Make sure you know yourself and what you really want.  

By Janet Boivin, BSN, RN

Deciding to change your nursing specialty can require as much self-assessment and research as transitioning into an entirely new career. Or it can be as simple as moving to a hospital unit that requires similar nursing skills but has a different patient population.

I started my Baby Boomer nursing career in orthopedics. After a year or so, I went to a neuro-medical surgical unit in a Boston teaching hospital. I made the change not because I disliked orthopedics but because I thought neurology and caring for cognitively impaired patients would be more challenging. But I also knew I didn’t want the level of complexity associated with patients in the neuro intensive care unit (ICU).

The challenge for today’s nurses who want to change specialties is the growing array of new nursing and health disciplines from which they can choose. These areas, such as information technology, pharmaceutical sales, and nursing research are the outgrowth of rapidly evolving healthcare tech and medical knowledge, as well as a national emphasis on providing more prevention, treatment, and end-of-life care in the home and community.    

Where do I begin?

Start by knowing yourself and what you and your family need psychologically, spiritually, and financially, say career coaches Carmen Kosicek, MSN, RN, CNM, PMHNP, and Keith Carlson, BSN, RN, NC-BC. (See Honest self-reflection.)

“Do a deep self-assessment of who you are and what you like to do; what lights you up and makes you feel happy and fulfilled,” says nursing career coach, nurse blogger, and podcaster Carlson. “For most people, that’s a big deal.”

Kosicek, who has an online coaching program and is CEO of Alay Health Team, a group of psychiatric prescribing providers caring for children and adults via onsite visits and tele-psychiatry throughout Wisconsin, agrees. “Think about what kind of work environment would be best for your personality and work needs. Do you like to be constantly busy with unexpected challenges? Or do you prefer a slower pace with a fairly predictable routine?”

Honest self-relflection Switching nursing specialties requires honest self-reflection. Ask yourself these questions to ensure you make a change that best suits your interests, abilities, and needs. • Why do you want to change specialties? • Are you making the change for the right reasons or do you want to get away from your boss or uncooperative colleagues? • Do you want a change from hospital nursing? • Do you want less or more contact with patients? • Do you want to work with patients only by phone or videoconferencing? • Do you want an entirely new specialty requiring additional skills and training, such as intensive care units or the operating room? • Do you prefer to work with colleagues as part of a team or to work on your own? • Would you like a job that requires traveling, such as pharmaceutical or medical device sales? • Have you ever considered the benefits of military nursing, such as free education and travel? • Do you prefer working in a rural or urban setting? For example, working in an emergency department (ED) in a rural area may provide a broader range of experience than a city ED where residents, medical students, and physicians provide most of the care. • Will changing to a new specialty require you to move to find a job? If so, will the cost of living, housing, and income levels of a new geographic area work for you and your family? If you require deeper insight, read a book frequently used by career centers: The Pathfinder: How to Choose or Change Your Career for a Lifetime of Satisfaction and Success, by Nicholas Lore. Another classic is What Color Is Your Parachute? 2017: A Practical Manual for Job-Hunters and Career-Changers, by Richard N. Bolles.

Next, do your research

Once you understand why you want a change and what you think you want to do, then it’s time to research your areas of interest. You don’t want to move into a new specialty only to find it’s not what you expected.

“Some specialties are simpler to jump into than others,” Carlson says. “If you have worked in an emergency department (ED) or ICU, it would be easier to become a flight nurse because you already have many of the skills you would need, such as thinking quickly and working with trauma patients.”

Think beyond the clinical setting, Kosicek urges: “Focusing [only] on a hospital job is so 1980s and 1990s. Nurses don’t realize how many jobs can be found working in the community.” For example, she says, pharmaceutical companies hire nurses to work with providers and patients, demonstrating how to use new injectable medications. Psychiatric telemedicine, home health, and patient monitoring for chronic diseases are other growing areas. “You just have to open your mind and ask yourself, ‘What can I do?’” Kosicek says.

Do some digging on Google to discover these new roles as well as more traditional specialties through nursing blogs, websites, and nursing publications. From your research, determine what transitioning into the specialty takes. You’ll want to find answers to these questions:

• Do you need certifications?
• Will you need additional education or training?
• Does the specialty require a certain amount of previous experience? If so, how can you get it?
• What are the physical requirements for the specialty?

Talk to nurses you know in that specialty and ask them what they do and how they like it. Don’t be shy. People usually love to talk about themselves. Carlson recommends setting up informational interviews that involve asking an experienced nurse in a particular specialty to meet with you and talk about his or her area of expertise. “These types of interviews are powerful tools,” Carlson says. “I consider them a form of deep networking.”

Take advantage of nursing organizations, such as the American Nurses Association. And most nursing specialties have a national association with local chapters. Their websites often contain a wealth of information. Take it one step further and call or email nurses who are listed as members of the local chapters and reach out to national association leaders and tell them you’re interested in learning about their specialty. They’ll be happy to talk about what they do.

You’ll find a comprehensive list of national associations at the Illinois Center for Nursing website (http://nursing.illinois.gov/nursingspeciality.asp).

Remember the patients

Patients and their characteristics and particular needs can get overshadowed when you focus on the nursing or medical discipline in which you’re interested. But the patients you care for every day will affect your job satisfaction, Kosicek says.

We all know some patients are easier to take care of than others, whether it’s because of their personalities or the type of illness, disease, injury, or disability for which they’re being treated. If you’re uncomfortable around serious illness or death, then oncology or hospice nursing probably isn’t for you. Some nurses enjoy caring for individuals in the final stages of life. Others may be better suited for specialties focused on an earlier stage of life, such as neonatology or pediatrics.

If you prefer less face-to-face contact with patients, you might want to consider working for a call center, telemedicine provider, pharmaceutical company, or health insurance provider.

How do I find a job in a new specialty?

Network, network, network. Talk to every nurse you know working in the specialty or specialties in which you’re interested and tell them you’re looking for a job. Carlson is a proponent of using social media, such as joining Twitter or Facebook chats and nursing conversations on LinkedIn.

More traditional job boards, such as www.indeed.com and nursing websites, are also worth checking out and let you narrow your job search by specialty and geographic location. Visit the Bureau of Labor Statistics website (https://www.bls.gov/ooh/healthcare/registered-nurses.htm) for information about the areas of nursing seeing the most growth.

Is it time for educational advancement?

Maybe it’s not a new specialty you want or need but more education to advance in your career or take it in a new direction. Deciding to return to school requires planning and a full understanding of your goals. (See Can you go back to school?) Several organizations and websites provide help. Two of the more useful sites are the American Association of Colleges of Nursing (www.aacn.nche.edu) and the Johnson & Johnson Campaign for Nursing’s Future (www.discovernursing.com).

Can you go back to school? A career move may require going back to school. Ask yourself these questions to help you make sure it’s the right move for you. • What’s your long-term career goal? • What do you want to do with the degree? • Do you have the resources to finance a new degree? • Do you want the challenge of being an advanced practice nurse, such as a nurse practitioner or certified nurse anesthetist? • Can you go back to school full-time or do you have family or work considerations to factor into the equation?