4 Things to Consider in Choosing Your NP Specialty

Thinking about becoming a nurse practitioner?  One pivotal decision you must make on your path to becoming a NP is selecting your nurse practitioner specialty.  From neonatal to geriatrics and midwifery to cardiology, universities offer a wide variety of specialty programs.  Your nurse practitioner specialty selection will affect your future career so it is important to choose wisely.

Here are four things you must consider in determining your nurse practitioner specialty:

1. Your Personal Areas of Interest

If you are already a nurse, you likely have some idea of your medical areas of interest, and more importantly areas you dislike.  If ventilators freak you out, for example, the ICU is not the place for you.  Do you enjoy children or do kicking, screaming kids have you reaching for a Xanax?  If you identify with the latter group, don’t pursue pediatrics.  Compile a list of positive and negative experiences from your medical career and look for patterns.  Choose a nurse practitioner specialty that encompasses your positives and minimizes your negative experiences.

2. Employment Outlook

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Although nurse practitioners are in high demand, your personal employment outlook is affected by specialty.  A current trend among NP programs is to offer more and more specialized degrees- think cardiology or dermatology.  I would recommend avoiding more specialized programs and pursuing a more general specialty such as acute care (ACNP) or primary care (FNP).  Even if you dream of mole removal, Botox and skin cancer screening and cannot wait to become a dermatology nurse practitioner, that the more generic FNP route.  Most nurse practitioner students don’t get their dream job immediately after graduation.  It is better to have a generic specialty to fall back on while you gain some practice experience than to be a highly specialized but unemployable NP.

As a nurse practitioner myself, I knew I ultimately wanted a career in emergency medicine.  I was unable to find a job in the ER immediately after graduation as employers required experience.  Luckily, I was able to work as a family nurse practitioner in urgent care clinics until landing my dream job in the emergency department.

3. Salary

Despite having the title ‘nurse practitioner’ in common, NP salaries do vary somewhat by specialty.  Some specialties such as emergency medicine and dermatology promise well into the six-figure salary range.  Others such as pediatrics fall closer to the $80,000 mark.  Although the difference in pay between nurse practitioner specialties is not as pronounced as it is among physicians, your specialty selection will affect your income.

4. Career Flexibility

Some prospective nurse practitioners have a clearly defined career path in mind while others are uncertain what their ideal plan entails.  Some NP’s gravitate toward stability while others anticipate practicing in multiple different roles throughout their careers.  If you aren’t sure which areas of medicine best accommodate your interests and talents, or if you would like to work in multiple specialties over the course of your career it is important to choose a broader specialty such as primary care or acute care.  A more general specialty selection will allow you to further define your career path as you go offering you the flexibility to work in multiple areas of medicine.

Take these points into consideration when choosing your NP specialty and your career will be off to a great start!  Questions about your specialty selection?  Get advice from other NP’s by commenting below.

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7 thoughts on “4 Things to Consider in Choosing Your NP Specialty”

  1. Hello! How was your experience in urgent care? I’m considering going into urgent care because I think I would enjoy taking care of people that need immediate help. I am also considering emergency but I think that would be a little too fast paced for me? Urgent care seems to be the perfect pace. Any insight or advice would be appreciated. Thanks!

  2. Thank you for your blog. As a ENP student, I read your blog all the time and I have found it very informative. I am an ICU nurse but I do plan to pick up shifts in our ER to gain that experience before I graduate.

  3. Hi Essence,

    Urgent Care is certainly a great place to start your NP career.  It isn’t as fast-paced and high acuity as the ER making it the perfect place to learn and gain some experience.  Also, in urgent care you get the opportunity to do some procedural work ex. draining abscesses and suturing preparing you to work in the ER later if you decide to transition.  After a year in urgent care, I did get a bit bored as the acuity level is low.  But, without my experience there I would not have been prepared to work in the ER.

  4. If I am interested in working as a surgical PNP, can I do so as a primary care PNP, or only acute care PNP? I have only 6 months NICU experience so do not qualify for the usual 2 years critical care experience required to get into an acute care PNP program. However, I do have OR experience as a circulator – hence my interest in the OR. I would like the flexibility of choosing to work in an outpatient office setting as well as in a surgery specialty office for peds (especially dealing with congenital defects that can be surgically corrected or ameliorated). Any suggestions? I am not so interested in adults.

  5. Hi Keri,

    That’s a tough question.  It ultimately depends on your employer.  While smaller private clinics typically don’t place as much emphasis on specialty, some larger hospitals and especially teaching hospitals sometimes do. 

    If you are planning to work in a certain area, or at a specific hospital in your area, I would try to meet with someone from their pedes surgical team (an NP, physician or HR employee) to see what they typically require.  This way you can be sure you attend the correct program.  

    Another option for you would be to complete the primary care PNP now, then if you need an acute care certification go back to attend the acute care PNP program.  Adding another specialty can be done in about a year, sometimes less.

  6. I currently have my BSN and am interested in becoming an NP. If I’m unsure on the exact specialty I want to do is it best to become a FNP first. I’m really considering emergency medicine so is the FNP the best route to get there?

  7. Hi Alexa,

    I think FNP is an excellent choice if you aren’t exactly sure what you want to do.  You are certainly employable in the emergency department with an FNP along with most other settings.  Personally, I am an FNP and work in the emergency department.  The other NP’s I work with are also FNP’s. 

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