There are so many different types of nurses in various specialties that work within the hospital setting. So how do you figure out which one is right for you?
When I was initially toying with the idea of going back to college to become a nurse, I had no idea how many types of nursing specialties there were. I thought there was just a single “type” of nurse who did pretty much everything.
I was so wrong. That just shows how little I knew about the nursing world back then! I think many potential nurses who are contemplating getting a BSN may think the same thing as I once did.
The good news about starting in nursing school is that you don’t have to decide on what type of nursing specialty you want to go into right away. At least not until you get closer to the end of nursing school and start interviewing for jobs. Also, you can even change your nursing specialty during your career if you want (I did it and reignited my passion for nursing). So, if you find you don’t enjoy one specialty after a while, you can look into others that might better suit you.
This particular post explores nursing career specialties within the hospital. If you don’t want to work in the hospital, that’s OK. There are a ton of opportunities to explore as a new grad nurse outside of the hospital setting too! However, if the hospital setting is for you (as it was for me), then this is a quick and dirty explanation of the different types of nurses and nursing specialties that may be available to you!
There are dozens of different nursing specialties and levels of care in the hospital to choose from. When deciding on a specialty, it may help to start with the level of care that works best with your personality and then work from there. While some nursing students think the intensity of working in an emergency room might be exhilarating, others may prefer to start by learning on a medical-surgical unit instead.
The next step may be to consider which patient age groups you would most enjoy working with. For example, a nursing school friend of mine knew from the moment she applied to nursing school that she had to be a pediatric nurse. Yet another student friend was passionate about working in the geriatric community. Some nurses find that they love working with newborn babies or children, while others find that they enjoy the intensity of managing patients at the ICU level of care.
Lastly, as you start studying more about the different body systems and doing clinical hours, you can decide which specialties that you are most interested in. Being a student nurse is a great time to learn all about the different types of nurses in the hospital you might want to work in!
If you are interested in learning more about the types of nurses that in the higest demand, check out this video:
Types of nurses, based on credentials:
Licensed Practical Nurse (LPN)
LPNs perform a number of duties under the supervision of an RN. They have a more limited scope of practice than an RN, however, they can check vital signs, give oral medication and give injections. LPNs are trained through a state-approved educational program, which takes 12 to 24 months to achieve.
Registered Nurse (RN)
Registered nurses (RNs) are nurses with an associate’s or bachelor’s degree. It takes two years to complete an associate’s degree in nursing and at least 4 years to complete a BSN.
Clinical Nurse Specialist (CNS)
A clinical nurse specialist (CNS) is an experienced nurse who has also completed a master’s degree in nursing. CNS’s are trained in diagnosing and treating illnesses within a specific realm of expertise.
Nurse Practitioner (NP)
NPs work under the supervision of a medical doctor, however, they have the autonomy to diagnose diseases, prescribe medications, and initiate patient treatment plans. Educational requirements include a master’s or doctoral degree.
Levels of care in the hospital setting
Medical/Surgical Care
Medical-Surgical Care, otherwise known as Med/Surg, is the largest nursing specialty in the United States. Med/Surg nurses care for adult patients who are acutely ill with a wide variety of medical issues or are recovering from surgery. Nurses on these units often care for 4-5 patients (or more) depending on acuity.
Telemetry Care
Telemetry Unit patients are often more acutely ill and need constant monitoring. Patients here are monitored with telemetry monitors that allow nurses to review a patient’s vital signs constantly so they can give more detailed care. Often, Med/Surg and Telemetry patients are referred to interchangeably as many Telemetry Units have both types of patients.
Intensive Care Units
An Intensive Care Unit, otherwise known as an ICU or Critical Care Unit is a unit that provides a higher level of intensive patient care. Patients in the ICU often have severe and life-threatening injuries that require constant, close monitoring. Nurses in the ICU usually only care for 1 or 2 patients at a time due to the high acuity of patient care.
Emergency Room
ER nurses treat patients in emergent situations who are involved in a trauma or other life-threatening injuries. These nurses deal with patients from all age groups involving many different levels of patient care. You may have patients with illnesses and wounds, ranging from dog bites or minor burns to more serious conditions such as strokes or other trauma victims.
Patient age groups
Hospital units are also broken into different age groups to offer more specialized care. This is also something to consider when deciding on a specialty you want to work in. Some of the age groups include:
Newborns
Pediatrics
Adult
Geriatric
Hospital specialties
Here is a general list of hospital specialty units that many nurses work in:
Cardiovascular
Thoracic
Neuro/Trauma
Medical
Orthopedic
Radiology
Hematology/Oncology
Liver Transplant
PACU
Emergency Room
Neonatal
Urology
Surgical
Gynecology
Operating Room
What nursing jobs are you most interested in?
As you can see from the above information, there are so many different types of nurses and nursing specialties. You may want to pick a few that are most interesting to you and narrow your search in from there. Once you get your legs wet in the profession for a few years, you may even want to look into other alternative and unique careers in nursing.
Now that you have a better understanding of the different career options out there for nurses, you may want to brush up on your interviewing skills. Let us help you achieve that with this article “How To Land Your First Nursing Job In Six Steps.”
Are you thinking about becoming a nurse and wondering what nursing specialties might be best for you? Or do you have any other questions about the different types of nurses in the hospital setting? Please leave a comment or question below!
Do you currently work as a nurse and have been thinking of a career change? Or perhaps you’re an aspiring nurse looking for an unusual avenue? Here are a few unique careers to consider within in the field of nursing.
Work on a cruise ship
Many modern cruise ships are able to accommodate thousands of passengers. When out at sea, access to a hospital is limited, which is why it’s essential to have nursing staff on these ships. Getting into this role can be challenging as positions can be very competitive – while cruise ship nursing can be tough due to the variety of patient problems and limited facilities, you get the benefit of being able to spend your days off seeing the world, as well as taking advantage of the cruise ship facilities. It’s the ideal job for people that want to travel and are young with no commitments. Sites such as this one can help you to find cruise ship vacancies.
Work for an air ambulance
Air evac teams are pretty much paramedics of the skies – it’s their job to rescue people from remote locations who are injured and bring them to a nearby hospital or clinic. A medical background can be great when trying to get into this niche career. There are various air evac companies and it’s worth doing your research to find the best ones by reading air evac testimonials and reviews. An accident and emergency background can sometimes be better suited for this role.
Work in the military
Nurses are also needed in the military to look after soldiers suffering injuries, sickness or mental health problems. This is an expectedly high-pressure job, but it can allow you to see the world and feel as if you’re serving your country. You’ll often need to do some military training on top of being trained as a nurse. There are military nursing courses that you can take if you’ve not yet got a nursing qualification.
Become a home nurse
If the above jobs are all a bit too wild for your tastes, you could always consider becoming a home nurse. Many patients that choose to stay at home need 24 hour care and this requires qualified medical nurses to take shifts monitoring them at home. Many people that want a break from the fast paced environment of a hospital pursue this avenue, although if you’re working for a company you may find that you’re having to attend to multiple patients every day, every week.
Become a legal nurse
Legal nurses are required to help with legal cases where the opinion of a medical expert may be needed. This could include helping to interpret data to be used for injury claims or helping to defend against claims of medical malpractice. On top of having a nursing qualification, you may also need to take certain legal training to pursue this role.
Have you considered any of these exciting and unique careers within nursing? Please leave a comment below!
If you have taken a peek over at my About Me page you may have read that nursing was NOT my first career. If fact, I did’t even discover that I had a calling for nursing until after I had been working in the medical sales field for about 9 years.
Ill press rewind for just a minute… Once upon a time, I worked in the competitive field of surgical equipment sales for a fortune 100 company and a few medical device startups.
I knew I didn’t love the career, but I made a pretty good living. It also allowed me to travel for work and I was able to afford to take a lot of incredible overseas trips. After a few years in the sales grind, I knew I wanted to do other things. The problem was that my resume said I was a medical device salesperson. So what was I supposed to do?
That voice in the back of my head continued gnawing at me, little by little. Every day a small piece of my soul was being eaten up by working in a career that I had no real passion for.
Until finally one day, after a near mental break down I made the difficult decision to leave the field. I went on a quest in pursuit of greater clinical medical knowledge and a desire to help humankind. After years of scratching my head I had finally discovered my new path.
It has been 9 years since my near mental breakdown that forced me to make an incredible life change. Nursing school was one of the hardest thing I have ever done in my life. But I am so thankful everyday that I did it. Ultimately, it was the best decision for myself and and for my family.
My whole point in writing this post was to talk about a really cool experience that I had recently…
A journalist at the Huntington Post recently contacted me through my blog. She asked if my husband and I would be interested in being interviewed for a piece that she was doing about what it was like being married to an ER nurse. Of course I said yes!
(I was a journalism major in college and still have an itch to write, which is one of the reasons I blog).
Nursing is challenging.
I want to be an advocate for nurses because I think we tolerate things that would never be tolerated in any other field (but we do it anyway because we’re awesome). I also really, really want to find a way to help nurses take better care of themselves. Plus, I am extremely passionate about being a nurse and have a passion for helping others. So, I was excited to share some of my thoughts (and I was also intrigued to see what my husband had to say about being married to an ER nurse).
Have I mentioned how much more I love my job now since I started working as an emergency room nurse?
A year ago, I was a per diem resource nurse who worked on multiple different med/surg and telemetry floors all over our hospital. Being a resource nurse works well for me due to the flexibility it gives me as a working Mom.
But unfortunately, I was becoming incredibly burnt out. Bitter even. I was losing my passion, and I started to wonder if I was due for a career change-up.
I even went so far as to interview for a few medical device companies as a Clinical Nurse Specialist (I was a medical device salesperson before my career change into nursing). I am so glad I decided not to accept any of those positions!
Instead, I adopted a new specialty as an RN in the emergency room and reignited my passion for nursing and healthcare. When the opportunity came up for me to interview for cross-training into my own hospital’s level 1 trauma center, I jumped on it. I started my ER journey on Easter Sunday, 2017.
I have always thought of the ER as a scary portal into the hospital. We are often overbooked with patients, and the load can be relentless. There are sometimes grim patient situations, and sometimes patients die, despite every life-saving effort.
You will be hard-pressed to find medical professionals who deal with more stress and pressure then emergency room nurses. But I am grateful to expand on my med/surg and telemetry knowledge base and learn a new specialty.
Here are my top 6 reasons that I love being an emergency room nurse:
My IV start skills are so much better.
Since becoming a nurse in the emergency room, my IV start skills have gotten so much better.
In an emergency, we need to be able to start IV’s fast for testing, various medications, pain and nausea relief, IV hydration, and antibiotic therapy, among other things.
Fortunately, in the ER, I get the opportunity to start anywhere from 5 or more IVs in a single shift. So I have the chance to perfect my skills frequently on many patients who are difficult IV sticks.
Many of the nurses I work with have been in the ER for a decade, or longer and their IV skills are unbelievable. Several nurses are even trained to do ultrasound-guided IV starts on patients with hard-to-stick veins.
There is an enormous variety in our patient population.
Every day is an adventure. Sometimes it can be overwhelming, but never boring. I have had patients ranging in age from 2 days to 108 years. Patients have arrived with complaints from hiccups, to every type of accident you can imagine and everything in between.
As one would expect, many of our patients are really sick or critically injured. Our patient loads include various types of trauma patients, septic patients, elderly patients, organ transplanted patients, patients with cancer or autoimmune diseases, psych patients, and small children and babies, and so much more. There is rarely a dull moment and always something new to learn.
The teamwork in the emergency room is impressive.
The coordination when a trauma patient arrives is impressive. Patients come into the ER in urgent situations where the cause of injury or disease isn’t yet known. Doctors, nurses, techs, pharmacists, and other medical professionals cohesively work together to give fast life-saving medical treatment.
Also, emergency room nurses often have their own sections, but there are also many “resource” nurses on the floor to assist with additional patient care. When a patient arrives with a more serious condition, there are always nurses who come in to help.
For example, we call a “code” for septic, stroke, and head trauma patients. It is an overhead call to other nurses in the ER that a particular room needs additional help. Within seconds there are a handful or more nurses in the room helping with triage, initial assessments, IV sticks, blood draws, and many other nurse protocols and procedures.
The emergency room moves fast.
Many call it “organized chaos.” The emergency room is a fine-tuned machine with each nurse component working semi-gracefully around one another. From the outside, it might look like craziness, but the madness always has a method.
I am constantly learning.
I am a closet science geek. And I love the cerebral stimulation that I get as an emergency room nurse. I have had the opportunity to see more disease states, complex injuries, and unusual diagnoses then I ever could have imagined even existed.
It would not be an exaggeration to say I learn ten new things every day at work. To top it off, I am surrounded by some of the most intelligent people I have ever met. Many of my co-workers have the same drive for helping people I do. They motivate me to keep learning.
I just have to laugh at some of the stuff I see.
Nursing is a work of heart.
Please forgive me for saying this. This may seem inappropriate, but it is how I maintain my resiliency.
The emergency room is a very emotional place. Patients never want to be there and usually don’t understand, for example, why they have to wait in the hallway an hour or even much longer until their test results are completed, or the medical team decides on a plan for them. They get upset and tired of waiting.
Sadly, sometimes they take out there frustrations on the people working the hardest to get them the medical treatment they need: the nurses.
Sometimes things just get so odd that I can’t help but laugh. There are days when I see people come into the ER saying that they feel like dying, but end up having a diagnosis of constipation. Once I had a college student come in for a temperature of 99 degrees. I’m like, seriously? How do you even get through the day?
I have had so many “I couldn’t make this stuff up if I tried” experiences in the emergency room to last me a long time. But that’s one of the reasons I like being in the ER versus other parts of the hospital. It can get weird, but I’m always learning. And I’m so grateful for the opportunity to keep learning.
While most people were with their families this Easter Sunday, I was working day one of Emergency Room RN training.
In light this, my family had our Easter celebration and egg hunt with our daughter the day prior. Celebrating holidays the day before or the day after has been one thing I have had to get accustomed to as an RN.
It was surprisingly not as busy as most days in the emergency room, or so I’m told. My preceptor, who has 10 years working in the ER, mentioned that fewer ER admissions occur on holidays then on other days of the year. Apparently, many people like to wait until the day after a major holiday to have a medical emergency and show up in the ER.
There are a wide variety of patients in the emergency room.
The day started off with a bang. I had my very first trauma patient. The unfortunate victim of a car crash that occurred somewhere along the 405. I was hoping the ER would get me out of my comfort zone, and my first experience absolutely did not disappoint.
I also got my first pediatric patient: a baby who luckily didn’t have anything seriously wrong. Having my own 20 month old daughter, I seriously don’t know how well I’m going to handle pediatric patients that are not so lucky.
My patients ranged in age from 8 weeks to 96 years old. Talk about a diverse patient population!
My IV start skills are constantly being challenged.
I started 3 IV’s during the shift, including a few elderly patients, which I often have a difficult time with. Not too shabby, if I don’t say so myself. I have always been pretty good at IV starts, but I hope to really fine tune my skills within the next few months.
One thing I was super impressed with was that my preceptor does ultra sound guided IV’s on a daily basis. So cool. I didn’t even know that nurses were allowed to do that. There are apparently several nurses who do it in our emergency room and it requires additional classes and a special certification. I don’t know of any other floors in the hospital where that happens.
HIPPA and patient privacy
I have been having an issue with how much I ethically can and should disclose on this blog. As much as I want to break down every little detail of what I see, we have this super important legal policy called the Healthcare Insurance Portability and Accountability Act. Otherwise known as HIPAA, it is basically a fancy way of saying that any healthcare professional will get fired if they disclose anything about a patient’s identity or medical information. Essentially it legally protects patient confidentially, which is a good thing.
On the off chance that anyone actually does read what I am writing I want to be very careful of this. Therefore, I am going to focus my writing on the skills and tasks that I perform and not on any patient information. It seriously limits what I can talk about, so I am mentioning that upfront.
Also, my husband is also a legal investigator at the hospital and he frequently reminds me about HIPAA. He even teaches courses about it to staff. It is a complete coincidence that we happen to both work for the same medical center (for the record though, I was there first).
Tomorrow I will get up at 5:15am and head out for day 2 of ER training and a whole new round of learning experiences. At some point I need to get a start on the 50 hours on online ER training courses I need to complete. My brain is tired just thinking about it.
Two weeks ago I was writing about how I wanted focus on trying to relax a little more and work a little less.
But life is so unpredictable. Just when you think things are going to be a certain way, a new opportunity spontaneously presents itself.
For the past year my RN title has been Resource Nurse, Float Pool. Essentially this means that I am a resource nurse for short-staffed units and I can float to any Med/Surg or Telemetry unit in the hospital. Soon my skill set is going to get an upgrade.
Soon I will be training to be an Emergency Room Nurse.
Emergency Room nursing is a whole new challenge for me.
I was recently selected to be in a new cross training program in our Emergency Department. Apparently they have some staffing issues and want to make sure they have trained Resource Nurses to help fill in the gaps.
In a few months I will be an Emergency Room Nurse at a Level 1 Trauma Hospital! Yay! Wait, wasn’t I just talking about not working so hard? Yup. Isn’t this program going to be stressful, exhausting and require a lot more work? Yeah, pretty much.
But opportunity is knocking and I’m going to go ahead and open the door. This is the first time this kind of cross training opportunity has ever been available at my hospital and I would be remiss to pass it up. In return, I get to expand my nursing prowess and make myself more marketable in my field.
I’m a nerd. I admit it.
If I’m not constantly learning or doing something new I get board pretty easily.
That partially explains why I left a lucrative career to go back to college for a second bachelors degree in nursing at the age of 32. I talk a little more about that here.
Back in my nursing school days I wanted to go directly to working in the ER or ICU after graduation. I had the desire to challenge myself right off the bat by caring for the most critical and vulnerable patient populations. But first I needed a job.
Nurse Residency programs are the place to be for a new grad.
As graduation approached I was frequently reminded that most new grad RN’s had a slim chance of getting excepted into a nurse graduate residency program. In fact, I knew of many RN grads who had been out of school for over a year and were still waiting to get their first job. This was due to the fact that there was a large surplus of graduate BSN’s coupled with a very limited number of nurse graduate residency programs available. From what I hear from new grads today, the problem still exists.
Patients never forget how their nurses made them feel.
To not have employment after 3 years in nursing school was definitely not OK for a gal graduating with 35k in student loan debt!
Since there are more Telemetry and Med/Surg Floors in most hospitals I thought I would have a better chance of just getting my foot in the door if I started there. So to maximize my chances for employment I asked to interview for ANY Telemetry unit position that was available in the entire hospital.
Fortunately my gamble paid off. Shortly after I applied to the nurse residency program at UCLA I started my nursing career on a Neuroscience and Stroke Telemetry Unit. I stayed on this unit for about 4 years and became certified in the specialty.
I still love Neuroscience and I’m so glad I started my nursing career there. Even though I have moved on to other things, I still feel like it is my home.
I’m back in school again. Sort of.
I’m back in student mode. I’m quickly finding out that becoming an Emergency Room Nurse requires an extraordinary amount of study and training. Just this week I completed Pediatric Advanced Life Support Certification (PALS) and Adult Certified Life Support Certification (ACLS).
Last week I shadowed two RN’s in the Liver Transplant ICU and Pediatric Unit to briefly introduce me to the specialties. This is because in the ER I will be working with Pediatrics as well as doing Trauma and Critical Care. Both are new specialties for me.
Next week I start orientation and will meet the preceptors who will help train me for the next 3 months. Then I start the 50+ hours of additional classroom training. I guess I will be doing a lot of studying after I put my daughter down to bed in the evenings.
Training to be an Emergency Room Nurse in a Level 1 Trauma Center will be very challenging to say the least. But I’m ready for it. It is amazing what opportunities arrive when you are least expecting them.
I’m sure I will have many tales to tell about the madness as an Emergency Room Nurse. Stay tuned!
