Nurse specialists and nurse generalists are common within the nursing profession and 21st-century healthcare, and both serve important purposes in patient care and non-clinical settings. What does it mean to choose to be a specialist or generalist? What are the repercussions for your nursing career? And how can one accomplish both?
Nurse Specialists Matter
In medicine and nursing, generalists and specialists serve many important purposes. Choosing which one to be can be difficult, but it’s not out of the question, and sometimes it’s possible to have the best of both worlds. So why does this choice matter, and how does one make the most prudent choice for nursing career growth and satisfaction?
In medicine, it’s often said that there’s a shortage of primary care physicians (especially in rural areas and some small towns and inner cities) because being a medical specialist pays much more handsomely. Nurse practitioners are thankfully filling those gaps in primary care. So, is money the greatest allure of specialization?
The nurse who graduates from an ADN or BSN program is a novice generalist with a lot more to learn. In my ADN program, I became the class “specialist” in orthopedics — especially hip replacement post-op care — because I was frequently assigned such patients. Nursing students need as many clinical experiences as possible, but circumstances sometimes lead us down specific paths for one reason or another.
Even though ortho was something I became significantly comfortable with, after graduating, I chose to skip med-surg and acute care in favor of community health and home health. I never looked back, and I developed my expertise, albeit not in the hospital setting.
Nurse specialists have a crucial purpose: those in ICU, flight nursing, OR, ED, and other critical areas are necessary to save lives. Pediatric nurses, dialysis nurses, school nurses, and others also play their parts in specific areas of clinical focus and patient care.
We always need a certain percentage of nurses and other clinicians to specialize — how else would those ICU and OR patients receive the highly specific care they need? Specialization is life-saving and central to the full function of any healthcare facility, and those who serve in such positions are often in high demand.
Nurse specialists are born of extensive clinical experience, high-quality education, and certification processes that determine a nurse’s knowledge and expertise. Some nursing specialty certification pathways are incredibly rigorous, molding enrolled nurses into high-level clinicians with a plethora of skills and intellectual/clinical rigor.
Nurse Generalists Matter
A nurse generalist knows a lot about many things; in some ways, you could call a nurse generalist a polymath. Generalists matter as much as specialists, and they serve in various functions and roles.
Licensed practical or vocational nurses are usually considered generalists. However, their work is crucial in nursing homes, assisted living facilities, physician offices, and other milieus, where they are the lifeblood of patient care.
Generalist nurse practitioners also serve an important clinical purpose in many facilities. Meanwhile, those with a previous unrelated bachelor’s degree become nurse generalists when they graduate from an accredited second bachelor’s nursing program (sometimes known as an accelerated generalist educational track).
Most newly graduated nurses are a generalist, no matter the program they attended. LPNs, ADNs, BSNs, and some NPs bring general knowledge and some learned expertise. There is no shame in being a nurse generalist, and choosing to specialize can lead to many rewards when and if the nurse decides to pursue that path.
To Specialize or Not to Specialize
Why would a nurse choose to specialize? Why would the process of specialization and acquiring expertise be appealing to a professional nurse clinician? I believe the following to be compelling reasons to do so:
- Specialization can lead to increased earning potential.
- Being a nurse specialist lends credibility to the nurse’s personal/professional brand.
- Many positions are reserved for nurses with specific training and expertise.
- A nurse’s professional standing and credibility are elevated by specialization and certification.
- The knowledge can positively impact personal self-esteem, that one has gone above and beyond in accumulating relevant training and expertise.
While specialization is not required nor necessary to have a successful and satisfying nursing career, it does bestow certain benefits, as noted above. At the same time, being a skilled generalist nurse is also a respectable career choice. Generalists can accomplish much on the twin engines of their professionalism and skill.
In the end, each nurse must make their own decision when it comes to choosing to move beyond generalist practice to specialization. The world will not end if a nurse decides to remain a generalist, nor will their life change dramatically once they’re certified and ensconced in their area of specialty.
If nothing else, every nurse can be a specialist in doing the job they are called to do, whether that position is clinical or not. Specialization is a path that can be chosen, and there is no judgment in my mind of nurses who forego that journey. Every nurse is valuable, and no one can take our worth away, individually or collectively.
Choose your path, own your way, and approach your nursing career trajectory with pride and the knowledge of your stellar contribution to a society that relies on courageous and intelligent nurses to be the veritable backbone of the complex 21st-century healthcare system.
Daily Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
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