For two decades, Americans have trusted one profession more than any other, regardless of industry: nurses. With an 81% approval rating from the public, nurses top the list of most trusted professions for the 20th year in a row, according to a new Gallup poll.

Every year the national survey organization publishes the results from the Most Honest and Ethical Professions Poll, which asks American adults who they trust most among a wide range of professions, from nurses to doctors, elementary school teachers to lawyers, pharmacists to judges. And nurses haven’t yielded the top spot since 2003. On the other hand, nurses have topped the list every year since the survey began, in 1999, except in 2001, when firefighters beat out nurses for the top spot in the wake of the 9/11 terrorist attacks. 

“I want to congratulate every nurse across the nation for earning this well-deserved recognition,” American Nursing Association President Ernest Grant, Ph.D., RN, FAAN, told American Nurse. “The fact that this is the 20th year in a row that the American public has voted nurses #1 is a testament to your consistent professionalism, despite the challenges of the persistent pandemic. We are all indebted to you and will continue to acknowledge and honor your courage, commitment, and expertise during the Covid-19 pandemic and well beyond.”

Doctors snagged the second most trusted profession, but they lagged 14 points behind nurses, with 67% of the American public rating them as “highly ethical.” Following doctors were grade school teachers, with approval of their ethics by 64% of respondents, pharmacists (63%), and military officers (61%). Police officers and daycare providers were tied, with 50% of respondents ranking them as highly ethical. Less than half of the respondents viewed all other professions as highly ethical. 

Gallup noted that nurses, medical doctors, and pharmacists had all received higher percentages in 2020, likely due to appreciation from the public during the first year of the pandemic. Still, this year the percentages dropped back to what they were before the pandemic.

Appreciation of nurses didn’t vary based on political affiliation, though. Their ratings were 82% among Republicans and 83% among Democrats. By contrast, doctors and pharmacists had a wider distribution of trust based on people’s political affiliations. For example, doctors were rated as highly ethical by 79% of Democrats but only 59% of Republicans. Similarly, pharmacists received the highest ethical rating from 72% of Democrats and 59% of Republicans. 

The numbers based on political affiliation were flipped for police officers, military officers, and clergy. Police officers were rated highly ethical by only 36% of Democrats and 71% of Republicans. Military officers had a smaller spread, with support from 67% of Republicans and 59% of Democrats. Clergy also didn’t have as significant a disparity between political parties: 41% from Republicans and 32% from Democrats. 

At the bottom of the list, Americans reported that they had the least trust in the ethics of Congress representatives (less than 10% rating), the media, lobbyists, salespersons, and advertising workers. Trust in TV reporters’ ethics, for example, dropped to 14%, nine points below their previous rating. People ranked judges, clergy, and auto mechanics as a little higher than lawyers and business executives, with bankers, nursing home operators, and local officeholders hovering in the middle. 

However, many of the professions fell in Americans’ esteem overall. Clergy, military officers, and judges were lower than in previous years, continuing a multi-year decline. Grade school teachers enjoyed a brief peak but were also lower this year than last.

Gallup conducted the poll from December 1st to the 16th, 2021. The company has surveyed Americans on their perceptions of professions’ honesty and ethics since 1976, doing so annually since 1990.

“As is the norm in Gallup’s long-term honesty and ethics trend, Americans most respect the honesty and ethics of people working in medicine, public safety (the military and police) and child care positions (specifically grade-school teachers and daycare workers),” the organization reported. “Some of these ratings are down from their peaks in 2020, but they are still high.”