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,’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.

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