After you celebrate, the reality sets in. It’s time to venture out and look for a job.
For nurses, the first few years after graduation are a good time to try several different specialties, until they find the area of nursing they love. With such a mind-boggling array of specialties available, it can be difficult to make a decision. You already have some experience from your clinicals during school but, now, you will be assigned more patients and ultimately have autonomy. Most new nurses will be assigned to a mentor to learn the ropes of the job. We have created a list of the most popular nursing specialties, including the type of work each entails, granting new nursing students and graduates a closer look into the diverse field of nursing care.
Stress Level: High. In today’s world, many hospitals give Medical/Surgical nurses a heavy patient load. New grads are learning a lot and beginning to use their skills and knowledge in the field, which can be nerve-wracking when you are just starting out. In this specialty, things can turn on a dime, and in a split second, your patient’s status can change. Patients and family can be worried and stressed, and may blow up at you out of frustration and fear.
Multitasking Required: High. A Medsurg nurse has morning, noon, and evening medications to pass, and performs regular blood glucose checks. Patients will constantly turn on their call lights at all hours. A lot of time is spent paging physicians and waiting for them to call back. Surgeries will be scheduled each day for which you will prepare your patients. Some patients will call you many times, and the list of patients you need to go see will get longer and longer as you attempt to fulfill all of your obligations. You will also constantly be triaging, and of course, charting.
Patient Interaction: High. Frequent contact is maintained with patients and their families. They will see you during their daily assessments, medication passes, and treatments. You may find that patients typically don’t feel very well and will require you to help them, or call with questions or requests.
Stress Level: High. In the operating room, emergencies can pop up without a moment’s notice. O.R. nurses must be able to keep their composure and continue to think critically, as every second counts. These nurses spend significant time on their feet when assisting with surgical procedures, which can be taxing.
Multitasking Required: Moderate. Since O.R. nurses are working with one patient at a time in surgery, there is less demand to be in three different places at once. However, within the surgical suite there may be multiple tasks for which the nurse is responsible, such as continuously monitoring vital signs, maintaining IVs, and ensuring that the sterile field is not compromised.
Patient Interaction: None - moderate. If your job description has you following the patient from the preoperative all the way through to the post-operative stages, you will be communicating with and supporting the patient and possibly their family. If you are working in the surgical suite exclusively, there will be no nurse to patient interaction.
Be sure to familiarize yourself with the crash cart, as a child’s status can change much more quickly than an adult’s. Some children will thrash around and kick to avoid getting shots. Others have behavioral problems that can make the visit a challenge for both themselves and the nurse. A hefty dose of patience, compassion, and a good sense of humor are vital for a pediatric nurse.
Stress Level: Moderate to high. The number of patients to care for can vary. Some days can flow without a hitch and some may be very chaotic. Children are often afraid to go to the doctor, and can become uncooperative. This can make time management a challenge. Also, families may be stressed about their sick child and will need the nurse to offer them support.
Multitasking Required: Moderate. As a pediatric nurse, you will have to make sure your young patients are well at ease, as well as assuaging the worries of protective parents. Your day will consist of seeing many patients, and it is important to be able to keep track of your schedule.
Patient Interaction: High. A pediatric nurse sees her patients from the moment they are checked in to the education at the end of each visit. Family interaction is also an essential component of pediatric nursing.
Stress Level: Clinic setting - Moderate. Hospital setting - High. During labor and delivery, you will be on your toes, assisting and monitoring the mother, then caring for both the newborn and the mother postpartum. Complications of labor can and do occur, and the condition of the newborn can change rapidly, leading to some very tense and stressful moments.
Multitasking Required: High. The Obstetrical Nurse continuously monitors both mother and baby. He or she communicates with and assists physicians, maintains IVs and administers medications, maintains communication with families, supports and coaches the mother, and provides care postpartum for Mom and baby. Assessments must be done frequently until patients are stable.
Patient Interaction: High. The majority of time is spent at the bedside with your patients. Obstetrical Nurses must be calm, patient, and able to establish an excellent rapport.
Stress Level: High. Don’t let the lower patient load fool you - a nurse will be on her toes constantly caring for these high-acuity patients and the status of a patient can deteriorate rapidly. A CCU nurse has an individual responsibility to keep her patients carefully monitored, and things can get dicey when more than one patient needs assistance at the same time.
Multitasking Required: High. Critical care patients will need very frequent assessments and complex treatments, and their medications can change often based on their fluctuating status. You will often interact with physicians and members of Respiratory Therapy.
Patient Interaction: High. The CCU nurse spends a lot of time with each patient, depending on the extent of their illness. CCU nurses also tend to do more primary care for their patients, such as bathing and linen changes.
Stress Level: Low. Nurses on the IV team usually have no set schedule, but cover the needs of multiple areas as they arise. There may be some downtime, or you may be called to several places at once.
Multitasking Involved: Low. The IV nurse is responsible for a more focused range of tasks, allowing for less multitasking.
Patient Interaction: Moderate. While you may return to your patient’s room from time to time for maintenance, you will spend only brief periods of time with each patient.
Stress Level: Moderate to High. Patients may turn up with multiple complaints, some in distress. The patient-to-nurse ratio can be high, with multiple patients needing care at the same time.
Multitasking Involved: High. Nurses in an Ambulatory Care will be called upon to use a diverse skill set. Injections, medication administration, X-RAY, wound care and assessments from head-to-toe physicals to depression screens can all be part of the average workday. This is an excellent setting to become very skilled at a broad range of procedures because the nurse will be responsible for administering them frequently.
Patient Interaction: Moderate. While you may see each patient briefly, usually you will see many patients in one day. Many patients return for ongoing care and form a relationship with their nurse.
Stress Level: Moderate to High. Public Health Nurses are behind the scenes, involving much more planning and researching than direct care. They have relatively infrequent patient interaction, and usually with patients stable enough to be out in the community. However, these nurses work very hard at improving the health of the entire community through an advocacy role and the stress of pushing for change and keeping abreast of current events can be difficult.
Multitasking Required: Moderate. Duties can include working with the community, developing a budget, research, and planning programs such as educational sessions at schools, community groups, senior centers, and other local groups.
Patient Interaction: Low. The Public Health Nurse does see some patients but spends much more time designing programs for the community and advocating on behalf of the community to authorities.
Stress Level: High. Highly stressful situations can arise when staffing and dealing with a potential conflict.
Multitasking Required: High. The Director of Nursing must be aware of what is going on at their facility, with both patients and nurses. Hiring, communicating with every person in the facility, and ensuring that policies are being adhered to are just a few of the duties this nurse will be responsible for.
Patient Interaction: Low. The Director of Nursing will establish a relationship with patients but will not provide much in the way of routine care.
Stress Level: High. The emergency room staff are on the front lines, receiving patients who are severely ill or critically injured. The ER can be quiet one moment, and then chaotic the next. Clear thinking can be a challenge in some of the situations an ER nurse faces.
Multitasking Required: High. An ER nurse has many duties that can change quickly and frequently. The ability to triage is essential.
Patient Interaction: High. The ER nurse will see a high volume of patients, though most patients will stay in the ER relatively briefly.
Stress Level: Moderate. Patients and their families can have many demands or may express anger as a side effect of fear and grief. As a result, this specialty can be emotionally stressful for the nurse.
Multitasking Required: Low, with the exception of lots of charting and documentation.
Patient Interaction: High. You will have to build a relationship with your patients and have to be prepared to give people the best, or possibly worst, news of their lives. It is very important that oncology nurses have a good bedside manner.
Some nurses are born knowing what they want to do, but most of us need a little time to explore. All nursing jobs can feel awkward and unpleasant at first: not knowing your way around, practicing new skills, or not knowing where things are kept, can be tough, but a good rule of thumb is that you won’t feel entirely at ease in your new environment until about six months at the job. If, after that, you find the specialty is not at all what you want to work in, consider heading in a different direction and trying another field. You will find your comfort zone with some time and experimentation, ultimately leading you to a rich, challenging, and rewarding career in nursing.