How To Get Experience in Another Specialty?

[SunnyPupRN]

I'm 45, with not much clinical experience; I did a little med-surg after school when I was 33 and then we were stationed in a pretty remote area. I had my child and was a SAHM for a while, got back to nursing in psych for 5 years, and now I'm doing home health/private duty, in a somewhat limited capacity....I do some trach care and breathing treatments. I would like to build on clinical skills, but I'm coming late to the party. I've repeatedly asked my company for some more training, but all I got was a three hour vent class, and it was mainly on the models of vents and definitions of stuff like PEEP, NOT how to manage a pt on a vent. I really didn't feel like that was safe to take on a pt on a vent in the home, so I've declined vent pts.

How did you move to your specialties? How did you get comfortable?