Yes, specialization can significantly impact a nurse's earnings. Nurses who specialize in high-demand areas such as neonatal care, anesthesia, or pediatrics often earn more than those in general medical-surgical roles. Specialized roles typically require additional certifications and advanced training, which justify the higher pay. For example, a Certified Registered Nurse Anesthetist (CRNA) is among the highest-paid nursing professionals due to the specialized skills and responsibilities involved.