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Top Ten Highest Paying Nurse Practitioner Specialties

Highest Paying Nurse Practitioner Specialties
Luca Bertolli/123RF.com

The role of the Nurse Practitioner (NP) is ubiquitous in the field of medicine. Wherever one finds a physician in a clinical setting, a nurse practitioner (with training and little oversight) may also be found. While salaries for these advanced practice nurses will vary from region to region in the U.S., there are also some salary differences based on area of specialty.

The more complex the specialty, the more knowledge, skill, ability and experience is required for the role and therefore a higher pay scale is offered. Nurse Practitioners working in a Collective Bargaining Unit (union) environment rarely receive additional compensation for specialty certifications or working in departments that require additional skills.

According to the website PayScale, the salary for Nurse Practitioners in the U.S. has steadily increased .5% year over year as they become one of fastest growing career fields. Unionized NP salary increases and adjustments are subject to contractual agreements. The employment website Indeed notes that NP’s earn between $42,000 and $195,000 with an average annual salary of $104,577. States such as Washington, California, Pennsylvania, Iowa and Connecticut tend to pay NP’s more than other states like Florida, Georgia, Alabama, and Texas. For additional salary guidance see nurse practitioner salaries.

Neonatal Nurse Practitioner

Nurse Practitioners in the neonatal field are responsible for collaborating with physicians to appropriately assess, create treatment plans, prescribe medication to, and care for neonatal (infants less than 28 days old) patients in critical care (NICU), the emergency room, delivery rooms, and specialized outpatient clinics. NP’s working with neonatal patients address not only the clinical treatment of the patient, but also manage the emotional and psychosocial needs of the families of this fragile population. Neonates may present with varying challenges such as heart defects, neurological disorders, GI reflux, jaundice, or more complex issues when born prematurely. This level of complexity requires that the NP possess expert clinical skills as well as skills with interacting with families experiencing a stressful medical encounter with their infant. Certification as a Neonatal Nurse Practitioner (NNP) is available through the National Certification Corporation (NCC).

Acute Care Nurse Practitioner

Nurse Practitioners working in an acute care setting such as a hospital can expect to specialize in a variety of disciplines. Even within available specialties such as neurology, gastrointestinal (GI), interventional radiology, cardiology, internal medicine, etc. an NP can further specialize to more focused areas. For example, an NP may work in neurology, but may run an Epilepsy Monitoring Unit, a deep brain stimulation clinic for patients affected by Parkinson’s disease, or a Botox clinic to treat patients who suffer from migraine headaches. NPs in acute care areas are responsible for collaborating with physicians to assess, formulate treatment plans, and care for patients in their area of clinical practice. The American Nurses Credentialing Center (ANCC) offers a certification for the Acute Care Nurse Practitioner which, while not always required by employers, is a proven method of skill and expertise.

Dermatology Nurse Practitioner

Nurse Practitioners who work in the area of dermatology can expect to collaborate with physicians to assess, create treatment plans, and otherwise aid in the care of patients with dermatological issues in both the acute care and outpatient settings. Such issues may include assessment and treatment for melanoma (skin cancer), psoriasis, impetigo, acne, and possibly managing small lesion clinics where the NP would be excising small dermatological lesions. Cosmetic Dermatology is a sub-specialty that an NP may find in clinical practice. The NP in Cosmetic Dermatology may perform laser treatments to improve the appearance of skin, inject Botox or fillers, or perform pre-op or post-op examinations for the plastic surgeons or dermatologists performing surgeries.

Psychiatric Nurse Practitioner

Nurse Practitioners in the field of psychiatry collaborate with physicians to assess, develop treatment plans, prescribe medications to, and follow patients with mental and psychiatric disorders. These disorders may include schizophrenia, bi-polar disorder, attention-deficit disorder (ADD), anxiety, substance abuse or mood disorders. NPs in this specialty area may have the opportunity to work in both the acute care and outpatient clinical settings. Some acute care facilities are lock-in units to care for patients who may be a danger to themselves or others during a severe psychosis period. Most employers require the NP to possess a Psychiatric-Mental Health Nurse Practitioner certification for this specialized role.

Palliative Care Nurse Practitioner

Nurse Practitioners who work in the field of palliative care treat patients with life-threatening illnesses by collaborating with physicians to assess, help care for, and monitor those patients who are considered terminally ill. The diagnosis may include cancer, advanced heart disease, neurological disorders and dementia. Nurse Practitioners in palliative care are skilled and knowledgeable clinicians who not only treat the physical ailments of such diagnoses, but the emotional and psychological effects of the illness for not only the patient, but the family as well.

Correctional Nurse Practitioner

Nurse practitioners in correctional facilities provide the same level of care as one would expect in the community. Working in collaboration with a physician, the NP in a correctional facility is expected to assess, help treat, and closely follow those patients who are incarcerated. Clinical settings for this role may be in an acute hospital or outpatient clinic managed by the specific detainment center. Emergency or trauma experience is preferred for this role as well as the requirement to obtain and maintain required security clearance for the facility.

Occupational Medicine Nurse Practitioner

The Nurse Practitioner working in the field of occupational medicine is expected to collaborate with physicians to assess, create treatment plans, prescribe and monitor those patients assigned to the facility for managing the health of the employees. This role may include conducting pre-placement health screenings for employer groups, creating and managing immunization programs for employees including infection control exposure plans, evaluating patients to return to work after an illness or injury, assessing patients for ADA disability issues or fitness for duty requirements, and more. NPs in this role should have current knowledge in the related regulatory statutes such as ADA, FMLA and Worker’s Compensation laws.

Women’s Health Nurse Practitioner

Nurse Practitioners working in the field of obstetrics and gynecology are considered under the umbrella of Women’s Health services. NPs in this role are expected to collaborate with physicians and midwives to assess, create treatment plans, prescribe medications to and follow female patients. Women’s services may include preventive health screenings such as Pap smear collection, pelvic exams, contraception education, prescription and application (such as an intrauterine device), breast education and exams, prenatal counseling and exams, postpartum care, and geriatric gynecological care. Certification as a Women’s Health Care Nurse Practitioner is available through the National Certification Corporation (NCC).

Emergency Nurse Practitioner

Nurse Practitioners in the field of emergency services offer in-depth and highly skilled clinical expertise. NPs in this role work with physicians to assess, create treatment plans, and care for patients presenting to the emergency department or urgent care clinic. NPs with experience in trauma are highly sought after for this role. The patient population in the emergency department is extremely diverse; NPs are expected to quickly and skillfully manage care for all ages, ethnicities, and cultural nuances. Often fast-paced, the NP must be confident in his or her ability to diagnose an illness and create an appropriate treatment plan in a chaotic environment.

Family Practice Nurse Practitioner

Family Nurse Practitioners (FNPs) are skilled in treating patients of all ages and are often the first line of clinician seen in outpatient medical offices. FNPs can also be found in the acute care setting supporting the hospitalists with rounding on admitted medical patients. NPs in this role are expected to collaborate with physicians to assess, help treat, and follow patients in a family practice setting. A Family Nurse Practitioner certification is offered through ANCC for this specialty to recognize the expertise required to care for patients of all ages. As an educator, the FNP reinforces preventive care measures with patients to ensure they understand why health and wellness are important. The FNP may see a newborn to assess normal growth rate, and then address concerns from a family member for a patient’s dementia in the next room. Nurse Practitioners in the role of the FNP provide immense clinical support to care teams and the patients they serve.

While this list is limited to ten NP specialties, it does show the range of salaries that are offered to NPs for the listed career options. The role of the Nurse Practitioner is vital to the future of healthcare in the U.S. Many clinical settings are choosing to train and oversee NPs in all clinical settings in an effort to extend the availability of care to more patients in a clinical practice. As advanced practice nurses, the role of the Nurse Practitioner is essential as well as limitless to the imagination of the medical community.

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About Catherine Burger, RN

Catherine Burger, RN, BS, MSOL, NEA-BC has worked as an RN for almost 30 years in numerous patient care and leadership specialties. Upon completion of her ADN from Pacific Union College, Catherine worked in Labor & Delivery and then ICU for several years before transitioning to Home Health and eventually to the outpatient clinical side of nursing. A move to leadership positioned her as a clinic charge nurse which evolved to manager and then department director for a large HMO in Northern California. She completed a BSN degree at University of Phoenix and a Masters in Organizational Leadership at Colorado State University. Catherine served as a Clinical Practice Consultant and Nursing Informatics Consultant before leaving executive nursing to start her own business. She enjoys spending time with her husband, five children, and raising service puppies for Canine Companions for Independence.