By Jessica Holbrook, MSN, RN

One of the greatest things about becoming a nurse is the variety the career offers. As a nurse, you can choose an adrenaline-filled career in emergency medicine or flight nursing, a work from home job combing through patient charts, an emotional and meaningful job in hospice care, and everything in-between. 

As you progress through nursing school, you may gravitate toward a particular specialty or hospital unit. Most nursing graduates spend a day or two working in many different specialty areas, but one or two shifts doesn’t always give them a full picture of what their career would look like. 

There are a few important factors to consider when choosing a specialty. 

Before you commit to a particular unit, think about what kind of patient conditions interest you, and the types of people you enjoy working with. Often, it is important to find balance within both. 

You may adore babies and children, but dislike working with respiratory problems and sputum. Alternatively, you may be fascinated by the heart, but struggle with high acuity situations. 

In the first example, you may choose to work on a children’s orthopedic unit. In the second example, a heart failure clinic might be a good choice. 

Consider that you will spend many hours each week working with whatever patient population you choose. With so many different options available to nurses, it is worth being picky to find the exact fit for your passions.

For better or worse, nurses can have almost any kind of schedule imaginable. Typical 9-5 jobs can be found in outpatient centers, clinics, and work from home jobs. Hospital nurses typically work three 12-hour shifts, and almost always have to take turns working night shifts, weekends, and holidays. 

While many nurses fight for weekdays and day shifts, other nurses enjoy the change in pace of night shift or having weekdays free for appointments and attending school events. 

If two different units are equally appealing to you, it is worth looking at pay. Specialty units typically pay their nurses more than general units. Travel nurses are known for finding high-paying contracts, but they sacrifice time and stability. 

Some nurses become device representatives, and are paid to travel and educate advanced practice providers. Others go into management or consult insurance companies for higher pay than bedside nursing. 

It is also important to remember that most hospitals pay nurses night shift and weekend differentials. Working a weekend-night shift can result in a 20-50% pay increase in some organizations. 

While making more money on a night shift or having an exciting career in a trauma 1 intensive care unit may be tempting, consider the stress levels you might face or the effect your job will have on your home-life balance. 

According to Walsh University, as many as 86% of critical care nurses experience at least one symptom related to burnout, and between 25 and 33% of critical care nurses report severe levels of burnout. 

Before taking on a high stress job or a demanding schedule, be honest with yourself about your resilience, ability to tolerate trauma, and support you’ll have at home. 

In 2020, the American Nurse Journal published an article stating that the turnover rate for bedside nurses was 17.2%. While those numbers are slowly decreasing, it is no secret that many nurses seek a change in their career or specialty every few years. 

Whether this need for frequent change is due to burnout, boredom, or low pay, it is challenging for nurses to leave a familiar place and start something new. Starting out in a specialty with lots of opportunity for growth is a way to ensure that you’ll get to experience changes within your career without having to start over in a new organization or with a new unit. 

Growth opportunities might include becoming a charge-nurse, becoming a nurse preceptor or educator, learning to manage more challenging patients, earning certifications for different medical devices, taking on a leadership role, or becoming a manager. 

Many nurses enter the profession with the intention of getting experience and then moving on to more advanced careers. 

For example, nurses hoping to be accepted into CRNA school will need at least two years of critical care experience, preferably in a cardiothoracic or other high-acuity intensive care unit. 

Nurses who want to pivot into management may want to get experience as a charge nurse in a unit that handles large volumes of different types of patients, or working as a hospital house-supervisor.

If becoming a family practice nurse practitioner is the goal, a medical unit that sees a variety of patients might be a good place to start. 

While choosing a specialty can be stressful, it is important to remember that you can always change your mind. Most people don’t know how they will be impacted by a particular schedule or work environment until they experience it for several weeks or months. 

While it always takes a few shifts to learn and get comfortable working in a new specialty, it is important to remember that you don’t have to stick with a specialty you do not enjoy. As you progress in your career, you’ll learn more about your likes and dislikes, your ability to tolerate different types of challenges, and what kind of schedule works best for your lifestyle.

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