How to choose a nursing specialty

The nursing field offers many options for specialization. Consider these factors when choosing the one for you.

How to choose a nursing specialty

From emergency-room and operating-room nursing to pediatric and orthopedic nursing and beyond, there's no shortage of specialties for today's ambitious nurse.

Besides the traditional specialties -- OB/GYN, nurse anesthetist and nurse practitioners -- there are lesser-known subfields such as telephone-triage nursing, forensic nursing (the application of nursing science to public or legal proceedings) and correctional nursing (nursing in prison settings).

While healthcare settings across the nation continue to experience nursing shortages, nurses are in particularly high demand in some subfields, including critical care (where the American Organization of Nurse Executives reports a 20 percent vacancy rate), emergency room and telemetry. Since these areas typically require nurses with higher levels of training, skills and certification, there are fewer candidates who fit the bill.

How can you zero in on the nursing specialty that will fulfill your career goals?

Nursing and Stress

One factor is your definition of stress. Some nurses find it more stressful to work in an operating room, where they are almost always on call. Others may find it stressful to work in the recovery room, which requires honed technical skills. Still others may find it stressful to work one-on-one with physicians on a medical/surgical floor.

Where do you feel comfortable? Do you enjoy independence, or do you crave the camaraderie of fellow nurses and staff? "You have to compare your personality with the working environment," says Bill Morris, president of Beitler Staffing in Chicago. "People who can deal with high stress and juggling lots of balls in the air at the same time are well-suited to the emergency department. If you want a slower pace, then try a community hospital."

You should also think about what you most enjoyed during training. If you have an affinity for children, you may want to specialize in pediatrics or maternity. If serving senior citizens satisfies you, then geriatrics would be a logical choice.

Continuing Education

You also need to consider any special certifications and qualifications you need to enter into a particular subfield.

Cardiopulmonary Resuscitation certification may be enough on a medical/surgical floor, for example, but to advance to the emergency room, you will need Advanced Cardiac Life Support training. And if you want to work with cancer patients, then you may need special chemotherapy training from the Oncology Nursing Society.

"Are you willing to continue education and further your skills?" asks Kathy Murphy, clinical director for Nursefinders, a healthcare staffing service in Arlington, Texas. "If you are, then you may be a candidate for intensive-care units and oncology units."

New Programs Narrow the Field

Programs are emerging in hospitals across the country to allow nurses to test different specialties before making a career commitment.

For example, the Ohio State University Medical Center offers a nurse internship program that allows newly licensed RNs to learn technical skills and experience the cultures within various medical units during a 16-week stint.

"Interns can choose from critical care, women and infant, cardiothoracic and four other specialties," says Gina Hirth, RN, MSN, nurse manager for the program. "Nurses receive full salary and benefits, formal classroom instruction specific to each track and clinical rotations that allow them to make important contacts that could lead to job placement."

Externships Offer Hands-on Experience

New Jersey-based Atlantic Health System offers its Hire Learning program to place new graduates in different divisions within the medical/surgical floors of its hospitals, such as oncology, surgical, renal and telemetry.

"We provide new nurses with medical/surgical training to ease their transition from a student nurse to a nurse graduate role, and then we link that training to a specific specialty they are interested in," says Corky Holm, manager of strategic recruitment at Atlantic Health System. "Meanwhile, our eight-week summer externship programs allow student nurses to experience different types of specialties."

Nurse recruiters recommend new nurses begin on a medical/surgical floor before venturing into a specialty. With that experience under your belt, it will be easier to choose a specialty that matches your interests.

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