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Time for a Career Change?

Deciding whether to stay in your current position, switch specialties or find a new job

Five years into my nursing career, I received a nerve-wracking professional ego boost: promotion to unit supervisor. My manager saw my leadership potential and convinced me to apply, despite my substantial case of imposter syndrome.

I vaguely understood the responsibilities of this new position, but I did know myself to be a hands-on mentor. I envisioned guiding coworkers at the bedside, furthering their critical thinking and clinical skills while cultivating a workplace environment that fostered staff and patient satisfaction. I’d watched colleagues revel in the role, and I was determined to follow suit.

My annual reviews confirmed that I met these objectives, but in reality, I didn’t thrive as an administrator. I missed caring for patients immensely, and worried that I was losing the hands-on skills I loved to perform.

Not My Calling

Most of my days were spent at a desk arranging schedules, budgeting or counseling employees on attendance issues. These are necessary functions and can be attractive aspects of nursing leadership, but I realized that the business side of healthcare is not my calling.

For three years, I persisted, feeling obligated to my team and not yet sure how to align my career with my well-being. However, when a teammate announced she was transferring to our ICU through an internal residency program, my ears perked up. Working in that unit had been a dream I’d set aside to try my hand at management. I applied, received an offer and made the leap. Returning to the bedside was gratifying, and for the next few years, I flourished. Nonetheless, making that decision wasn’t easy.

Tough Decisions

Career transitions are common in nursing — one of the profession’s greatest benefits is its myriad roles and opportunities for advancement. If you aren’t satisfied with what you’re currently doing, chances are there’s another area that will better suit your preferences and passions.

Deciding when and if to pivot, however, can be overwhelming. When is it favorable to stay in a job that’s not a perfect fit? When is it optimal to move on, and how do you begin that process? Any time you’re faced with such a big career decision, there are often compelling arguments on both sides, and each nurse may weigh those considerations differently.

Why Stay?

Even if you don’t love your current job, there may be some strong arguments for staying with it at least for now, such as:

• Practicality

Money can’t buy happiness, but it certainly buys things that enhance happiness — or at least peace of mind — like shelter, transportation and healthcare. Salary, benefits and perks like tuition reimbursement are excellent motivations for staying in a job.

So is flexibility; hospitals often incentivize staff with self-managed flexible scheduling and the option of doing longer shifts fewer days a week. If you’re raising children, traveling or furthering your education, the ability to set your own work/life balance can be priceless.

However, attractive perks and a good salary can sometimes lead nurses to remain in unsatisfying roles for longer than planned, or longer than they’d prefer.

• Stepping Stones

Some specialty areas, such as flight nursing and anesthesia nursing, are not immediately accessible to new graduates. Reaching your dream job in those fields may require a “stepping-stone” track, where you must work for some years in other areas like the ICU or emergency department before having a real shot at your eventual goal.

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Quite frequently, those units require prior acute care floor experience in med/surg, so it may take you a series of steps to get where you’re going. It’s worth putting in the time, effort and energy in a position that isn’t your end goal if it serves to propel you towards your dreams.

• Limiting Beliefs

There are sometimes less tangible but equally compelling reasons we remain in unfulfilling positions. Fear of change is one powerful deterrent; it’s natural to be apprehensive about taking on new challenges in an unfamiliar environment.

Underestimating our worth can hinder professional progress. Believing we lack the talent, experience or charisma needed to impress potential new employers is paralyzing. Too often, we assume each and every skill listed in a job description is an absolute requirement.

The truth is that many prospective employers value enthusiasm, basic competence and a desire to learn as highly as they do additional bullet points on your resume. One manager said, “I can teach skills, but I can’t teach a positive attitude.”

You can conquer these psychological limitations by seeking support to overcome your limiting beliefs and cultivate self-worth.

• Commitment to Care

Now more than ever, nurses — especially frontline workers — feel a profound responsibility towards patients and communities. Nurses have banded together during the pandemic, which for some has reinvigorated a passion and changed their priorities.

Heather, an ICU RN colleague, was ready to accept a job in an outpatient wound care center when her department became a COVID-19 unit. She recommitted to her team and put her other plans on hold, a decision she says was rewarding and worthwhile. As a caregiver, there’s a fine balance to maintain between your desire to nurture others and the self-care you deserve.

Soul-Friction

Sadly, there’s no magic formula for knowing when it’s the right time to make a move. In my 16 years as a registered nurse, I’ve had the good fortune of holding six different titles.

Most recently, eight years in the medical ICU granted me everything I wanted from a job: fast-paced patient care, optimal nurse-to-patient ratios, great pay and schedule, and opportunities for skill advancement. However, the stress level was intense, and the demands on my physical and mental health could be brutal.

Like many nurses in 2020, a year of service to patients in the midst of a pandemic compelled me to reevaluate my work/life balance and goals. After months of deliberation, I chose once again to leave the bedside to begin the next phase of my career, as a nurse educator.

This was an exciting, angst-provoking decision. Was the timing right? Would I miss the exhilaration of acute patient care, as I did when I left bedside for management? There was no way to be sure. However, one thing was clear: I needed a dramatic change for my personal health and wellbeing. I describe this feeling as soul-friction: a gnawing sense that my current role no longer aligned with my long-term goals.

Making the Move

If you find yourself feeling the same way, transitioning out of your present workplace or changing career directions can go smoother with thoughtful investigation and introspection. Here are some tips for that process:

• Do the Research

Be sure you understand what would be involved in making a change. For example, will a new role require further education or additional certifications? If so, does your current employer have tuition reimbursement or education stipends?

Nursing Education

Consider whether your current organization offers the kind of career change you have in mind. Check internal job postings and reach out to managers in your area of interest. Internal candidates often have a leg up, even if the position is in a completely different unit or department.

You might already have a good idea of the position you want, but if not, are you aware of the many roles available to nurses at every level of licensing? I recommend the book 301 Careers in Nursing by Joyce J. Fitzpatrick, RN, Ph.D., MBA, FAAN, to my nursing students, who are shocked to learn that nurses aren’t confined to clinics and hospitals. Atypical roles like utilization review nurse, simulation laboratory director and even yoga trainer also make the list.

Specialty organizations can be a great help in learning what’s involved in transitioning to that field. For example, the National Nurses in Business Association is an excellent resource for nurses interested in entrepreneurship and other unconventional pathways.

Social media sites such as LinkedIn provide a forum for job hunting and networking with peers and experts, who may have insights you can’t easily get anywhere else.

• Set Your Non-Negotiables

Create a list of personal requirements for your job search. For example, you might need a specific schedule or have bottom-line salary requirements. You may need to turn down an opportunity that isn’t quite right, but holding firm can sometimes pay off. An employer may be willing to compromise for a desirable candidate, and if they aren’t, you might find a better fit elsewhere.

One of my colleagues was recently offered a job in her dream specialty, but it was a fulltime night shift position, and she attends school in the day. She struggled with the dilemma: whether to turn it down or attempt to function under unrealistic terms. I suggested that she present her needs clearly and perhaps the prospective employer would make an exception. She happily reported they agreed to reduce the position to part-time, with an option to increase her hours during school breaks.

• Identify Your Core Values

Recognizing your ideals and preferences can help you authentically navigate important decisions. Be honest about what you value and what you don’t. For instance,

if you thrive on teamwork and collaboration, clinics and acute care settings might be ideal, whereas if you demand more independence and autonomy, home health might be a better fit. A travel position may be a good choice if adventure and novelty are at the top of your list of priorities, but might not suit you if you need consistency and stability.

Visit www.positivepsychology.com for a worksheet to help you identify your most essential values.

• Enlist an Expert

You don’t have to go it alone; seeking professional advice is a savvy option. If you have a mentor, their knowledge and experience may be a big help in making career development decisions. If you don’t have a mentor, consider finding one: Mentors are accomplished nurses that function as motivators, role models and trusted allies who can help you grow in your current role or advance to leadership or other practice areas.

Mentor-mentee relationships are especially valuable for new nurses entering practice after graduation, but mentors can help you at all stages of your career development.

If you’re not sure where to find a mentor, see if your current institution has any internal programs, or look into the options offered through organizations like the American Nurses Association Mentoring Program or Johnson & Johnson Nursing Mentorship.

Nurse career coaches can also provide an assortment of services and support for career development, such as resume writing, LinkedIn profile creation and techniques to help you overcome limiting beliefs and cultivate self-esteem. If you’re prone to cold feet, a coach can also provide structure and accountability to keep you motivated and on track.

Deciding whether to stay or leave a position can be overwhelming, so trust your nursing intuition while carefully considering the pros and cons of each option. Above all, it’s vital to explore your career path with intention, whether it’s to find fresh inspiration within your current role or to launch forward towards future endeavors.


Tiffany Swedeen, RN, BSN, CPRC/CPC, works in critical care and as a clinical instructor. Follow her on Instagram @scrubbedcleanrn or at www.recoverandrise.com.


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