How to Choose the Right Nursing Specialty for You

Whether you are a newly graduated nurse beginning your career or an experienced nurse ready to make a career transition, choosing a nursing specialty can be a daunting task. Nursing schools typically train students in the five most common nursing specialties: medical-surgical, pediatrics, labor and delivery, mental health, and critical care.

In reality, there are over 100 nursing specialties, industries, and settings to choose from. These can include common specialty roles, such as nursing instructors and case managers, as well as less common ones, such as cruise ship nurses and camp nurses.

Factors to Consider When Choosing a Nursing Specialty

Nursing specialties are associated with certain populations, medical conditions, work settings, and degree level or license types. For example, a registered nurse who desires to work with adolescents with mental health conditions but prefers to work virtually in an outpatient setting might consider a virtual nursing coach role. This may require the nurse to return to school for a graduate degree, particularly a nurse practitioner degree with specialization in pediatric mental health.

The first step in selecting a new nursing specialty is deciding where, how, and with whom you want to work.

Populations can include:

• Infants and young children
• Adolescents
• Pregnant individuals
• Females
• Males
• Older adults
• Veterans
• Disabled individuals
• Employees
• Migrants

Medical conditions might include:

• Psychiatric illness
• Cardiac disease
• Surgery
• Gynecological conditions
• Urological conditions
• Pregnancy
• Trauma and sexual assault
• Terminal illness

Work settings may include:

• Hospitals and other acute care facilities
• Provider offices
• Radiology and laboratory centers
• Skilled nursing facilities and group homes
• Correctional facilities
• Residential homes
• Academic institutions
• Online, virtual, or remote environments
• Unconventional settings, such as amusement parks, campgrounds, or cruise ships

Other factors include whether you want to fulfil a clinical role (i.e., direct patient care, face-to-face or virtual) or a non-patient-facing role, such as a nurse administrator. You may even prefer to work outside the patient care setting, such as in a nursing school as a professor. Do you want to work full-time, part-time, or on-call? Would you prefer to work days, nights, or weekends?

With these considerations in mind, you can narrow down the route you want to take.

Education and Certifications for Nursing Specialties

Unfortunately, transitioning into a new career may not be as simple as applying for a new position. Additional education or training may be required. An online search can help you determine if a higher degree, additional license, or certification might be required before making the transition.

Degrees, licenses, and certifications may include:

• Bachelors degree in nursing (BSN)
• Masters degree in nursing or a related field (MSN)
• Practice-based doctoral nursing degree (Doctor of Nursing Practice or DNP)
• Theory-based doctoral degree (i.e., PhD)
• Nurse practitioner license (with specialty in family practice, mental health, geriatrics, internal medicine, etc.)
• Nurse anesthetist license
• Nurse midwife license
• Clinical nurse specialist license (with specialty in geriatrics, maternal-child health, etc.)
• Advanced Cardiac Life Support or Pediatric Advanced Life Support certifications
• Specialty training (i.e., trauma or disaster training, arrhythmia recognition courses, etc.)

Inpatient Nursing Specialties

Nurses working directly with patients in hospitals and other inpatient settings primarily perform bedside nursing skills and are often called bedside nurses. They may also provide teaching to patients and families. These nurses frequently collaborate with other professionals, including lab and radiology technicians, physicians or other primary care providers, and dieticians, among others. Inpatient direct care nurses primarily work in hospitals and subacute care facilities.

Inpatient specialty roles include:

• Bariatric nurses
• Burn care nurses
• Clinical nurse specialists
• Critical care nurses
• Dermatology nurses
• Emergency/triage nurses
• Forensic nurses
• Gastroenterology nurses
• Infusion (or vascular access) nurses
• Labor and delivery nurses
• Lactation nurses
• Medical-surgical nurses
• Neonatal intensive care nurses
• Nephrology/renal nurses
• Nurse anesthetists
• Nurse midwives
• Nurse practitioners
• Orthopedic nurses
• Pain management nurses
• Pediatric nurses
• Peri-anesthesia nurses (pre-operative, surgery, and post-anesthesia)
• Postpartum or maternal-child care nurses
• Psychiatric nurses
• Radiology nurses
• Rehabilitation nurses
• Telemetry/cardiac care nurses
• Transplant nurses
• Wound/ostomy nurses

Outpatient Nursing Specialties

Like nurses in the inpatient setting, nurses working directly with patients in outpatient settings also perform patient-facing nursing skills. However, they may find themselves providing a significant amount of education to patients, families, and communities. Other roles include making referrals and following up with patients. These nurses work in outpatient surgery centers, provider offices, rehabilitation centers, schools, nursing homes, residential homes, correctional facilities, shelters, and health departments, among others.

Outpatient specialty roles may include:

• Aesthetic nurses in outpatient surgery centers
• Ambulatory care nurses in clinics and rehabilitation centers
• Bariatric nurses in specialty clinics
• Camp nurses on camping grounds (often caring for children)
• Clinical nurse specialists in specialty clinics
• Correctional nurses in jails, prisons, and detention centers
• Cruise ship nurses
• Disability nurses in specialty schools and clinics
• Faith community (or missionary) nurses
• Forensic nurses in community clinics, shelters, and coroner offices
• Gastroenterology nurses in specialty clinics
• Geriatric nurses in nursing homes and rehabilitation centers
• HIV/AIDS care nurses in clinics, residential homes, and palliative/hospice care centers
• Holistic nurses in clinics, hospice/palliative care centers, and virtual care settings
• Home health nurses
• Hospice/palliative care nurses in nursing homes and residential homes
• Infusion (or vascular access) nurses in clinics and residential care
• Lactation nurses in clinics and provider offices
• Nephrology/renal nurses in dialysis centers
• Nurse anesthetists in outpatient surgery centers
• Nurse midwives in birthing centers
• Nurse practitioners in clinics and provider offices
• Nursing coaches or educators in clinics or virtual care settings
• Occupational health nurses
• Oncology nurses in specialty clinics
• Orthopedic nurses in outpatient surgery centers
• Pain management nurses in pain clinics and palliative/hospice care centers
• Peri-anesthesia nurses in outpatient surgery centers
• Psychiatric nurses in mental health clinics and correctional facilities
• Public health nurses in community clinics and health departments
• Rehabilitation nurses in nursing homes and rehabilitation centers
• Reproductive health nurses in fertility clinics
• Rural nurses (may also work at mining sites)
• School nurses
• Wound/ostomy nurses in clinics, nursing homes, and residential homes

Non-Clinical Specialty Roles

Nurses can choose to work in non-clinical specialty roles. A nurse in this role can work in both inpatient and outpatient settings, but they typically do not perform bedside nursing skills or interact with patients face-to-face. They work behind the scenes, contributing to the nursing profession in other ways, such as through teaching, writing, consulting, or working on projects.

Non-clinical specialty roles include:

• Legal nurse consultants
• Managed care (utilization review) nurses
• Nurse administrators or managers
• Nurse authors/writers
• Nurse case managers (or care managers)
• Nurse informaticists
• Nurse recruiters
• Nurse researchers
• Nursing professors
• Quality improvement nurses

Bottom Line

Although the nursing field is vast and roles can vary, principles of nursing care remain the same across all specialties. Transitioning into a new nursing specialty role starts with paying attention to your desires, preferences, skillset, strengths, and weaknesses. After narrowing down where, how, and with whom you want to work, consider that you may need to return to school for a higher degree or apply for additional licenses or certifications. Choose the specialty that best aligns with your personal and professional goals.

For a full breakdown of different nursing specialties and their typical salaries and settings, visit our article Complete Guide to Nursing Specialties.

About the Author:

Charmaine Robinson, MSN-Ed, BSN, RN, is a nurse writer with a background in medical-surgical nursing and nursing instruction.

Charmaine is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your healthcare provider for any health-related questions or concerns.

If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions