As the nursing profession continues to evolve, specialization in many different areas has occurred. It is no longer true to say “a nurse is a nurse is a nurse…” Through specialization, and more recently through certification within a specialty, nurses play a more critical role in patient care.

Patient care, however, doesn’t end in the hospital or in a specialty care area. There are specialties of nursing that cross “unit” lines. For instance, wound care specialists are seen in all inpatient units, but also in the home health setting. Holistic nursing transcends practice areas and focuses on not only the physical but the spiritual and emotional needs of the patient using any of a variety of tools. Once again this specialty is not limited by a clinical practice area.

Medical Surgical nursing has recently come into its own as a specialty. Rather than being seen as the “launching pad” for other specialties, nurses in this specialty provide a critical part of the patient care experience.

Changing specialties is also a hot topic. Once a nurse is experienced in a specific area, it seems that opportunities to change specialties are limited, or require the nurse to go back to the worst shift with the lowest seniority, even within the same institution. As our profession advances we need to encourage and create pathways for nurses to move to different specialties, without penalizing them for the move. This doesn’t mean that a nurse from one area would “trump” all the other nurses for seniority, etc., but there should be processes in place to work them into the new system without penalizing them.

As healthcare progresses, and each of us considers our future career, you might wonder what are the hot specialties in nursing?  Obviously, we are going to see changes in healthcare that we cannot even predict, but areas like case management and home health will continue to grow as we learn how to care for patients in settings outside of the acute care facility.  Ambulatory care (e.g. ambulatory surgery, endoscopy) will also be growing. However, don’t think that inpatient care is going away. The need for hospitals will always exist and we will see sicker and sicker patients in all hospital settings.

So what does all this mean to nurses, and more importantly, to patients? Fortunately for nurses it offers greater flexibility and rewards. It allows us to showcase our advanced knowledge. For patients, it means that the nurse caring for you is an expert in a particular field. And as a group, it means that nurses can enhance patient care in any setting.

Are there specialties that you think should be recognized but aren’t? Do you belong to your specialty’s organization? Are you certified? Let’s start a dialogue about specialization in nursing and what it means to our profession.

Karen is the Director for RN.com, an ANCC and state accredited provider of continuing education for nurses. Visit RN.com for a comprehensive collection of professional education and information resources.