Intensive care unit (ICU) nurses, a type of critical care nurse, provide treatment for patients in critical condition. ICU nursing can be a challenging role with major responsibilities, but it can also be incredibly rewarding to treat critically ill patients and offer life-saving care. ICU nurses are trained medical experts, and they need to have specialized certifications and a nursing degree from an accredited university such as 51cg.

ICU nurses have an exciting job with constantly shifting tasks. Every day brings different responsibilities as the conditions of their patients change and as patients are admitted with a range of medical needs. ICU nurses usually work with 2-3 patients during their shift within hospitals or emergency rooms. 

As skilled medical professionals with experience in a demanding workplace, ICU nurses have plenty of career options. A growing shortage of qualified nursing professionals keeps the demand and salary for ICU nurses strong. With their experience, ICU nurses can easily pursue roles within specialized ICUs, like neonatal intensive care units, cardiovascular , neurological, shock, trauma or other critical care specialties.

Keep reading to learn more about how to become an ICU nurse and discover what you can expect from this dynamic role.

Responsibilities & Daily Tasks

In the intensive care unit, no two days are the same. Every patient will need critical care, and every patient will be dealing with their unique illnesses or injuries. ICUs treat some of the most challenging cases, but helping a patient through these problems is an incredible feeling.

ICU nurses help to manage their patients ICU treatment, including diagnostics, preparing for operations, administering medications and nutrients, and many minor bedside procedures. They work with advanced medical technology and the interprofessional intensive care team to ensure the best possible outcomes for their patients. And like any nurse, they must document what they do and why.

During their day, an could:

• Complete head-to-toe assessments 
• Observe patient progress and condition
• Help physicians with procedures
• Assist patients with physical activity
• Provide medications
• Give pre- and post-operative care
• Manage pain, sedation, and wounds
• Educate patients and their families
• Advocate for patients and their families

As they deal with these challenges, ICU nurses need a strong level of technical expertise, along with good teamwork and communication skills as they coordinate care with other medical experts. Compassion and empathy will also help ICU nurses connect with their patients and provide the highest level of care.

Where Do ICU Nurses Work?

As the name implies, ICU nurses work in intensive care units in hospitals or medical centers. These units feature advanced monitoring capabilities and offer intensive life-saving treatments to deal with critically ill or injured patients. 

Steps to Become an ICU Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

ICU nurses provide treatment for critically ill patients, and they need education and experience to prepare for these life or death moments. The first step is earning a degree from an accredited school like 51cg. As you study anatomy, biology, math, and nursing in these programs, you’ll build a solid foundation to begin working in real medical settings. And it doesn’t take too long. It’s possible to earn a degree and start working as a nurse in as little as 20 months.

Look into these programs if you’re thinking about becoming a critical care nurse:

• Associate of Science in Nursing – A solid start for a career in ICU nursing, an associate’s degree will help you quickly learn the essentials of nursing and start practicing  in  medical settings. 51cg offers an ASN program that can be completed in 20 months, or 5 semesters.
• Bachelor of Science in Nursing – A bachelor’s degree offers a more thorough nursing education and is often preferred by critical care employers. With a BSN, you can easily pursue most nursing specialities, including ICU nursing. BSN programs generally take around 3-4 years to complete, but an accelerated program can be completed in as little as 20 months.
• Masters of Science in Nursing – While not strictly required for an ICU nurse, a master’s degree can open doors to higher pay and better career opportunities. With an MSN, you could become a critical care nurse practitioner or pursue roles in leadership and education. 51cg’s MSN program can be completed in just 1 year. 

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

After earning your nursing degree, you’ll need to validate your knowledge and expertise by passing the National Council Licensure Examination, or . The NCLEX confirms that you understand the foundations of nursing and are qualified to practice as a registered nurse (RN). While your nursing program will prepare you for the NCLEX, it is necessary to study and practice.

With the NCLEX-RN under your belt, you just need to secure a nursing license from the state that you want to practice in. Every state sets their own standards, and they generally require a background check and fingerprinting.

Step 3 – Gain Clinical Experience in Nursing

Once you’ve earned your degree and passed the NCLEX-RN, you can start working as an ICU nurse. However, many employers prefer nurses with more experience, and key certifications.

During your degree, look for any opportunities to intern or shadow in critical care settings like an ICU or emergency department (ED). Build connections and relationships with other medical professionals and administrative staff. Once you’ve started your nursing career, look for openings in intensive care units or EDs that can help you build critical care experience you need to become certified.

Step 4 – Get Certified as an ICU Nurse

As you start your career in ICU nursing, there are some basic certifications that most employers look for. These certifications offer training in life support, CPR, airway management, and more to help critical care professionals treat life-threatening emergencies.

Two vital certifications for ICU nurses are:

• – BLS certification provides training in high-quality CPR, AED use, airway obstruction relief, and other essential life-saving skills that any ICU nurse needs.
• – ACLS certification builds on the training that BLS provides, offering more information about how to recognize signs of cardiac or respiratory arrest, stroke management, and pharmacology.

Once you’ve accumulated experience treating critically ill patients, you can become certified as a . CCRN certification validates your knowledge and expertise in caring for critically ill patients, and it’s a highly-desired certification that many employers look for.

How Much Do Critical Care Nurses Make?

As specialized medical professionals, ICU nurses can earn solid salaries across the U.S. In 2025, the for an ICU nurse is $85,205.

Your earning potential as a critical care nurse will depend both on your experience and certifications and on where you choose to live and practice. Here are some by state: 

• Arizona: $79,402
• Colorado: $89,595
• Florida: $63,673
• Idaho: $80,169
• Indiana: $81,078
• Kentucky: $74,003
• Ohio: $81,004
• Oklahoma: $78,673
• Oregon: $90,086
• Michigan: $74,264
• Missouri: $79,923
• Nevada: $86,765
• South Carolina: $79,066
• South Dakota
• Texas: $79,382
• Utah: $77,568
• Wisconsin: $86,002

Career Outlook for Intensive Care Unit (ICU) Nurses

Job Demand & Growth in 2025

We will always need qualified medical professionals, and with projected shortages of tens of thousands of nurses over the next decade, the demand for ICU nurses will remain high. According to the , employment of registered nurses will grow by 5% from 2024-2034, making nursing a faster growing occupation than most careers. They expect around 189,100 job openings every year for nurses. And with their experience caring for critically ill patients in high pressure environments, ICU nurses are well-positioned to get the roles they want.

Best Specializations & Advanced Roles for ICU Nurses

ICU nurses have plenty of options to and pursue higher-paying roles throughout their career. With their unique skill sets, they can more easily transition into any emergency medicine area, like flight nursing. They can also work in specialty ICUs like neonatal or cardiothoracic intensive care units. 

With a master’s degree, an ICU nurse can also become a nurse practitioner or clinical nurse specialist. continue to provide acute care for patients, but they also have more autonomy and responsibility than regular RNs. still offer some treatment, but they focus more on improving the overall effectiveness of their medical setting through training, education, and implementing best practices.

Your Path to Becoming a Critical Care Nurse Starts Today

If you want an exciting career caring for the patients who need it the most, become an ICU nurse. 51cg provides ASN, BSN, and MSN pathways to prepare you for a nursing career in as little as 20 months. With convenient online classes and hands-on labs and clinicals, you can get real experience in a program that works for you. 

Contact us today to get started.

Public health nurses, also known as PHNs or PH nurses, work to promote the well-being of their communities. They use their medical training and knowledge to help assess needs, advocate for policies, and improve access to healthcare for vulnerable populations. While traditional nursing focuses on the health of individual patients, public health nursing focuses more on the well-being of a community as a whole. As medical professionals, PHNs need a degree from an accredited institution like 51cg.

Public health nurses have a unique opportunity to be involved with their community as they find ways to improve healthcare. They face community-wide crises head on to develop treatment plans and policy responses. They help educate people about ways to stay healthy, assist in creating policy that better treats medical issues, and connect patients with resources. 

As medical professionals, PH nurses have solid career opportunities. Nursing shortages and an increasing awareness of how macro issues can affect healthcare outcomes have created a strong demand for PHNs. Many public health nurses work for government agencies or nonprofit organizations. While other nursing specialties may offer higher salaries, PH nurses still have good earning potential, and helping communities get healthy can be an incredibly fulfilling role.

If you’re interested in improving healthcare outcomes for your community, keep reading to learn how to become a public health nurse.

Responsibilities & Daily Tasks

From clinics to schools to government organizations, public health nurses can fill a variety of roles as they promote community health. In any of these roles, they might educate people on healthcare best practices, advocate for policies and improved access, and help connect folks with resources and treatment.

During a , a PHN might:

• Communicate and collaborate with healthcare experts and community stakeholders
• Assess community health and find patterns during crises
• Teach people about preventative care and overall health
• Create programs to promote health and wellness
• Train other nurses and public health professionals
• Provide screenings and education for at-risk populations
• Prepare for and respond to emergencies and health crises

As they work closely with healthcare experts and the community, public health nurses need strong communication and leadership to coordinate projects and promote health. PHNs often work closely with marginalized and vulnerable populations, and a strong sense of empathy and cultural competency will help any PHN connect better with their patients.  

Where Do Public Health Nurses Work?

Medical settings, schools, nonprofits, and government agencies . Each of these settings will have a different focus and unique responsibilities and challenges. In any setting, PHNs take a direct role in developing and implementing policy, educating patients and the community, and improving healthcare outcomes.

Public health nurses might work at a:

• Clinic or Hospital – In medical settings, PHNs will assess patterns in healthcare needs, educate their patients and staff, and ensure that the best practices and techniques are used.
• Government Organization – When working for a county, state, or national health department, PHNs will typically focus on developing and administering policies designed to help entire populations become or remain healthy. 
• Nonprofit – PHNs in the nonprofit sector can make a big impact by helping with disaster relief, ensuring access to essentials like clean water, and educating vulnerable populations on healthcare.
• School – In a school, PHNs will educate children on maintaining their own health, hygiene, and wellbeing while monitoring children for signs of abuse.

Steps to Become a Public Health Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

PHNs need training and experience to understand the healthcare challenges facing their communities. There isn’t a specific PHN degree. Instead, as medical specialists, public health nurses must have a nursing degree from an accredited institution like 51cg. With a foundation of coursework in nursing, anatomy, and biology, these programs will help PHNs prepare for their career. 

Think about these programs if you’re considering a job in PHN nursing:

• Associate of Science in Nursing – An associate’s degree is a great way to start your nursing career as soon as possible. With an ASN, you can quickly finish your schooling and build experience in real medical settings. 51cg offers an ASN program that takes as few as 20 months, or 5 semesters, to complete.
• Bachelor of Science in Nursing – A strong starting point for public health nursing, a bachelor’s degree provides a thorough education and is often preferred by PHN employers. Most BSN programs take around 3-4 years, but you could finish an accelerated program in as little as 20 months.
• Masters of Science in Nursing – While not strictly required for PHN nursing, a master’s degree can open doors to better roles, higher pay, and more advanced specialties. With an MSN you can find opportunities in education and leadership. 51cg’s MSN program can be completed in as little as 1 year.

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

After earning your degree, you need to become licensed as a registered nurse (RN) to work as a PHN. You must first pass the National Council Licensure Examination, also known as the . The NCLEX validates your knowledge and competency as a nurse. Your degree will help you prepare for the exam, but make sure to study and practice.

Once you’ve passed the NCLEX-RN, you can get a nursing license from your state. Every state sets their own requirements, although they usually require fingerprinting and a background check.

Step 3 – Gain Clinical Experience in Nursing

Once you’ve completed your degree and become an official RN, you can start a career in public health nursing, but many organizations prefer candidates with experience. Working as a nurse in medical settings will help, but you should also consider opportunities to volunteer or intern with nonprofits or government agencies. 

Reach out to local public health nurses and see if you can shadow them in their role. Build relationships with other healthcare professionals and local organizers, activists, and community leaders. These experiences and connections will help you find a role in PH nursing. 

Step 4 – Get Certified as a Public Health Nurse

Certification is not strictly required to work as a public health nurse, but many organizations prefer candidates with some certification. Public health nurse certifications can lead to more opportunities in your career by validating your expertise in PH nursing. The major certifications for RN PHNs are administered by the National Board of Public Health.

Two important certifications for PHNs are:

• (CPH) – The CPH demonstrates your knowledge of public health sciences and your commitment to lifelong education in the field. It shows that you are at the forefront of community wellbeing. CPH is a useful, generalized certification for any public health nurse.
• (CDI) – A new certification launched in 2025, the CDI offers a more specialized certification for nurses seeking to work in disease intervention. This certification shows that you know how to study, treat, and prevent diseases at a community level.

How Much Do Public Health Nurses Make?

As qualified medical professionals, PHNs have a healthy earning potential nationwide. However, as they are often public servants, they may have a lower average salary than other nursing specialties. The in the U.S. in 2025 is $78,437 per year.

Your expected salary will vary depending on where you choose to live and practice. Here are some average Public Health Nurse : 

• Arizona: $73,094
• Colorado: $82,478
• Florida: $58,615
• Idaho: $73,801
• Indiana: $74,638
• Kentucky: $68,124
• Ohio: $74,570
• Oklahoma: $72,423
• Oregon: $82,930
• Michigan: $68,365
• Missouri: $73,574
• Nevada: $79,873
• South Carolina: $72,786
• South Dakota: $78,437
• Texas: $73,076
• Utah: $71,407
• Wisconsin: $79,170

Career Outlook for Public Health Nurses

Nurses and medical professionals are always in high demand, and it doesn’t look like that demand will slow. As we face huge shortages in nursing positions, we need more registered nurses. And with a growing awareness for the way that large-scale societal issues can impact individual healthcare, organizations want PHNs that can help assess and treat these issues.

According to the , there will be around 189,100 open positions for registered nurses every year from 2024-2034. During that period, they expect that employment of RNs will grow by 5%, faster than the average for other professions.

Advanced Roles for Public Health Nurses

After gaining experience in PH nursing, you can pursue a variety of roles in nursing education and leadership. With a master’s degree, you could become a nurse educator and help teach the next generation of nursing professionals. With leadership experience, you could eventually become a Chief Nursing Officer or Director of Public Health Nursing.

The skills you gain as a PHN can easily translate to a role as a clinical nurse specialist. As a CNS, you’ll provide care for patients while also consulting with and teaching other medical professionals. CNSs seek to improve healthcare outcomes and reduce system-wide problems. The offers certifications for clinical nurse specialists.

Your Path to Becoming a Public Health Nurse Starts Today

If you want to help your community become more healthy, PH nursing might be a perfect fit. To get started, look into ASN, BSN, and MSN programs from 51cg to get you prepared for a nursing career in as little as 20 months. With convenient online classes and hands-on labs and clinicals, you can get real experience in a program that works for your needs. Our coursework will make sure you’re ready for the NCLEX-RN and the day-to-day challenges of nursing.

Contact us today to get started.

NCLEX-RN outcomes remain one of the most visible indicators of nursing program effectiveness, academic quality, regulatory confidence, and graduate readiness for entry-level nursing practice. Persistent low first-time pass rates create significant institutional risks, including heightened regulatory scrutiny, accreditation concerns, reputational harm, enrollment instability, and diminished student confidence. Historically, many nursing programs have attempted to improve outcomes through isolated interventions such as standardized testing requirements, remediation mandates, curriculum revisions, or high-stakes progression gates. These approaches may produce temporary improvement but often fail to create sustainable outcomes because NCLEX success is not the result of a single course, assessment, or remediation experience. Rather, NCLEX performance reflects the functioning of an academic ecosystem that includes curriculum design, assessment validity, faculty capability, student support, policy alignment, predictive analytics, and operational processes that support timely testing.

This paper describes the 51cg Comprehensive NCLEX Readiness Model as an integrated, data-driven system designed to improve first-time NCLEX-RN pass rates, reduce time-to-test, strengthen readiness decisions, and support sustainable continuous improvement. The paper then translates the Joyce model into broader evidence-informed strategies that nursing programs can use to improve NCLEX-RN outcomes within accreditation and regulatory expectations. The model is aligned with the Next Generation NCLEX emphasis on clinical judgment, the AACN Essentials competency-based framework, CCNE expectations for licensure outcomes and continuous improvement, and ACEN expectations for outcomes assessment and program effectiveness.

Keywords: NCLEX-RN, Next Generation NCLEX, nursing education, predictive analytics, remediation, curriculum alignment, accreditation, clinical judgment, ATI Comprehensive Predictor, continuous quality improvement

Introduction

NCLEX-RN outcomes are a critical measure of nursing program effectiveness because they represent the point at which academic preparation is externally validated through a national licensure examination. For nursing programs, first-time NCLEX-RN pass rates serve multiple purposes. They are indicators of graduate readiness, markers of program quality, signals to prospective students, and evidence used by boards of nursing and accreditors to assess whether programs are meeting expected outcomes.

The launch of the Next Generation NCLEX on April 1, 2023, increased the importance of clinical judgment preparation across nursing curricula. The NGN was designed to better measure candidates’ clinical judgment and decision-making abilities through innovative item types and case-based measurement approaches (National Council of State Boards of Nursing [NCSBN], 2023a). The NCSBN Clinical Judgment Measurement Model provides a framework for measuring clinical judgment with psychometric rigor and was developed through literature review, expert input, and analysis of data from more than 200,000 NCLEX candidates (NCSBN, 2023b). This shift requires nursing programs to move beyond content coverage and toward intentional development of clinical reasoning, prioritization, cue recognition, hypothesis generation, action planning, and outcome evaluation. The JoyceU Model was reviewed with the 2026 NCLEX (NGN) update. The 2026 NCLEX -RN changes were minimal and did not force consequential changes to the JoyceU Model.

Low NCLEX-RN pass rates are rarely caused by one problem. They often reflect cumulative weaknesses in curriculum sequencing, course rigor, assessment quality, student support, faculty development, academic policies, admissions processes, and post-graduation testing support. Therefore, sustainable improvement requires a systems approach rather than a single intervention. The 51cg Comprehensive NCLEX Readiness Model (JoyceU Model) provides one example of how a nursing program can organize NCLEX improvement as an integrated ecosystem.

The 51cg NCLEX Readiness Model

51cg developed a comprehensive NCLEX readiness system to improve first-time NCLEX pass rates, reduce time-to-test, and ensure consistent and defensible readiness decisions. This work integrated several components of the Diane M. Breckenridge, Zane R. Wolf, and Mary J. Roszkowski (2012) Risk Assessment Profile and Strategies for Success framework. Dr. Johnson introduced the model to 51cg after applying and observing successful implementation at other institutions with historically lower NCLEX performance. Johnson and Rogers adapted and expanded the model for use at 51cg. The model was further tailored to address the specific needs of Joyce students through collaboration with academic leaders, including Dean Jennifer Ayotte, Dr. Becky Collins, Dr. Ashley Otto, Assistant Dean Jennifer Cowherd, Dr. Cory Myers, and Dr. David Haskell. The model is intentionally organized as an integrated ecosystem rather than a collection of isolated initiatives. It includes six interdependent domains: assessment and evaluation, faculty development, NCLEX readiness infrastructure, policy alignment, student support, and curriculum design.

The JoyceU model is grounded in a central premise: NCLEX success is designed, measured, managed, and continuously improved. This differs from traditional approaches that place responsibility primarily on students near the end of the program. In the Joyce model, readiness begins at admission and orientation, continues through course-level assessment and remediation, is reinforced through curriculum and faculty development, and is supported through operational processes that help graduates test promptly.

Assessment and Evaluation

51cg implemented a comprehensive assessment and evaluation model to ensure consistent, valid, NCLEX-aligned measurement of student readiness. The model includes centralized governance, standardized blueprinting, subject matter expert review, AI-assisted item development, unbiased item review, item piloting, and psychometric validation. Exam item piloting was planned to began in Spring 2026, with the goal of developing at least 20 validated new items per exam beginning Fall 2026. The institution also established a key performance indicator to maintain exam failure rates at or below 20% per course beginning Summer 2026.

This assessment strategy recognizes that poor exam quality can distort readiness decisions. If course exams are not psychometrically sound, students may pass courses without demonstrating readiness or fail courses because of flawed items, misaligned content, or inconsistent rigor. Valid assessment systems, therefore, protect students, faculty, programs, and the public. These Joyce-content specific exams were given, along with the standardized, nationally-normed ATI subject-specific Content Master Series examinations in select courses throughout the pre-licensure programs.

Faculty Development

The Joyce model positions faculty development as a core NCLEX readiness intervention. Faculty influence curriculum delivery, classroom rigor, assessment validity, clinical judgment development, remediation quality, and the consistency of student expectations. Joyce strengthened program-specific faculty orientation, developed NCLEX-aligned item-writing and assessment training, prepared faculty for competency-based education, and created a new faculty support and readiness model that includes onboarding, observation, mentoring, and performance monitoring.

Faculty performance data are used to monitor course launch and closure compliance, end-of-course surveys, Content Mastery Series outcomes, predictor performance, and NCLEX pass rates. This approach reframes faculty development as an accountability and improvement system rather than a one-time orientation activity.

NCLEX Readiness Infrastructure

51cg revised its readiness infrastructure by replacing a single high-stakes predictor standard with a multi-indicator readiness model. A revised ATI Comprehensive Predictor benchmark of at least 74% raw average across two attempts replaced the prior single-attempt 95% probability-of-passing requirement. Remediation was required and guided based on each student’s individual learning needs. This change was designed to reduce high-stakes pressure while encouraging sustained preparation and allowing more students who demonstrated readiness to progress.

The ATI RN Comprehensive Predictor is designed to provide a numeric indication of a student’s likelihood of passing the NCLEX-RN and to guide remediation based on missed content (Assessment Technologies Institute [ATI], 2020). ATI’s technical documentation links percent-correct score ranges to predicted probability of passing, including a 74.0% to 74.7% range associated with an estimated 94% to 95% probability of passing the NCLEX-RN (Assessment Technologies Institute, 2020). However, Joyce’s model appropriately uses the predictor as one component of readiness rather than as a stand-alone determinant.

Joyce also incorporated VATI Greenlight requirements, weekly NCLEX data infrastructure, predictive analytics, Pearson VUE voucher incentives, and fast-track transcript processes. These strategies are designed to provide individualized readiness coaching, reduce financial and administrative barriers, and shorten the time between graduation and NCLEX testing.

Policy Alignment

The Joyce model includes systematic policy review because academic policies can either support or undermine readiness. The institution reviewed transfer credit, grading scale, dismissal and appeals, course expiration, assessment expiration, and entrance assessment policies. It also increased the weight of CMS assessments and removed reliance on an in-course exam-average requirement as the sole high-stakes determinant of progression.

The purpose of policy alignment is not to weaken standards. Rather, it is to ensure that standards are valid, equitable, evidence-informed, consistently implemented, and linked to licensure readiness. A defensible readiness system should avoid overreliance on a single high-stakes measure when multiple indicators can provide a more accurate picture of student readiness.

Student Support Systems

Joyce implemented proactive student support systems that identify risk early and intervene before failure occurs. The model includes at-risk dashboards, individualized remediation plans, key concept reviews, ATI CMS-based study plans, learning support services, re-entry safety and success plans, and redesigned new student orientation. Risk indicators include Comprehensive Predictor performance below 74%, CMS performance below benchmark, any single course examination below 80%, and course averages below 77%.

The student support model is designed to shift the institution from reactive remediation to predictive intervention. Rather than waiting until students fail a course or fail the NCLEX, the system identifies risk during the program and deploys targeted supports.

Curriculum Design

Curriculum alignment is central to the Joyce model. The institution strengthened alignment between Joyce-developed curriculum and ATI resources, improved course sequencing, mapped courses to the NCLEX blueprint, AACN Essentials, and program outcomes, and emphasized integrated learning across didactic, lab, simulation, and clinical environments.

This curricular design reflects the NGN emphasis on clinical judgment. Students must not only recall nursing content but also recognize cues, analyze data, prioritize hypotheses, generate solutions, take action, and evaluate outcomes. Therefore, NCLEX improvement requires curriculum structures that repeatedly develop and assess clinical judgment across the program.

Conceptual Figure: The 51cg NCLEX Readiness Ecosystem

Evidence Supporting the JoyceU Model

NGN and Clinical Judgment

The NGN requires programs to prepare students for complex clinical decision-making rather than content recall alone. NCSBN describes the NGN as an exam designed to better measure clinical judgment and decision-making abilities through innovative item types (NCSBN, 2023a). The NCJMM provides a framework for valid measurement of clinical judgment and decision-making within the NCLEX context (NCSBN, 2023b). These developments support Joyce’s emphasis on curriculum alignment, clinical judgment assessment, simulation integration, and progressive complexity across the program.

Predictive Analytics and Multiple Readiness Indicators

The literature supports the use of multiple predictors rather than a single readiness measure. Cummings et al. (2024) found that GPA and the ATI Comprehensive Predictor both accurately classified 86.67% of NCLEX-RN success, while performance in anatomy and physiology and pathophysiology classified 84.81% of NCLEX-RN success. ATI Medical-Surgical scores and the ATI Comprehensive Predictor were also correlated with first-time NCLEX-RN success. These findings support a multi-indicator model that includes academic performance, course-specific standardized assessments, and comprehensive predictors.

The ATI Comprehensive Predictor technical documentation states that the assessment is intended to estimate readiness and guide remediation; it also cautions that institutions using the exam are responsible for decisions based on test scores (Assessment Technologies Institute, 2020). This distinction is important. Standardized predictors can inform readiness decisions, but program leaders should avoid treating them as the only evidence of readiness. Joyce Nursing Leaders track key student performance indicators on a month-over-month basis, comparing performance to past semesters, and then they utilize the data to make real-time adjustments as needed.

Remediation and Student Support

Structured remediation is associated with improved readiness indicators. Meehan and Barker (2021) found that a prescribed remediation protocol helped high-risk students achieve the necessary Comprehensive Predictor scores associated with NCLEX success. House et al. (2021) also reported that a distance-delivered remediation course supported NCLEX-RN success among at-risk students during COVID-19 disruptions. These findings support Joyce’s use of individualized remediation plans, key concept reviews, ATI-guided remediation, and learning support integration.

Assessment Quality and Validity

NCLEX readiness decisions are only as strong as the assessments used to make them. Assessment validity requires alignment between course outcomes, program outcomes, licensure expectations, item design, administration conditions, and score interpretation. ATI’s technical manual emphasizes content validity, reliability, construct considerations, and standardized administration assumptions (Assessment Technologies Institute, 2020). Joyce’s assessment governance model, item piloting, psychometric review, and faculty item-writing development address these validity concerns at the program level.

Systems Thinking and Continuous Quality Improvement

A systems approach is necessary because NCLEX outcomes are influenced by multiple interacting variables.

NOTE:

• Curriculum alignment alone is insufficient if assessment quality is weak.
• Faculty development alone is insufficient if policies create inappropriate progression barriers.
• Remediation alone is insufficient if the risk is identified too late.
• Testing incentives alone are insufficient if students are not academically prepared.

The Joyce model addresses these interdependencies through feedback loops and shared accountability. The Feedback loops are outlined below:

Outcome Metrics and KPI Tables

A comprehensive NCLEX readiness system requires clearly defined outcome measures, operational benchmarks, and continuous performance monitoring processes. Sustainable improvement in first-time NCLEX-RN pass rates cannot be achieved through isolated interventions or retrospective analysis alone. Rather, nursing programs must establish measurable indicators that evaluate readiness longitudinally across the educational continuum.

The following outcome metrics and key performance indicators (KPIs) were developed to support continuous quality improvement, early risk identification, regulatory accountability, and evidence-informed decision-making within the 51cg NCLEX Readiness Model. These metrics intentionally combine leading indicators, such as predictor performance and CMS outcomes, with lagging indicators, such as first-time NCLEX-RN pass rates and time-to-test. This multidimensional approach reflects the understanding that NCLEX success is the product of interconnected academic, operational, instructional, and support systems rather than a single assessment event.

Importantly, these KPIs also support alignment with accreditation and regulatory expectations, including AACN Essentials competency development, CCNE outcomes assessment requirements, ACEN continuous improvement standards, and the Next Generation NCLEX emphasis on clinical judgment readiness. Collectively, these metrics allow institutions to monitor student progression, evaluate intervention effectiveness, identify curricular or assessment concerns, and ensure defensible readiness determinations through systematic and ongoing review processes. Refer to Table 1 below.

Table 1

Core NCLEX Readiness Outcome Metrics

Table 2, below, outlines the key leading, intermediate, operational, lagging, and quality indicators used to monitor and improve NCLEX-RN outcomes within a comprehensive readiness system. Together, these indicators provide a structured framework for continuous quality improvement by allowing institutions to identify risk early, evaluate intervention effectiveness, monitor operational efficiency, and assess long-term licensure outcomes. Leading indicators provide early warning signals that support proactive intervention, while lagging indicators evaluate the ultimate effectiveness of curriculum, instruction, assessment, and support systems. Operational and quality indicators further ensure that institutional processes, assessment validity, and program infrastructure remain aligned with student success and regulatory expectations. Collectively, these measures support evidence-informed decision-making, accountability, and sustainable NCLEX readiness improvement across the program.

Table 2

Leading and Lagging Indicators for NCLEX Improvement

The next table, Table 3, summarizes the major domains within the 51cg NCLEX Readiness Model and translates each domain into actionable strategies that can be adopted by other nursing programs seeking to improve NCLEX-RN outcomes. The framework demonstrates that sustainable licensure success requires coordinated improvement across assessment systems, faculty development, student support, curriculum design, academic policies, and readiness infrastructure. By pairing institutional strategies with transferable program actions, the table provides a practical roadmap for implementing evidence-informed, systems-based approaches to NCLEX readiness and continuous quality improvement.

Table 3

Joyce Model Domains and Program-Level Improvement Actions

Accreditation and Regulatory Implications

CCNE Implications

All 51cg Bachelor’s degree nursing programs are accredited by the Commission on Collegiate Nursing Education (CCNE). The CCNE 2024 Standards require programs to demonstrate achievement of required program outcomes related to licensure. Programs may demonstrate licensure pass-rate achievement through several approaches, including first-time pass rates of 80% or higher for each campus/site and track for the most recent calendar year, all-taker pass rates of 80% or higher, or three-year aggregated approaches (Commission on Collegiate Nursing Education [CCNE], 2024). CCNE also expects programs to provide aggregate student outcome data, including completion rates, licensure pass rates by campus/site and track, certification pass rates where applicable, employment rates, and evidence that data are analyzed and used for ongoing program improvement (CCNE, 2024).

The Joyce model aligns strongly with these expectations because it does not treat NCLEX performance as an isolated annual statistic. Instead, it creates a continuous improvement system in which NCLEX outcomes, assessment analytics, faculty performance, and student success data inform curriculum, policy, and intervention decisions.

ACEN Implications

Our associate’s degree nursing program is accredited by the Accreditation Commission for Education in Nursing (ACEN). ACEN Standard 5 focuses on outcomes and requires nursing programs to demonstrate student learning and program outcome achievement. Although specific benchmarks and reporting structures vary by program type and accreditation context, the underlying expectation is that programs systematically evaluate outcomes, analyze data, and use findings for program improvement. For programs with declining NCLEX outcomes, an integrated model such as Joyce’s provides a stronger accreditation response than a narrow remediation plan because it demonstrates root-cause analysis, shared accountability, data-informed decision-making, and sustained monitoring.

The Joyce model is especially useful from an ACEN lens because it connects NCLEX outcomes to curriculum, faculty, students, policies, and assessment quality. This creates a defensible narrative that the program is not merely reacting to pass-rate concerns but has implemented a structured, measurable, and continuously monitored improvement system.

Board of Nursing and Public Protection Implications

Boards of nursing are concerned not only with pass rates but also with public protection and the readiness of graduates to enter practice safely. A model that strengthens assessment validity, clinical judgment development, remediation, and timely testing supports the public protection function of nursing regulation. The NGN emphasis on clinical judgment further reinforces the need for programs to align learning activities, simulation, clinical experiences, and assessments with entry-level decision-making demands.

Recommendations for Nursing Programs Seeking to Improve NCLEX-RN Outcomes

1. Conduct a Full-System Diagnostic Review

Programs should begin by examining the entire readiness ecosystem rather than assuming the problem is limited to students or a single course. The review should include admissions data, progression data, course outcomes, standardized assessment performance, faculty preparation, curriculum mapping, exam quality, remediation effectiveness, and time-to-test patterns.

2. Build a Multi-Indicator Readiness Model

Programs should avoid overreliance on a single predictor, exit exam, or course grade. A stronger readiness model includes course performance, CMS or specialty assessment performance, comprehensive predictor results, remediation completion, clinical judgment performance, faculty input, and student engagement data.

3. Establish Assessment Governance

Programs should implement standardized blueprinting, item-writing training, item review, exam analysis, and psychometric review. Assessment quality should be monitored as a program-level quality indicator rather than left solely to individual faculty preference.

4. Align Curriculum to NGN Clinical Judgment Expectations

Programs should map curriculum to the NCLEX test plan, NCJMM cognitive operations, AACN Essentials competencies, and program outcomes. Clinical judgment should be developed progressively through didactic learning, unfolding case studies, simulation, lab, clinical, and debriefing.

5. Implement Early Alert Dashboards

Programs should identify risk before course failure or graduation. Dashboards should include academic performance, standardized assessment scores, attendance, progression history, remediation completion, and engagement with support services.

6. Standardize Remediation

Remediation should be structured, individualized, documented, and connected to missed content and clinical judgment deficits. Students should receive clear expectations, targeted resources, faculty follow-up, and accountability checkpoints.

7. Strengthen Faculty Capability

Faculty development should include NCLEX test plan updates, NGN item-writing, clinical judgment pedagogy, exam analysis, remediation coaching, and competency-based education principles. Faculty data should be used to guide support, not merely evaluation.

8. Review Policies for Validity and Equity

Programs should evaluate whether grading, progression, dismissal, transfer credit, re-entry, and standardized testing policies are evidence-informed and consistently implemented. Policies should protect academic standards while avoiding unnecessary barriers that are not predictive of licensure success.

9. Reduce Time-to-Test

Programs should examine operational delays between graduation and NCLEX testing. Transcript processing, ATT support, testing fee barriers, advising, and scheduling assistance should be reviewed and improved.

10. Create a Continuous Improvement Rhythm

NCLEX performance should be reviewed continuously through formal governance structures. Programs should establish monthly and quarterly NCLEX readiness reviews, annual curriculum variance reviews, post-exam assessment reviews, and regular reporting to academic leadership. Annual program reviews are not enough.

Discussion

The 51cg model demonstrates that NCLEX improvement is most defensible when it is framed as academic quality improvement rather than test preparation alone. This distinction matters. Programs that focus only on test preparation may improve short-term performance while leaving deeper curricular, assessment, and faculty issues unresolved. In contrast, programs that build integrated readiness ecosystems can improve NCLEX outcomes while strengthening overall educational quality.

The model also supports equity. Overreliance on a single high-stakes gate can disproportionately harm students when the gate is not sufficiently valid, when remediation is inconsistent, or when operational barriers delay testing. A multi-indicator model allows programs to maintain rigor while ensuring that readiness decisions are based on a fuller body of evidence.

Finally, the model supports accreditation defensibility. Accreditors expect programs to analyze outcomes, identify variances, implement improvements, and evaluate effectiveness. The Joyce ecosystem provides a structure for demonstrating that NCLEX outcomes are actively managed through a formal quality system.

Conclusion

NCLEX-RN outcomes are not isolated student outcomes; they are institutional outcomes produced by curriculum, assessment, faculty, policy, student support, and operational systems. 51cg’s Comprehensive NCLEX Readiness Model offers a practical and evidence-informed example of how nursing programs can improve first-time pass rates through intentional design, predictive analytics, early intervention, assessment governance, faculty development, policy alignment, and continuous feedback loops.

We have had early, clear, and measurable NCLEX_RN pass rate success with initial implementation. We will continue to test and refine this model over the next two years. Programs seeking to improve NCLEX-RN outcomes should move beyond reactive remediation and adopt integrated readiness ecosystems that work for their unique system and student demographics. Such systems are better aligned with the Next Generation NCLEX, competency-based education, accreditation expectations, and the public protection mission of nursing education.

References

American Association of Colleges of Nursing. (2021). The Essentials: Core competencies for professional nursing education. Author.
Assessment Technologies Institute. (2020). Technical manual for the RN Comprehensive Predictor 2019. Assessment Technologies Institute.
Breckenridge, D. M., Wolf, Z. R., & Roszkowski, M. J. (2012). Risk assessment profile and strategies for success instrument: Determining prelicensure nursing students’ risk for academic success. Journal of Nursing Education, 51(3), 160–166.
Commission on Collegiate Nursing Education. (2024). Standards for accreditation of baccalaureate and graduate nursing programs. American Association of Colleges of Nursing.
Cummings, J. A. F., Kennard, D., Egan, J., Aryal, S., & McVey, C. (2024). An exploratory study: Indicators of NCLEX-RN success. Teaching and Learning in Nursing.
Giddens, J. F. (2022). The revised AACN Essentials: Implications for nursing regulation. Journal of Nursing Regulation, 13(1), 53–56.
House, S. K., Hubbard, J., & Bacus, R. (2021). Adapting NCLEX-RN remediation during the COVID-19 pandemic. Teaching and Learning in Nursing, 17(1), 74–78.
Lewis, L. S., Willard, V., & Staudt, C. (2023). Effect of a commercial NCLEX-RN preparation product on first-time pass rates. Nursing Reports, 13(3), 1141–1150.
Meehan, C. D., & Barker, N. (2021). Remediation for NCLEX-RN success in high-risk nursing students. Teaching and Learning in Nursing, 16(3), 254–257.
National Council of State Boards of Nursing. (2023a). Next Generation NCLEX.
National Council of State Boards of Nursing. (2023b). Clinical Judgment Measurement Model.
National Council of State Boards of Nursing. (2026). NCLEX pass rates.

Appendix A

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Self-care for nurses isn’t about luxury or perfection. It’s about finding realistic ways to recover, protect your well-being, and sustain yourself in a profession and avoid nurse burnout before it sets in. 

Below are 50 practical self-care ideas designed for working nurses, with a focus on realistic ways to recharge and reduce burnout.

Physical Self-Care Ideas for Nurses

Your body is your most essential tool at work. These ideas focus on restoring energy, reducing physical strain, and supporting recovery.

1. Prioritize sleep, even if it means saying no to extra commitments
   
2. Stretch before and after shifts to reduce muscle tension
   
3. Take short walks outside on days off to reset your nervous system
   
4. Stay hydrated during shifts, even when it’s busy
   
5. Meal prep simple, nourishing foods for workdays
   
6. Schedule regular massages or bodywork, if accessible
   
7. Practice gentle yoga or mobility exercises
   
8. Invest in supportive footwear designed for long shifts
   
9. Take power naps when your schedule allows
   
10. Try breathing exercises to calm your body after stressful moments

Emotional and Mental Self-Care for Nurses

Nursing often requires emotional strength without much space to process it. These ideas support emotional regulation and mental health.

11. Journal about difficult shifts to process emotions
    
12. Talk with peers who understand the realities of nursing and can offer mutual support
    
13. Set boundaries around work-related conversations on days off
    
14. Practice mindfulness or meditation, even for five minutes
    
15. Limit doom-scrolling after work to protect your mental energy
    
16. Seek professional counseling or therapy when needed
    
17. Listen to music that helps you decompress after shifts
    
18. Name compassion fatigue when you feel it; it’s not a personal failure
    
19. Practice self-compassion during high-stress periods
    
20. Allow yourself to feel pride in the work you do

Self-Care During and Between Shifts

Self-care doesn’t always happen on days off. These ideas fit into real workdays.

21. Take your breaks when possible and protect them
    
22. Step outside for fresh air during longer shifts
    
23. Pack snacks that support steady energy levels
    
24. Use during intense moments
    
25. Create a calming post-shift routine
    
26. Change out of scrubs as soon as you get home
    
27. Keep a comforting item in your work bag
    
28. Hydrate and refuel as needed during or after shifts to support recovery
    
29. Recognize when work conditions are contributing to stress and seek appropriate support
    
30. Ask for help when you need it

Social and Relationship Self-Care

Connection matters, especially in emotionally demanding professions.

31. Spend time with people who recharge you
    
32. Say no to social obligations when you need rest
    
33. Connect with other nurses and peers outside of work
    
34. Plan low-effort social activities on days off
    
35. Maintain relationships outside healthcare
    
36. Set clear work-life boundaries
    
37. Laugh often; humor is a powerful stress reliever
    
38. Share meals with people you care about
    
39. Stay connected even during busy seasons
    
40. Protect your emotional bandwidth

Long-Term Self-Care and Burnout Prevention

Sustainable nursing careers require proactive care, not just recovery.

41. Reflect on what drains you most at work
    
42. Identify what brings meaning to your role
    
43. Explore continuing education or new specialties
    
44. Consider schedule changes if possible
    
45. Take PTO before burnout forces it
    
46. Revisit your professional goals regularly
    
47. Advocate for yourself in the workplace
    
48. Practice saying no without guilt
    
49. Celebrate milestones in your nursing career
    
50. Remember that your well-being matters as much as your patients’

Why Self-Care Matters for Nurses

Nursing is built on showing up for others, often in high-pressure, emotionally charged situations. Over time, that constant demand can take a real toll, especially when rest and recovery are treated as optional instead of necessary.

Self-care helps nurses reduce burnout, protect patient safety, and stay connected to the purpose behind their work. When nurses are supported and well-resourced, they’re better able to focus, respond, and provide the level of care their patients deserve. Just as importantly, self-care helps preserve your own well-being, so the work you do remains sustainable over the long term.

Supporting nurses means recognizing that well-being and professional growth go hand in hand. At 51cg, we’re committed to helping nurses build sustainable careers through flexible nursing programs designed to support both personal and professional goals. If you’re considering your next step in nursing, explore the pathways that align with where you are now, and where you want to go.

Ready to connect with us?

In a 2025 survey of 1,000 registered nurses across the United States, we heard firsthand how emotional exhaustion, skipped breaks, and sleepless nights continue to shape their professional lives.

Nearly three in four nurses surveyed (74%) say they feel emotionally drained from work multiple times each week, underscoring a growing concern that extends beyond long shifts and heavy workloads. 

This growing wave of burnout is more than a workforce challenge. It’s a call to action to care for the caregivers who keep the healthcare system running.

Key Survey Findings:

• 74% of nurses have felt emotionally exhausted from work multiple times a week in the past month. 
• Among early-career nurses, 28% of Gen Z nurses have felt burnt out from work every day over the past month. 
• 55% of nurses skip breaks or meals on most shifts or more because they’re too busy.
• Among Gen Z nurses who represent the newest entrants to the workforce, 25% reported having access to employer-provided mental-health resources but choosing not to use them because of confidentiality or career-impact concerns. 
• 47% of nurses have trouble sleeping due to work-related stress most or all nights. 
• 40% of women nurses are uncomfortable discussing burnout or mental health concerns with their direct supervisor, compared to 26% of male nurses.
• 53% of nurses have seriously considered leaving the nursing profession monthly or more in the past 6 months. 
• 49% of nurses have been worried, once a week or more, that they might make a medication error or other mistake due to fatigue or being overwhelmed.
• 49.5% of nurses have felt unsafe due to verbal or physical aggression from a patient or a patient’s family member in the past year.
• 74% of nurses have worked mandatory overtime 3 or more times in the past month.

Nearly 3 in 4 Nurses Surveyed Feel Emotionally Exhausted Each Week

In our 2025 survey, 74% of nurses say they have felt emotionally drained from work multiple times a week in the past month, reflecting a high level of self-reported strain among participants and echoing within the nursing workforce.

This strain comes as hospitals across the country face a historic staffing shortage. Federal projections show the United States will be , leaving current staff to shoulder heavier patient loads and longer shifts. 

Despite these conditions, nurses continue to serve on the frontlines of care, driven by their commitment to their patients and communities.

Young Nurses Are Reportedly Burning Out Faster Than Older Cohorts

Survey data suggest that younger nurses may be experiencing higher levels of daily emotional strain. A national published by the American Nurses Association examining generational differences in burnout and turnover risk found that early-career nurses consistently report higher levels of stress, fatigue, and intent to leave, particularly during periods of heightened workforce strain.

Our survey reflects a similar pattern. While not nationally representative, Gen Z respondents reported the highest rate of daily emotional exhaustion (28%), compared with 25% of Millennials, 22% of Baby Boomers, and 17% of Gen X respondents. Together, these findings align with broader research indicating that younger and early-career nurses may face elevated burnout and turnover risk relative to older cohorts.

With an as older nurses retire, new graduates are entering a field already under significant pressure. This underscores the importance of supporting nurses early in their careers through mentorship, manageable workloads, and environments that encourage open conversations about well-being.

The Hidden Stigma: Fear Keeps Young Nurses From Seeking Help

suggest that even when mental-health resources exist for nurses, utilization may remain low, and stigma (such as concerns about confidentiality or career impact) continues to be a barrier among many in the workforce. 

This pattern also appeared in our findings, particularly regarding new nurses entering the field: one in four Gen Z respondents (25%) with access to employer-provided mental health support said they chose not to use it due to these same concerns.  

This reluctance comes at a time when hospitals are placing greater emphasis on retention, resilience, and workplace well-being. National workforce studies have found that stress and burnout continue to influence nurses’ decisions to leave the profession. In the , 41.3% of RNs who plan to leave or retire within five years cited stress and burnout as a contributing factor, second only to retirement itself. Workload and understaffing were also cited frequently, underscoring the ongoing impact of workplace pressures on long-term career decisions.

Together, these findings highlight that emotional strain is only part of what nurses are navigating; many also face barriers to accessing the support intended to help them cope. Reducing stigma, strengthening confidentiality protections, and promoting psychological safety are essential steps in creating environments where nurses can seek help without hesitation. As the broader workforce continues to face high demands, addressing these cultural and structural barriers is critical to supporting long-term well-being and retention of nurses.

Skipped Meals, Skipped Breaks: Daily Survival Over Self-Care

Physical strain is also a significant part of a nurse’s day-to-day routine. More than half of the nurses surveyed (55%) say they regularly skip meals or breaks on most shifts because they are too busy. For many respondents, basic needs are set aside to keep pace with workload demands, leaving little time for rest, recovery, or self-care routines.

These findings occur against the backdrop of ongoing staffing shortages that continue to stretch healthcare systems across the country. In states facing some of the such as California, Georgia, and Washington, reports of heavy patient ratios and high workloads are common, making consistent breaks difficult to sustain.

While many nurses continue to show remarkable endurance and compassion for those in their care, they are likely to still face burnout if appropriate measures aren’t taken to create a more sustainable work environment.

The Systemic Roots of a Workforce Crisis 

The forces shaping today’s nursing shortage extend beyond long hours and emotional fatigue. National experts point to several structural barriers that limit the number of new nurses entering the field each year. 

Educational capacity remains a major bottleneck. In 2023, U.S. nursing schools turned away 65,766 qualified applications to baccalaureate and graduate programs, largely due to shortages of faculty, clinical placements, classroom space, and other resource constraints, according to the . 

At the same time, the , increasing retirements among experienced nurses and the lasting impacts of the COVID-19 pandemic. Together, these pressures have narrowed the pipeline of new graduates at a moment when the healthcare system needs them most.

Addressing these systemic factors requires long-term investment in educational capacity, faculty development, and clinical training opportunities. Institutions across the country are beginning to respond by expanding access to high-quality nursing education, developing flexible pathways into the profession, and building clinical partnerships that bring training closer to where students live. 

Hybrid learning models and innovative simulation technologies are helping widen the pipeline for future nurses while preserving rigorous, hands-on skill development. These efforts by emerging universities, represent an important step toward strengthening the workforce and supporting the profession’s long-term stability.

Sleepless Nights: Work Stress Follows Nurses Home

For many nurses, the stress does not end when the shift does. Nearly half of survey respondents (47%) say they struggle to sleep most or all nights because of work-related anxiety.

Additionally, 49% of respondents also say they worry weekly that exhaustion could lead them to make a medication error or another grave mistake. The fear of harming a patient because of fatigue adds another layer of emotional strain, creating a feedback loop that endangers both caregivers and those they serve.

As national shortages deepen, this risk may increase. Fewer nurses on duty mean higher patient loads and thinner margins for safety, a reality that places both staff and patients in jeopardy.

Chronic sleep disruption is one of the most consistent predictors of fatigue-related errors, emotional exhaustion, and long-term attrition in nursing. Research shows that tired nurses are or miss care tasks and that nurse fatigue and reduced alertness are . 

Shifting the conversation from individual stamina to systemic safeguards such as fatigue-risk management, optimized scheduling, workload controls, protected rest periods, and institutional support, acknowledges that sleep and alertness are core safety issues for both nurses and patients.

Staffing pressures can exacerbate fatigue, as fewer staff leads to longer shifts and greater pressure. Creating workplace environments that prioritize rest and mental wellness is essential to breaking this cycle.

From Burnout to Bedside: Nearly Half of Nurses Fear Fatigue Puts Patients at Risk

Burnout affects not only nurses but also the quality and safety of patient care. from the Agency for Healthcare Research and Quality (AHRQ) shows that hospitals with adequate nurse staffing and manageable patient ratios experience lower mortality, fewer adverse events, and shorter lengths of stay. When staffing levels become strained, whether due to vacancies, high turnover, or persistent fatigue, evidence shows that patient outcomes can suffer. The effects of burnout reach far beyond the workforce. 

These findings underscore that supporting the well-being of nurses is also essential to maintaining patient safety. Ensuring that teams are adequately staffed, especially as demand for qualified nurses continues to rise, helps alleviate many of the stressors nurses experience, from heavier patient loads to reduced recovery time between shifts. 

Expanding pathways into the profession can further strengthen staffing by ensuring that aspiring nurses have access to the high-quality education and training needed to enter the workforce. Reducing barriers to education not only supports a more stable, well-prepared nursing workforce but also reinforces the safe, reliable care that patients depend on. Supporting staff well-being is not only a matter of workforce stability but of patient safety. Healthy nurses make healthier communities, and when the profession thrives, patients receive safer, more consistent care.

Violence at Work: A Growing Threat

Violence toward healthcare workers remains a persistent and troubling reality in many care settings. Nearly half of nurses surveyed (49.5%) reported that they have felt unsafe in the past year because of verbal or physical aggression from patients or their families. Encounters like these can heighten stress, erode morale, and compound the fatigue nurses are already navigating. Facing workplace hostility adds another layer of strain to an already overburdened profession.

National safety organizations have long identified , and health systems across the country are responding with measures such as de-escalation training, clearer reporting pathways, enhanced security protocols, and zero-tolerance policies. This reflects a growing recognition that protecting nurses from harm is essential for a sustainable workforce.

Mandatory Overtime and Intensifying Pressure

Roughly three out of four nurses surveyed (74%) report working mandatory overtime three or more times in the past month. Such demands can magnify existing strain: fewer nurses on shift mean heavier workloads, longer hours, and rising fatigue. As some nurses leave due to exhaustion, the burden intensifies for those who remain. 

published in the International Journal of Public Health (2024) confirms that high rates of mandatory overtime and extended scheduling contribute to job dissatisfaction and a greater intent to leave.  

With staffing shortfalls deepening, many in the field are calling for serious reforms and stronger recognition of nurses’ role in keeping the health system afloat. has raised concerns that a proposed federal change to how nursing degrees are classified for financial aid eligibility could affect access to advanced training, underscoring the importance of expanding educational pathways into the profession. 

A Profession Worth Protecting

Across this survey, respondents reported experiencing multiple factors commonly associated with burnout, including emotional exhaustion, fatigue, staffing pressure, and safety concerns. While this survey represents a non-representative sample, the patterns observed reflect challenges widely documented in national research on the nursing workforce. Together, these findings suggest that aspects of nurse well-being, safety, and workforce sustainability may be under strain, reinforcing the importance of continued attention to how nurses are supported within the healthcare system. 

Many states, health systems, and educational institutions are beginning to respond to mounting workforce pressures by expanding capacity, strengthening training opportunities, and piloting initiatives that support nurse well-being and retention.  

51cg has taken steps aligned with these priorities, including regional expansion to broaden access to accredited nursing programs, flexible hybrid learning models that blend online coursework with hands-on training, and partnerships with clinical sites across the U.S. to bring education closer to where nurses live and work. Together, these efforts contribute to strengthening the nursing pipeline at a time when staffing shortages are placing increased strain on nurses already in the field.

Methodology

To understand the state of nurse burnout in 2025, 51cg commissioned a survey of 1,000 nurses across the United States. Participants answered questions about their emotional well-being, workloads, mental-health resources, and workplace experiences. Responses were analyzed by demographic group to identify patterns in stress, burnout, and professional satisfaction.

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For commercial use or publication purposes, including but not limited to media outlets, websites, and promotional materials, please contact the authors for permission and licensing details. We appreciate your respect for intellectual property rights and adherence to ethical citation practices. Thank you for your interest in our research.

Neonatal intensive care unit, or NICU, nurses provide care for less-than-healthy newborns. It can be a demanding, but fulfilling, role that can lead to higher pay and more career opportunities. As a highly specialized role, NICU nurses are required to have training and certifications in addition to an associates or bachelors degree from an accredited school like 51cg.

No two days are the same for a NICU nurse. Their responsibilities range from providing patient care to helping with feeding and changing diapers. Caring for critically ill babies is challenging, but the role can also be incredibly rewarding. As the name implies, NICU nurses work in the neonatal or newborn intensive care unit of hospitals or clinics, checking for complications, and administering medicine. 

NICU nurses have strong career prospects. With a and a shortage of qualified nursing professionals, the demand for NICU nurses continues to grow. They generally take home a healthy six figure average salary. However, getting into this in-demand career field requires specialized training and education.

Keep reading to learn about what a NICU nurse does, expected salary, and career opportunities, and discover the steps you need to take to become one. 

Responsibilities and Daily Tasks

NICU nurses work in the neonatal intensive care units of hospitals. If a baby is born prematurely, with a low birth weight, or with medical complications, these specialized units provide monitoring, treatment, and support.

NICUs use advanced technology and highly-trained specialists to help high-risk newborns. Ventilators, monitors, IVs, and incubators all help ensure the best possible outcome for infants. Staff work around the clock to prevent infections, regulate temperature, and prepare newborns and their family for life outside the hospital. 

Among their , NICU nurses:

• Care for babies, including feeding, bathing, and changing diapers
• Provide medicine, treatments, and therapies
• Monitor vitals and watch for signs of distress
• Educate parents on care and treatment
• Coordinate treatment with other staff
• Document everything

Beyond these more practical responsibilities, NICU nurses should also be prepared to provide emotional support throughout the stay of newborns and their families. The NICU is an incredibly challenging setting for families, and nurses often need to encourage parents, provide hope and an empathetic ear, and advocate for their patients’ needs.

Where Do NICU Nurses Work?

NICU nurses primarily work in hospital, clinic, or medical center settings. NICU nurses work in hospitals with designated levels of neonatal care, from basic to advanced, that indicate the types of newborn conditions and treatment capabilities available.The experience of working at a smaller community hospital with a Level I or II NICU can be totally different from working in a regional children’s medical center with a Level III or IV. In smaller healthcare facilities, NICU nurses may be required to support multiple maternal-newborn units. Larger hospitals typically offer more specialized NICU roles with less need to float to other departments. 

Here’s a brief overview of the different and the care they may provide:

• Level I (Well-Newborn Nursery)
  Provides basic care for healthy, full-term infants and can stabilize newborns with unexpected complications before transfer to a higher level of care. NICU nurses are not typically required in Level I settings, though staffing models may vary in smaller hospitals.
• Level II (Special Care Nursery)
  Cares for moderately ill or premature infants who require closer monitoring or short-term respiratory support and are expected to improve without the need for advanced intensive care.
• Level III (Neonatal Intensive Care Unit)
  Provides comprehensive intensive care for very premature or critically ill newborns. Infants in Level III NICUs may require prolonged life support, mechanical ventilation, advanced imaging, and care from pediatric medical subspecialists.
• Level IV (Regional NICU)
  Offers the highest level of neonatal care. In addition to all Level III capabilities, Level IV NICUs have 24/7 access to pediatric surgical specialists and can perform complex surgeries and advanced interventions for critically ill infants.

While becoming a nurse for either level of NICU requires training, higher level NICU units may require additional experience and certifications.

Steps to Become a Neonatal Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

Becoming a NICU nurse involves training and experience. As specialists providing intensive care, NICU nurses must have a degree from an accredited institution, like 51cg. These programs provide training in nursing, anatomy, and biology, ensuring nurses have a solid foundation of knowledge as they begin treating patients. It is possible to earn a degree and start working toward a NICU career in as little as 20 months.

You should consider these programs if you’re looking to become a NICU nurse:

• Associate of Science in Nursing – Can you be a NICU nurse with an associate’s degree? Yes! An associate’s degree is a solid start to any nursing career. You will require additional training or certifications to become a NICU nurse, but with an ASN you can quickly get experience, and a job, in real medical settings. ASN programs through 51cg can often be completed within 20 months, or 5 semesters.
• Bachelor of Science in Nursing – A bachelor’s degree provides a great starting point for nursing specialties, like becoming a neonatal nurse. With a comprehensive set of courses and hands-on training, you’ll be prepared to work as a nurse and to pursue advanced training and certifications. Many BSN programs can be completed in 3-4 years, but an accelerated program can be finished in as little as 20 months.
• Masters of Science in Nursing – A master’s degree in nursing can prepare you for advanced certifications and roles in leadership, education, or advanced clinical practice. Nurses who complete a specialized neonatal nurse practitioner (NNP) MSN track can provide advanced care to high-risk infants. 

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

Once you’ve completed your courses and clinicals, there are still additional steps to becoming a NICU nurse. You’ll need to pass the National Council Licensure Examination, or the . This exam certifies that you have the knowledge and competency to practice nursing. While your nursing program should prepare you for the NCLEX, you may also want to study and practice to be prepared.

After passing the NCLEX-RN, there are still more requirements to be a NICU nurse. First, you’ll need to secure a nursing license from your state. Each state has different specific requirements, but they may often require a background check and fingerprinting.

Step 3 – Gain Clinical Experience in NICU

NICU units need nurses with real experiences providing pediatric care. Working for a pediatrician or a delivery unit can help you gain experience caring for children in a less intensive environment, but if you want to get started in the NICU right away, consider an . These programs can help you build the skills, relationships, and experience you need to thrive as a neonatal nurse.

Step 4 – Get Certified in NICU Nursing

Beyond your degree, NCLEX certification, and clinical experience, additional certifications in NICU nursing can show your dedication, knowledge, and competency. These certifications can lead to better career options and more advanced roles. Here are some of the certifications to consider for a career in NICU nursing:

• (NRP) – The NRP provides advanced training for resuscitating newborns, an essential skill in a NICU unit. This certification is considered mandatory for many neonatal nurses.
• (RNC-NIC) – The RNC-NIC tests specialty knowledge, providing a comprehensive examination to ensure that NICU nurses are prepared for the unique challenges they will face.
• – The CCRN (Neonatal) is a specialty certification that verifies experience providing care for critically-ill neonatal patients.

How Much Do NICU Nurses Make?

As medical professionals, NICU nurses have a very solid earning potential. In 2025, the for a NICU nurse in the U.S. is $127,391.

Salaries vary from state-to-state based on cost of living and local economies, but NICU nurses make an average of six figures in the vast majority of states. The for NICU nurses are: 

• Washington – $144,283
• District of Columbia – $143,955
• New York – $139,370
• Massachusetts – $139,127
• Alaska – $137,193

Career Outlook for Neonatal Intensive Care Unit Nurses

Job Demand & Growth in 2025

Medical professionals are almost always in demand, and nurses are no different. With large decreases in the supply of nurses and projected shortages of tens of thousands by 2030, we need qualified NICU professionals, and their career opportunities will continue to grow.

According to the , there will be a 6% growth in the employment of nurses from 2023 to 2033. This makes nursing one of the fastest growing occupations in the U.S. Specialty nurses, like NICU nurses, have incredible opportunities to secure lasting, lucrative careers as this demand grows.

Best Specializations & Advanced Roles for NICU Nurses

With their training and certifications, NICU nurses can easily adapt to advanced nursing , and building experience in such an intensive environment can prepare NICU nurses for leadership and educational opportunities as well. An experienced NICU nurse can become a nurse manager or nurse educator, helping to guide their unit and train the next generation of nurses. 

Neonatal nurses can also seek out advanced positions such as a neonatal nurse practitioner (NNP) or a clinical nurse specialist (CNS). While these roles require additional training and experience, they also provide strong career opportunities and greater responsibility for patient care.

• (NNP) – Neonatal nurse practitioners provide critical care for high-risk patients, along with support and education for families.
• (CNS) – Clinical nurse specialists provide diagnosis, treatment, and management for patients, especially those suffering acute or chronic illnesses.

Your Path to Becoming a NICU Nurse Starts Today

If you’re ready for a challenging, fulfilling, and well-paid career in NICU nursing, it’s time to get started. 51cg offers ASN, BSN, and MSN programs to get you ready for a nursing career in as little as 20 months. We offer convenient online classes with hands-on labs and clinicals for real experience. Our programs will ensure you’re prepared for the NCLEX-RN exam and the actual challenges of working as a nurse.

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Pediatric nurses provide care for children from birth to age 18. In caring for children at many different stages of development, pediatric nurses should have an empathetic, listening ear and show patience as they clearly communicate diagnoses, treatment plans, and care instructions to patients and parents in a way that is easy for their patient to understand. Pediatric nursing is a perfect career for people that enjoy working with children, and the healthy salary and career prospects certainly don’t hurt.

Every day is different for . Depending on where they work, they may mostly care for healthy patients throughout childhood, or they may deal with critically ill or injured patients that require specialized care and intensive treatment. Helping sick and hurt children can be very challenging, but treating patients and watching them grow can also be incredibly fulfilling.

Pediatric nurses have many career options. From hospitals to private practices to schools, pediatric nurses can work in a variety of different healthcare settings. A shortage of qualified nursing professionals is also driving demand and salaries for nurses across the country. 

Read more to learn about the day-to-day tasks of a pediatric nurse, their average salary, and what you need to do to become one.

Duties & Daily Tasks

From birth to adulthood, pediatric nurses care for children. Depending on where they work, they will encounter different types of patients. Nurses at a private practice will generally see healthy patients or those with a minor illness or injury, while nurses at a hospital will probably care for more serious issues. School nurses will mostly help children of a specific age range, while nurses in a newborn intensive care unit (NICU) will exclusively treat newborns. To thrive as a pediatric nurse, you should be able to connect and empathize with children at any stage of development. 

include:

• Assessing patients’ health
• Recording patient and family medical history
• Checking vital signs
• Administering medication
• Gathering samples from patients
• Helping pediatricians and neonatologists
• Educating patients and caregivers
• Encouraging preventative healthcare education
• Working with other healthcare providers
• Recording everything for their patients’ medical records

Pediatric nurses must be able to communicate and connect with both their patients and with their patients’ parents, guardians, or caregivers. A successful pediatric nurse should be prepared for the emotional challenges of caring for sick and injured children while providing support and comfort for the patient and their family.

Where Do Pediatric Nurses Work?

Pediatric nurses work in many different healthcare settings including hospitals, clinics, private practices, schools, and social services. Each of these settings will have different schedules and levels of care. Specialty clinics and hospital units may require additional training and certification. 

• Hospitals – General hospitals with pediatric units, children’s hospitals, and specialty hospitals all need pediatric nurses. Hospital nurses often work 12-hour shifts to provide coverage 24/7, and they usually deal with patients with more serious illnesses or injuries, especially in a unit like the pediatric intensive care unit (PICU). Pediatric nurses working in a hospital should be prepared to work long shifts on weekends and holidays.
• Clinics and Private Practices – Clinics and private practices generally offer a schedule more typical of business hours. Pediatric nurses in these settings will often see patients that are healthy or require less intensive care.
• Schools – School nurses work typical school hours, with summers off, and provide basic medical care like treating small wounds, administering medicine, and helping students manage conditions like diabetes or asthma.
• Social Services – Pediatric nurses working in social services will generally work with vulnerable families to coordinate care, advocate for their patients’ needs, and connect them with resources and support. 

Steps to Become a Pediatric Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

How long does it take to become a pediatric nurse? You’ll start with earning a degree from an accredited institution, like 51cg. You will need an associates degree, at least, to become a nurse, but a bachelors or masters can open doors to more specialized roles and higher salaries. A good program will provide training in nursing, anatomy, biology, and more so that you’re prepared to treat patients in the real world. Fortunately, you can earn a degree and start working towards a career in pediatric nursing in as little as 20 months.

These programs can help you get started as a pediatric nurse:

• Associate of Science in Nursing – An associate’s degree is a good foundation to quickly move into a nursing career, though some employers may require additional certification for pediatric nursing. 51cg offers ASN programs that can be completed within 20 months, or 5 semesters.
• Bachelor of Science in Nursing – Bachelor degrees offer a comprehensive set of courses and hands-on training, providing a strong start for pediatric nurses. BSN programs can often be finished in 3-4 years, although an accelerated program can be completed in as little as 20 months.
• Masters of Science in Nursing – With a master’s degree, you can pursue more advanced roles such as a pediatric nurse practitioner or clinical nurse specialist, along with the increased earning potential these careers provide. RNs seeking advanced training can pursue an  MSN degree in as little as 1 year.

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

After earning your nursing degree, you still have one major step to become a pediatric registered nurse: passing the National Council Licensure Examination, or NCLEX-RN. By completing this exam, you prove that you have the knowledge and skill to be a nurse. Your degree should prepare you for the NCLEX, but be sure to study and practice.

After the NCLEX-RN, you must secure a nursing license from your state. Each state has their own requirements that often include a background check and fingerprinting.

Step 3 – Gain Clinical Experience in Pediatric

The classroom is great, but learning on the job will prepare you for the specific challenges of pediatric nursing. While studying for your degree, consider pursuing internships, volunteer roles, or shadowing opportunities to gain as a nurse. 

Once you have your degree and pass the NCLEX-RN exam, you can work as a pediatric nurse. Look for opportunities at clinics, private practices, and hospitals that specialize in pediatric care. As you continue gaining experience, you can earn additional certifications to demonstrate your expertise and increase your earning potential.

Step 4 – Get Certified in Pediatric Nursing

As you pursue your career, additional pediatric nursing certifications can open up more opportunities, specialized roles, and better pay. There are many organizations that offer certifications to prove your expertise and experience, including:

• – The AACN provides the critical care registered nurse (CCRNPediatric) certifications in both and . These speciality certifications show your expertise in caring for critically ill pediatric patients, a useful skill if you want to advance in a hospital or pediatric specialty unit.
• – The PNCB offers the Certified Pediatric Nurse (CPN) exam, a high standard in pediatric nursing. This exam qualifies you as a CPN and can lead to more responsibility, advanced roles, and higher salary.

How Much Do Pediatric Nurses Make?

Pediatric nurses have similar earning potential to most registered nurses. In 2025, the average was $76,348. More advanced roles like make an average of $98,532. 

Salaries will vary depending on your local economy and cost of living, but pediatric nursing offers a healthy salary for most regions. The for pediatric nurses are:

• Washington – $86,471
• District of Columbia – $86,275
• New York – $83,527
• Massachusetts – $83,381
• Alaska – $82,222

Career Outlook for Pediatric Nurses

Job Demand & Growth in 2025

We always need more medical professionals, and pediatric nurses have plenty of career opportunities in the years to come. With shortages of tens of thousands of nurses expected over the next decade, the predicts a 6% growth in the employment of nurses from 2023 to 2033. That means around 194,500 job openings each year for registered nurses.

Best Specializations & Advanced Roles for Pediatric Nurses

As you continue your career as a pediatric nurse, there are countless opportunities for advancement and specialization. If you find caring for critically ill or injured patients rewarding, you can pursue a role as a pediatric emergency nurse or a career in a pediatric or neonatal intensive care unit (NICU). You can also specialize in a particular field of medicine, such as pediatric cardiology, oncology, or neurology. 

With a masters degree, you can become a or a . These roles offer more responsibility and higher pay. PNPs work in both primary care and acute care to diagnose and treat patients, while CNSs offer education, consultation, and leadership to ensure the best possible outcomes.

Your Path to Becoming a Pediatric Nurse Starts Today

If you enjoy working with children and are ready for a career in pediatric nursing, you can get started right away. 51cg has ASN, BSN, and MSN programs to prepare you for a nursing career in as little as 20 months. With convenient online classes and hands-on labs and clinicals, you’ll have the real experience to feel ready for the NCLEX-RN exam and the day-to-day responsibilities of being a nurse.

Aesthetic nurses, also known as cosmetic nurses or esthetician nurses, perform  cosmetic procedures like chemical peels, liposuction, threads, weight-loss injections, microdermabrasion, filler or Botox injections, laser hair removal, and tattoo removal. Throughout these processes, they consult with their clients and provide advice for post-procedure care to ensure the best possible outcomes. 

Aesthetic nursing is an exciting career that can connect you with interesting people. A good aesthetic nurse completes procedures, but they also have a personal touch as they build relationships with their clientele to achieve desired results. Aesthetic nurses also need attention to detail as they perform precise techniques and record everything for their patients’ files.

Career options are also plentiful for aesthetic nurses. They earn a healthy salary nationwide and can work in settings ranging from private practices and medical spas. Keep reading to learn more about what they do, how much they earn, and how to become a cosmetic nurse.

Responsibilities & Daily Tasks

As they help their clients look their best, aesthetic nurses have a lot of . From initial consultations to performing procedures to post-procedure care, cosmetic nurses are involved in the entire process. Where you work will also influence your daily tasks.

During a typical day, an aesthetic nurse might:

• Learn about their patients’ needs during initial consultations
• Prepare rooms and tools for procedures
• Independently perform minimally invasive procedures
• Observe patient condition
• Keep accurate records
• Provide post-procedure care and instructions to patients

Throughout these tasks, aesthetic nurses must communicate with both patients and physicians. They should know how to talk with other healthcare professionals while ensuring that instructions are clear to clients. Good people skills will help your patients feel comfortable so you can thrive as a cosmetic nurse.

Where do cosmetic nurses work?

Cosmetic nurses have plenty of options when deciding where to work, and each setting will have different patients, levels of care, and provided treatments. Some specialized workplaces may require additional training or certification. 

Here are some of the most for aesthetic nurses:

• Physician’s offices – More and more physicians offer minor cosmetic procedures such as Botox or dermal fillers. Aesthetic nurses help make these procedures quick and efficient, and nurses may perform some minor procedures themselves.
• Dermatologist’s offices – These specialists treat cosmetic skin issues like scarring or burns, and they need aesthetic nurses to help.
• Medical spas – A more luxurious setting than a doctor’s office, medical spas offer cosmetic laser services, Botox, fillers, and other aesthetic procedures. 
• Laser clinics – From hair and tattoo removal to body contouring, laser clinics offer a wide range of cosmetic procedures that require aesthetic nurses.

Steps to Become an Aesthetic Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

As registered nurses, aesthetic nurses must at least have an associates degree to practice. An accredited institution, like 51cg, will help you complete this first step. While an associate’s degree is the minimum requirement to become an esthetician nurse, a bachelor’s or master’s degree can lead to more specialized roles, leadership positions, better career options, and higher salaries. An aesthetic nurse’s education will involve nursing, anatomy, biology, and more so that you’re prepared for the challenges of the job. It’s possible to earn a degree in as little as 20 months.

These programs are a solid start for an aesthetic nurse:

• Associate of Science in Nursing – An associate’s degree is all you need to pursue a nursing career. An ASN program through 51cg can be completed in just 20 months, or 5 semesters.
• Bachelor of Science in Nursing – A bachelor’s degree in nursing gives a comprehensive foundation for nursing with thorough coursework and hands-on training. BSN programs generally take around 3-4 years, but you could complete an accelerated program in as little as 20 months.
• Masters of Science in Nursing – A master’s degree opens the doors to better pay, career options and flexibility, and more responsibility. A master’s is required to work as an aesthetic nurse practitioner. MSN programs can be finished in just 1 year.

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

Once you’ve learned the ins and outs of nursing with your degree, you need to prove your expertise by passing the National Council Licensure Examination, or NCLEX-RN. This exam qualifies you to become a registered nurse, so make sure to study and practice.

After passing the NCLEX-RN, you’ll need to get a nursing license from your state. Every state sets their own requirements, but they often include fingerprinting and a background check.

Step 3 – Gain Clinical Experience in Cosmetic

As you prepare to take at step from a student nurse to a registered nurse, look into internships, volunteer opportunities, or shadowing .

Once you have your degree and pass the NCLEX-RN exam, you are able to work as an aesthetic nurse. Settings like can help you quickly build experience and strengthen your resume. As you work, keep an eye out for additional certifications that you might qualify for to showcase your experience.

Step 4 – Get Certified in Cosmetic Injection Nursing

Nurse injectors focus on cosmetic treatments that are delivered through needle injections, like Botox, dermal fillers, or fat reduction injections. Cosmetic nurse injectors are always in demand, and they get to work closely with clients to help them see results almost immediately. 

While nurse injectors aren’t legally required to have specific certifications, many employers will prefer training and certification from a qualified organization like the or the . These courses and certifications provide specialized injection nurse training, showing that you are qualified and ready to perform these procedures.  

How Much Do Aesthetic Nurses Make?

As registered nurses, aesthetic nurses have very healthy earning potential nationwide. The for an aesthetic nurse in 2025 is $80,321. Advanced roles like are earning average salaries of $130,295.

Here are the for cosmetic nurses:

• Washington – $90,972
• District of Columbia – $90,765
• New York – $87,874
• Massachusetts – $87,721
• Alaska – $86,502

Career Outlook for Cosmetic Nurses

Job Demand & Growth in 2025

With advances in technology, changing beauty standards, and an aging population, aesthetic nurses are constantly in demand. are leaving nursing roles in traditional healthcare in favor of aesthetic nursing, as aesthetic nursing offers strong career options, work-life balance, and entrepreneurial opportunities.

While there isn’t specific data about the projected growth of aesthetic nursing opportunities, related fields are expected to grow faster than the average for all occupations. According to the Bureau of Labor Statistics, should grow by 6% between 2023 and 2033, while will grow by 10% during that same period. This growing demand for registered nurses and beauty specialists ensures solid career prospects for aesthetic nurses.

Best Specializations & Advanced Roles for Aesthetic Nurses

There are many specialities aesthetic nurses can pursue, from tattoo removal to cosmetic injection to dermatology to body contouring. Each of these specialties will have their own advanced training and certification programs, but here are some widely recognized advanced certifications you should consider during your career as a cosmetic nurse:

• – A CANS certification demonstrates that nurses can perform a wide range of aesthetic procedures, including Botox and fillers, laser treatment, and other non-surgical techniques. This certification can help you secure roles in specialized aesthetic practices like medical spas.  
• – A DNC certification shows your expertise and experience in dermatology, leading to more advanced roles in skincare treatment.

With experience and certifications under your belt, consider becoming an aesthetic nurse practitioner. You’ll need a master’s degree to become a nurse practitioner, and more licensing from your state, but this role offers stronger career options and a much higher salary. Even nurse practitioners can specialize further, like becoming a .

Your Path to Becoming an Aesthetic Nurse Starts Today

If you want to help people look and feel their best with a career in cosmetic nursing, it’s time to start. With ASN, BSN, and MSN programs from 51cg, you could be ready for the NCLEX-RN exam and a nursing career in as little as 20 months. We offer convenient online classes with hands-on labs and clinicals to help you get real experience. 

Flight nurses, also known as flight care nurses or aeromedical nurses, have the high-flying role of for patients as they are transported in a helicopter or plane. With many patients coming from severe accidents, flight nurses must be able to provide critical care to keep their patients stable during transportation. As registered nurses, flight nurses need a degree from an accredited institution like 51cg, as well as additional specialized training and certification.

Because flight nurses respond to accidents, every day brings its own challenges and responsibilities. Flight nurses may provide treatment from basic first aid to resuscitation and everything in between. Their critically ill patients require careful attention and constant monitoring, as the severe conditions that required a flight team could have the patient changing dramatically in an instant. 

As medical professionals working as first responders, flight care nurses are always in demand. They have a healthy average salary across the nation, and their career opportunities are expected to grow as the demand for registered nurses increases. 

If you’re ready for an exciting, challenging, and rewarding career as a flight nurse, keep reading. We’ll explore their day-to-day responsibilities, average salary, career prospects, and how to become a flight nurse. 

Responsibilities & Daily Tasks

Flight nurses usually work for hospitals or private companies where they assist with air ambulance operations. When a severe incident requires fast medical attention, flight nurses will help keep patients stable as they are moved to intensive care units. Air nurses can also help transport patients, supplies, or even donated organs from one facility to another.

A flight nurse’s daily responsibilities might include:

• Monitoring patient vitals and condition
• Providing treatment and medication
• Performing emergency procedures
• Using, preparing, and caring for medical equipment
• Coordinating with flight physicians, paramedics, and pilots
• Recording everything in careful detail

Flight nursing is a uniquely challenging and rewarding field of nursing. Flight nurses generally treat patients in critical condition in a confined, moving aircraft. They must move quickly to provide care, all while dealing with rapidly changing altitude, turbulence, and weather. These challenges can be demanding, but many flight nurses also love the excitement of the role. When you work as a flight nurse, no two shifts are the same.

Where Do Flight Nurses Work?

While airport nurses provide medical treatment at airport facilities, work while they are on the aircraft, including helicopters, propeller planes, and jets. Some work for private organizations like hospitals or trauma centers, while others assist government operations with search and rescue or emergency response. Flight nurses also have plenty of opportunities in the U.S. military, as branches like the Air Force need experienced medical staff that can operate under pressure. 

Here are some of the most common settings that employ flight nurses:

• Trauma centers
• Emergency departments
• Organ transplant services
• Search and rescue teams
• Local, state, and federal government
• The U.S. military

Steps to Become a Flight Nurse

Step 1 – Earn Your Nursing Degree (ASN or BSN)

There are a few important requirements to become a flight nurse. As registered nurses, flight nurses need to earn a degree from an accredited institution like 51cg. A degree demonstrates your knowledge of nursing, pharmacology, anatomy, biology, and more. Accredited nursing programs will prepare you to treat real patients with real problems. If you’re ready to start your career as an flight nurse, you could earn a degree in as little as 20 months.

These programs can help you become a flight nurse:

• Associate of Science in Nursing – A great way to start any nursing career, an associate’s degree covers the knowledge and skills you need to become a registered nurse. While additional training, experience, or certifications can help you secure more specialized roles like flight nursing, you can get an ASN and quickly get experience in real medical settings within 20 months, or 5 semesters. 
• Bachelor of Science in Nursing – A bachelor’s degree offers comprehensive coursework and hands-on training to prepare you for a career in nursing. Many organizations that hire flight nurses prefer candidates with a BSN. Most BSN programs take around 3-4 years to complete, but an accelerated program can be done in as little as 20 months.
• Masters of Science in Nursing – While not required for a career in flight nursing, a master’s degree can open doors to more advanced certification, specialized jobs, and careers in leadership and education. For RNs seeking advanced education, many MSN programs can be completed in just 1 year.

Step 2 – Pass the NCLEX-RN Exam & Get Licensed

After earning your degree, there are two major steps to becoming a registered nurse. First, you’ll need to pass the National Council Licensure Examination, or the . Then you’ll need to secure a nursing license from your state.

The NCLEX-RN exam showcases your knowledge and skills, demonstrating that you are ready to practice nursing. Your nursing degree will prepare you for the NCLEX, but you should also study and practice.

Each state sets their own requirements for a nursing license, so you’ll want to research what the standards are for the area you want to work in. Generally this process will involve a background check and fingerprinting.

Step 3 – Gain Clinical Experience in Nursing

While a degree and nursing license qualify you as a registered nurse, many organizations prefer that flight nurses have specific experience in similar settings. During your degree, look for volunteer, internship, or shadowing opportunities to gain experience. Once you’re working, positions in trauma centers, emergency rooms, and intensive care units can help you that will be useful as a flight nurse. These fast-paced environments require quick thinking to provide intensive treatment for patients, a vital skill for flight nurses.

Step 4 – Get Certified in Flight Nursing

With a degree and experience under your belt, additional certifications and training can help you secure the role you want. Certifications in life support, emergency nursing, and critical care show your expertise in the skills that air nurses need to provide care in life and death situations.

Here are some certifications and training to consider:

• – Basic Life Support Certification demonstrates your ability to provide emergency care for patients until they can receive full treatment at a hospital.
• – Advanced Cardiovascular Life Support, or ACLS, provides intensive training in CPR, helping medical professionals manage respiratory or cardiac emergencies.
• – PALS focuses on assessing and managing critically ill or injured infants and children, helping flight nurses respond to pediatric emergencies such as respiratory failure, shock, and cardiac arrest.
• – NRP prepares nurses to support newborns experiencing respiratory or cardiac distress, an important skill set for flight nurses involved in neonatal transport.
• – The Board of Certification for Emergency Nursing validates skills in emergency, transport, and trauma nursing.
• – Critical Care Registered Nurse (CCRN) certifications demonstrate your ability to provide critical care for patients. There are unique certifications for adult, pediatric, and neonatal nursing.
• – Becoming a Certified Flight Registered Nurse (CFRN) shows that you are prepared to provide care in the uniquely challenging environment of a moving aircraft. Often, this certification is gained during your first year working as a flight nurse.

How Much Do Flight Nurses Make?

Flight nurses have strong career prospects and earning potential thanks to a growing demand for qualified medical professionals and first responders. In the United States, the average medevac nurse salary in 2025 is .

Here are the for flight nurses:

• Washington – $124,256
• District of Columbia – $123,974
• New York – $120,025
• Massachusetts – $119,815
• Alaska – $118,150

Career Outlook for Flight Nurses

Job Demand & Growth in 2025

There is always a demand for medical professionals, and with an aging population and projected nursing shortages, the U.S. needs tens of thousands of qualified nurses over the coming years. 

The predicts that employment of registered nurses will grow 6% between 2023 and 2033, a faster growth rate than most professions. Over that same time, they predict that there will be nearly 200,000 openings for registered nurses each year. While these statistics are for registered nurses in general, flight nursing will likely see similar demand and growth.

Related Specialties & Advanced Roles for Experienced Flight Nurses

Flight nursing is often a long-term career in itself, and many nurses remain in this specialty throughout their careers. That said, the advanced clinical judgment, autonomy, and critical-care expertise developed in flight nursing can also translate well into related leadership, education, or advanced practice roles. For flight nurses interested in expanding their impact beyond direct patient transport, these adjacent paths build on the skills they already use every day.

While many nurses remain in flight nursing long term, the skills developed in this role can also translate to positions such as:

• Clinical Nurse Specialist – Clinical nurse specialists provide care to patients while also focusing on improving overall practices, educating staff, and optimizing patient care. To become a CNS, you do need a master’s degree.
• Nurse Educator – As a nurse educator, you can help train the next generation of flight nurses and emergency medical professionals. Nurse educators develop curriculum to prepare nurses for real world patients.
• Acute Care Nurse Practitioner – ACNPs provide treatment for patients in critical condition. Like flight nurses, ACNPs typically work in fast-paced environments that require split-second decision making for life or death cases.

Your Path to Becoming a Flight Care Nurse Starts Today

If you want an exciting, challenging career, flight nursing might be for you. 51cg provides ASN, BSN, and MSN programs to prepare you for a nursing career in as little as 20 months. With convenient online classes and hands-on labs and clinicals, you’ll be prepared for the NCLEX-RN exam and the real medical emergencies you’ll treat as a flight nurse.

Nursing is one of the most versatile, stable, and respected roles in healthcare, offering professional growth, job security, and the chance to make a meaningful difference daily.

Why Choose an RN Over Other Healthcare Careers?

Strong income and steady demand
Registered nurses as of 2024, and the role is projected to grow 6% from 2023 to 2033, generating about 197,200 openings annually.

Variety in where and how you work
From hospitals to clinics, schools to telehealth roles, RNs fill many environments. To see just how many paths are open to you, take a look at this list of 18 BSN Nursing Careers to Consider.

A career you can grow with
Nursing offers clear progression from charge nurse to educator, , certified registered nurse anesthetist (CRNA), or leadership roles, often without leaving the healthcare setting you love.

3 Key Benefits of Becoming an RN

• Job stability in any economy – Consistent demand for skilled nurses equals reliable career opportunities.
  
• Competitive pay for meaningful work – A salary that reflects the responsibility and expertise required.
  
• Flexibility and mobility – Work full-time, part-time, or per diem, and move between specialties or locations as your goals evolve.
  

What Being an RN Really Involves

RNs aren’t just caregivers, they’re . They assess patients, create care plans, coordinate with other professionals, and deliver direct treatment and patient education. That fusion of technical skill and human connection is what makes nursing both demanding and deeply rewarding. Read more about what to expect in your first year as a nurse.

FAQ

Do I need a science background to get started?
Nope! Just enroll in an accredited ASN or BSN program and build the clinical and critical thinking skills.

How long to become an RN?
With our ASN or Accelerated BSN programs, you could be ready for licensure in as little as 20 months. Learn more about the benefits of an accelerated BSN program.

Will I make a difference right away?
Absolutely. Nursing students contribute directly during clinicals, building skills and confidence from day one, not to mention all the friends you’ll make along the way. When you are a student nurse, you become a part of the nursing culture and instantly have a camaraderie with other nurses.

Myths 51cg Nursing, Busted

• Myth: Nurses only carry out doctor’s orders.
  Truth: RNs make independent judgments within their scope and often lead care coordination efforts that improve patient outcomes.
  
• Myth: It takes decades to see career rewards.
  Truth: Nurses benefit early with solid pay and clear, rewarding pathways. Curious how doing more can pay off? Check out our breakdown of the costs and benefits of an ASN degree.
  

Related Reads from Joyce

• Considering career paths? See Explaining the Differences Between RN and BSN.
  
• Curious about the value of a BSN? Read Top 10 Reasons You Need Your BSN Degree.
  
• Want the fastest entry point? Explore What to Consider 51cg an Accelerated BSN Program.
  
• Looking to grow your credentials? Learn about the RN to BSN Completion Program—online, flexible, and just over a year.
  
• First year jitters? Get solid prep with What to Expect in Your First Year as a Nurse.
  

Take the next step toward your nursing career. Ready to become an RN in just 20 months? Explore our ASN or Accelerated BSN programs today.