February 7, 2022

The Best (and Worst) Specialties for Nurses Right Now

The Best (and Worst) Specialties for Nurses Right Now

To understand the current state of nursing, we asked nurses to share their feelings and experiences of working during the COVID-19 pandemic. In short, what we found was that nurses are not okay.

Nurses, whether at the bedside or in advanced practice roles, have struggled since the first COVID diagnosis was announced. It has only continued to get progressively worse as the pandemic lingers on. But based on the responses of nearly 1,500 nurses, we found that the degree to which they are struggling is largely dependent on what specialty they work in. 

Nurses Practicing Clinically Have It Worse in COVID-19

The stark truth is that the overwhelming number of bedside nurses are NOT happy in their current position and this doesn’t seem to be changing anytime soon. According to our State of Nursing survey, only 9% of nurses practicing clinically are “happy where they are.”

Meanwhile, 25% of NPs/APRNs are happy in their current roles. While the number of NPs and APRNs clinically satisfied is slightly higher than bedside RNs, it is still rather low. reported that between 20% and 30% of frontline U.S. healthcare workers were considering leaving the profession.

90% of Nurses Practicing Clinically Are Burnt Out

Nurse burnout was already an ongoing concern prior to COVID-19, but now the number of clinically practicing nurses who feel burnt out has risen to unheard of numbers. 

Overall, 87% of nurses are feeling burnt out, but that number rose to 90% for nurses practicing clinically. Bedside nurses around the country are feeling the effects of short staffing, lack of PPE, and overall sicker patients. 

The Best Specialties for Nurses During the Pandemic

There are countless nursing specialties that one can choose from, especially given the ongoing nursing shortage. But found that nurse educators, home health nurses, nurse managers, OR-perioperative nurses, and pediatric nurses reported the highest levels of job satisfaction. 

Nursing Specialties With the Highest Satisfaction Ratings

Specialty % That Replied “I am Happy Where I am”
Nurse Educators 33%
Home Health 24%
Nurse Managers 18%
OR-Perioperative 18%
Pediatric 18%

Nurse Educators

Nurse educators reported the highest satisfaction ratings of any other type of nurse, with 33% reporting that they were happy where they are in their current role. Nurse educators are master’s prepared nurses that generally work in academia, not at the bedside, which may explain why they are faring better than many other types of nurses.

Nurse educators work with nursing students to help bridge the space between didactic learning and clinical practice. While most generally teach didactic courses, others are responsible for educating nursing students in the clinical setting. They develop coursework and curriculum, teach courses, evaluate educational programs, oversee clinical rotations, and conduct research. 

Home Health Nurses

Home health nurses had the 2nd highest satisfaction ratings, particularly amongst nurses practicing clinically. 

One of the main reasons that home care nurses enjoy a higher job satisfaction is because there is more autonomy and less oversight from management – both major issues reported by nurses in our survey.

Home health nurses provide care for individuals in their own homes. This care may be needed because of an injury or illness for which a patient has already been hospitalized, or for those who require medical supervision but who either do not require or do not want to be in an institutional setting. 

Nurse Managers

Nurse managers are typically advanced practice registered nurses who've earned at least a master's degree. They manage and oversee the nursing staff in a healthcare facility, and are also known as nurse administrators. 

As they are at the management level, nurse managers are facing less time at the bedside and therefore may have had to deal with fewer struggles than bedside nurses during the last two years. With that being said, nurse managers have had to overcome ongoing staffing shortages as well as constant difficulties from bedside nurses. 

OR-Perioperative Nurses

OR and perioperative nurses, also commonly referred to as surgical nurses, also reported higher levels of job satisfaction compared to the average. These are registered nurses that have been trained to assist during surgeries. They care for patients before, during, and after surgical procedures and work on everything from life-saving procedures to elective ones.

Surgical nurses assist with all aspects of surgery and there are a variety of perioperative nursing roles including:

  • Scrub nurses 
  • Circulating nurses 
  • RN first assistants (RNFAs) 
  • PACU (post-anesthesia care unit) nurses
  • Operating room directors 
  • Medical-surgical nurses 

Pediatric Nurses

Pediatric nurses also reported being happy in their current role at higher rates than other types of nurses. Pediatric nurses are registered nurses that specifically work with newborns, children, adolescents, and teenagers. While the duties of a pediatric nurse are similar to other bedside nurses - pediatric nurses must have increased knowledge because of the specific needs of a pediatric patient. 

The Worst Nursing Specialities to Be in During COVID

Based on our survey, nurses in the following specialties reported the highest levels of dissatisfaction, burnout, discomfort, and other negative feelings: 

  • Telemetry
  • Emergency Room
  • Progressive Care Unit (PCU)
  • Medical-Surgical 
  • Labor and Delivery 

It is difficult to determine if nurses in these specialties were experiencing burnout prior to the pandemic, but previously labor and delivery nursing positions were one of the most coveted jobs in the nursing professions. Now, these nurses reported some of the highest levels of dissatisfaction in areas of feeling short-staffed, not receiving hazard pay or adequate back-up, and feeling underpaid.

Nursing Specialties With the Lowest Satisfaction Ratings

Specialty Happy at Current Job Feel Underpaid Feel Unsupported Face Staffing Shortages Not Getting Hazard Pay
Telemetry 0% 91% 91% 91% 93%
ER 2% 88% 83% 88% 80%
Progressive Care 3% 94% 87% 94% 77%
Medical-Surgical 6% 82% 74% 92% 82%
Labor & Delivery 11% 84% 76% 91% 89%

Telemetry Nurse

Telemetry nurses had the highest reported levels of job dissatisfaction, with 0% reporting that they were happy in their current role. In addition, 9% of telemetry nurses felt underpaid.

Telemetry nurses are registered nurses that generally work in the hospital setting using high-tech equipment to measure life signs, dispense medication, and communicate with patients that suffer from acute disorders such as caring for patients who are recovering from cardiac intervention, such as a cardiac stent or coronary artery bypass grafting (CABG) surgery. 

Emergency Room Nurse

Only 2% of emergency room nurses reported feeling happy in their current role. On top of that, they had the highest reports of feeling unsafe at work, at 82%. 

Throughout the pandemic, ER nurses were on the frontline and generally were the first nurses that encountered COVID patients. They dealt with countless struggles including ongoing PPE shortage as well as overrun emergency rooms. Now, as the number of ER cases stabilizes, ER nurses are struggling with caring for unvaccinated patients. 

Progressive Care Unit (PCU) Nurse

Progressive care unit nurses, commonly referred to as PCU nurses, have a difficult job with only 3% replying that they were satisfied in their current role. Similar to a long-term care nurse, PCU nurses care for patients that require intermediate care prior to going home or a long-term care facility.

Unfortunately, since COVID, PCUs have become units that house patients that do not have anywhere else to go. Some are awaiting beds in long-term care facilities while others would be able to go home if there wasn’t a shortage of home health nurses. This could explain why 94% of PCU nurses reported feeling understaffed - higher than any other specialty.

Medical-Surgical Nurse

Medical-surgical nurses, commonly referred to as med-surg nurses, are the most common type of nurses. These nurses require the broadest knowledge of nursing as they are required to care for patients suffering from a variety of ailments. 

Med-surg nurses have the highest nurse-to-patient ratio. During COVID, this number continued to rise. At one time, med-surg nurses would care for 4 to 6 patients during a shift. At the height of COVID, that number rose to 7 to 9 patients in some areas of the country. Unfortunately, as a result, this led to very high nurse dissatisfaction rates, with 92% of med-surg nurses reporting they feel understaffed. 

Labor & Delivery Nurse

This might be the most shocking nursing specialty on the list. Generally speaking, labor and delivery nurses usually have very high job satisfaction; however, given the changing climate many labor and delivery nurses have had to also handle intense patient relations. 

During the height of COVID, some maternity wards were not allowing expectant mothers to have a support person, including the baby’s father, present during delivery. As a result, there were countless unhappy patients and families which helped lead to increase nurse dissatisfaction. Other issues L&D nurses report having are that 84% feel underpaid, 91% feel understaffed and 89% feel they don't have adequate backup. 

Learn More About the State of Nursing and the Ongoing Nursing Shortage

Interested in learning more about the current state of nursing? We surveyed nearly 1,500 nurses to find out how they felt about the past year and get to the real reasons behind the nursing shortage. Find out what they had to say. Read more about the State of Nursing survey or download the full report below.

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