Specialized Nursing - How to decide before graduating? (Cross Post: Students)

[spudpatch]

Greetings ~

As a nursing student in my final semester, I am constantly asked what kind of nursing I want to specialize in. I come from an EMS background, and gravitate toward the ED, but thus far have enjoyed all aspects of care during my education. While I know that there are advanced certifications that I wish to pursue, after 2 years in an ADN program I think it is presumptuous for me to know what kind of nurse I want to be when I 'grow-up' and should spend a my first year (or two) just getting my nursing skills in line, being employed as a nurse to understand the day-to-day minutia. I would like to give myself a year in Med-Surg and just see what aspects of nursing appeal to me as well as what opportunities arise before picking a concentration or returning to school for an advanced degree. More than anything I want to I do not want to be pigeon holed or have my future opportunities reduced by not being perceived as having ambition toward the career.

My questions are: Should I be more aggressive in looking ahead for new career paths or is my attitude of building the basic nursing skills appropriate? And, does anybody have input regarding some of the certifications or training courses that a nurse graduate should pursue in the first couple years to advance your practice without 'specializing' per se?

Thank you very much for any input and suggestions you may offer!

[Whispera, MSN, RN]

I believe, if you don't have any leaning toward a specific specialization, going with med-surg at first is a good plan. It will serve you well anywhere else you go in the future.

[sbyramRN]

There are various schools of thought on this one. The Med Surg nurses will swear to you that the "best" thing to do is to go into Med Surg, learn your skills and move on to something else. The problem I see with this, is that once in Med Surg, the nurses have a hard time getting out and finding jobs in different specialties. The other school of thought is to pick what you love and go right for it. The director of my nursing school told us not to feel like going into Med Surg is the only right way... we were told if we knew what we loved, to go right into it. I know that I would loathe being a med surg nurse, so I am starting off in the ER of a large pediatric hospital.

Do what feels right to you! Good luck.

[Whispera, MSN, RN]

the operative phrase is IF you know what you love...

[spudpatch]

I have a proclivity toward the ED, but still want to make sure that I get the basis of my practice down as well. When you state that Med-Surg nurses have a hard time getting out, is that due to their own inertia or rather because they have not built the skill set necessary to advance? If this is the case, are there certifications and/or advanced skills that I should pursue as quickly as possible to make myself more marketable and ensure that I can ‘get out’ if I would like to?

[sbyramRN]

I have a proclivity toward the ED, but still want to make sure that I get the basis of my practice down as well. When you state that Med-Surg nurses have a hard time getting out, is that due to their own inertia or rather because they have not built the skill set necessary to advance? If this is the case, are there certifications and/or advanced skills that I should pursue as quickly as possible to make myself more marketable and ensure that I can 'get out' if I would like to?

I a not sure. The Med Surg nurses I followed during nursing school stated they went into med surg to learn skills, but now that they were trying to get hired into specialty areas, they were finding that new grads were getting hired before they were. They felt the reason they were not getting hired is because it was hard to hire people into med surg. I know out of the 16 people that graduated from my class, only 2, maybe went into med surg. The rest specialized in other areas.

[Whispera, MSN, RN]

I can see if you work in a hospital and are in med/surg there, they might not want you to transfer out, but you can still go to another hospital.

[VORB]

I would say if you know what you want, go for it. Everyone naturally falls into a rut - the question is where do you want that rut to be?

Back when there was a shortage of applicants, the new nurse pretty much had their pick. Now in the sour economy and with an over-abundance of applicants, hospitals can be a little more picky. The fact that it probably costs twice as much or more to train an ED or unit nurse versus a floor nurse cannot be overlooked by administration in these economic times, and may be more likely to fill an opening with an experienced nurse - even if a floor nurse.

Bottom line is to go for what you want with the understanding that you may have to settle for plan B. But then that's life.