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Changing nursing specialties might be metamorphosis your career needs

Mariann had a horrific awareness that she picked the wrong specialty.

Seven years of post-college education and interminable anesthesiology training had morphed into brutal 12-hour, in-house OB shifts, when she often gave more than a dozen epidurals. She envisioned a joyless future as she watched the other women in her anesthesia group who were 20 years older and still working long hospital hours.

Mariann decided no amount of money justified this lifestyle. And she had grown dissatisfied with anesthesia practice itself — long hours of boredom, punctuated by minutes of crisis when a patient tried to die on her. No matter the cost, she had to change specialties.

With great trepidation, 42-year-old Mariann simultaneously enrolled in a master of public health program and a brand new, start-all-over-again residency in occupational medicine. Much to her surprise, she felt liberated.

She thrived on the academic aspects of her residency program, even participating in research projects and their publication. Three years later, she joined an occupational medicine practice, working 9-to-5 Monday through Friday; she eventually became the director. With that position, she learned to become a manager.

Was it hard switching specialties? You bet. But learning a new specialty as well as a new role was stimulating and satisfying. She never looked back.

Ask yourself the hard questions

If Mariann could change her specialty, so could you. Whatever the discipline, specialty training in healthcare is intensive and expensive for the practitioner and the organization. For example, it can take up to a year to train a new critical care or operating room nurse, and that training costs the hospital about $60,000 per nurse, according to some experts I asked.

And there are many specialties to pick from — Johnson & Johnson’s Discover Nursing site lists more than 100, and subspecialties can augment them even further.

The American Board of Nursing Specialties has 32 regular member organizations, each one representing a distinct nursing specialty. We might experience a periodic nursing shortage but never a shortage of specialties.

Changing nursing specialties is not easy, but it’s sometimes necessary. For instance, you might decide your current practice area is a bad match for you, a dissonance you experienced from the beginning or an everyday reality that grew to be stressful or just boring over time.

Whatever your reason for seeking something new, here’s a step-by-step action plan for moving toward your more utopian practice.

  1. Make sure it’s the specialty – not the job – that’s causing your dissatisfaction. Are aspects like the scheduling or staffing making you unhappy? Are you working in an environment that is unpleasant because of the coworkers, supervisor or the organization, that a simple change in your job location would fix? Is your current situation fine, but you think things could be improved, just by moving to a different shift, for example? Are you looking for better hours, more money and a change? Again, maybe a change in your job would suffice without a drastic change in nursing specialty.
  1. If changing your nursing specialty seems inevitable, look for a good match and motivator. Although no firm evidence supports matching personality types and specialties, your gut can at least guide you away from choosing a specialty that just wouldn’t suit you and toward one that does. For example, if you don’t like kids, stay away from pediatrics. If you crave excitement, a busy urban emergency practice might keep you happy. If you don’t have a particular specialty in mind, be sure to look outside of the hospital setting (according to Becker’s Hospital Review, only 61% of American nurses work in hospital settings) for a new work environment. Specialties are exploding out there that offer Monday-to-Friday day jobs with decent salaries.
  2. Decide if wanting a better salary is your motivator for changing nursing specialties. It’s not politically correct for nurses to say they entered the profession for the money, but all things being equal, cash is a strong motivator for some colleagues. If you are looking for the best-paying jobs in nursing, do your homework, because this information is readily available. For example, Nurse.com’s 2017 Salary Survey has a wealth of information about 40 specialties, including their associated salaries. Just a quick note, informatics and ambulatory care are paying well right now, and those jobs can be found within and beyond the hospital environment.
  3. Once you settle on a specialty, start your due diligence and find out as much as possible about this new line of work. Search the web and start networking. Meet with veteran practitioners to find out what their daily work life is like. Ask them about qualifications you might need to satisfy to begin and what credentialing you eventually need to advance. If your new specialty is available within your current organization and you like where you work, find out how you can transfer into that department. Retaining you as a known positive entity, even in another department, should be a great motivator for your hospital. Why? Because your proven track record and the fact that it can cost tens of thousands of dollars to replace a specialty nurse like you.
  4. If you have to go to another organization, look for one that not only agrees to retrain you but also has a good tuition reimbursement program. You might want to use this time of change to go back or schedule your return to school. Remember, until you obtain a terminal degree, you should always continue your formal education. All of this might come with a time obligation as pay back, but you’ll want to stay put while you gain experience in the new specialty anyway.

Don’t forget to negotiate your salary as you move into another organization. Your prospective employer might have to invest in you, but as a professional nurse who is already credentialed in a nursing specialty, you are a proven hot commodity. Be proud of that and use your status for a better deal. Do your homework and make a midlife shift that really counts for something.

Just as you might need to make a change in your career, the healthcare environment in the U.S. is constantly moving, and this might be your time to move with it.


Courses related to ‘changing specialties’

Nursing Informatics Certification Review
(20.5 contact hrs)

The Nursing Informatics Certification Review Focused CE Series is a comprehensive learning experience that provides an extensive review of the Nursing Informatics board certification exam. Learn key concepts of NI including design, maintenance and support. Also, discover how quality improvement is vital to patient and staff satisfaction from experts in the NI field. This six-week self-paced program combines online education and webinars to provide you with a study choice that will fit your schedule and is aligned with the core elements of the exam. Complete the series and earn 20.5 contact hours and a certificate of completion.

Changing Specialties in Three Easy Steps
(1 contact hr)

This module provides an overview on making a transition from one nursing specialty to another. It identifies the steps to manage a specialty change, research the new potential specialty and prepare to make the career change.

What Can I Do with a Nursing Informatics Degree?
(1 contact hr)

Are you a nurse who is comfortable with technology and thinks about ways in which technology and data can be incorporated into care for better outcomes for patients and clinicians? Have you been a super user or nurse trainer for a new software program at your employment? Have you wondered if these kinds of experiences might help you in the field of nursing informatics? Join this webinar to discover what a day in the life of a nursing informaticist may be like and some steps you may need to consider if you are thinking about a career in nursing informatics. What is the career outlook for nursing informatics?

By | 2018-09-05T17:38:37+00:00 September 10th, 2018|Categories: Nursing careers and jobs|2 Comments
Robert G. Hess Jr., PhD, RN, FAAN
Robert G. Hess Jr., PhD, RN, FAAN, is OnCourse Learning's executive vice president and chief clinical executive. He also is founder and CEO of the Forum for Shared Governance (www.SharedGovernance.org). As an editor for Nurse.com, Hess penned editorials on career topics. As a presenter at professional conferences, Hess often addresses participants on how to find the right job and steps for building a successful career.

2 Comments

  1. Ethel September 13, 2018 at 5:58 pm - Reply

    Why am I hearing there are no jobs for people with
    This degree? Heard from several people.

  2. Susan M. Lyrla September 14, 2018 at 8:04 pm - Reply

    I have a degree in Psychology, as well as a AA degree in Nursing. In 2007, I implemented (5) Mental Health Programs in five community based outpatient clinics (known as CBOC’s) in Southern California for the VA Healthcare system. It was a self-starting position that consisted of one sheet of paper on a desk, informing what my task would be. During the set-up of these Mental Health Clinics in the VA Healthcare system, I was informed that there would be a Mental Health Nurse with each clinic that was implemented. WRONG! From 2007 – 2015, I did everything to take the burden off of me, including renting an 1800.00 apartment within a mile from the VA Hospital. No one knew that. On my application, I informed the VA, that I had a disability of Rheumatoid Arthritis, but when I took the position it was in remission. I knew that I could type 100 wpm. My problem with RA, was that I couldn’t grip, so physical nursing was out of the question. In 2015, there were NO Mental Health nurses available (per Obama) for the five mental health clinics that I solely implemented. The Chief of Psychiatry, who I leaned from quite a bit, died at an early age on his favorite day 10/31. I have now been looking for a position over the past 3years. I would appreciate a position telecomuting from my home. I feel that they could have provided me this position, as all my Initial Assessments and follow-ups were over the phone. Other people were able to work from home, but it was not considered for me. I don’t know why. I fought for several months, as I had put so much effort into this program. I am now out of (3)yrs. of paychecks. My husband’s health insurance is $1200.00, my secondary health insurance is $500.00. My social security disability check is $1900.00,, so you can see, after I pay health insurance, I have approximately $200.00 left. REALLY!!!! During these three years, I had my right foot rebuilt and several injections in my lower back. I truly feel, my RA would have never have fallen out of remission, if they would have only assisted me with additional help. BTW, after >3yrs., they did place in two RN’s to assist me that were from the main hospital. Why did they need these two nurses in the main hospital, when there were plenty of psychiatrists within the hospital, and nothing but telecomunting to our veterans, from one registered nurse in the hospital. Oh, by the way, before the Director of Behavioral Medicine passed away, he informed me that I was a “victim” of my own success. I am a Registered Nurse that had (9) brothers from one family – all serve this country!
    I thought that this would be a most rewarding position, and it was. No help was given to me, in order to keep my position and work from home.

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