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

[Nurse Beth]

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!

---

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

[ms04drip]

Good luck!

[bebebond]

I think Beth, RN gave good advice. I an 64 and on a Med/Surg floor at a small community hospital. I have found over the last 10 years that the stress of management, ER and ICU is not what I want in my life.

I also see that transferring within a company system that you have been with for a long time is nearly impossible after 55-you are usually too high paid.

I also feel education is the key. Have you considered teaching? The future is a very good investment. They will be taking care of us.

[greenandsilver]

OR Nurse, Discharge Planner, Care Coordinator, Diabetic Educator. All much easier on your body. The oldest working nurse in the country is an OR nurse.

[Kssrn404]

I am 51 and have been out for ten years. I'm going back to CVU. Post surgery. No lifting though it is high stress it's not so physical.

[whitneym]

It depends on what you like. I am 51 have been an RN for 7 years 4 of them in the ED. I work with alot of nurses in their early 60's that are in good shape. It depends on how healthy and fit you are.

[Axgrinder]

I highly recommend telephone triage! If I didn't find it nursing would have seen the last of me and my sore joints looong ago.

[Infusion50]

I have recently changed my specialty at age 50 and absolutely LOVE it! I took a part-time position in a small infusion center. As an ADN with previous experience in ICU/CCU/NICU/Homecare, it was still difficult finding positions in my area teaching hospitals which prefer BSNs. However, infusion centers really value nurses with IV skills which is the reason I was hired. Within six months, the hospital trained me to do PICC insertions and I obtained my Chemo/Biotherapy certification on-line. At first I was really anxious about mastering all these new skills and pharmacology.....but I can tell you that old dogs really can learn new tricks. Infusion environments are intimate ones and you have the opportunity to develop mutually satisfying relationships with your patients as many of their regimens are months or years in length. Our infusion center has almost a family atmosphere. I only wish I had found this specialty earlier in my career. Its never boring and there is always something new to learn. The work is stimulating without being overly stressful (as long as staffing is adequate) and not physically taxing. The ONS is a very active and social professional association that offers tons of program dinners and educational activities. I plan to get my OCN this year (one of the few certifications that don't require a BSN) and finish out my career in Infusion. Home infusion is also in high demand. Its just an all around versatile specialty with many job openings. My only caveat would be to only work in an infusion center that does NOT mix their own chemo. Mercifully, our pharmacists do all that dirty work for us.

[purehogman1975]

I would stongly discourage looking into the specialized areas you mentioned such as ICU, you are just asking for a more stressful and physically demanding job, you want job security and longevity balance. I found myself in this quandry about 3 years ago, and after much investigation into options, I chose the Care Managment realm. It was a blessing, I still get daily patient-family-physician, nurse and other collaborative team members interactions, and I have so much opportunity for advancement of career as Case Management is a CMS directive which will be growing in jobs in near future.

[GrammyCat]

Excellent topic. I am recareering INTO nursing (foundations student), and just turned 50 in January. This topic has been on my mind, as I try to figure out what avenue to aim for, for my first clinical position. I do think about what roles would be best, as I age into this career. Due to my age, I don't know how long the heavy duty lifting is actually feasible.

[Axgrinder]

Me too! I did it a while ago, but had to medically retire for 10 years. I came back to it again just after turning 48 - my 2 year anniversary will be at the end if the month. The job is an excellent fit for me, my coworkers are amazing, and my boss is the greatest. I got so lucky - I work from home in my pajamas, and it is the fastest commute I've ever had. At lunch I can sit in my spa, or nap if I want to (a full hour, not a measily 30 minutes). I wouldn't be able to work otherwise, and certainly not in nursing. I asked for an at home nursing job (which everyone said couldn't be done): God delivered!

[calivianya, BSN, RN]

If you are worried about your aging body at all, I would not consider ICU. Only one ICU I have worked in had any CNAs at all - for the most part, it's total patient care - and with what seems like 99% of people on the vent getting tube feeds, that can mean physically manhandling a 400 pound or more patient every few hours to clean them up with all the tube feeding diarrhea and C. diff around.

Had a heavy one last week in liver failure getting Lactulose q6h and on tube feeds. As you can imagine, that patient was constantly pooping. We cleaned her up at least 6-7 times per shift every shift. My back felt so horrible after my three shifts I just wanted to lay around and not do anything and it took 800mg of ibuprofen to even get comfortable enough to sleep for several days afterwards. A lot of my coworkers have back injuries - lots bring all kinds of pain relief creams and patches; some bring their narcs and Flexeril to work and wouldn't survive a shift without them. I can hit up just about any of my coworkers for pain medicine if I forget to bring my own. One of my coworkers is retiring many years earlier than she intended to in a few months because her back is so damaged she physically can't handle it any more and she is going to need back surgery.

I would NOT recommend ICU to someone looking for a specialty to retire in unless you're one of those that lifts weights at the gym 3-4 days per week and you're in the best shape of your life. I worked as a CNA on an inpatient rehab floor in nursing school and all of that getting people up to the commode was less physically demanding than working as a nurse in ICU.

[cricket0414]

I work in my states largest hospital - close to 700 beds. We have 7 icu's, are the leading neuro and cardiac and transplant hospital. I got my degree at 53, i am now 55. My hospital welcomes nurses new and old experienced and unexperienced. They have a great preceptor program and no one is thrown to the wolves without 3 months orientation/recepting. Resources are always available and other nurses on the unit are great. Granted it is an icu which is a whole different ballgame than floor nursing. Patient load is 2/1 never higher. I don't think any of the other hospitals in my state are any different. I am in Wisconsin. i am so surprised when I read about these hospitals with so many presumptions of their nurses and their degrees and experiences. We just do not have that here.