Mid-forties : Looking for a Specialty to Grow Old In

[Nurse Beth, MSN]

Hi Nurse Beth,

I am in my mid-40's and only have 6 years of nursing experience which is mostly in acute care. I am thinking about my future a lot, especially my old-age, but would like to go into a specialization which I could grow old in. Knowing that I am not getting younger, and is fairly new to the field, I would like to make sure that the area I would be choosing is a best fit for me. Which area do you think is advisable for me to go into considering my age and the background I have? I am thinking of signing up for a continuing education opportunity either in ICU, Nephrology or High Acuity Nursing. What other factors do you think I should consider in choosing right?

Thanks very much!

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Dear mid-forties,

It's wise to be considering your options now. Here's some ideas, maybe you'll see something that appeals to you.

I see a lot of mature nurses going into Case Management. It's 0900-1700, mostly weekdays. There's Infection Prevention, and Informatics. I'm mentioning non-bedside roles as down the road you may want a less physical job.

Telephonic nursing is a new, growing field.

Dialysis still gives you patient contact, but it's not as demanding as typical bedside nursing. There's pre-op or admission nursing, where you interview patients before surgery, and provide patient education. GI Lab, interventional nursing, any kind of clinic work can also provide patient contact but is not quite as heavy as floor work.

How do you feel about nursing management? It's not physical, but it is stressful. Every hospital has a Palliative Care nurse (or more), and there's Quality and Risk Management. House Supervisor can be a great, challenging role if you're cut out for it.

Your choice depends on your educational level (the higher, the more options), your skills and passions, and the opportunities available to you.

Best of luck. I hope I got the brainstorming started for you!

Nurse Beth

[KittyLuv]

I switched to telephone triage nursing at 49. Been in it a year and a half now and it's definitely a good fit for me.

[BacktotheBeach, ADN, BSN, RN]

I'm 51 and contemplating a move from the floor to case management. I'm just worried about giving up the freedom and flexibility of 3 12's for the 5 - 8 hour days. But those long 12's are killing me! I had an interview this week, so we shall see!

[oncivrn]

I work in an infusion center. The work requires a high skill and knowledge level but is less physically demanding than floor nursing.

I have done telephone triage and that has regular hours and you build great relationships with patients. But if you don't finish something it is waiting for you the next day lol.

[dishes, BSN, RN]

Ambulatory care is a good place to work until retirement, staff who work in hospital clinics often have high levels of job satisfaction and low employment turn over.

[greenerpastures]

Just be careful. Many hospitals have started rejecting older nurses who try to go back to some side of bedside nursing once they've stepped away for a few years. I know several nurses who have 20-30+ years of bedside nursing, but have stepped away for a year or two, sometimes doing PRN work, that have been having a difficult time getting back in, even PRN. They're being told they've been away from the bedside too long. REALLY! 20+ years experience is just "lost". Sad state of probable age discrimination. Anyway, I truly wish you best of luck in finding a specialty, just think hard before you step away from the bedside unless you are sure you won't want to go back.

[Kooky Korky, BSN, RN]

Main Factors: Your body is aging, you probably don't want to have to keep racing around hallways, being exposed to needles and bugs, don't want to have to keep lifting and cleaning body fluids. You don't want to always think about blizzards, ice, hurricanes, or whatever the weather hazards are where you live. Maybe you'd like to work at home eventually.

Explore insurance company work.

If you choose Case Management, do it before much time goes by that you're away from direct care. Right now, you're a great candidate because of your current Med/Surg background.

Maybe Psych, but that can call for physical interaction with patients.

Nurse Recruiter

NP

Education - you'd probably still be in the clinical setting and also lecture

Administration (Nursing Admin or Health Care Admin in hospitals, doc's office, correctional facilities, home health, SNF's)

I don't think school nursing is too physically demanding and it gives you all major holidays off. You could be a summer camp nurse, a cruise ship nurse, a nurse for a private jet firm, or work Agency during the summer.

School nurse for a college/university. Could be lower pay but good breaks on tuition for you and dependents.

Occupational Health

private nurse for Donald Trump or similar bigwig who can afford a private nurse

Agency nurse or PRN nurse to keep up your M/S skills if you go non-clinical

nurse for parish, domestic violence shelters, and homeless shelters

Public Health nurse - check governments, including USPHS

If you want to do other than nursing and can afford a pay cut, learn medical billing and coding.

You're smart to be planning, while you still will work likely another 20+ years.

Best of luck.

[bgxyrnf, MSN, RN]

I'm thinking about trying to hook up with the BRN, Joint Commission, or state department of public health as an auditor/inspector.

Better put those snacks away, The State's Here!

[Spidey's mom, ADN, BSN, RN]

Just be careful. Many hospitals have started rejecting older nurses who try to go back to some side of bedside nursing once they've stepped away for a few years. I know several nurses who have 20-30+ years of bedside nursing, but have stepped away for a year or two, sometimes doing PRN work, that have been having a difficult time getting back in, even PRN. They're being told they've been away from the bedside too long. REALLY! 20+ years experience is just "lost". Sad state of probable age discrimination. Anyway, I truly wish you best of luck in finding a specialty, just think hard before you step away from the bedside unless you are sure you won't want to go back.

My hospital is begging me to come back to L&D and ER. And I'm 58.

I keep saying no. Our area really needs in influx of nurses.

I work in hospice part-time and just started in outpatient doing wound care and IV stuff. Just enough to qualify for medical insurance.

Personally, I want to be able to retire and just go on medical mission trips.

[anon456, BSN, RN]

I am early 40's and just left a busy critical care unit for hospice (in-patient). It's still very busy but a different kind of busy. Not crazy running around and hard on the body, but focusing more on patient comfort, listening and educating families, and communicating between the patient's doctors and home care team. It's very fulfilling. I can see myself doing this for a long time.

[Twinmom06, ASN, APN]

I went into dialysis nursing (in patient acute) - the days are long BUT my only focus is the one or two pts that I'm dialyzing at a time- they aren't allowed out of bed, no med pass (except for Epogen and Venofer) and the vast majority of the time they are AOx3 - you sit and have conversations or they snooze or watch TV. Much less physically demanding.

[sherri64]

These are all good suggestions. The more well-rounded your experience is, the more options you will have to choose from. Skilled nursing units in nursing homes can always use a nurse with good acute care background. MDS Coordinators are always needed. You can get certified from AANAC and still be involved in patient care/interaction without heavy floor work. Staff education is always a place where a well informed nurse can make a difference. Working in a VA setting will provide you with excellent retirement benefits. And they have just about every position you can think of. Best of luck to you in pursuing your future in nursing. It is a smart move to make now.