What other nurse specialties are available?

Nurse Specialties Available in Healthcare

Nurses can pursue numerous specialty areas including rheumatology nursing, critical care nursing, maternal-fetal nursing, pediatric trauma nursing, and surgical nursing, each requiring specialized training and offering opportunities for extended roles and advanced practice.

Rheumatology Nursing

• Rheumatology nursing has developed into a recognized specialty in many countries, with nurses undertaking advanced and extended roles including self-management support, patient education, counseling, intra-articular injections, medication management, and monitoring disease-modifying and biological treatments 1
• Rheumatology nurses play a crucial role in improving patients' self-efficacy, patient activation, and motivation through nurse-led interventions 1
• Nurse-led clinics in rheumatology have demonstrated effectiveness in bringing added value to patients' outcomes at a lower cost 1

Critical Care Nursing

• Critical care nursing encompasses intensive therapy, high-dependency, coronary care, and other specialist critical care units where patients are more highly dependent and critically ill than those on general wards 2
• Critical care charge nurses are expert at assigning patient beds based on acuity and anticipating abilities of nurses based on experience level 1
• In critical care settings, nurses may work in "pod" models where critical care nurses oversee groups of patients and mentor non-critical care caregivers, or in "functional" models where nurses are assigned specific care functions for groups of patients 1

Maternal-Fetal Nursing

• Maternal-fetal nursing specialties exist within level III and IV facilities, requiring expertise in critical care at the physician, nursing, and ancillary services levels 1
• These specialized nurses care for women with complex medical illnesses and obstetric complications, requiring completed orientation and demonstrated competence in the care of obstetric patients 1
• Level IV maternal care facilities require nursing leaders with expertise in maternal intensive and critical care to handle complex maternal conditions such as congenital cardiac lesions, vascular injuries, and neurosurgical emergencies 1

Pediatric Trauma Nursing

• Pediatric trauma nursing is an essential component in trauma centers that care for children, requiring demonstrated competency in the care of pediatric trauma patients 1
• Nurses with specialized pediatric trauma training work within pediatric intensive care units (PICUs), which are essential components of pediatric trauma centers 1
• The presence of experienced PICU nursing personnel supports the environment necessary for frequent monitoring and assessment of injured children 1

Surgical Nursing

• Surgical nursing specialties include perioperative nursing with certifications such as CNOR (Certified Nurse Operating Room) and CRNFA (Certified RN First Assistant) 3
• Specialty certification for surgical nurses enhances patient safety by validating that practice is consistent with standards of excellence 3
• Research has shown that higher rates of specialty certification in perioperative units are associated with lower rates of certain complications like central-line-associated bloodstream infections 3

Advanced Practice Roles

• Nurses are encouraged to undertake extended roles after specialized training and according to national regulations 1
• Advanced practice providers (nurse practitioners and physician assistants) in specialty settings perform as well as physicians in terms of clinical safety and positive patient outcomes 4
• In acute and critical care settings, advanced practice providers contribute to improved patient care outcomes, continuity of care, and enhanced quality and safety metrics 5

Educational Requirements

• Nurses should have access to and undertake continuous education in their specialty to improve and maintain knowledge and skills 1
• Educational programs for specialty nurses are associated with increased knowledge, skills, and improvement of practice 1
• Some specialized tasks traditionally performed by physicians can be learned by nurses through structured training, such as joint examinations or musculoskeletal examinations in rheumatology 1

Common Challenges in Specialty Nursing

• The fluidity of boundaries between critical and acute care can lead to challenges for nurses working on acute general wards when caring for post-critical care patients 2
• Some specialty nurses may lack confidence in performing certain procedures or providing specific support, highlighting the need for specialized training 1
• Nursing care rationing differs between specialties, with interventions related to basic care being most frequently rationed in critical care/emergency settings, while planning is most frequently rationed in medical and surgical specialties 6