Field of dreams

Getting From Here to There

Nursing school can feel like such a slog that it’s difficult to get a good sense of where you want to be the next semester, let alone determine your specialty. Exposure to specialties happens randomly, without much opportunity to reflect, so nursing students end up taking a thumbs-up/thumbs-down approach to different clinical sites and, by extension, to possible future jobs. During my rotation in psychiatric nursing, I decided that working with schizophrenics would be the most frustrating clinical work anyone could ever do. Psych got a big thumbs down. The cardiothoracic surgery floor where I did a med-surg rotation felt extremely unkind, leading me to categorically rule out nursing on a surgical floor.

School, then, gave me a strong sense of the fields I didn’t like, as it did for Shannon Riskey, now working in Pennsylvania as an oncology nurse pretty much by fortunate default. She says she disliked every specialty she saw as a student—cardiac, GI, psych, OB, med-surg. I wanted to choose my field deliberately, so I tried to focus on areas that appealed to me. First I had to determine whether I wanted to work with kids or adults. Oncology wasn’t even on my radar; I had enjoyed my pediatrics rotations and elected to do my final student clinical at the Children’s Hospital of Pittsburgh. My reasons for preferring pediatrics were emotionally simple—I love kids—and profoundly practical—there’s lots of poop and pee to clean up, but the volume is much smaller with kids than with adults. That’s as deep as my thinking went, although the emotions behind those superficial-sounding reasons were strong.

Ultimately, though, my feelings about not wanting to go into pediatrics were stronger. My son was 11 and my twin daughters were 8 when I was finishing nursing school and deciding on a specialty. During my last clinical shift I sent a very sick 11-year-old boy to the Pediatric Intensive Care Unit. The resemblances between that boy and my own son, Conrad, only went as far as their ages, but for me that small similarity was way too much. He could have been Conrad, I realized, understanding on the final day of a clinical rotation I had loved that the struggling, sick kids in the children’s hospital had the potential to remind me too painfully of my own children left at home.

My rejection of pediatrics reveals how choosing a specialty can be a difficult balancing act. Nurses want work that feels personally meaningful, but nursing is often so intimate that the line between emotionally rewarding and too painful to tolerate can be very fine. I loved pediatrics, but in the end, working with sick children would have been unbearable for me.

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