nurses in 2012 of $67,930 annually. However, experienced nurses in some specialties and those who earn master’s degrees and become advanced practice registered nurses can earn significantly more.

Kari E. McConnell, RN, CORLN, immediate past president of the Society of Otorhinolaryngology and Head-Neck Nurses, said she thinks otolaryngology nurses demand a higher salary than some specialties because there are so few experts. She estimates there are only 200 certified otorhinolaryngology nurses in the country. Most procedures are outpatient, and those patients in the hospital require complex care, such as airway management and reconstructive head and neck surgery.

“They are rare,” McConnell said. “And care of the head and neck patient is specific. You have to know airways and how to position patients.”

Cardillo agreed that nurses experienced in narrow, highly specialized fields may earn more, ranging from nurse researchers to NICU nurses and CVOR nurses. However, she cautions that there remains variability between facilities.

Advanced degrees may affect the biggest difference in compensation. BLS data shows that the median salary in 2012 for nurse practitioners, certified nurse midwives and certified registered nurse anesthetists (CRNAs) was $96,460 — more than $30,000 over the median salary for all other registered nurses.

Healthcare settings also make a difference when it comes to salaries, work environments and career potential.

“Healthcare is shifting out of the hospital to the community and other nontraditional areas, as are nursing jobs,” Cardillo said. “Currently and in the future, there are a lot of well-paying opportunities for nurses beyond the hospital, in areas like the insurance industry, the pharmaceutical industry and occupational health.”

Those nurse specialties jobs also offer greater potential for growth than a hospital setting and opportunities to negotiate a better salary, benefits or working conditions, Cardillo added.

Karon Gibson, RN, of Chicago, said that independent practice nurses, such as herself, often earn more than average. She is a producer of educational and entertaining television programs and co-author of the book Nurses on Our Own.

Wendie A. Howland, RN-BC, MN, CRRN, CCM, CNLCP, NLCP-C, principal of Howland Health Consulting in Massachusetts, also has pursued a more independent practice as a certified nurse life care planner. She has grossed approximately $120,000 annually in recent years, but knows of colleagues who earn in the $300,000 range. She prepares and reviews life care plans, estimating medical and nonmedical needs of people with a catastrophic injury or chronic illness over an estimated life span. Howland said that in addition to traditional nursing roles, many opportunities exist for nurses to positively affect the country’s health.

The part of the country where a nurse works also affects average income, with California nurses topping the earnings at $94,120 annually, and Iowa nurses on the other end of the scale earning $52,540 on average, according to the BLS. The data shows that metropolitan areas also tend to pay better than nonmetropolitan areas.

Cardillo said that nurse salaries, in general, are higher on the east and west coasts and in major metropolitan areas, while they will likely be lower the middle of the country and in rural areas. But that is also relative to the cost of living.

“Again, that’s why you have to look at the big picture: Is housing less? Goods and services?” Cardillo said. “Try to take the focus off money, money, money.”

Suggested for you

Sign up and stay in the know with

We just need a little bit more from you...