NICU nursing specialties
Career Resources

Choosing Nursing Specialties: A Guide for New and Experienced RNs

Career diversity is a significant advantage when you become a registered nurse (RN). There aren’t many professions that allow for such a range of opportunities within the same field. You could be a medical-surgical nurse for several years and then become a labor and delivery nurse with minimal additional education despite the significant change in practice. Nursing specialties allow you to get specific about the kind of care you want to provide and the patient population in which you want to work. 

Whether you’re a new nurse just entering the profession or an experienced nurse looking for a change, this article takes an in-depth look at 15 nursing specialties to help you choose the right one for your career goals. First, let’s take a deep dive into considerations for choosing a nursing specialty.

Factors to Consider when Choosing a Specialty

First and foremost, consider your personality and the culture of the specialty you’re considering. Nursing culture may change slightly from hospital to hospital. However, most specialty units have a very similar culture.

The feel of an ICU in one city is likely similar to an ICU in another city. Maternity wards across the nation generally have the same type of vibe. Keep this in mind when you’re choosing a specialty. Try and do some float shifts in the specialty unit you’re considering to help assess if your personality fits the environment and workflow.

If you’re leaning toward a particular specialty, here are a few key factors to consider:

  • Time to Enter: How much time do you realistically have to put into more schooling, certifications and credentials? Time constraints are equally important for new nurses, who may be eager to pay back their student loans, and more experienced nurses, who may have different commitments outside of work and other financial obligations.
  • Salary Considerations: Financial stability is important to any nurse. For some, it may weigh heavier in the decision-making. You want to ensure your salary expectations align with the specialty you’re considering. View transparent RN salary expectations and gain insights into your career path’s average and maximum earning potential on Vivian Health. 
  • Job Opportunities: It’s a good idea to browse nursing jobs in a specialty you’re considering. You want to ensure that there is a sufficient amount of work available, with minimal competition and opportunities for growth in the field. 
  • Personal Interest: Finding a fulfilling job that aligns with your passions is key. Although some days are still hard, it’s always easier to go to work if you love what you do and the population you work with daily.

For New Nurses: How Do I Choose a Nursing Specialty?

Graduates of Accelerated LPN Programs

Some key questions to consider as a new nurse or nursing student when exploring different types of nursing specialties are:

  • Which patient population would I like to work with?
  • Do I prefer to work in a hospital, clinic or community?
  • What are my long-term career goals?
  • What’s my skill set and what do I like to do?
  • What kind of work-life balance am I looking for?
  • Do I have the time commitment to do more schooling?
  • What’s the average and maximum salary? 
  • Is there potential for career advancement within the specialty?
  • Do I work well under pressure in a high-stress job or would a more casual job be better?
  • Do I have enough experience?

For Experienced Nurses: How Do I Choose a New Nursing Specialty?

Choosing a new specialty as an experienced nurse can feel daunting. Change can be tricky. Some questions to ask yourself if you’re considering a different type of nursing include: 

  • What are my long-term career goals?
  • Does my current specialty help or hinder me to achieve my goals?
  • What’s my current salary and will a new specialty increase my earnings?
  • Do I feel fulfilled going to work or am I bored and looking for something new?
  • Can I put the time and energy into switching specialties, with extra training and certification if necessary?
  • What’s the job demand in my current specialty versus the one I’m looking at?

In-Demand Nursing Specialties in 2024

The Bureau of Labor Statistics (BLS) predicts an annual increase of 193,100 RN jobs between 2022 and 2023, among the fastest-growing healthcare careers in 2024. The increased job prospects for RNs are positive and show this career choice will be in demand for the foreseeable future. 

However, the BLS doesn’t provide information for specific nurse specialties. We based the information provided below under Job Demand on the number of travel and staff jobs available on Vivian Health on February 13, 2024. While the number of jobs on our online marketplace constantly changes, with new jobs added hourly, these nursing specialties typically remain in high demand. 

We separated the following 15 specialties into subcategories for new nurses, experienced nurses and niche specialties. The specialties we placed under the category for new nurses are there because fewer specialties fit newer nurses who don’t yet have the experience to enter more advanced specialties. However, if you’re an experienced RN, these specialties are also well-suited for you. The average pay rates were pulled from Vivian Health’s salary data on February 15, 2024.

5 Specialties for New Nurses or Nursing Students to Consider

1. Medical-Surgical

Med-surg nurse providing patient care

  • Education Requirements: ADN or BSN
  • Relevant Certifications: CMSRN 
  • Job Demand: 27,380
  • Average Weekly Travel Rate: $2,115
  • Average Hourly Staff Rate: $43.99

A medical-surgical (med-surg) nurse is the most in-demand and versatile specialty for RNs. After graduation and success on the NCLEX-RN, you can begin working on a med-surg floor. Med-Surg nurses work with patients who are acutely ill or pre-op or post-op surgery. 

Typical tasks for med-surg nurses include patient assessment, medication administration, basic wound care, patient education, documentation, comfort measures, care plans and discharge planning. Getting experience on a med-surg floor is invaluable before pursuing other specialties. The range of conditions you experience and skills you gain provides unparalleled expertise and prepares you for diverse healthcare settings. 

2. Telemetry

Telemetry nurse

  • Education Requirements: ADN or BSN
  • Relevant Certifications: NTA
  • Job Demand: 14,674
  • Average Weekly Travel Rate: $2,159
  • Average Hourly Staff Rate: $45.29

Telemetry nurses are responsible for monitoring and analyzing cardiac telemetry readings. They typically work in hospital settings with cardiac patients who need continuous monitoring due to an unstable heart condition. Interpreting telemetry data can be a steep learning curve in a high-stress environment. 

Although unnecessary, having extra education is a good idea for new nurses seeking this specialty. The National Telemetry Association offers many courses based on experience and credentials. The courses provide various options, from comprehensive study plans covering ECG introduction, fundamentals, anatomy and operations tailored for newer or less experienced telemetry nurses to an option for more experienced RNs to sit for the exam without taking a course. 

3. Labor and Delivery

labor and delivery nurse

Many hospitals offer nurse residency programs for labor and delivery (L&D) straight out of nursing school, making this an excellent specialty option for new nurses. Most residency programs are 2 12 months long and involve a theory component and nurse mentorship

L&D nurses provide care to mothers and newborns, ensuring safety throughout labor. They typically care for two to three patients per shift, monitoring vital signs, timing contractions, assisting with delivery and administering medications. L&D wards can have high-stress moments and be emotionally draining. However, they tend to have a calm, relaxed environment with a low patient-to-nurse ratio.

 4. Long-Term Care

Long-term care nurse

  • Education Requirements: ADN or BSN
  • Relevant Certifications: GERO-BC
  • Job Demand: 1,270
  • Average Weekly Travel Rate: $1,942
  • Average Hourly Staff Rate: $44

Long-term care (LTC) is a great place to start your career as an RN. LTC offers a supportive environment to build foundational nursing skills and confidence. Working in this setting allows new nurses to develop a deeper understanding of patient care and the nursing process, as you often have the opportunity to work closely with a consistent group of patients over time. New nurses can hone their assessment and critical thinking skills in this specialty while working on interpersonal and empathetic communication. 

5. Pediatrics

Pediatric Nursing

  • Education Requirements: BSN
  • Relevant Certifications: CPN / PALS
  • Job Demand: 512
  • Average Weekly Travel Rate: $2,292
  • Average Hourly Staff Rate: $47.26

As an entry-level nurse, specializing in pediatrics is a rewarding yet sometimes bittersweet path, not for the faint of heart. Pediatric nurses work with the under-21 population and provide medical care to patients recovering from surgery or undergoing treatment. Their responsibilities include monitoring vital signs, administering medications, aiding in wound care, collaborating with healthcare teams and offering support to children and their families. 

Sub-specialties within the pediatrics specialty are among the highest-paying RN specialties, such as pediatric cardiac cath lab, cardiac stepdown, cardiovascular operating room and post-anesthetic care unit nursing.

5 In-Demand Nursing Specialties for Experienced Nurses

1. Stepdown / Intermediate Care / Surgical Stepdown

stepdown nurse

  • Education Requirements: BSN
  • Relevant Certifications: BLS / ACLS
  • Job Demand: 10,471
  • Average Weekly Travel Rate: $2,112
  • Average Hourly Staff Rate: $42.56

There’s a significant need for nurses in intermediate-level care. We grouped these specialties because, despite their diverse patient populations, they care for the same subtype of patients. Stepdown and intermediate care nurses look after patients who are stable enough to transition out of the intensive care unit (ICU) but not onto the general ward. Patients may still require frequent monitoring, assessment and intervention, but less monitoring than the 1:1 care provided in ICU. 

Nurses don’t need a higher level of education past their BSN to work in a step-down unit. However, this specialty is for nurses with more experience who are comfortable caring for and managing more complex patient needs. Duties may encompass vigilant monitoring of patients’ vital signs, complex wound healing, pain management and medication administration. Stepdown nurses collaborate with interdisciplinary teams, offering education on continuing care, post-procedure recovery, complications, customized care plans and discharge planning.

2. Intensive Care Unit

Young patient with pediatric intensive care unit nurse

  • Education Requirements: BSN and specialty-specific education and training
  • Relevant Certifications: CCRN / TCRN / ACLS
  • Job Demand: 7,673
  • Average Weekly Travel Rate: $2,178
  • Average Hourly Staff Rate: $44.56

ICU nurses are highly trained and specialized to care for critically ill patients. This high-stress specialty usually involves 1:1 nursing care to closely monitor and manage patients’ vital signs, life support equipment, medication and care plans with the interdisciplinary healthcare team. 

The ICU specialty is for more experienced nurses with hands-on, practical experience caring for complex health challenges. They must possess advanced clinical skills and the proper training to operate and interpret the advanced healthcare monitors required for this job. They must also have highly developed critical thinking skills and the ability to remain calm under pressure to effectively manage changing conditions and emergencies in the ICU. 

3. Emergency

emergency room nursing aka emergency department nursing

The excitement of the emergency room is good for some and anxiety-provoking for others. This is an excellent specialty to explore if you’re a nurse who thrives on change and works well under pressure and with the unknown. Emergency room RNs triage and assess patients, provide emergency interventions, administer medication, coordinate care with the healthcare team and manage emergencies.

4. Perioperative

surgical technician / perioperative nurse

  • Education Requirements: BSN 
  • Relevant Certifications: CNOR
  • Job Demand: 2,460
  • Average Weekly Travel Rate: $2,476
  • Average Hourly Staff Rate: $48.52

Perioperative, or operating room (OR) nursing, is an excellent specialty to explore if you enjoy the anatomy of the human body, working as a team and having a little less interaction with patients. OR nurses set up surgical equipment, organize supplies, support the surgeon and surgical team, educate patients and their families, ensure a sterile environment and monitor patients’ vital signs throughout surgeries and other procedures. 

5. Home Health

Home health nurse

A home health nurse must possess vast knowledge of chronic disease management, wound care and case leadership. They must have the skills and confidence to work autonomously, use developed critical thinking skills and provide extended care in a non-clinical setting. Many home health nurses manage an extensive patient caseload, coordinate care, give patient education, communicate with the interdisciplinary team and provide care within the community to a wide range of patients. 

5 Niche Nursing Specialties 

 1. Oncology

Oncology nurse

  • Education Requirements: ADN or BSN and specialty-specific education and training
  • Relevant Certifications: OCN / CPHON
  • Job Demand: 2,283
  • Average Weekly Travel Rate: $2,210
  • Average Hourly Staff Rate: $45.57

Oncology RNs don’t have any legal requirements to work in this specialty. However, many employers do require experience and prefer certification. To obtain the Oncology Certified Nurse certification, RNs need at least two years of nursing experience and 2,000 hours working in oncology before they can sit for the exam. The exam tests knowledge of professional practice, cancer science and symptom management. 

The main tasks of an oncology RN are to monitor and assess patients with cancer. Primary job duties include administering cancer-fighting medication like chemotherapy, inserting IVs and accessing ports. Oncology nurses must stay current with new research and drug development as they educate patients and their families on the best treatment plan available. 

2. Psychiatric 

psychiatric nurse

  • Education Requirements: BSN 
  • Relevant Certifications: PMH-BC
  • Job Demand: 1,247
  • Average Weekly Travel Rate: $2,019
  • Average Hourly Staff Rate: $44.27

Psychiatric RNs may work in a hospital or community setting with patients of all ages who have mental health conditions. Their primary duties include assessing mental health status, administering and monitoring medications, providing therapeutic interventions and offering comfort, support and education to patients and their families. They’re the frontline of the care team that provides mental health support to psychiatric patients. This demanding job requires a nurse to have clear boundaries and the balance of a strong yet casual and calm personality.

3. Dialysis

Dialysis nurse

  • Education Requirements: ADN or BSN
  • Relevant Certifications: CDN
  • Job Demand: 604
  • Average Weekly Travel Rate: $2,153
  • Average Hourly Staff Rate: $47.06

A dialysis nurse is the primary care provider for patients with kidney disease. As a dialysis nurse, you work with patients with renal failure who require dialysis procedures. This highly specialized field requires knowledge about dialysis equipment, monitoring fluid balance, administering medications and assessing patients’ condition throughout the procedure. The role of a dialysis nurse is to educate patients and their families on healthy living and proper choices when living with kidney disease. This function makes a deep understanding of kidney disease necessary for the job. 

Previous work with renal patients on a med-surg unit, through internships or clinical rotations, offers valuable insights into whether this specialty would suit your interest. Generally, one perk of dialysis unit nursing is working within business hours to allow patients to sit for their treatment during regular daytime hours. However, this detail can vary if you work on-call. If night shifts aren’t your thing, this may be a good specialty for your lifestyle. 

4. Neonatal Intensive Care Unit (NICU)

Pediatric Intensive Care PICU nurse

  • Education Requirements: ADN or BSN
  • Relevant Certifications: NRP / PALS / ACLS
  • Job Demand: 459
  • Average Weekly Travel Rate: $2,399
  • Average Hourly Staff Rate: $48.02

NICU nurses work with newborn babies who require special medical attention. This specialized field works with high-acuity infants in a sensitive environment. Nurses should have previous experience with newborn babies and critically ill patients before working in this specialty.

A NICU nurse’s role includes closely monitoring a newborn’s development and well-being, providing specialized treatment procedures such as oxygen and respiratory support, ensuring proper nutrition intake, administering medication, infection prevention and control, and offering emotional support to families. 

5. Nurse Educator

Preparing for a certification exam or taking an HCP class

  • Education Requirements: BSN and then MSN or DNP
  • Relevant Certifications: CNE
  • Job Demand: 162
  • Average Weekly Travel Rate: $2,923
  • Average Hourly Staff Rate: $45.66

If you’re passionate about passing your experience and expertise to the next generation of nurses, the nurse educator specialty may be for you. Becoming a nurse educator requires a strong clinical knowledge base and excellent communication skills to effectively teach others and pass your expertise along. 

A nurse educator must stay current on the latest research in nursing to follow and teach best practices proficiently. Nurse educators must be patient in introducing new skills while creating a comfortable environment conducive for students to learn. 

These are just a few nursing specialties available. With so many to consider, we hope you find one that aligns with your personality and fuels your passion for nursing. 

Join Vivian Health to discover numerous job opportunities tailored to your expertise and specialty today. 

Amanda Farquharson, BSN, RN

Amanda Farquharson, BSN, RN is a registered nurse, travel nurse, writer and wellness warrior. She practices from a holistic lens with a focus on health promotion and prevention. Amanda has been actively engaged with the wellness community for over 15 years, supporting and developing activities that strengthen individuals' and communities' emotional, mental, spiritual and physical health.

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