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The secret to choosing a specialty (yes, there is one)

puzzle-piecesIt’s not a choice of moving, but more a choice of direction.

Everyone’s choice to be a nurse is different. We all have our reasons for entering into this wonderful profession, but you can usually sit them under the umbrella of ‘helping others’.

At the risk of over-generalizing, we all follow the same path initially. We stress over getting accepted into a nursing school. We stress over surviving nursing school. Stress over graduating nursing school. And of course, stress over passing our state board exam the NCLEX.

Yes we all have unique journeys along that path. We can choose, LPN, BSN, diploma RN, or Associate Degree RN. I won’t go into the specifics of each. I just want to mention the doors of unlimited opportunities start early in our nursing careers.

So now that you’ve graduated, hopefully passed your state boards, and now hold the title. What now?

Where are you going to work?

What area of nursing do you choose?

What nursing specialty fits you? What nursing specialty does not fit you?

The irony is you already know where you want to work. You already know what ‘fits’. You already know what doesn’t ‘fit’.

Yes. Yes you do.

I’ll tell you the secret.

But first, here are some things to keep in mind when choosing a path:

  • Being a student in no way reflects how your life will be like as an nurse in the workforce
  • Some of the worst students make the very best nurses.
  • Some of the best students make the very worst nurses
  • Grades are only a number. Passing is passing. What matters most is what your patients think and feel about your care.
  • Just because you could care for one, or two, maybe even 5 patients as a student, doesn’t mean you will be great at it as a nurse
  • Just because you couldn’t handle more than two patients as a student, doesn’t mean you won’t excel as a nurse.
  • Delegation is the bond that strengthens and saves your day, and your team’s day.
  • You will ALWAYS be behind, get used to it.
  • You will ALWAYS have charting to do, get used to it.
  • The doctors are only scary, if you let them be.
  • Respect is not given, but earned.
  • You will never know everything, get used to it.
  • When choosing between arrogance and fear- fear will save your life, and your patient’s life EVERY TIME.
  • You haven’t begun to understand what tired really is.

With those pearls in mind let’s also be honest here:

  • I don’t care what your fellow student or classmate tells you. (Following in their footsteps due to a lack of courage and fear of losing your security blanket is an excuse, not a decision)
  • I don’t care what your former nursing instructors recommend.
  • I don’t care what other nurses tell you is better.
  • Oh, and I don’t care what your family or friends tell you.

The bottom line is, you already know where you belong. You already know where you don’t belong, and where you don’t want to be. You only have to remember the ‘feeling’.

As a student you were exposed to pieces of nursing. You got ‘snapshots’ of the main categories of nursing. You’ve ‘experienced everything from basic Medical-Surgical nursing, scared your way through Pediatrics, held your breath passing Obstetrics, and fumbling your way around Critical Care. These snap shots were just that. A brief ‘view’ of what you could do. A brief glimpse of what it’s like in that world of nursing.

I think it’s safe to say, and we all can agree that each one of those snapshots was NOT like the other. You may need the same type of basic nursing skills and education, but one cannot float in and out of these worlds freely. It takes a special person, ergo, a very particular person with a specific type of ‘make-up’ to function and thrive in each of those worlds.

So here’s that secret I was hinting at earlier.

Do you remember that moment as a student nurse where you just ‘got it’. You found a level of comfort that just ‘clicked’ for you. Everything else around you kind of fell into place. Even if it was only a brief moment, we have all had that “AH-HA” moment as a student. When the books, the skills, the practice, and the fear all meshed together and just ‘worked’. No matter how brief that moment was for you, it mattered.

Do you remember that same moment where everything just did not go well. You felt uncomfortable. You felt uneasy. You were ‘all-thumbs’ that day. You forgot your basic skills. You sat back during that moment, and after that moment and said to yourself, “What the heck?”. More importantly you had to ‘force-feed’ this moment to yourself because you knew you needed it to graduate, you knew you needed it to pass and become a nurse, but other than that, it was like eating nails.

What area of nursing should you pursue? – That area of nursing where you experienced the ‘AH-HA’.

Do you know what area of nursing is not made for you? – The area of nursing that was ‘force-fed’.

My AH-HA moment was being in the ICU as a student. I force-fed Medical-Surgical nursing. I’ve been in critical care nursing for my entire career as a nurse, and I still love every moment.

No. This is not an easy decision. Everyone has some great opinion’s on why you should or shouldn’t do this or that. This is not a popularity contest, nor is it a chance to ‘hang-out’ with your friends.

It’s not a decision to take lightly. You will get out of it, what you put into it.

But, it’s also not a decision that can be made for you.

Best of luck to you.

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9 Responses to The secret to choosing a specialty (yes, there is one)

  1. Prisca

    I so agree w/ your list of things to keep in mind–brilliantly put, Sean. As usual your blog is right on!

  2. Sean Dent Scrubs Blogger

    @ Prisca Thank you.

  3. Megan Gilbert RN

    Really Great article!! You are so right! As a student it is great advice for picking an area of nursing! I haven’t found my ah-ha moment yet…but can’t wait until I do!!

  4. Sean Dent Scrubs Blogger

    @ Megan You’ll know it when it happens!

  5. Jeriane

    Sean, I enjoyed your article! I graduated in May, and passed boards June 8th. I started working on a busy Med-Surg floor shortly after I passed boards. I know Med-Surg is not my “AH-HA” moment but I am working it to get the experience. I honestly am not sure what that moment was to be honest…maybe psych or nursery….?

  6. Wendy Grable RN

    Awesome article. My AH-HA moment was definitely ED but haven’t found a place around here that wants to hire a nurse right out of school. Until then, I’m taking what’s available but I will eventually be in ED and stay there the rest of my career. It was the only place I felt like I belonged the moment I went in. I have the need for the fast-paced craziness they call Emergency! Thanks again for a great article.

  7. boo31

    Thanks Sean!!! I am an LPN and thinking about where I want to be. I want to go back and learn more to do more. As a nursing student, it was just not a single ‘AH-HA’ moments. I have been a nurse for 1.5 years. I still have ‘AH-HA’ moments. I have learned to “listen to the patient” and to trust my “gut instinct” I have saved lives because of this. Sometimes we just have to trust and listen to our own hearts. I work in a SNF on Rehab and LTC–I never know where I am going to be. I would not trade my job for any other. I have learned much about myself and “Nursing”. I can not wait to continue my education and career as a nurse. I always say I want to make a difference–every day I DO!!!!!

  8. Ndy

    wow! very inspirational. it’s not all about what people say but we have to choose our AH-HA moment

  9. Lravid

    Just read your article and truly enjoyed it. My question to you now is : if we made a mistake to go for security blanket specialty and now want to switch specialty to that of the “ah ha” moment specialty … How hard is it to switch ? I did pediatrics and was not for me, now I’m voluntarily unemployed to care for my children but when I return to nursing I would love to do OR / perioperative ( that was my “ah-ha” moment in nursing school) ..

    Both are extremes in skills, pace, type of patients ..

    How difficult is it for nursing to get a chance at switching ?

    Thanks :)

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