Even if you look only at “traditional” hospital nursing, you will find different units prioritize specific skills or give a chance for certain personalities to thrive.
But what was that saying about too many choices being harder than too few? Nowadays, most nursing schools strive to offer a wide “tasting menu” of clinical experiences. For some of us, this helped us find the environment where we performed best or where we could see ourselves in the long term. In other cases, these early exposures get muddled by the occasionally unfriendly preceptor, the promised pay, or just general indecisiveness.
In this article, I’d like to explore the values, traits, and perks that should influence your decision.
Nursing Specialties: An Overview of the Top Runners
There are too many choices to explore all options in-depth – and it would be impossible to describe the “best nursing specialty” in one article. This will depend on what means best for you. And yet, there are a handful of questions that are usually good to ask.
What’s the easiest nursing specialty to get into? 🏃
If your priority is to get hired as quickly as possible after graduating, then your best bet is either standard medical-surgical nursing or long-term care. Technically speaking, neither constitutes a “specialty”: medical-surgical nurses are the “generalists” that make up the bulk of hospital staff, and long-term care facilities deal with people with chronic but non-life-threatening issues.
What makes them the easiest? Simply put, they offer the highest number of open job positions across the country. Even without experience, you’ll likely find an employer quickly.
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What’s the hardest nursing specialty? 💪
In short, anything that requires advanced certifications will be harder to get into as a new graduate. Leaving aside midwifery and Nurse Practitioner jobs, which often require an entire additional degree, some of the most competitive specialties include:
- Pediatric ICU and Neonatal ICU
- Cardiac units
- Flight nursing
- Nurse Anesthetists
What do all of these specialties have in common? The same feature that makes them highly competitive: they are all subspecialties. You will need a few years of experience in a special unit plus an extra certificate or internship.
For example, flight nurses – who help transfer patients via plane or helicopter between hospitals or evacuate them from very remote areas – often work in an emergency setting or as ground transport nurses and then follow it up with extra training to tackle air safety. To work in a NICU, you’ll follow a similar path.
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What is the highest paid nursing specialty? 💰
Unsurprisingly, the top-paid nursing specialties overlap much with those in the above section. But if one has to take the cake, it would be Certified Registered Nurse Anesthetists (CRNAs). Most of the time, this will require a Master’s degree. Just gaining a spot in a CRNA program is competitive and will require you to spend a few years as an OR (theatre) nurse.
On average, a CRNA working at a mid-sized facility can earn nearly US$ 180,000 per year – although, at magnet hospitals, the mean annual salary surpasses US$200,000.
Which nursing specialty is the least stressful one? 🧘
Many specialties cater to patients who are not acutely ill and instead focus on building long-term relationships. Away from the rat race of life-and-death situations, the least stressful nursing specialties offer more predictable hours and results. And in many cases, they even leave the hospital behind!
Top runners in this category include:
- Occupational health nurses work at large companies, treating and preventing work-related accidents.
- Home health nurses deal with patients well enough to be at home but who still need IV medication, specialized education, or long-term wound care.
- Case managers work at specialist hospitals or concierge medical facilities, where they need to coordinate an entire team of allied professionals around a single patient. Where does the magic happen? Often, from a home office.
Which environment is ideal for work-life balance? 💆♂️
Even if you are a natural night owl, rotating shifts and working on the holidays can quickly take a toll on your family life. For some people, being able to devote their evenings to their kids or to disconnect from work completely regularly can be more important than a paycheck.
If this sounds like you, some of the most suitable specialties include:
- School nursing: The nurse who saw your ankle sprains at gym class and ensured any kids with diabetes received their insulin on time, worked 9 to 5, and summers off.
- Public health nursing: Often attached to government agencies, public health nurses mostly focus on implementing preventive programs rather than on direct patient care.
- Insurance claim reviewers: Although often seen as “the enemy” when they deny coverage, insurance claim nurses review a patient’s information and help determine what types of treatment are necessary or whether an injury was directly caused by an accident. Almost all of this is done from 9 to 5.
- Travel nursing: Although it will require you to follow intensive, rotating schedules for up to 13 weeks, you can follow them with a fortnight or a couple of months of… nothing. Travel, visit your relatives, or sleep at home and catch up on your Netflix queue.
5 Aspects to Consider when Choosing a Nursing Specialty
So far, all the job options we’ve explored maximize one aspect of nursing. And with enough money, comfort, or excitement, we can all find a worthwhile career.
But will they make you happy? How do you know if the path you are pursuing is the one that will keep you engaged and compassionate for the next 30 years? What if the benefits that looked exciting on paper lose their luster, leaving you burnt out?
Ultimately, much of your job satisfaction will come down to whether the position fits your personality and priorities. So before you commit to a contract (and spend that signing bonus), consider whether these five aspects match your dream position.
1. Your social battery
Dividing the world between introverts and extroverts often feels simplistic. However, much of the fatigue you will feel at the end of a shift will depend on the social interactions you’ve just dealt with.
In general, nurses skew towards being extroverted. And yet, many of us still prefer to take care of a handful of patients closely and for extended periods rather than dozens of superficial interactions. If that sounds like you, avoid short-stay hospital units, primary care, or large institutions. Instead, look for office-based jobs, case management, or positions that involve a lot of counseling or patient education.
2. Your work style
Patients and clients are only one side of the coin. What about your colleagues and coworkers? Team playing is always a valuable skill, but it can have a lot of nuances:
Do you prefer to do most of your job with a close-knit, small team? ICUs and flight nursing often have you working in sync with people you know very well. Other settings, such as surgical wards or Emergency rooms, will have you communicating “on the fly” with many people. It leaves less room for pleasantries and increases the need for clarity.
Are you the kind of person that always ends up as the team leader somehow? Consider becoming a case manager or a nurse practitioner, running your own practice.
3. Your attitudes towards routine and chaos
Some people get irritated when they see a messy desk. If that sounds like you, steer clear from Emergency, home care, or patient transport positions – you’ll rarely get the chance to control your environment there.
Others see a room that’s a little bit too tidy and immediately feel self-conscious about touching anything. Details and clear procedures can be comforting or confining. If you fall into the latter group, maybe Operating Room nursing or Critical Care will quickly become stifling.
4. Your favorite type of people
We shouldn’t be prejudiced – but let’s admit it, we all have a type of person we love to hang out with or that we’d rather avoid.
Imagine yourself in a large family gathering. Where are you spending most of your time – catching up with the new moms? Distributing snacks among the kids? Checking on the elders and listening to their stories?
5. Your budget for further education
Two practical considerations that can never be overstated are money and time. A Master’s degree, a Ph.D., or even flying classes require you to invest a lot of money on tuition or hundreds of hours in practice and prior experience. Depending on your circumstances, further education may not be in the cards yet – or it can give you a new goal to work towards, keeping you centered and motivated.
A Final Reminder: You Don’t Have to Settle on “Forever” Yet!
Lecturers and recruiters alike often talk about choosing a specialty with a sense of urgency. “Decide now or lose the chance for a rewarding career forever!” But in reality, this is rarely the case. Even a three-year contract ends eventually, and many of the “hottest specialties” are expected to continue growing for the next ten years.
So if you can’t decide what type of nurse you want to be or are afraid of pursuing the wrong dream, that’s okay. One of the beauties of nursing is that it uses many transferable skills, and its core principles – prioritizing, identifying, and addressing needs – remain the same across the board. Today’s unpleasant job could be tomorrow’s eye-opener, so feel free to take a few years to make up your mind.
