Which nursing specialty is most competitive and which one is the least competitive

[theantichick]

I'm just starting RN school in the spring, so I'm a couple years out from worrying about this, but my goal is to work ER. I used to be a paramedic, and am working on becoming fluent in Spanish (I'm in Texas). What else can/should I do do improve my chances at ER?

[TheCommuter, BSN, RN]

What else can/should I do do improve my chances at ER?

Find a job as a tech at a local ER and work there during nursing school either full-time, part-time, or PRN status. Once you graduate, you'll already have one foot in the door. Also, you'll be an internal candidate for hiring purposes, which should give you a better shot than the external applicants.

[sunnycalifRN]

Easiest: don't know

Toughest: Cath lab (not necessarily the most technical or skilled nursing, but it's usually M-F, 8-5 and it's a small team and they stay there until they retire)

[theantichick]

Find a job as a tech at a local ER and work there during nursing school either full-time, part-time, or PRN status. Once you graduate, you'll already have one foot in the door. Also, you'll be an internal candidate for hiring purposes, which should give you a better shot than the external applicants.

Would love it, but I have to keep working through RN school (yeah, I know, but it's the reality) but will definitely try it if I win the lotto!!

[ExtraShotNoWhip]

Toughest: Cath lab (not necessarily the most technical or skilled nursing, but it's usually M-F, 8-5 and it's a small team and they stay there until they retire)

When I was doing my clinicals in that area, those were almost the exact words several of the staff.

[~Mi Vida Loca~RN, ASN, RN]

I'm just starting RN school in the spring, so I'm a couple years out from worrying about this, but my goal is to work ER. I used to be a paramedic, and am working on becoming fluent in Spanish (I'm in Texas). What else can/should I do do improve my chances at ER?

I hope to eventually end up in the ED also. I am about to be a 4th semester student. I got some great advice from a wonderful ED nurse I was assigned too. She said at least in my area the best way to get in the ED is to first work on the Telemetry floor for a year. Especially if there are no new grad internships for the ED. She said that the Hiring managers in the ED always like to see a strong tele background in the potential employees since cardiac issues are such a huge part of what brings people into the ED.

With this information I plan on putting in for my Senior Practicum at a hospital a little further away (we have 4 hospitals within 40 mins of me by 2 different companies) anyway, I didn't want to really work at this particular hospital but they are much bigger, hire more new grads. Anyway, I am going to put in to do it on the Tele Floor at this hospital and hopefully make a good impression. My most recent Clinical Instructor is a NP at this hospital and rounds on many floors and is very well respected, she knows the hiring manager on the Tele floor and knows the HR lady. She told me that once I was ready to apply for the job to let her know and she will write a letter of recommendation for me. So I am hoping things will fall in place. I plan on working at the Tele Floor for a year or two and than trying for the ED. Best of luck to you, being Bilingual is for sure a plus when you are in an area where it's needed.

[shoegalRN, RN]

I hope to eventually end up in the ED also. I am about to be a 4th semester student. I got some great advice from a wonderful ED nurse I was assigned too. She said at least in my area the best way to get in the ED is to first work on the Telemetry floor for a year. Especially if there are no new grad internships for the ED. She said that the Hiring managers in the ED always like to see a strong tele background in the potential employees since cardiac issues are such a huge part of what brings people into the ED.

With this information I plan on putting in for my Senior Practicum at a hospital a little further away (we have 4 hospitals within 40 mins of me by 2 different companies) anyway, I didn't want to really work at this particular hospital but they are much bigger, hire more new grads. Anyway, I am going to put in to do it on the Tele Floor at this hospital and hopefully make a good impression. My most recent Clinical Instructor is a NP at this hospital and rounds on many floors and is very well respected, she knows the hiring manager on the Tele floor and knows the HR lady. She told me that once I was ready to apply for the job to let her know and she will right a letter of recommendation for me. So I am hoping things will fall in place. I plan on working at the Tele Floor for a year or two and than trying for the ED. Best of luck to you, being Bilingual is for sure a plus when you are in an area where it's needed.

That is a very good move! Work Tele (or PCU/Stepdown) if you can. Really develop your assessment skills, really know your rhythms, especially your blocks (First Degree, Second Degree Type I and Type II, Complete heart block, left and right bundle branch blocks), learn how to read a 12 Lead, and really know your interventions for pts with chest pain, afib/flutter, SVT, and bradycardia. Alot of rapid responses get called on the Tele floors in my hospital. Know what to do with a NSTEMI pt vs a STEMI pt (STEMI either cath lab if stable or call the code). You will learn so much on a tele floor, it will help you so much when you go to ER.

Good luck!

[Butterfliesnroses]

sourapril:

tablefor9 speaks the truth from tablefor9's perspective, and probably, experience.

However, from my perspective and experience, Psych is relatively easy to get into. I've witnessed some RN's merely need to undergo spontaneous respirations in order to work in Psych. If you're a warm body with an RN behaind your name, you can work Psych.

Medical, communication, or reporting skills are always handy, but not necessary.

I'm looking to the day when The Forces That Be will accept RN's without the skill of being able to undergo spontaneous respirations and still be able to work Psych.

For whatever it's worth.

Dave

When I did my mental health rotations (in a state psych hospital) they gave us employment packets listing the wages. No other specialty or rotation did this.

[Butterfliesnroses]

Hardest to get into OR. In nursing school there is usually very little exposure to what a circulating nurse does. The equipment and machines they use. A circulator is not a scrub tech but you need to know what a scrub tech knows (the instruments) if you are going to be a good circulator.

Easiest is long term care, then med/surg. They are both the basic bedside nursing skills focused on in nursing school. They are both very demanding. Depending on what institution or state you work in you can have 8 - 12 - 20 + patients to care for on one shift. That does lead to burn out.

Any area of nursing, (any job) has people who burn out. Even Psych.

I've never been a psych nurse. But even so I resent the comments. Psych nursing can be exhausting and demanding. Walk a mile in someones shoes before you comment.

There was a new nurse who was a circulator and I was shocked at the eye rolls and snotty comments made to her (I was a student nurse observing). However on the other hand I understood their frustration as OR HAS to be able to move fast. They also HAVE to be able to depend on each other.

[IHeartPeds87]

I gotta say, I'm a little surprised by the responses so far.

I don't really think nursing works that way, in terms of their being a 'more competitive' or 'less competitive specialty.'

I think a lot of people think about specialties and competitiveness in that way about nursing BECAUSE that is true about physician specialties. As a physician, you would have to apply for a residency in a specialty, and some specialties (like dermatology, radiology, opthamology, etc) are known to be extremely challenging to get into, while others are known to be less competitive (like psych, family medicine, general pediatrics, etc).

It doesn't work that way in nursing because as a nurse in the United States anyway, you aren't educated or trained to a specialty. What makes an OB nurse an OB nurse? He/she works on an OB floor. That same nurse can get a job in a LTC facility, and he/she would become a LTC nurse. There isn't special school for that (credentialing and orientations are a different story).

So, having said all of that, what is the most competitive/least competitive nursing specialty? It totally depends on what area of the country you are talking about. I know that in a town where my cousin lives, there is a need for oncology nurses. I know that where my friend lives, there is a need for psych nurses. It is all about need.

That being said, there are certain areas of nursing that are known to hire more new graduates than others, so I suppose you could state that those are the 'least competitive' specialties (but by no means are more or less challenging than other areas of nursing!). Typically, LTC facilities, rehab, and med-surg are areas that are typically more willing to hire new graduates. These are also places that typically have some of the worst nurse-patient ratios in the country, so many people typically do not like working in these areas and are eager to switch jobs because of the sheer number of patients and work load. Ever hear the phrase ' I feel like a chicken running around with my head cut off? ' That is a phrase that is typical of these specialties, and so they typically have a much higher turnover and thus can be considered, I suppose, "less competitive specialties."

In terms of the 'most competitive nursing specialties' again, it doesn't really work that way in nursing. Still, there are some specialties that typically won't hire people until they've had years of experience in other fields. Many ICU's are known for this. Flight nursing is known for this Some ER's do this, some OB floors do this, etc. Again though, this varies based on need and by place of employment because I generally believe it has more to do with the 'supply/demand' situation rather than the competitiveness of one's resume.

Jobs were you have a high amount of autonomy could be considered 'more competitive' because of the additional requirement they usually have(years of experience). This would include school nursing, hospice care, private duty nursing, or home health typically because you are on your own and don't have a lot of help so years of experience are required to realize when a problem is a problem and the patient needs to be rushed to a hospital/what needs to be done for the patient is solely based on your judgement.

There are also typically highly coveted nursing jobs because of their schedules. 9-5 nursing jobs, office jobs tend to be highly competitive. In that regard, I guess you could say that day shift jobs are competitive.

It honestly completely depends on where you are. There are some NICU's, for example, that are very willing to hire new graduates because it is so vastly different from most other specialties, that experience in , for example, adult med-surg may even be harmful if you want to work in a NICU because you have to 'unlearn' things.

Nursing doesn't work in the same way as the field of medicine works. I hope I helped you answer the question!

[klone, MSN, RN]

That being said, there are certain areas of nursing that are known to hire more new graduates than others, so I suppose you could state that those are the 'least competitive' specialties

I think that's what the OP meant - which areas of nursing are more or less easier to get into with no previous experience, and/or areas that are in higher or lower demand.

[Meriwhen, ASN, BSN, MSN, RN]

I've never been a psych nurse. But even so I resent the comments. Psych nursing can be exhausting and demanding. Walk a mile in someones shoes before you comment.

I've found that 90% of the people who make remarks about psych nursing being "easy" have never actually worked in psych. I've seen new nurses (both new grads and those new to psych) in tears because they were expecting the job to be a cakewalk but got a very rude awakening at that first code We have a high turnover in psych because it's not what people think it'll be.

OP: generally, the more specialized the area, the harder it is going to be for you to break into as a new grad. It's not to say it's impossible to start in the ICU, ED, etc., so definitely give it a shot! But you will have probably have better odds landing a job in med-surg...or psych In this market, it's going to be hard no matter what you choose.

Good luck!