Our Survey

Medscape invited practicing nurses, including licensed practical nurses (LPNs), registered nurses (RNs), and advanced practice registered nurses (APRNs) from the United States to participate in a 10- to 15-minute online survey about compensation and career satisfaction.

Like the general US population of nurses from which our Medscape reader sample was drawn, survey respondents tended to be older and have more years of experience.

The following slides report survey findings from the entire sample of 10,026 nurses. Where applicable, we compare findings from the current year with those of last year's compensation survey.

Would you like to comment on what you see in this slideshow? Go to slide 17.

It's not easy to answer a question like, "What is the most rewarding aspect of your job?" We asked this question of all survey respondents, and you will find their answers on this slide and the next. Most nurses have trouble narrowing it down to a single most rewarding aspect of nursing, because nurses typically perceive numerous personal and professional rewards. Bearing this in mind, this slide shows the rewards of nursing jobs selected most often by RNs and LPNs among our survey respondents.

Many nurses reap nonmonetary rewards from their profession. The gratitude expressed by patients for their excellent care, enjoying their jobs, and pride in being a nurse were the top sources of gratification for RNs and LPNs.

Among APRNs, liking their work and relationships with patients were top choices for NPs, NMs, and CNSs, whereas many CRNAs most enjoy being good at what they do.

The most likely to identify money as the most rewarding aspect of the profession were CRNAs, who (although they represented only 8% of the sample) also earn more than any other group of nurses.

It is perhaps a hopeful sign that less than 2% of the overall respondents (LPNs, RNs, and APRNs combined) chose "nothing" (data not shown). And although we know from our salary survey that most nurses are satisfied with their pay, very few chose "the amount of money that I make" as the most satisfying aspect of their jobs. Not shown are the results for the reward of "Being respected by my nursing peers," which was selected as most rewarding by 1%-5% of all nurse respondents.

Survey respondents shared their feelings about the day-to-day gratification of being nurses, whether they were LPNs, RNs, or APRNs. In addition to those listed above, a significant number of respondents cited flexibility in job hours, enabling them to spend more time with families, the autonomy that many nurses experience, and the intellectual challenges of nursing. It was striking that nurses didn't focus on occasional experiences or rewards that they may receive now and then, like a good evaluation or a pay hike, but on the feeling of satisfaction in doing their best to help patients every day and during every shift.

If only nursing could be all about personal and professional fulfillment, without any sources of dissatisfaction. It's not always smooth sailing, however. We discovered that among the vexations experienced by nurses, the amount of documentation that was required was the most burdensome to RNs, while the amount of money paid was least satisfying to LPNs. Two other factors that were very rarely selected as "least satisfying" were the lack of gratitude from patients and/or families, chosen by only 1%-3% of respondents, and a fear of violence, chosen by 1%-2% (data not shown).

The amount of documentation required was also the least satisfying aspect of the job for most APRNs. The only exception was CRNAs, who cited a lack of respect from physicians and other colleagues. Of note, a surprising number of respondents (6%-11% overall) answered "nothing" to this question (data not shown).

Some of the complaints expressed by nurses overall are personal (long commutes to work, interference with work-life balance) while others are professional (overwhelming workloads/caseloads, insufficient staff or resources, excessive regulations, oversight, and payer denials). Everyone, it seems, received a share of the criticism, from managers (unsupportive, incompetent, and uncommunicative) and physicians (bullying, rude, and disrespectful), colleagues (apathetic, unprofessional, lazy, back-stabbing, and mercenary), and even patients (drug seeking, noncompliant, demanding, and holding unrealistic expectations).

Many nurses do not believe that they are appreciated by administrators, and they believe that those at the top do not understand what they do or the resources needed to do the work. Hospital policies and politics were also frequently mentioned sources of frustration. Many nurses are unhappy with having to take call or work overtime without pay, or being obliged to work rotating shifts. Others fear for their job security. A lack of support and of respect were prominent themes in survey respondent comments.

Overall, in answer to the question, "Are you glad you became a nurse?" 95% said "yes." Another time-honored way of finding out whether someone is satisfied with a choice he or she made is to ask, "Would you do it all over again?" We asked, but considering that the overwhelming majority of nurses claimed to be glad that they became nurses, some of the answers (shown on the next slide) were unexpected.

Despite 95% of nurses saying that they were glad they became nurses, somewhat smaller proportions indicated that they would once again choose a nursing career if they could start over. A low of 73% (CRNAs) to a high of 85% (CNSs) of respondents would become nurses again, and overall, about 1 in 5 nurses would not.

Respondents with the most years in practice were more likely to say that they would not choose nursing again. None of the nurses with less than 1 year of practice under their belts were disillusioned as yet, whereas 21% of those with more than 21 years of practice were significantly more likely to want a different career (data not shown). Men were significantly more likely than women to say that they would not become a nurse if they could do it over again (27% vs 19%). But even among nurses who would still pursue nursing given a second chance, many would do things differently with respect to their education or choice of practice specialty.

We all appreciate the convoluted paths that many nurses take in their careers. Even among those who are satisfied with their choice to become a nurse, many would not necessarily take the same educational route. Less than half of those with a master's degree or a doctorate would follow the same path, while only 24% of those with a bachelor's degree and 10% of those with an associate degree would do so. Only 6% of those with practical nurse training would choose the same path for their nursing education.

This might reflect the recent push for nurses to have higher levels of basic nursing education, as well as to seek higher degrees for advanced practice and leadership roles. Educational options for nurses have also expanded in recent years. Or perhaps it just reflects the desire to have taken a shorter route to the same end goal!

Although most respondents would largely choose nursing again, most would not choose the same practice setting. Nurses who work in hospitals were most likely (28%)—and those in skilled nursing, home health, or contract/agency positions were least likely (11%-15%)—to say that they would choose the same practice setting if given the chance to start over.

Nurses who said they were not happy that they became a nurse, and would not choose nursing again, were then asked what they planned to do with their careers in the next 3 years. Between one third and one half of these nurses had no firm plans to retire early, pursue a new path within nursing, reduce their hours, seek education outside of nursing, or leave the nursing profession entirely.

Overall, APRNs were less likely than RNs and LPNs to say that they planned to act on their career dissatisfaction. Older nurses who have not yet reached retirement age but are dissatisfied with nursing were more likely to say that they would retire earlier than planned.

The higher the nurse's educational level, the less likely the nurse was to plan a career change within the next 3 years.

Plans and aspirations are great, and some of our respondents outlined future goals. But for others, plans don't always come to fruition. In optional comments, some respondents explained that despite a desire to leave the profession, nursing paid well enough and offered enough job security to make a major career change impractical at their stage of life. Still others cited the additional expense and time required to leave nursing for greener pastures. And even though we asked about near-future plans, many respondents took the opportunity to imagine "What if…?" as shown on the next slide.

Of all "If I could do it again" comments, the most frequent was "go to medical school." It's not uncommon for nurses to come to the conclusion that they would prefer a career as a physician. According to the Association of American Medical Colleges, 1034 applicants with undergraduate degrees in nursing applied to medical school between 2010 and 2014, and 319 nurses matriculated during that time.^[1] Many nurses who become physicians feel that their nursing experience is a huge benefit in the practice of medicine. And wishing that one had become a physician doesn't necessarily speak negatively of nursing, as one survey respondent explained: "I am not sorry about my nursing career, which has been rich and fulfilling, but if I had to do it over again, I would pursue medicine as a career."

Tell us what you think! How do your feelings about your nursing career align with our survey responses? Are you glad you became a nurse? Would you do it differently if you had a chance to do over your career? Is there anything else you would like us to ask in next year's survey?

Please add your comments at Voice Your Opinion: Medscape Nurse Career Satisfaction Report 2016.