Nursing: America's Backbone

Education Options:

• ADN (Associate's): 2 years, $6,000-$25,000

• BSN (Bachelor's): 4 years, $20,000-$80,000

Licensing: NCLEX-RN exam required (~$200)

Median Salary: $93,600/year

The Reality: This is the golden ticket. ADN gets you in fast and cheap, BSN opens more doors long-term. Either way, you're a real nurse with real responsibility. The pay is decent, the jobs are everywhere, but the stress is crushing. You'll be managing multiple critical patients, dealing with life-or-death decisions, and getting blamed when things go wrong.

Training Required:

• State-approved program: 4-12 weeks (75-120 hours)

• Many programs are FREE or under $1,000

Cost: $500-$2,000 (often FREE through Red Cross, community colleges, nursing homes)

Certification: State exam $64-$105

Median Salary: $30,000-$35,000/year (~$14-17/hour)

The Reality: You can be working in healthcare in 6 weeks. But you'll be doing the hardest, most physical work in the hospital. Bathing patients, changing diapers, lifting people who weigh 300+ lbs, cleaning up vomit and feces. You'll be treated like the bottom of the ladder by everyone. Your back will hurt constantly. But it's a real job, and you can start the climb to RN from here.

Education Required:

• Certificate/diploma program: 12-18 months

• Offered at community colleges and vocational schools

Cost: $2,000-$18,000 (average $12-15K)

Licensing: NCLEX-PN exam required

Median Salary: $48,000-$55,000/year

The Reality: You can give medications, start IVs, do wound care - actual nursing tasks. But you work under RN supervision, so you get the responsibility without the autonomy. It's a stepping stone - many LPNs bridge to RN programs. Pay is better than CNA but you're still doing heavy physical labor and dealing with all the same abuse and understaffing.

Path Required:

• First: Become an RN (2-4 years)

• Work as RN: 1-2 years minimum

• Master's (MSN) or Doctorate (DNP): 2-4 years

Cost: $40,000-$100,000+ for graduate degree alone

Median Salary: $120,000-$130,000/year

The Reality: You can diagnose, prescribe medications, order tests - basically function as a doctor in many states. The pay is excellent, the autonomy is real. But you're looking at 6-8 years total and potentially $100K+ in student loans. Many NPs still face the same understaffing and burnout issues, just with more responsibility and liability.

Requirements:

• Active RN license

• 1-2 years bedside experience in your specialty

• Willingness to relocate every 13 weeks

Contract Length: Typically 13-week assignments

Salary: $90,000-$140,000/year (including housing stipends and completion bonuses)

The Reality: You can make significantly more than staff nurses and see the country. But you're always the new person, always learning new hospital systems, always dealing with being treated as "just a traveler." You have no job security (contracts can be canceled), no benefits, no roots. Great for young single nurses, exhausting if you have a family.

Requirements:

• Active RN license

• 1-2 years clinical experience preferred

• Valid driver's license and reliable transportation

Median Salary: ~$93,600/year

The Reality: You're driving house to house, seeing patients in their homes. You have way more autonomy than hospital nurses - you're making decisions alone. But that also means you're ALONE. When something goes wrong, there's no code team, no backup. You'll see heartbreaking living conditions, hoarding, elder abuse, family dysfunction. You'll smell things you can't unsee. But you avoid hospital politics and have a more flexible schedule.

Requirements:

• Active RN license

• ICU orientation/training (usually 3-6 months)

• CCRN certification preferred but not always required

Median Salary: $85,000-$110,000/year

The Reality: You manage the sickest patients in the hospital. Ventilators, cardiac monitors, multiple IV drips, codes happening constantly. The learning curve is brutal - you'll feel like you're drowning for the first 6 months. But ICU nurses are respected, the skills are invaluable, and you actually have better nurse-to-patient ratios (1:2 instead of 1:6). The trauma is real though - you'll watch people die despite your best efforts.

Requirements:

• Active RN license

• ER orientation (usually 3-6 months)

• CEN (Certified Emergency Nurse) certification preferred

Median Salary: $80,000-$100,000/year

The Reality: You never know what's coming through those doors. Gunshot wounds, car accidents, heart attacks, overdoses, psychiatric emergencies all at once. You have to be able to triage, think fast, and handle chaos. The violence is worse here than anywhere - drunk patients, psych patients, gang members. You'll get assaulted. But if you thrive on adrenaline and variety, this is your place. Just know that compassion fatigue hits hard in the ER.

Requirements:

• Active RN license

• Psychiatric nursing experience or training

• PMH-BC (Psychiatric-Mental Health Board Certification) optional but valuable

Median Salary: $75,000-$95,000/year

The Reality: You're working with severely mentally ill patients - schizophrenia, bipolar disorder, suicidal patients, violent patients. De-escalation is a daily skill. You'll be threatened, you'll witness self-harm, you'll manage psychiatric emergencies. The system is broken - not enough beds, not enough resources, patients cycling through repeatedly. But if you can handle it, you're truly helping people in crisis. The emotional toll is massive.

Requirements:

• Active RN license

• OR orientation/residency (6-12 months typically)

• CNOR (Certified Nurse Operating Room) certification preferred

Median Salary: $80,000-$95,000/year

The Reality: You assist during surgeries - either scrubbing in (handling instruments) or circulating (managing the room). Sterile technique is everything. Surgeons can be notoriously abusive to OR staff - throwing instruments, screaming during cases. You'll stand for 8-12 hours straight during long surgeries. But the work is fascinating, the skills are specialized, and there's less patient interaction (they're unconscious). On-call requirements mean your phone can ring at 2 AM for emergency surgeries.