How Do You Choose a Specialty?

NutmeggeRN, BSN · Mar 11

The beauty of nursing is that you can choose and then change! I graduated before dirt was invented!! (1983😂😂) and I did med surg for 2.5 years. Life changed and I relocated and then did 1.5 years in LTC, 2 years in a clinic and then 5 in home care. THEN found my passion-school nursing! Been here since 1994 and could not be happier!

Lipoma, BSN, RN · Mar 11

I always knew I wanted to be in critical care someway somehow. Ended up doing emergency and ICU. I'm an adrenaline junky I suppose and dislike routine...

Smwill2901 · Mar 11

NutmeggeRN said:

The beauty of nursing is that you can choose and then change! I graduated before dirt was invented!! (1983😂😂) and I did med surg for 2.5 years. Life changed and I relocated and then did 1.5 years in LTC, 2 years in a clinic and then 5 in home care. THEN found my passion-school nursing! Been here since 1994 and could not be happier!

I love that about nursing! It is so reassuring to hear that there is room to explore and change paths along the way. Your journey is amazing—so much variety before finding your passion in school nursing! It must be so rewarding to build relationships with students and be such a key part of their well-being. What do you love most about school nursing?

Smwill2901 · Mar 11

Lipoma said:

I always knew I wanted to be in critical care someway somehow. Ended up doing emergency and ICU. I'm an adrenaline junky I suppose and dislike routine...

That is awesome! I definitely see the appeal of critical care—every day is different, and you are constantly thinking on your feet. I am currently doing my ICU internship and really enjoy the fast-paced environment. What made you choose ER and ICU over other critical care areas?

Lipoma, BSN, RN · Mar 12

Smwill2901 said:

That is awesome! I definitely see the appeal of critical care—every day is different, and you are constantly thinking on your feet. I am currently doing my ICU internship and really enjoy the fast-paced environment. What made you choose ER and ICU over other critical care areas?

ICU actually had no appeal to me as a new nurse. Emergency nursing was always my goal but after a few years I gave it a shot and went to the coronary ICU since I found the heart fascinating and enjoyed caring for that specific population in the ED whether it was a cardiac arrest or other cardio-pulm issue. I took care of enough medical ICU level patients and had no desire to do that. Neuro, peds, and burn also did not interest me. The ICU does bring some level of routine to it but I continued doing ED as per diem to keep my skills sharp and to "get my fix"

If you find an interest in a specific patient demographic, give it a shot. This is the only way to find your niche.

NutmeggeRN, BSN · Mar 12

Smwill2901 said:

I love that about nursing! It is so reassuring to hear that there is room to explore and change paths along the way. Your journey is amazing—so much variety before finding your passion in school nursing! It must be so rewarding to build relationships with students and be such a key part of their well-being. What do you love most about school nursing?

The relationships I build with students and families. We are the go between for families and educators and we advocate tirelessly for our kids who are often in vulnerable positions due to illness or injury. I consider myself a leverager of information! I don't always have the answer, but after almost 39 years of living and working in my community and 31 in the same building as the high school nurse, I usually know someone who does have the answer. I am still in touch with many former students, and I am well into my second generation.

Smwill2901 · Mar 13

Lipoma said:

ICU actually had no appeal to me as a new nurse. Emergency nursing was always my goal but after a few years I gave it a shot and went to the coronary ICU since I found the heart fascinating and enjoyed caring for that specific population in the ED whether it was a cardiac arrest or other cardio-pulm issue. I took care of enough medical ICU level patients and had no desire to do that. Neuro, peds, and burn also did not interest me. The ICU does bring some level of routine to it but I continued doing ED as per diem to keep my skills sharp and to "get my fix"

If you find an interest in a specific patient demographic, give it a shot. This is the only way to find your niche.

That is really interesting! It is great to hear how your interest in cardiac patients led you to the coronary ICU. I like the idea of keeping a per diem ED role to stay sharp—that seems like a great balance. Thanks for sharing your experience, it definitely gives me a lot to think about as I figure out my own path!

NutmeggeRN said:

The relationships I build with students and families. We are the go between for families and educators and we advocate tirelessly for our kids who are often in vulnerable positions due to illness or injury. I consider myself a leverager of information! I don't always have the answer, but after almost 39 years of living and working in my community and 31 in the same building as the high school nurse, I usually know someone who does have the answer. I am still in touch with many former students, and I am well into my second generation.

That is truly amazing! Your dedication and the impact you have had over the years are so inspiring. It is great to hear how nursing allows for so much flexibility and growth. Thank you for sharing your experience!

Patricia Ordnung · Mar 13

I would have been the last person in my class anybody, including me, would have expected to go into LTC. After a few starter positions, guess who ended up spending 19 years in LTC? My passion turned out to be dementia care. I'm old(er) now, and doing community health nursing, but during those 19 years, I rarely clocked out without feeling like I had done a good thing.

Smwill2901 · Mar 13

Patricia Ordnung said:

I would have been the last person in my class anybody, including me, would have expected to go into LTC. After a few starter positions, guess who ended up spending 19 years in LTC? My passion turned out to be dementia care. I'm old(er) now, and doing community health nursing, but during those 19 years, I rarely clocked out without feeling like I had done a good thing.

That is amazing! It is really encouraging to hear how your path unfolded in a way you did not expect but led you to something you were passionate about. Dementia care is such an important and meaningful field, and I can imagine how rewarding it must have been to make a difference for those patients and their families. Now that you are in community health nursing, do you find any similarities between the two roles? Or was the transition a big adjustment?

Hannahbanana, BSN, MSN · Mar 21

Back when Florence and I were probies, many people had one career; maybe not one job, but certainly one career. Nowadays, people can expect to have four or five. As they say, God laughs at your plans. I planned to go to the pediatric NP Program in the city where I went to college, but husband got a transfer to the other side of the known universe and I was slotted for a job in a medical/respiratory unit. The week before I started, they had a hiring freeze but would take me in a 20-bed PACU. Sure, why not? I'd had Summer jobs in the OR suite as a student and spent some time with the nurses in PACU. When I started, they had hired three new grads, one ADN, one diploma grad from that hospital, and me. After about 6 months I ended up being relief charge on the 1pm-9pm shift (oh, how I loved those hours!) and got recruited by the ICU head nurse because she saw me bringing pts there all the time — critical postop pts stayed in PACU UNTIL THEY WERE STABLE, LOL, so sometimes up to 24 hrs. Then before I got there, husband got another transfer, so I applied to another ICU.

Surprise! Nursing strike! I ended up in stepdown, but then got to the ICU in about two months, world-class joint with major trauma, neurosurgery, open heart, heart transplant, you name it. ACLS Instructor Trainer, Mobile ICU cert, flight nursing, Took the second CCRN exam ever given. 5 yrs later, another transfer; day charge in a ICU/CCU/Stepdown in a community hospital.

Pregnancy, grad school, temp jobs, CC faculty, second pregnancy, divorce...

Cross-country move again, staff development in critical care in a community hospital for 6 years, plus some semesters teaching clinical for the local CC. Hospital financial failure, job was RIF'd.

No ICU jobs, took what I thought would be a temporary job as a work comp case mgr, about which I knew pretty much nothing. Loved it!! Learned a whole new field, good pay, company car!, loads of autonomy, days, no weekends, no hospital politics, business lunches in nice restaurants, heaven. Critical care certs aged out. Worked for about 8 years at that, took a nifty job for a company working with big-money comp claims (think $1-50 million, 4-20 years). Certified in rehab nursing and case mgmt.

From there, got a lot of legal exposure and learned about nurse life care planning (critical care background helpful here), worked a lot of legal cases, got asked to be a testifying expert on some, started working as a legal nursing consultant, explaining medicine/hospitals/nursing standards for attorneys. Also needed up editing two journals in my fields. More learning, more new fields... certified in legal nurse consulting and nurse life care planning, People kept telling me I should have my own business, but I resisted that for a long time, Finally hung out my shingle and retired 8 yrs later after traveling all over the country for cases. Not fabulously rich, but quite adequately comfortable because work-life-balance was my prime directive.

Moral of the story: have an idea of the path you want to be on, but keep your peripheral vision open for interesting side trips. Your nursing background can take you waaaay more interesting places than hospitals, so don't be afraid of change. Stretch your wings! Nurses can do anything. It's freaking awesome.

Smwill2901 · Mar 24

Hannahbanana said:

Back when Florence and I were probies, many people had one career; maybe not one job, but certainly one career. Nowadays, people can expect to have four or five. As they say, God laughs at your plans. I planned to go to the pediatric NP Program in the city where I went to college, but husband got a transfer to the other side of the known universe and I was slotted for a job in a medical/respiratory unit. The week before I started, they had a hiring freeze but would take me in a 20-bed PACU. Sure, why not? I'd had Summer jobs in the OR suite as a student and spent some time with the nurses in PACU. When I started, they had hired three new grads, one ADN, one diploma grad from that hospital, and me. After about 6 months I ended up being relief charge on the 1pm-9pm shift (oh, how I loved those hours!) and got recruited by the ICU head nurse because she saw me bringing pts there all the time — critical postop pts stayed in PACU UNTIL THEY WERE STABLE, LOL, so sometimes up to 24 hrs. Then before I got there, husband got another transfer, so I applied to another ICU.

Surprise! Nursing strike! I ended up in stepdown, but then got to the ICU in about two months, world-class joint with major trauma, neurosurgery, open heart, heart transplant, you name it. ACLS Instructor Trainer, Mobile ICU cert, flight nursing, Took the second CCRN exam ever given. 5 yrs later, another transfer; day charge in a ICU/CCU/Stepdown in a community hospital.

Pregnancy, grad school, temp jobs, CC faculty, second pregnancy, divorce...

Cross-country move again, staff development in critical care in a community hospital for 6 years, plus some semesters teaching clinical for the local CC. Hospital financial failure, job was RIF'd.

No ICU jobs, took what I thought would be a temporary job as a work comp case mgr, about which I knew pretty much nothing. Loved it!! Learned a whole new field, good pay, company car!, loads of autonomy, days, no weekends, no hospital politics, business lunches in nice restaurants, heaven. Critical care certs aged out. Worked for about 8 years at that, took a nifty job for a company working with big-money comp claims (think $1-50 million, 4-20 years). Certified in rehab nursing and case mgmt.

From there, got a lot of legal exposure and learned about nurse life care planning (critical care background helpful here), worked a lot of legal cases, got asked to be a testifying expert on some, started working as a legal nursing consultant, explaining medicine/hospitals/nursing standards for attorneys. Also needed up editing two journals in my fields. More learning, more new fields... certified in legal nurse consulting and nurse life care planning, People kept telling me I should have my own business, but I resisted that for a long time, Finally hung out my shingle and retired 8 yrs later after traveling all over the country for cases. Not fabulously rich, but quite adequately comfortable because work-life-balance was my prime directive.

Moral of the story: have an idea of the path you want to be on, but keep your peripheral vision open for interesting side trips. Your nursing background can take you waaaay more interesting places than hospitals, so don't be afraid of change. Stretch your wings! Nurses can do anything. It's freaking awesome.

Wow—thank you so much for sharing your journey! I truly appreciate the time you took to write that all out. It is so inspiring to see how your career evolved in so many unexpected and exciting ways. I really love what you said about keeping your peripheral vision open and not being afraid of side trips. It is comforting to know that even if I do not figure everything out right away, there is room to explore and grow into different roles over time. Your story definitely gave me a fresh perspective—nursing really can take you anywhere! Thank you again for the encouragement and insight!