By Donna Reese, MSN, RN

Outpatient case managers and office nurses are some of the happiest in the field, while school nurses and hospital staff nurses are some of the unhappiest in the field due to understaffing and the pandemic.

Metrics such as salary, upward mobility, stress level, flexibility, work-life balance and future industry growth were used to determine happiness and unhappiness within nurse specialties.

The 15 Happiest Nursing Positions:

1. Outpatient case management

According to the 2022 "Case Management Salary and Trends Survey Report" from the Case Management Society of America and the Case Management Institute, this position has above-average pay, good benefits, supportive management, a lack of the need for overtime and high job satisfaction.

2. Office nurse

Although this job has one of the lowest wages, it also has low stress and an intimate work environment.

3. NICU nurse

High pay and working with babies are the two greatest perks of this position.

4. Informatics nurse

Nurses who enjoy the technical side of medicine will enjoy this low-stress, high-pay job. The work allows for autonomy away from the grind of hospital work.

5. Legal nurse consultant

High autonomy, working in the business side of the profession, regular hours and prestige are a few reasons why nurses enjoy this position.

6. Health writer

Many health writers work freelance or hybrid long-term contracts, which provides a lot of freedom and an alternative way to using nursing expertise.

7. Private duty nurse

A high-paying job with low stress and the potential for lasting relationships with patients and family are reasons this job is gratifying. This job also allows ample time to complete all necessary duties well.

8. Dermatology nurse

This job has a reasonable caseload, pleasant work conditions and good pay and tends to have cooperative and grateful patients.

9. Virtual nurse coach

Working from home is one of the benefits of this job, although the pay is average.

10. Stress lab nurse

The stress lab can be a calming, refreshing environment after working in a hospital. Working one on one with patients at a slower pace alongside a small team is also one reason this job is one of the happiest.

11. Occupational health nurse

A low-stress with patients who tend to appreciate input and help, this job also has competitive pay.

12. Transplant nurse

Low nurse-to-patient ratios and excellent pay make this highly specialized job satisfying to many nurses.

13. Research nurse

For nurses who enjoy solitary, autonomous and analytical work, the research nurse position can be an excellent fit that comes with great pay.

14. Ambulatory surgery nurse

Top pay with daytime hours and weekends and holidays off make this a desirable position.

15. Nurse medical reviewer

No patients, no physicians and autonomous work from home or a quiet conference room makes this job great for people who want a change from direct patient care.

The 15 Unhappiest Nursing Positions:

1. School nurse

School nurse has typically been on the "happy nursing job" list, but it topped the unhappiest nursing job list due to the pandemic. Nurses' job loads increased with constant student checks, COVID-19 regulations, contact tracing and more upset teachers and parents.

2. Hospital staff nurse

Spending long hours on their feet with required rotating shifts and weekends, hospital staff nurses are often overworked and understaffed, the effects of which are worse with the "great resignation" of nurses underway. "Inadequate staffing has made the job unbearable,".

3. Emergency room nurse

The constant hustle of caring for people at their worst and the unexpected nature of the position can lead to more stressful, exhausting and dangerous situations for ER nurses.

4. Substance abuse nurse

Although a growing field, the patients can be frustrating and, at times, dangerous. Many patients in recovery facilities are there because of legal orders and are not committed to recovery, making them less cooperative or appreciative of nurses. Combined with challenging circumstances like patients who are detoxing and have criminal backgrounds, this work environment is difficult for nurses.

5. Correctional nursing

Correctional nurses similarly find themselves in a setting where patients aren't happy, have criminal backgrounds and many haven't taken care of their health for years. With a high percentage of inmates suffering from mental illness or trauma, prisons can be a harsh working environment.

6. Nurse educator

Most nurse educators enjoy their work, but recent meager pay has caused ripples in happiness. Many feel unappreciated, underpaid and that their expertise is not recognized.

7. Nurse manager

Many nurse managers find the job unsatisfying once in it. The high daily pressure and being the go-between for administration and staff, along with keeping the bottom line on patient dissatisfaction, budget cuts, staff drama and more, can make this job stressful.

8. Home health nurse

Long hours, late nights, emergencies and understaffing make this job stressful. Nurses in this field have caseloads too large to give adequate care to, leading to burnout and dissatisfaction.

9. Insurance physical nurse

Although this job offers a lot of autonomy, most nurses don't stick with the work due to the lack of benefits. Going into strangers' homes by yourself to perform hands-on procedures can lead to dangerous situations that aren't worth the money.

10. Nursing home RN

Many consider this a last choice position due to staff shortages, patient safety and care infractions, poor working and living conditions and the bad reputation of many nursing homes.

11. Public health nurse

This job has become complex and unpleasant since the COVID-19 pandemic. Public health nurses were front and center with tracking and controlling COVID-19, with daily puzzles and frustrations to solve. The lack of leadership and clear guidelines plagued many in this field during the pandemic.

12. Camp nurse

While some nurses love this job, others find it lonely, boring, understaffed and sometimes exhausting and traumatizing depending on the needs of the campers. Many positions are volunteer-only and the few that pay are low in compensation.

13. Diabetic educator

Although this can be satisfying work, the number of diabetes cases is rising and post-COVID-19 trends show increased cases of children with Type 1. The increased need does not mean there is increased staffing at hospitals and many educators find they hold "unreasonably large caseloads." The inability to care for patients properly can result in burnout.

14. Hospice nurse

This job can be physically and emotionally demanding, but rewarding. The personality of the nurse can determine if this is a great or terrible fit due to the independent and sometimes depressing work environment.

15. Hospital OR nurse

Being a highly skilled nurse can be gratifying, but staff shortages can make the work frustrating. Unhappy physicians and surgeons, inexperienced travel nurses and slow turnaround times can trickle down to the nurses assisting procedures.