Nurses Largely Satisfied, but Many Would Change Path

Marcia Frellick

January 24, 2019

The overwhelming majority of nurses who responded to a Medscape survey said they were glad they became a nurse or an advanced practice registered nurse (APRN).

The most who answered that way were nurse midwives (NMs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs), all at 98%.

Nurse practitioners (NPs), licensed practical nurses (LPNs), and registered nurses (RN) all had satisfaction rates from 94% to 96%.

But when the question was asked a different way (whether respondents would choose nursing again if they could do it over), fewer among the 10,284 total nurses who responded to the online survey said yes.

Table 1. Would You Choose Nursing Again?

Nurse Type % Answering Yes
CNS 88
NM 85
NP 82
LPN 80
RN 76


The authors of the report, titled Medscape Nurse Career Satisfaction Report 2018, said, "We've seen this phenomenon in previous survey results, and as yet don't have an explanation for it. It's easier to understand that nurses and APRNs might wish they'd ended up in a different practice setting."

In this survey, only from 28% to 38% of nurses and APRNs said they would choose the same practice setting again.

Next Moves for Dissatisfied

For those dissatisfied with their career, many planned to pursue another path within nursing. That was the top choice for nurses/APRNs who shared their plans, except for CRNAs, who were most likely to say they would retire earlier than they had planned. LPNs (16%) were the most likely group to say they would leave nursing and seek other employment.

Some who plan to make a career change shared what's next. And while some gave the more traditional answers of pursuing medical school or faculty positions, other answers included starting a home-based business, working in health policy or advocacy, or going to law school.

Most, Least Rewarding Aspects

All nurses were asked about the most and least rewarding aspects of their jobs. For RNs and LPNs, the most common answer by far was helping people and making a difference in people's lives (40% for RNs and 44% for LPNs).

That was also the most common answer for APRNs, with the exception of CRNAs, whose most rewarding aspects were split between "helping people" and "working to the full extent of my education, certification and licensure," which was a new choice in this year's survey.

Least rewarding aspects for LPNs and RNs were administrative tasks and workplace politics, with about a quarter stating that choice, and paperwork. Among the top least rewarding aspects for APRNs were administrative/workplace politics, amount of paperwork, and not enough time with patients.

Views of Retirement

Nurses/APRNs who were less than 10 years from retirement had very different confidence levels in their financial readiness for the transition, depending on nurse type.

Table 2. Are You Financially Prepared for Retirement?

Nurse Type % Yes % No % Unsure
CRNA 77 6 17
CNS 60 10 30
NM 57 14 29
NP 57 12 31
RN 45 19 36
LPN 30 28 42


Expected length of careers differed by age. Generally, older nurses expected to work for more total years than did younger nurses.

The report authors say this could indicate either a generational difference in views toward working or the fact that older nurses are finding they aren't financially ready to retire and need to work longer.

The numbers show that a 30-year-old RN expects to work until age 60, a 50-year-old RN until age 64, and a 65-year-old RN until age 68.

Few Get Help as Retirement Nears

The survey found that as retirement nears, few nurses get help from employers with respect to reducing hours, having less physically demanding roles, or receiving guidance in retirement planning. The numbers of older nurses/APRNs saying they were offered none of those things ranged from 46% to 63%, depending on the nurse type.

"Employers looking to replace their older nurses with far cheaper new-graduate nurses have little incentive to help nurses stay on the job," the authors write.

Among RNs nearing retirement, for example, only 5% said they were offered less physically demanding work; 18% said they were offered reduced hours; 38% said they received guidance in retirement planning; and 50% said they received none of the above.

New Nurses Hired Quickly

This year's survey asked about new nurses' experience in landing a job and found that LPNs, RNs, and NPs on average all found their first job in less than 3 months. Hourly starting pay was $18.61 for LPNs, $25.80 for RNs, and $33.38 for NPs.

Among the three groups, from 5% to 7% received hiring bonuses.

Residency programs are not universally offered, the report authors note, but this year there was a significant increase.

More than a third of RNs participated in a residency program (35%, up from 27% last year), and 18% of NPs participated in a program, up from 7% last year. Only 3% of LPNs entered a program.

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