How To Decide on a Nursing Specialty When you Graduate

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I feel like one of the most common questions I get about nursing is how do you know what specilaity to start in?

For those of y’all that didn’t know, I am licensed as a RN and worked in a medical ICU for almost 4 years. Just this past January, I stepped away from the bedside to focus on my blog full-time! If you want to see more nursing blog posts you can find them all here.

But for those of you that are thinking of going to nursing school or you’re in the beginning of nursing school, this is not something you need an answer to! I think so often we feel like we need to know from the beginning what our plan (and in this case speciality) is going to be but you definitely don’t need to know right away. It’s not going to affect the nursing classes or clinicals you take until the very last semester, and you also will learn the area you are most interested in while you’re in nursing school. So there isn’t any reason that you should have this planned out ahead of time.

When I started nursing school, I knew nothing regarding all the different areas and specialties nurses could work in. Literally nothing LOL. I mean, I knew there was the ER and ICU (vaguely) from tv shows, but beyond that I really had no idea what the options were. And to be honest, I didn’t even realize how diverse nursing was until I actually started working as RN. That is also one of the most beautiful things about being an RN, is that you can always pivot and find a field that you’re really interested in. Whether it’s in patient or out patient, there is something for everyone.

My advice would be when you first start nursing school, don’t even worry about what area you may want to start in. There are so many other things to learn and focus on, that choosing a specialty is probably going to be the furthest thing from your mind once you get into the trenches of nursing school lol. As you go through nursing school and have a chance to move through different clinicals, you’ll eventually start to naturally gravitate towards some more than others. For me, I ended up really loving the ICU and critical care, but I didn’t really realize that until my last semester or two. During your last semester you’ll get to choose a capstone to do your clinical in and at this point you can pick a specialty that you think you may want to start in when you graduate.

After getting a taste of different specialties through clinicals, you may automatically gravitate towards one in particular and your decision is relatively easy on where you want to start/apply to. If this isn’t the case though, that’s okay! These are some things that you may want to think about:

-Do I want to work in a hospital in out-patient? I would say that most nursing students start in a hospital because you need to actually learn “how to be a nurse.” Let’s be real, you don’t know anything when you graduate and you need to learn how to actually implement nursing skills. In my humble opinion, you’re not really getting that if you go straight to working in an office or out-patient. You need to learn how to start IVs, manage medications, titrate drips (if in ICU), how to actually give patient care etc. So if you’re on the fence about what speciality, I would strongly suggest at least starting off in a hospital.

-What type of environment do you do well in? This can be kind of a tricky one to answer because you may not yet know what type of environment you thrive in. For me though, I knew I didn’t want to do a lot of patient education…basically talking to patients wasn’t really what I was interested in. I ended up being drawn to more of the critical care side of things and I didn’t want to have a lot of interaction with my patients (LOL just being honest, give them to me intubated and sedated). Don’t ask me really how I came to this conclusion, but I tutored pathophysiology & pharmacology for a few semesters in nursing school and it was super interesting to me. So I think I just thought I wanted to work with patients where I really got to dive into how the human body responded and how we managed care, vs. the education/conversing aspect.

-What kind of patients do you like working with?  Some people start to realize they really want to work with kids so that helps narrow down the field. Some girls who I went to nursing school with realized they really loved geriatrics, or were more drawn to psych. Again, as you move through nursing school you’ll start to realize what you’re drawn too and what would be a good fit outside of school.

-What are your career goals? Do you want to go back to school and if so, what do you want to go back to school for? For example, if you want to be a CRNA, you’ll have to have several years of ICU experience before applying so that is obviously something to consider. Or maybe you know that you’ll be starting a family soon, and you won’t be working full-time anyway, so you want a specialty with hours that are more flexible with raising kids.

But here’s the thing. Regardless of where you start out after nursing school, you should never feel like you are locked into a specialty–people change specialties within nursing all the time. Again, that is one of the beautiful things about being an RN. So don’t feel like this decision is going to dictate the rest of your nursing career. I had plenty of friends in nursing school that started off in one specialty and moved to another one a year later.

In my next nursing blog post, I’ll share with y’all about my experience starting off in an ICU right after nursing school. In general though, I had an opportunity to do a summer externship at Duke while I was still in nursing school, and I realized during that summer that I really loved the ICU. My point being, if you’re in nursing school and you can shadow or extern somewhere, take advantage of that opportunity. One, you’ll learn so much being able to provide more hands on care than you do in nursing school but two, the more clinical experience you’re able to get the more you’ll start to get a feel for areas you may be interested in working in.

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1 Comment

  1. July 1, 2020 / 11:37 am

    Great article! It is very informative and detailed to the core. As nursing student, I will think what I can specialize in.

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