Help! I Chose the Wrong Nurse Practitioner Specialty

When I started my nurse practitioner program, I enrolled as an acute care nurse practitioner student. I was ready for the excitement of the ER, the steady drip, drip of the IV medications in the ICU and eager to master operating a ventilator.  I wanted to see some serious stuff.  But, during clinical rotations in my accelerated program, I was awakened to the realities of the hospital environment.  I hadn’t foreseen the smells and sounds of the neurology unit, for example, or expected that interacting with families of terminally ill patients could be so taxing.  So, enrolled in acute care I was silently freaking out about my future.  I had chosen the wrong NP specialty.

The fear of working with patients hooked up to ventilators while simultaneously suffering from C. diff eventually got to me, so I approached the director if the acute care program about switching to the family nurse practitioner specialty.  Based on my clinical experience, I thought focusing on outpatient care was a much better fit for my personality.  The director said I was welcome to request a change to the FNP program, but would need to run this by the FNP program director as he would be the one making the decision.  Unfortunately, she wasn’t optimistic about my chances of changing as the FNP program was full.

I marched myself in the the family nurse practitioner program director’s office and plead my case.  While he gave me a bit of a hard time, after a few weeks he let me into the program.  Disaster averted.  I would not have to work in the ICU.

I often receive e-mails from readers in similar situations, concerned they have chosen the wrong NP specialty.  If your interests change or your hands on experience in a certain area of medicine doesn’t go as expected, is there a way out?  If you are freaking out, stressing out, and on the edge of a mental breakdown, stop.  I’m happy to report that, yes, if you have selected the wrong specialty you do have options for changing course in your NP education.  Here are a few things to consider if you are contemplating a specialty switch.

1. Evaluate: Did you really choose the wrong specialty?

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Most nurse practitioner specialties aren’t very specific and there is a lot of overlap in where you can work with different specialties.  For example, if you want to work in the emergency department you can do so with either an FNP or ACNP degree.  Looking to work in cardiology?  An acute care, family or adult specialty degree will land you a job working with the heart.  A family nurse practitioner degree doesn’t necessarily preclude you from working in the hospital and an acute care nurse practitioner degree doesn’t always mean you will work in the hospital.

Even if you aren’t loving you clinical rotations, chances are the specialty you have chosen can lead to the career you are looking for-the road to getting there may just be a bit rockier.  Think about where you want to work.  Talk to other nurse practitioners working in that field and ask their opinions about which specialty will be right for the job.  Most NPs undergo a significant amount of on-the-job learning in their first positions.  The specialty you choose in school is simply a foundation from which to learn from.  The path you choose in school does direct your career but not as much as you might think.

2. Ask your NP program administrators if you can switch programs.  You may get pushback but remember you are a customer of the school.

Even though the specialty you select in school won’t limit your career as much as you might think, it is of course best to get educated in the area that best fits your career goals.  Most nurse practitioner programs offer multiple specialties to accommodate students with a variety of interests.  If you think you have selected the wrong specialty, ask to change to another.  Some NP programs advertise that this is not allowed or is dependent on availability, but it never hurts to ask.  You are a customer of your university and are paying thousands of dollars for your education.  Your NP program should treat you accordingly.

3. Going back to school for a second specialty isn’t as difficult as you might think.

Going back to school again is probably the last thing you want to think about if you are nearing the end of your NP program.  But, adding a second NP specialty to you educational repertoire is not as difficult as you might think.  Post-graduate programs are much shorter than initial nurse practitioner programs and can often be completed online.  While you will still have course content to study, essays to write and tests to take, you will already be familiar with much of the material taking much of the stress out of your additional degree.  While going back to school does require time and money, it is always an option and not a daunting of a task as getting your first NP degree.

There’s always a second chance for NP students looking to practice in a different setting.  If you’re worried you selected the wrong path to becoming an NP, evaluate your choice, try to make a change, and remember it’s never too late to make a change.


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5 thoughts on “Help! I Chose the Wrong Nurse Practitioner Specialty”

  1. Hi Em,

    FNP or Adult would be good for this.  Of the two, FNP gives you more flexibility if you change your area of interest in the future.

  2. My goal is to become a surgical nurse practitioner. I don’t want to work in an ICU. I would see patients outpatient and post operative. I also would like to assist during surgeries eventually seeing as my background is OR nursing. What is the best route? I was leaning toward FNP because there are more opportunitites.

  3. Hi B., 

    You could do either the family nurse practitioner or acute care nurse practitioner route. For surgical NP positions in the OR, some hospitals will require that you have an acute care NP specialty. Others will allow either an FNP or ACNP. 

    If you aren’t sure if you want to work in surgery, you are correct – the FNP is the most flexible specialty option. 

  4. Ideally, one would work as an RN to know what an ICU is like (patients on vents, with C-diff, terminal illness, difficult talks with families) BEFORE you chose an ACNP program. Le sigh… the issues with direct-entry programs.

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