Nursing Specialties: How Do You Choose?

NursingJuly 22, 2014

It's hard to pick one of the nursing specialties before you've been out working in the "real world." Here are few tips to help you narrow down your interests and get an idea of what areas of nursing might make a good fit for you and your long-term goals.

High vs Low Patient Ratios

Would you prefer working with a large group of patients with chronic conditions, or would you rather work with a small number of critically-ill patients? If you prefer to only handle a few patients at a time, you'll likely look at specialty areas such as critical care, emergency room, or surgical nursing. However, if you prefer taking care of people who aren't necessarily as sick and don't mind a higher patient volume, you might be a great candidate for geriatric nursing in a long-term care setting.

Advanced Nursing Skills and Knowledge

Are you always in pursuit of knowledge? While critical care may seem "easier" with its lower patient ratios, this specialty requires an advanced level of nursing knowledge beyond your basic training. Typically, critical care nurses enter this area after some experience in a regular medical-surgical unit, but some hospitals do offer special training programs for new grads. Regardless of your background, expect an extensive preceptorship because of the advanced skills needed. Rest assured, one or two patients can keep you as busy as 30 when they are medically unstable and hooked up to a handful of medical devices and monitors.

Other options for those who love to continue learning and love the more academic elements of nursing include research and development or getting an advanced degree to teach student nurses.

Supervising Others vs Working Independently

If you like supervising others, consider geriatric care in a long-term care center or nursing home. There, you'll supervise many nurses and nursing assistants who will work under you if you are a charge nurse or unit manager. If acting in a supervisory capacity isn't your thing, working in home health may be your best bet, although home health case managers do some minor supervisory work with home health aides. But home health nurses work fairly independently, setting their own appointment schedule for patient visits with little supervision over others.

The "Desk" Job

Would you prefer an office job to a clinical setting? Consider becoming a hospital case manager, or possibly specializing in completing the Minimum Data Set (MDS) for long-term care facilities. Case management coordinates the services provided to patients with the insurance billing to ensure that the documentation accurately reflects the care given and that the billing is appropriate. Likewise, nurses who specialize in MDS complete the assessment paperwork for insurance and Medicare billing for long-term care and rehabilitation facilities, ensuring compliance with government guidelines and maximizing reimbursement to their facilities. To work in either of these specialties, you'll typically need to become certified, although some employers may offer on-the-job training pending completion of your certification.

You'll get a better idea of which of the nursing specialties is right for you when you're out in the field, but consider these tips for helping you find the best career path for your strengths and skills.