Changing specialties mid-career (long)

[bluesnurse]

Well, the writing is on the wall at the cardiology clinic where I work. We lost our most popular doc last summer. Our numbers are down, micromanagement is up, the bean counters are onto us, and they're ever-insistent that no one's job is in jeopardy. This ain't my first rodeo and I know rearranging deck chairs on the Titanic when I see it.

I'm fortunate to work in a large health system. I've got almost 4 years of service with consistently good reviews and patient feedback. There are dozens of positions open for transfer, and half a dozen in my specialty, cardiology, for which I'd be highly qualified.

The problem is, I can't bring myself to apply for them. I've worked in cardiology for my entire 17-year career, doing everything from echocardiograms to cath lab to telemetry to CCU. It's always been my passion, and none of the many clinical experiences of nursing school was enough to change that.

Bit there *was* one that made me pause. That was psych. I did my clinicals in the forensic unit of a state hospital, and it was truly a pivotal moment in my life. I loved it. It was amazing to sit face to face with men who had been found NGRI and hear their stories. It really changed my law-and-order politics; these were men whose uncontrolled mental illnesses drove them to acts they could not comprehend any more than I. I have bipolar disorder, well-controlled with medication, that pales in severity to what they lived with.

I was going to apply there, just to check it out, when I graduated. Then hubby got a job across the country, and we moved, and of course I stayed in my career comfort zone.

I know I could do telemetry or cath lab. But I am 41 years old. I'm not sure I want to go back to the high-adrenaline, pager-ruled world of cardiac critical care. I *am* sure I don't want to be there when I'm 51.

I recently started doing some volunteer work with at-risk women, and it's the same kind of thrill I used to get in a code to connect with someone and help them move forward. Among the other transfer openings, there is one in inpatient adolescent psych. And it is calling my name.

So, has anyone transitioned to a completely different specialty after becoming highly experienced in another? (It doesn't have to be the ones I've named; I don't want to limit this to any specialty forum!) How did you get your foot in the door? Was it what you expected? Any advice for someone who wants to do it? Thanks for any input :heartbeat

[Anisettes, BSN, RN]

You know, one of the greatest things about nursing is the lateral mobility if offers. You can changes specialties, work environments, etc... for any reason and as often as you want.

I think most nurses with any time under their belt, have changed career paths. I know I have - my two long term specialties were trauma resus/ ED (10 years) and OR (for last 10) as well as having done my initial year in Med/Surg. Throughout that time, I have also dabbled/and currently dabbling in ambulatory care (both walk-in quick-care non-emergent clinic type and amb. surgery), Corrections, and Sexual Assault (not at the same time and not necessarily in that order).

All have very different skill sets - how do you do it? Keep your eyes peeled for openings in hospital based programs that accept you and pay while you learn - when I was in med/surg my hospital at the time posted a skills training job offer to transfer to the ED - I jumped on it. Later, I found myself getting burned out and saw an ad for the same thing for the OR.

You might not be able to teach an old dog new tricks, but old (and young) nurses can learn just about anything. If something is calling your name, it's doing it for a reason - I say go for it and Good Luck!

[Neveranurseagain, RN]

You are not changing careers--you are just changing specialties! Go for the adolescent psych! It may be a welcome change of pace. I have worked med surg, worked in a birth center, attended home births, have been a movie set RN, worked ER, public health and homehealth. The diversity is what I liked about nursing!

Show interest in the job you want. Talk to the nurse manager and ask her if you can job shadow to see if it is a good fit for you.

[PostOpPrincess, BSN, RN]

GO, GO, GO, GO, GO for it!!!!!!

[JBudd, MSN]

I switched from medsurg to ER, after about 15 years. Now, I also teach at a community college, being a newbie educator. It's good for the mind to stretch in new ways.

The hardest part for me was being the newbie instead of the old hand expert. (Benner's theory anyone?)

It doesn't take as long to get comfortable in new roles as it did in the beginning, all your experience really does feed in; but there is definitely a transition period. Plus being older, not so worried about "looking stupid" for asking questions, or that new grad angst to get it the way.

So, yes, I've done major switches several times, and liked it. Go for it!

[bluesnurse]

Thanks to all for the encouragement. To update, I did tell my manager I was applying for a transfer, and she actually seemed relieved. They were in fact getting ready to eliminate my position, and although she was hoping to transfer me to another office within the practice, she's supportive of my decision. There's no great time pressure; they're still chewing on some other "right-sizing" ideas and with the holidays coming, everyone seems to be kicking it down the road.

Now the bad news -- the adolescent psych job closed the day before I applied. There really isn't another option posted right now that turns me on. But I'll keep an eye on things and hopefully have a little time to look for a good fit.

Thanks again, I'll update again if there's anything interesting to report!