By Jeanne Whalen

Healthcare jobs, especially nursing, have become a reliable path to middle-class prosperity in the U.S., offering stability amid labor market uncertainty.

The median annual wage for registered nurses is $93,600, while advanced-degree nurses earn $132,050, according to the Labor Department.

The Labor Department projects advanced-degree nurse employment to increase 35% from 2024 to 2034, significantly outpacing other occupations.

Miranda Mammen became a licensed practical nurse after earning a community-college diploma. Later, she went back to school for a bachelor’s in nursing and worked in an emergency room during the pandemic. Four years ago, she got her doctorate and became a nurse practitioner.

With each step, the 33-year-old has boosted her pay and responsibilities. These days she is working at a primary-care clinic in Lincoln, Neb., earning about $120,000 a year. She conducts annual physicals, treats respiratory illness and abdominal pain, and manages chronic conditions.

She and her husband, a garage-door technician, own a three-bedroom home, contribute to their 401(k)s and are taking their child on a trip to Florida this summer.

“We don’t really have to worry about getting our bills paid,” Mammen said. “That definitely takes away the stress of the economy that I know a lot of people are experiencing.”

Factory work used to be Americans’ most reliable ticket to the middle class. Office jobs offered another dependable route. But as automation, globalized manufacturing, and now artificial intelligence threaten or narrow some of these paths, healthcare jobs have become the surest bet. At a time of uncertainty in the labor market, nursing offers not only stability but, for some, a pathway to real prosperity.

The median annual wage for registered nurses in the U.S. is $93,600, compared with $49,500 for all occupations, according to the Labor Department. For nurse practitioners and others with advanced degrees, it is $132,050.

Healthcare has generated some of the most consistent job growth of any U.S. profession since the early 1980s, thanks to soaring healthcare spending and the aging population. Total jobs in the industry overtook those in the manufacturing and retail sectors in the early 2000s, and the gap has continued to widen since then, according to an analysis of federal data released by the University of Chicago.

The sector was the largest source of job creation in the U.S. last year, as many other industries cooled or contracted. That trend continued in January, though employment in the sector dropped in February, partly because of nursing strikes in New York City and elsewhere.

The profession’s future, though, looks bright. The Labor Department projects that employment of advanced-degree nurses will increase by 35% from 2024 to 2034, eclipsing the expected 3% growth across all occupations. Registered-nurse employment is projected to rise 5% over that period.

A recent research paper found that from 1980 through 2022, earnings of healthcare workers rose much faster than for non-healthcare workers—particularly for nurses.

The paper also found that, compared with the rest of the workforce, wage growth in healthcare over that period was more evenly distributed across all pay levels, with particularly strong gains for middle and upper-middle-income workers.

‘Jobs engine’

The U.S. healthcare sector is “a modern middle-class jobs engine,” said Joshua Gottlieb, a University of Chicago economics professor who co-wrote the paper.

The nursing boom coincides with the aging of the U.S. population and big shifts in healthcare delivery.

Gone are the days when nursing was confined to the provision of basic care and feeding. More than two-thirds of registered nurses these days have a bachelor’s degree, while others with graduate degrees can prescribe medication, deliver anesthesia and handle primary-care visits.

Michael Nolan had a software sales job that looked great on paper. But the 27-year-old Chicagoan was discouraged by impersonal Zoom meetings, and by the number of his friends getting laid off in the corporate world.

So last year, he ditched his white collar and donned a pair of scrubs to go to nursing school.

“I was just thinking, like, stability. I want to be in demand. I want that future to be in my control,” he said. “And of course there was a calling that was intertwined.”

He also sees a lot of potential for upward mobility. Nolan, who already had a bachelor’s degree in business administration, graduates in May from his nursing program at Loyola University in Chicago and is hoping to land a job in an emergency department. He anticipates that his starting income will exceed the $70,000 he earned in his sales job, and could grow to roughly $120,000 after five years of bedside nursing.

He also is considering going back to school to become a nurse anesthetist, where annual pay can exceed $200,000.

“Long-term, when I think about the finance part of it, I only see potential,” he said. That contrasts with what some of his friends are experiencing in the corporate world, he said, including struggles to land jobs, and layoffs. “You don’t really prepare for that as a 24-year-old, a 25-year-old,” he said.

Janna Janthapaiboonkajon, 24, became a nurse after watching her mother and two aunts thrive in the profession as immigrants from Thailand. All three were able to buy homes in the Chicago area and “to have a very nice lifestyle,” she said.

Her mother worked for 30 years at Cook County Hospital—the inspiration for the television show “ER”—which paid for her master’s degree and other training that boosted her pay. She was the sole provider for Janna, and worked hard to save for her education and to take her on a road trip most years, Janthapaiboonkajon said.

Less than a year after graduating with a bachelor’s in nursing from University of Illinois Chicago, Janthapaiboonkajon is earning $75,000 a year working the night shift on a cancer ward at the university’s hospital, where she monitors vital signs, administers IVs and comforts chemotherapy patients.

The hospital also is paying for her to go back to school part-time to get her doctorate to become a nurse practitioner, which will bump her pay to about $120,000. Recently, with help from her mother, she made a down payment on a condo.

Some of her friends in technology and finance, she said, are struggling. “I think I had four or five friends who were laid off from their jobs,” Janthapaiboonkajon said. “I’m very grateful for the job security of nursing…You’ll always find a position.”

U.S. healthcare spending has soared from 7% of GDP in 1970 to 18% in 2024, partly due to the growing number of elderly Americans. High levels of chronic illness and the proliferation of medical tests and procedures have also driven up spending and demand for healthcare workers.

Cost factors

Insurers and healthcare companies have pushed to move more care out of the hospital and into the hands of lower-cost providers, allowing nurses to perform more work previously reserved for physicians. The Affordable Care Act of 2010 turbocharged demand by expanding medical insurance to millions more Americans.

Loyola’s nursing school has grown in recent years to keep up with demand, said Lorna Finnegan, the dean. Last year, it enrolled 305 freshmen in its bachelor of nursing program, up from about 200 a few years earlier, and it aims to admit 400 a year once a new building opens. About 13% of registered nurses in the U.S. last year were men, up from 8% in 2005, according to the Labor Department.

“Nursing, I think, is really recession proof,” Finnegan said. “We have an aging population. We have growing chronic illnesses in our population. We also have healthcare expanding outside the hospital.”

Finnegan also called nursing “AI proof,” saying it “will never replace the human element, the connection between the nurse and patient.”

The downsides of the job are also real. Night shifts, weekend duty and long days caring for physically and emotionally fragile patients can lead to burnout. The pandemic was especially tough on many, contributing to a steep drop in the registered-nurse workforce in 2021, studies showed. Those ranks rebounded in 2022.

A 2024 survey of 800,000 U.S. nurses by the National Council of State Boards of Nursing found that among those planning to leave the profession within five years, 41% attributed that to stress and burnout, second only to retirement. Thousands of nurses in California, Hawaii and New York City went on strike early this year to protest staffing shortages and push for higher wages.

“We’re exposing ourselves to these different infections…And, oh my goodness, bodily fluids,” said Mar’i Fox, a 28-year-old hospital nurse in Chicago who earns about $80,000 a year. She appreciates the job’s pay and stability and is currently saving to buy a home with her husband. Ultimately, though, she chose nursing because she felt a calling to care for others, she said.

“I think nursing, and medical professions in general, you have to have a connection to something that will keep you beyond the money,” she said. “Because if you don’t, you won’t survive.”

For some, the opportunities extend beyond patient care. The founder of the Nebraska primary-care clinic where Miranda Mammen works has reached the profession’s upper echelons by becoming an entrepreneur.

LaDonna Hart, also a nurse practitioner, co-owns the primary-care practice where she and her colleagues serve about 80 patients a day. Her income as owner is about $300,000 a year.

When she was fresh out of high school, Hart said, she experimented with a few different jobs, including secretarial work, cosmetics sales and real estate. Her career didn’t really take off, she said, until she landed on nursing.

As a registered nurse with a bachelor’s degree in the 1990s, her wages were fairly modest, but they helped cover the cost of a starter home for her husband and her. “What really made a difference in my life is when I became a nurse practitioner,” she said. “That’s when I really saw opportunities and an ease of bills.”

Hart, the main breadwinner in her family, now owns a four-bedroom, $600,000 home in Lincoln, takes a couple of vacations a year and has been able to save for retirement. “I live a better than middle-class life,” she said. “It’s afforded me security.”