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Careers in investment banking aren't what they used to be. Thousands of Web designers have had to draw a new line of work. Opportunities in telecom have crumbled to gigabits. Do any of the hot careers of the 1990s still offer copious challenges and substantial rewards, together with nearly ironclad job security well into the 21st century?

Nursing is one of a small minority of occupations that meets these criteria. Let's take a look at how and why becoming a registered nurse (RN) is a blue-chip career choice for the 2000s.

Nursing Shortage Present and Future

There are two populations whose aging is driving the chronic and acute shortage of registered nurses: patients and RNs.

Many elderly people now living with multiple serious illnesses wouldn't have survived had they been born a generation earlier. So Americans are living longer and spending more years with various medical problems that require nursing care.

In 2002, there were 2.3 million nurses in the United States, and the nation will need a million more by 2012, according to the US Bureau of Labor Statistics. As the demand for nurses rises, the supply may dwindle; the median age of nurses continues to increase, and a wave of retirements is building.

Put all of these trends together and what do you get? “There are fewer nurses doing more complicated things for sicker patients,” says Annette Vallano, author of Your Career in Nursing and an RN.

Nursing Grads Are in Demand

“The job market is great,” says Rita Clifford, associate dean of student affairs at the University of Kansas School of Nursing in Kansas City, Kansas. “Nursing students get recruited in a number of ways: through contacts where they're doing clinical, through student jobs, career fairs and campus recruitment. Recruitment is very intense.”

Indeed, recruitment is a huge task for hospitals looking to hire a corps of nurses. “We do five to 10 events per month to recruit nurses,” says Nancy Eubanks, nursing program manager at the University of Texas Medical Branch (UTMB) at Galveston. UTMB typically hires 50 to 100 nurses each spring.

Raging demand for RNs made it relatively easy for Traci Meeds to land a promising job before her May 2003 graduation with a bachelor's degree in nursing from the University of Kansas. The luck of the practicum lottery led Meeds to the neonatal intensive-care unit at Children's Mercy Hospital in Kansas City, Missouri, where she has now accepted a permanent position.

“It's exactly what I wanted to do,” Meeds says. She will be caring for just one or two ill babies at a time, all requiring constant monitoring and some on heart-and-lung bypass machines.

Technology, Nursing and Careers

Through this decade and beyond, the evolution of medicine and technology will have a major impact on nurses and their careers.

As hospitals and insurers pitch renewed battles to control costs, pressure will increase to push patients out of $1,000-a-day hospital beds and into more economical healthcare settings, from emergency clinics to rehabilitation facilities to nursing homes and even home care. It is in these alternative environments, rather than in hospitals, where nurses will find the greatest percentage increase in jobs.

The technology challenge to nurses is formidable. “Some technologies now used for home care are straight from critical-care treatment,” says Carol Bickford, a senior policy fellow with the American Nurses Association in Washington, DC.

“Increasingly, we find the curriculum has to include much more complex theory and skills,” says Gene Mundie, assistant dean in the School of Nursing at Stony Brook University in Stony Brook, New York. For example, most Stony Brook students know how to read an electrocardiogram when they graduate, Mundie says.

“Nurses need to be comfortable with technology and able to transfer knowledge from one piece of equipment to another,” Vallano says.

The nurses of the future will also continue to answer an even higher calling by helping patients and their families handle the difficult issues raised by many life-saving technologies. When these technologies can prolong survival but not always support quality of life, “the real question is, is the technology appropriate, and are patients' wishes recognized?” Bickford says.