By Susan Kreimer, MS, contributor
If you’ve ever thought about switching to another nursing niche, there are some factors to consider before making the move.
Nurses shouldn’t switch until after immersing themselves in a specialty for at least two but preferably five years, said Amy Nichols, RN, EdD, an associate professor at San Francisco State University School of Nursing, which collaborates with Lucile Packard Children’s Hospital in Palo Alto, California.

Before switching specialties, nurses should inquire about the level of assistance they can expect during the transition.
“It takes an RN two or three years to become competent in a specialty,” Nichols said. Switching too often doesn’t allow a nurse to become an expert in any area, and it makes the RN less valuable to an employer.
Nichols has been a faculty member since 1986 and a perinatal clinical nurse specialist since 1988. She ventured into nursing administration in 2003 and simulation in 2005. In counseling nurses who want to change specialties, she helps them identify the reasons behind their desire to enter another area of nursing.
“At Lucile Packard Children’s Hospital, we are about to open a part of the Center for Nursing Excellence that primarily deals with nurses who want to advance their careers in nursing but don’t know how to do it, who to talk to, or what resources are available within the organization,” Nichols said.
Before switching, nurses should inquire about the level of assistance they can expect from the employer during the transition, said Janet Haebler, MSN, RN, associate director of state government affairs at the American Nurses Association.
“Some questions to ask: Will there be a preceptor readily available on the unit? And what is the level of experience of the assigned preceptor? If not, what type of support will exist? Will there be an orientation to the unit and for how long? Is there a probationary period associated with the change?” Haebler said.
Each registered nurse is accountable for maintaining professional competence, but an employer shares some responsibility. Health care organizations need to foster an environment conducive to continued learning and development, she said, either within a current practice area or in another specialty.
By virtue of working in a hospital or other health care facility with a diverse patient population, a nurse has the opportunity to shadow another nurse in a different specialty. It’s a good way to sample a new work setting before committing to a change, said Susan Spivock Smith, PhD(c), RN, MSN, CRNP, director of professional practice and a geriatric nurse practitioner at Holy Cross Hospital in Silver Spring, Maryland.
“The more skills a nurse has, the better he or she is able to handle any medical crisis,” Smith said. “While there is a lot to be said for a nurse being an expert in a specialty area because that is the only area she works in, nurses can become more skilled when they challenge themselves by stepping out of their comfort zone.”
Nursing leadership should accommodate work schedules to enable nurses to pursue advanced degrees and prepare for certification exams, she said. It’s much better to retain a good nurse in your institution even if that means losing the employee to another unit, she said.
Sometimes a nurse may switch and later decide to return to a previous specialty or combine skill sets from both areas in another position. “I know of a nurse who worked as a staff nurse in home care. She wanted to become a clinical manager in home care but did not have experience,” Smith said.
“She had to switch to another department to gain the clinical manager experience, and when she was ready, she came back to home care and is now in the role she wanted.”
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