Can you switch from L&D to Emergency?

[acer33]

I'm a student in my last semester of an Accelerated BSN and I've been vacillating on where I want to go on and apply to from here. I would love some advice on thoughts of being able to switch specialties. 

I have an extreme interest in Labor & Delivery, and the hospital I intend to apply to allows new students to go right into L&D after orientation. It was the area I was most drawn to, excelled in, and felt the most comfortable in, maybe because I've been through the labor process twice.

I also have a strong interest in the ED, I find it fascinating and exciting and equally rewarding, but as a student I find it very overwhelming and not sure if I can hack it. The fellowship also intimidates me, I'm just not as comfortable in those departments as I was in L&D. 

I'd like to try my hand at L&D and get comfortable nursing first, but is it very difficult to switch out of that kind of specialty? What if I decide L&D is not for me? Am I pigeonholing myself by starting in a specialty? I've had so many mixed answers. 

Thank you for any and all advice!!

[Rose_Queen, BSN, MSN, RN]

Are you pigeonholing yourself? Not likely. As long as there is a supportive and thorough orientation, it is possible to change specialties. 

However, just because you become comfortable in L&D or any other specialty doesn't mean you won't feel like a fish out of water when you change specialties. That discomfort you feel about the ER? It's going to find you should you change specialties to work there. The same with any specialty you choose when you've already worked in one area. 

[FiremedicMike, RN, EMT-P]

A positive for L&D to ED is that both are fairly autonomous and require independent critical thinking.  In both cases, your docs are immediately available, but in both instances you'll be more involved in the decision making process (caveat to my previous statement, this is based on what I observed during med-surg and L&D clinical in school and my current work environment in the ED).

I will say that the small number of floor nurses that we've had transition to the ED have struggled quite a bit, and most end up leaving.  I'm not sure if it's the pace, the expectation of relative autonomy, or the focus on stabilizing and transferring as opposed to long term planning.  I believe all but one of them (an ICU nurse who's now one of my favorite ED nurses) have gone back to the floor.