How to choose the right nursing specialty for you

Find out what nursing specialties are and how to choose the right one for you.

Last updated: August 1, 2023

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One of the biggest questions facing new nurses is, “what nursing specialty should I do?” 

In this article we discuss the most important considerations when choosing a nursing specialty with insights into the different types of specialties and what it takes to get into those areas. 

Whether you’re a new nurse or a seasoned nurse looking for a change and asking yourself, what nursing specialty is right for me, keep reading to find your answer. 

Choosing a Nursing Specialty

Sometimes, the choice is made for you based on where work is available or where you did your final practical placement in school, and that’s ok. Every nursing experience teaches you a skill or technique you can carry into future practice.

Then, later on once you’ve settled in, chances are you will be asking yourself again, what nursing specialty should I do now

Before making the leap, it’s important to understand what nursing specialties are, the differences between them, and how to choose the right one for your career. 

Here’s nurse educator extraordinaire Nurse Zara with some tips on how to choose and the differences between specialties.

Understanding Nursing Specialties

Nursing specialties refer to different areas you can work in as a nurse that require different skill sets and qualifications. 

Examples of popular nursing specialties are Intensive Care, Operating Room, Cardiac, or Psychiatric. 

For the most part, each nursing specialty will require at least two years of working experience and some advanced education. 

For example, if you want to work in ICU, most states and provinces require you to have your CCRN or CCACN (in Canada) certification.

Whereas an area like Renal/Dialysis might only require a lengthy orientation and an on-the-job learning period once you’ve had a few years experience in other nursing areas. 

Do I Have to Choose a Nursing Specialty?

The simple answer is no. 

For new graduates choosing a nursing specialty might feel preemptive or overwhelming. Remember, you don’t have to choose right away. Look for jobs on more generalized nursing units. 

We always recommend new nurses work at least a year or two on a standard Med-surg floor before branching out to more specific nursing specialties. 

Even for those nurses who have a specialty in mind upon graduation, working Med-surg is an invaluable experience. 

Med-surg allows you to build a solid nursing base into your practice to can carry into any area you choose later on. You have the opportunity to hone your skills in time management and organization, critical thinking, communication, and in the hard skills like IV starts, and med admin. 

Additionally, working Med-surg exposes you to every patient population and condition, so you get to see what you truly enjoy doing or are suited for before investing time and money in more education. 

So, do you have to choose a nursing specialty right out of school? In most cases the answer is no. In fact, we encourage you not too. 

Settle into a regular medical floor, hone your skills, and take the time to explore your preferences as well as your strengths and weaknesses. 

Important Considerations When Choosing a Nursing Specialty

Which nursing speciality provides the most job satisfaction depends in large part on your particular interests, your personality, and your needs around scheduling and salary.

Here are some of the most important considerations when choosing a nursing specialty:

  • Interests and skillset
  • Education level required
  • Schedule
  • Possible locations
  • Average salary

Let’s take a look each of these areas in more detail. 

Interests

Is there some thing or medical condition that got you interested in nursing in the first place? 

Follow your interests when choosing a nursing specialty and your job satisfaction will increase exponentially. 

For example, if you can’t get that Grey’s episode out of your head where they did cardiac massage, take a look into Cardiac Surgery, Cath Lab, or Cardiac ICU. 

Nurses who are more interested in the outcome rather than the process might prefer a surgical step down unit to the more acute units. 

Whereas nurses who enjoy intensity and fast paced environments will get more satisfaction from the initial part of a patient’s journey like ER or ICU. 

Try to find a nursing specialty that suits your interests. This will not only keep you motivated but helps prevent burnout as well.

Skillset

When it comes to skillset, there are the skills you come to nursing with and those you acquire on the job. 

As mentioned above, we recommend at least a few years on a busy generalized floor (think Med-surg) to lock in the basic nursing skills you learned in school. 

However, everyone comes to nursing with a handful of life skills and interpersonal skills already intact. 

Take the time to reflect on what skills you already have and how those might translate into different nursing specialities. 

But, don’t let a lack of skills keep you from entering a specialty you are truly interested in. 

Nurses, no matter how new or far along in our careers, are always learning and growing. If you have a solid base to build from, the skills you need can often be learned on the job or during your orientation period. 

Be sure to reach out to other nurses, nurse educators, or managers in the specialties you are considering. Ask them what skills they look for in a candidate or which skills they see as most important for their specific area. 

Which of those skills do you already possess? Which do you need to acquire?  

Maximize the skills you already have while upscaling the ones you lack for your target specialization. 

Education Level Required

Each nursing specialty has its own education requirements. 

Unfortunately, the requirements from state to state, province to province, and hospital system to hospital system can vary widely. 

For the most part (but not always), any advanced nursing specialty requires an RN degree over an LPN. Next, you will need a few years experience and some up-skilling in the form of additional degrees or certifications. 

It is important to plan ahead. Speak with other nurses or educators in the area you want to work and find out the requirements to qualify as a candidate in that specialty. 

Then take the time while working in your current area to seek out advanced education. Often there are opportunities through the hospital to get your continuing education paid for while working.

Speak with your unit educator to find opportunities within your organization.

In general however, critical care areas like ICU/PICU, PACU, CVU, ED will require an RN with a Critical Care Certificate and ACLS (in addition to BLS). 

Schedule

One of the best parts of being a nurse is the flexibility you can create with your schedule. 

You also have the ability to choose your income structure based on where you work and the schedule you work. 

Many nursing specialties work 10-12 hour shifts, giving you more time off and less time stuck in the daily commute. 

In addition, working nights, weekends, or evenings gets you a shift differential in the form of increased pay, and certain areas like critical care get hourly premiums while specialty areas like OR or Cath Lab will give you premiums for on call hours. 

For the most part Canadian nurses are stuck with a day-night rotation, while nurses in the US have more potential for choosing straight nights or straight days. 

People who need a predictable-regular schedule may not want to work in Critical Care areas as those areas are usually 12 hour shifts in block rotations – meaning your weekly schedule is always different. 

If you require a more stable schedule look at specialties that are only open during the day such as dialysis, day surgery, endoscopy or radiology. Some of those may require call but it is not often and you can usually find someone who wants to cover it for you. 

Some units even do self-scheduling, allowing you even more flexibility and freedom. 

Moral of the story, each nursing specialty offers different types of schedules. 

Before committing to your chosen specialty, find out what the schedule is like to see if it fits your needs. 

Always, before committing to a unit, ask the manager or a colleague about the shift durations, rotation, overtime, shift differentials, and time-off request structures. Every unit has a different culture around shift trades and time off; you don’t want to be stuck on a unit that can’t accommodate your lifestyle needs.

Possible Locations

Another great thing about nursing is its portability. 

Whether you want to travel the world or simply move across town, there is almost always a job waiting for you. 

Which specialty you choose can influence the number or options available to you when traveling or moving. 

Most travel companies like Host Healthcare or facilities require a minimum number or years experience.

Nurses with Critical Care experience will have access to higher paying contracts as well as more options to work outside of their last specialty area. 

For example, Host Healthcare currently lists an ICU RN job in San Francisco, California at $3,750-3,940/wk while a Med-surg jobs in the same location are quoted at $2,220-2,400/wk.

Travel RN Job Listings
Source: Host Healthcare

Keep in mind, in the US you will need to be licensed in each state you want to work. The easiest way to get started is to be licensed in Compact State.

This allows you to work in any of the states within the compact without going through the long and expensive process of relicensing. 

Here’s A. Lee talking about her experience and how to get your Compact State Nursing License.

In Canada, you need to be registered in each province you want to work. 

Many of the travel nursing agencies can assist you in applying for additional registration or at least direct you towards the right resources to get started. 

We recommend starting these processes early as it can take anywhere from a few weeks to many months for registration in a new state or province to go through. 

Average Salary

As mentioned above, specialty areas may offer financial incentives in the form of shift differentials and premiums or on-call pay. 

Travel nursing usually pays better than standard lines with the added bonus of per-diem and relocation stipends. 

In the US wages vary dramatically from state to state and hospital system to hospital system. 

For Canadians, the variance in salary across the country is generally not more than $5-10/hour at the highest step pay scales. 

If you are wondering what nursing specialty should I do and pay is big factor for you, aim for advanced degrees or nursing specialty areas with on-call shifts and shift premiums. 

Summary

Whether you’re a new nurse or a seasoned nurse, choosing a nursing specialty can be challenging. 

There are so many options and each area has its own set of requirements and nuances. 

When looking at different specialties keep in mind the requirements or additional education needed as well as the prevailing schedules and pay within those nursing specialties. 

Take time to acknowledge the skills you already have that might translate into this specialty area.

Think about what really interests you in nursing and find the specialties that possess those aspects of healthcare. 

You don’t have to choose a nursing specialty right out of school. It is always a smart choice to start in a generalized area like a Med-surg floor before moving on to more advance nursing specialties. 

This gives you time to hone your organizational, interpersonal, and technical skillsets; allowing you to transfer those experiences to the next phase of your nursing career. 

So next time you find yourself wondering, what nursing speciality should I choose, remember there is a nursing speciality out there for everyone. 


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