Nov 14

Nov 14 Hey Nurse: Finding Your Specialty

Dominique Louise

Nursing

So you passed your NCLEX… what's next?

Get a job!

We all know the there are a lot of job opportunities for nurses, but there are a lot of questions you have to ask yourself before you start applying for different jobs.

The questions I provided for you are only half the questions you could ask yourself for you to find your specialty. But to be honest, most nursing students know what specialty they want to get into before they even graduate. Try to make the most out of your clinicals and explore your inner feelings about a specific specialty.

From a personal standpoint, when I first started nursing school, I wanted to be an emergency department (ED) nurse. I wanted to experience the adrenaline and get into that fast-paced, high-intense environment. I wanted to see traumatic situations, similar to scenarios that you see in movies and TV shows. After doing my rotations, I found out how much I hated it. It's very different from what I expected and I felt like I got more patient interaction when I was on a medical-surgical unit. I also wanted to work on a general floor and get the most out of my experience at bedside so I decided to apply only for medical-surgical positions.

So how about you? Ask yourself the following questions and find what specialty you want to get into.

Questions to ask yourself?

Why did you get into nursing?

Some people naturally wanted to get into nursing because they want to work with kids or the elderly. Only you would know what your 'calling' is and you should go towards that direction.

Which facility did you like working in, hospital, long-term, dialysis, rehab, school, etc?

I have eyed the hospital setting since I was in nursing school. I knew that I needed to get into the hospital as soon as I became a licensed practical nurse.

What population did you like working with? Geriatrics? Pediatrics? Newborns?

I have a soft-spot for the geriatric and adult population. Though I love babies and children, I do not have the patience to work with them (just being honest here), therefore I knew I would not be able to work in a pediatric or mother-baby unit.

What specialty did you find the most interesting during nursing school? Did you do well in that course?

I loved medical-surgical. It was the most interesting and I did the best in that course because I understood the disease processes very well. It’s one thing to find something interesting, but it also matters if you did well in it. Once you’re on the field, its better to get a good understanding of what you’re dealing with.

Do you find yourself going for an ED and/or ICU position?

This can be controversial but heck, I’ll say it anyway. It is harder for ‘fresh’ new grads to thrive at an ED and ICU position if they have never had any clinical experience in the past.

I know that people will read my post and try to argue my statement, but let me state the reality. Any specialty has its own ‘specialized' workload and their own specialized stress. An oncology nurse’s stress, for instance, could be different from a stroke nurse’s stress. However, a lot of units have a medical-surgical foundation, in which a medical-surgical nurse can float to an Orthopedic or Stroke unit.

With that being said, ED and ICU requires a little bit more. As a medical-surgical nurse, I will not be able to float to either of those units because it’ll be unsafe. ED and ICU units not only require a strong medical-surgical background, but they also require knowledge of what to do during emergency cases, ventilation machines, high-risk medications, and so much more. You will be exposed to situations that could be traumatizing to a fresh mind. The amount of work stress in intense care units could lead to nursing burnout and in turn, could cause compassion fatigue and career changes. Be mindful of your workloads and patient ratios: A medical-surgical nurse’s patient ratio could be 5-6:1 versus an ICU nurse’s ratio could be 2:1, which is said to be an equal workload. (I believe that a medical-surgical nurse’s workload should be 4:1, but I’ll save the for an opinionated article… LOL!)

So now let us all be realistic. For those who are new grads with no experience, do not be surprised if an ICU or ED unit turns you down! Apply for a medical-surgical unit, build your foundation, and apply for any position.

HOWEVER, I know that some ED and ICU units have hired new grads with BSN degrees. But even with that being said, I have spoken to many ICU nurses within my hospital that state how unsafe this may be, not only for the unit but also for the actual new grad.

Where do you see yourself in the next 5 years?

Try to find a deep answer for this. I see myself with my master’s in leadership and management and help run operations within a hospital. Now what that may entail… I have no idea. There are so many positions available within management, but regardless, building nursing experience is the most important.

Finding the answer for this question could help guide how you drive your career path when you’re out on the field.

Which one is more important: high pay or experience?

There are so many factors that could affect pay. Long-term care facilities pay higher than hospitals. Advancement (which comes with higher pay) could also vary depending on how small or big a company/facility is. Pay could also depend on location, in which hospitals within major cities pay higher.

Nursing is known for its high pay and good benefits, but I hope you are not in nursing just for the pay…

Depending on your end career goal, nursing experience is so important for a lot of job opportunities. Job opportunities could care less about what you’ve been paid with in the past. In this field, the more experience you have, the more opportunities you have.

How many specialties are there?

Too many to count! I came across a list from discovernursing.com that shows the characteristics and the education required for each nursing specialty. If you click a specific specialty, it provides a brief preview of what to expect when you're in the field.