Specialization: When to Decide?

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Hello everyone - this is my first post on this website, and I'm very excited to have found it, as I've been looking for a site like this for a long time. I don't know many people in person who are nurses - or, if I do know them it's only from hospitals or my physician or what have you.

I will be starting nursing school this fall and am immensely excited at the prospect, but I don't really know what to expect...

What I do know is that my mother constantly says I need to know my specialization now. My problem is, I don't really have any experience with the different types of nursing or how the different levels differ in terms of care.

I have been working as an in-home caregiver for some time, and I love it. Even the grosser sides like toileting and blood and vomit don't detract from the fact that I love my job. I don't provide any medical care of course so this is strictly a feeding/toileting/cleaning up after sort of job.

From my very little experience... it seems the further up you go in nursing, the less the jobs have to do with what I love, and what makes it worth it for me.

My mom says if you specialize, there's money. If you go higher, there's money. But I firmly believe that the world needs good, dedicated people in all positions - from the lowest to the highest. If you love your job and are good at it and happy with it, even if it pays less, it just seems like a disservice to yourself and others to go higher into jobs you might not be as happy with and may even come to resent.

I am not good with children as a general rule - young babies and from middle school age up is fine. So I have already sort of ruled Pediatrics out, though I will of course do my best when we do those units in school :D

I am actually looking more into geriatrics, but I'm not sure.

How far should I go if I want to keep doing the more "undesirable" side of nursing? Does it all depend on where you work? Do I have to think about what I want to specialize in before I'm even in nursing school?

I would be the first nurse in my entire family. I don't really have many places to turn for information. I try to be cool and collected and go along with what my school tells/sends me, but I'm really in a bind and don't have a solid place for advice... my adviser won't e-mail me back and I can't get a hold of anyone knowledgeable over the phone.

Any answers or advice would be appreciated.

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I think youre looking too far into this. This isnt med school where you have to choose a specialization DURING your schooling. I would advise you to just get through school, and see which specialty you enjoy through your clinical experience. A lot of people think they really want to specialize in 1 unit, but once they are actually see what goes on, on that floor, they completely change their mind. Take it one step at a time.

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Specializes in OR, Nursing Professional Development.

I think instead of listening to your mother (is she a nurse who knows how it works?), you need to keep an open mind during school and clinical experiences. I went into school thinking I wanted to work in L&D or peds. Guess what my least favorite clinical experiences were?

That's the beauty of nursing in the US- there is no specialization in pre-licensure programs. They all graduate general nurses who may then decide what types of units to apply for when it comes time to seek a job. And if it turns out that specialty isn't the right one or the nurse decides to make a change, it's possible to do so without having to return to school.

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Specializes in ED, med-surg, peri op.

I'm sorry I wouldn't be listening to you mum, who isn't a nurse. This is your career, you are the one doing it every day not her. Do what makes you happy, that's worth more than money! Also it's important to keep an open mind in nursing school, as well as you career. There is so many options in nursing and you can switch to different areas as much as you like. It's one of the best parts of the job. Don't close yourself off now.

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Go in with an open mind, you never know what you may fall in love with. I have classmates who love trauma, telemetry, critical care, some just love med-surg. Get in school, focus on the skills and knowledge, and let the clinical experience guide you.

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Some of us, are lucky enough to know going in where our interests are because of previous experience. The best thing anyone can say, is enjoy your clinicals, and see what you like. Furthermore, don't focus on tomorrow so much that you forget about today. If you don't make good grades in NS you will not be able to move ahead and further your education. Besides most MSN and Advanced Practice programs require 1-2 years of experience.

For now, explore, learn, and enjoy the adventure that is nursing school.

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Specializes in Emergency Nursing.

A lot of people don't know what kind of nurse they want to be when going in to nursing school, and most of us changed our minds once we got through the various clinical sites. As someone else mentioned above, the beauty of nursing is that you don't need to decide right away. Just be open minded and explore!

I knew what kind of nursing I wanted to do before nursing school, but I kept an open mind during my clinicals. That ended up being the best course of action for me, because I found numerous other areas of nursing where I could still work and be happy. Now, I probably wouldn't be AS happy (I still want to specialize in the area I wanted before nursing school, 100%) but happy enough to do what I need to do and be content. I'm currently applying to the job of my dreams right now, but I find comfort in knowing that even if I don't get it, there's tons of other places where I could still be happy and thrive. You may very well end up in a position similar to mine where it's not about where you want to work, but instead narrowing it down to the few specialties in nursing where you definitely don't want to work... and then go from there. haha

Just relax and enjoy the beauty that is nursing school. Go have fun! You don't need to decide for sure where you want to specialize until you start looking for jobs... and even then, so much of it is based on the available jobs in your area at the time that you're applying, and if you're willing to relocate :)

For me, I've found it best to just sit back and try and enjoy the ride. Life will take you where it wants to, sometimes whether you like it to or not. And even when that happens, so often I've found myself not minding the trip that much lol.

Good luck, OP! Now stop worrying and go kick some nursing school butt!

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Specializes in PICU, Sedation/Radiology, PACU.

It sounds like you've got a good head on your shoulders. Enjoy school, get good grades, learn as much as you can, and keep an open mind to all areas of nursing you encounter. I guarantee that there are specialty areas of nursing that you don't even know exist yet.

In terms of how the role of the nurse changes as you advance up the career ladder, that just depends on which way you go. Many specialties offer national certification that can (sometimes) get you a pay raise while remaining fully in clinical care. There are also non-clinical nursing positions that earn a good wage as well. If higher education (such as a Master's degree) is on your radar, there are programs with both clinical and non-clinical focus. Literally, the possibilities are endless. Just learn how to be a solid, competent critical thinking nurse and have fun figuring out what interests you the most. That's your only job for now.

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Specializes in Oncology, OCN.

I'm also starting nursing school this fall. No serious plans of what area of nursing I'm going to focus on. A few ideas of what I probably want to avoid and a few things I think I might enjoy but I'm just going in with an open mind and see where that leads me.

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If you really don't know, just take Med/Surgical route.

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The best advice I got on this was to have an open mind for clinicals, and once you're in there and enjoying an area, ask your preceptor to work with a challenging or complex patient so you get a fuller picture of what working there is like. Your mom just wants the best for you and doesn't understand the process. Reassure her that you have to do continuing education anyway and always have the ability to add more certifications and explore different specialties. I can't tell you how many people I've talked to (nurses, doctors, etc.) who were sure they wanted to do one thing and fell in love with something unexpected as they rotated through clinical settings. I'm pretty sure it's the only way anyone winds up in urology.

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I think the first thing going into nursing is to enjoy the job and the different people whose lives you will touch. I see you said you don't want to go into pediatrics,sounds like a personal problem instead of someone who is passionate about helping others. Don't knock it until you have tried it.To grow and become skillful and successful as a nurse is to open your heart to the needs of others.

Anyway to answer your question it does matter where you work because much is based on how much skills you have upon experience.Geriatric,you should be working in a Long term care facility,to add skills such as specialty like cardiac,spinal you should be working and gaining knowledge from a hospital on Telemetry etc..Most of specialty units require you have skills from LTC.So you do learn the basics of nursing from LTC then advance to hospital because it's hard to get employed fresh out of school with no back bone.

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