By Jessica Holbrook, MSN, RN

Nursing is one of the most versatile career choices in healthcare. There are endless specialties to choose from, a variety of scheduling options, and job opportunities available in almost any location. Building on the factors to consider when choosing a nursing specialty from Part 1 of Finding Your Nursing Specialty, this guide dives deeper into the process of becoming a nurse in some of the most sought-after specialties.

While the different options and opportunities appeal to many nurses, it can be challenging to decide on a specialty. Knowing more about different specialties and what it takes to get there can make the decision-making process a lot easier. 

Forensic nurses play an important role in both patient care and criminal investigations. They help victims of abuse and violence heal while ensuring that the criminal justice system gets accurate information. Forensic nurses may have to testify in court and often work with pathologists and coroners to determine the cause of death. 

Forensic nurses need to be incredibly detail-oriented, compassionate, and empathetic. They are at high risk of secondary trauma due to the nature of their jobs. However, many nurses find this work to be extremely rewarding. 

Most employers require nurses to have two to three years of clinical experience before working as a forensic nurse. In addition, there are two certifications that forensic nurses can earn. The Generalist Forensic Nurse Certification and the Advanced Forensic Nurse Certification. Most working forensic nurses earn both. 

Surgical nurses work in operating rooms and can work as circulating nurses or right at the bedside with the surgeon. Circulating nurses are not sterile, and take care of tasks such as charting, gathering supplies, preparing the patient for surgery, and watching for any errors in sterility. Nurses at the bedside may hold tools for the surgeon, assist with suction, or position the patient during surgery. 

Surgical nurses can further specialize in fields like cardiothoracic surgery, orthopedic surgery, general surgery, and pediatric surgery. Surgical nurses are often drawn to the schedule, which typically includes four 10-hour shifts with night and weekend calls. 

Many surgical nurses started their careers as scrub techs or operating room orderlies. General surgical nurses may be able to start right out of nursing school, while pediatric and cardiac surgical nurses may need a few years of experience. Surgical nurses may choose to become Certified Perioperative Nurses. 

Working in home health is extremely rewarding, allows nurses to have autonomy, and offers a flexible schedule. Home health nurses visit patients in their own homes to help them manage medications, administer injections of IV medications, care for catheters, and check on central lines. 

Because they visit their patients’ homes where there are no other nurses or caregivers immediately available for questions or backup, most home health nurses feel more comfortable having a few years in a hospital or clinic before working independently. However, this is not a requirement.

The American Nurses Credentialing Center offers a Home Health Nursing Certification. 

Holistic nursing is a relatively new specialty and became officially recognized as a specialty by the American Nurses Association in 2006. Holistic nurses’ goal is to focus on the whole person, caring for their physical, mental, emotional, spiritual, and environmental health.  

Holistic nurses often work in alternative or complementary medicine clinics such as massage therapy, acupuncture, or herbal medicine. The American Holistic Nurses Association offers educational opportunities for all nurses including conferences, videos, published articles, and much more.  

Telehealth nurses are experienced, knowledgeable nurses who give support to caregivers working in low-resource areas. Telehealth nurses can monitor patients from their homes or call centers and are available for nurses who have questions about their patients or general nursing questions. 

Telehealth nurses can alert the bedside nurse of a change in a patient’s vital signs, give guidance about IV medication compatibility, answer questions about potential medication side effects, or help troubleshoot mechanical devices such as dialysis machines or mechanical circulatory support. 

Because they are a resource and guide for other nurses, nurses must have several years of in-person experience before they can become telehealth nurses. The American Academy of Ambulatory Care Nursing offers a Telehealth Nursing Certification. 

Certified Emergency Nurses are some of the most versatile nurses. On the same night, they may take care of a pregnant mother with abdominal pain, an older gentleman with chest pain, a child with a fever, and an adult victim of a motor vehicle accident. 

Emergency medicine nurses have to identify problems and make decisions quickly. They are often considered the “jack-of-all-trades” because they never know exactly what kind of patient they will see. 

Emergency nurses, like other critical care nurses, often have a few years of experience in a lower acuity unit before transferring to emergency services. Many other emergency nurses start their careers as Emergency Medical Technicians. 

The Board of Certification for Emergency Nursing offers several different certifications:

• Certified Emergency Nurse
• Certified Flight Registered Nurse
• Certified Pediatric Registered Nurse
• Certified Transport Registered Nurse
• Trauma Certified Registered Nurse
• Certified Burn Registered Nurse

Neonatal nurses work in newborn nurseries or neonatal intensive care units (NICU). Babies who need extra support after their birth may have to go to the NICU, while healthy babies spend just a few hours in the newborn nursery. 

Neonatal nurses often progress from newborn nursery to level I NICU and all the way up to level IV NICU. Babies in level IV NICUs need the most intensive care, including high-frequency ventilation, continuous dialysis, and ECMO. 

Neonatal nurses may choose to earn their certificate for Critical Care Registered Nurse (Neonatal).  

Pediatric nurses work with children of all ages and can work in a variety of settings. Pediatric hospital units and clinics typically care for patients ranging from a few days old up to 20 years of age. Pediatric nurses can further specialize in general pediatric medicine, surgery, intensive care, emergency medicine, home health, and more. 

Nurses who want to work in pediatrics should remember that kids are not small adults. They respond differently to many illnesses and medications, and there can be a steep learning curve when transitioning from adult care to pediatric care. 

Lower acuity pediatric units often hire new nursing graduates, while operating rooms and critical care areas require a few years of experience.  Certifications available to pediatric registered nurses include Certified Pediatric Nurse and Critical Care Registered Nurse (Pediatric).

Choosing a nursing specialty is a deeply personal decision that depends on your interests, strengths, and career goals. Whether you’re drawn to the fast-paced environment of the emergency department, the delicate care of neonatal nursing, or the holistic approach of alternative medicine, there is a specialty that aligns with your passion. By exploring different fields and pursuing the necessary education and certifications, you can find a fulfilling path that allows you to make a meaningful impact on your patients' lives. No matter which specialty you choose, the most important thing is that it brings you both professional satisfaction and the opportunity to provide excellent patient care.

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