Should I Specialize?

Ideas and tips to transition from floor nursing to a specialty. Specialties General Specialties Article


Should I Specialize?

In nursing school, most students come into the field with an idea of what they want to do in nursing. Some of the favorites for students include OB, pediatrics, or emergency nursing. However, as it has always been, most hospital employers want to start out GNs or new RNs on the Med Surg floor until they get their feet wet.  A good number of those nurses stay on the floor or migrate to sub-specialty floors in general bedside nursing.

But how do you transition to see if you are better suited for a specialty, like ICU, emergency, surgery, cardiology, dialysis, etc?   Perhaps it's the challenge of learning something new, you need a change or you need a different work schedule to match your personal life. One of the best opportunities for student nurses is to take advantage of the clinicals where you get to observe different departments. I have had a number of students observe with me over the years, and many couldn't care less what was going on because "it's not what I want to do".  Well, maybe not now, but what about in the future?  Here are a few ideas and suggestions to get you started.

Keep your eyes and your mind open

The student observation in different departments is amazing. You can see what goes on in the different departments, even if you can't physically do anything, at least you can see what it truly is like. You wouldn't believe how many students have come into my operating room thinking they want to work in a NICU and then leave saying, "that was so cool! Maybe I need to think about this a bit more.”

Did you know seasoned nurses can also observe other areas? Networking with friends in other areas can be very helpful. Of course, always ask permission before you wander into another unit.

Network with your colleagues

Talk to your nursing colleagues or join an online group to see what different roles nurses play in different types of nursing.  Honestly, it is so diverse depending on where you go, from Long Term Care to the hospital is a huge difference, and then specialties can range from cancer to burn units, pediatric to palliative care, emergency to surgery.  And if you don't want to do bedside nursing anymore, there are still even more opportunities such as infection prevention, risk management, supervision/management, the list goes on and on, and that is just in the hospital setting!

Your friends can be a guide for you to see what else is out there. Use them to paint a picture of what they do on a daily basis, what their schedule and assignment is like, and what they like (and dislike) about their job.

How to decide

Okay, so now I have an idea where I want to go, but how do I make a decision?  If you can narrow your options down to a small list, now is the time to take action.

1.  First, look at the practicality: are there jobs available near you? If you live in the country and there is no NICU within 2 hours of your house, perhaps that's not a real option for you (right now).

2.  Talk to the manager. If you have a contact who knows the manager, or you know them yourself, set up a quick meeting with them to feel them out. Ask to shadow (for free) a nurse for a shift or for a few hours at least. Also, ask what the qualifications are. Many specialties require experience, additional training, education or certifications. Is there on-the-job training available?

3.  Apply for open positions. It doesn't hurt to apply. Remember, when you interview it is just as important that you interview them as well. Come with questions about the job. Not just about pay or benefits, but what is the shift schedule? Is there on-call time required? Do the shifts rotate day/night/weekends?

4.  Research, research, research. All of these steps above will help you make an educated decision of where you may fit in the best. Because at the end of the day, it's possible you will be happiest where you started!

If You Decide to Change ...

Don't forget: if you decide to change positions in the same company or the same town, do NOT burn bridges at your original job when you leave!  It's never wise to burn bridges when you leave a job, but especially in this situation. Everybody knows everyone, and with social media, everyone has access to anyone these days!  Also, if that new job doesn't pan out like you thought it would, you can always reapply to your old position.

One of the best features of the nursing profession (besides patient care) is the ability to diversify. Specializing in a new area can feel like a completely new career, even though your skill base is similar. It can help anyone who is feeling stuck in their nursing job find something new and reignite their passion for nursing once again.

Ellie Kearney has 11 years experience as a BSN, RN and specializes in OR circulator/scrub CNOR, writing.

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The only solid piece of advice in this was the shadowing if one is already a floor nurse and trying to do something else (essentially every position you look at/want to apply to will want experience). For new nurses, pick your specialty as soon as start nursing school, when you graduate and start applying, apply for said specialty. 


Specializes in Med-Surg.

I used to dream of ICU nursing.  Never got an opportunity.  After working through the pandemic, I don't feel so enticed anymore.  I also have a family now and I don't have the energy to keep doing crazy schedules.  After 4 years as a bedside CNA and 2.5 as a bedside nurse (most of my time doing night shifts) I'm too tired. I can't seem to get away from the bedside though because everywhere wants department-specific experience. I don't know exactly what I want to do, but this ain't it. 

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