The Most Difficult Nursing Specialty: Ranking the Toughest Fields in Healthcare

Choose the specialty you think is the most difficult!

Author: Gregor Krambs
Updated on Apr 18, 2024 06:39
Are you ready to cast your vote in the ultimate face-off of nursing specialties? Welcome to StrawPoll's exclusive ranking of "What is the most difficult Nursing specialty?"! With thousands of healthcare professionals navigating through an array of unique and challenging fields, we need your expertise to help us uncover the most demanding nursing specialty out there. Will it be the high-stakes world of emergency nursing, or the intricate complexities of critical care? Perhaps it's the delicate balance of neonatal care, or the emotionally-taxing realm of oncology? The choice is yours! Vote now for your favorite, or suggest a missing option to make sure your voice is heard. Dive into this captivating ranking and join the conversation that has nurses around the globe buzzing with anticipation!

What Is the Most Difficult Nursing Specialty?

  1. 1

    Critical Care Nursing

    Sister Mary Jeanette Feasey
    This specialty is considered one of the most difficult due to the high-stress environment, fast-paced decision-making, and the complexity of patients' conditions.
    Critical care nursing is a nursing specialty that focuses on providing care to patients who are critically ill or unstable. These patients require constant monitoring and interventions to maintain their vital signs and manage their complex medical conditions. Critical care nurses work in intensive care units (ICUs) and other specialized critical care areas, such as cardiac care units (CCUs) and neonatal intensive care units (NICUs). They collaborate with physicians and other members of the healthcare team to deliver high-quality care and optimize patient outcomes.
    • High level of expertise: Critical care nurses must possess advanced knowledge and skills to manage complex patient conditions.
    • Constant monitoring: Continuous assessment and monitoring of patients' vital signs, including heart rate, blood pressure, and oxygen levels.
    • Advanced life support: Proficiency in advanced life support techniques, including cardiopulmonary resuscitation (CPR) and airway management.
    • Medication administration: Knowledge and administration of critical medications, such as vasoactive drips and sedatives.
    • Collaboration and teamwork: Working closely with physicians, respiratory therapists, lab technicians, and other healthcare professionals to ensure coordinated patient care.
  2. 2
    Oncology nurses care for cancer patients, who often experience significant physical and emotional distress.
    Oncology Nursing is a nursing specialty that focuses on providing care to patients diagnosed with cancer. It involves the comprehensive assessment, management, and support of individuals and their families throughout the different stages of cancer treatment and beyond. Oncology nurses work closely with oncologists, surgeons, and other healthcare professionals to deliver quality care and improve patient outcomes.
    • Advanced knowledge: Oncology nurses require advanced knowledge of cancer biology, treatment modalities, and the physical and psychological impact of cancer on patients.
    • Expertise in symptom management: Oncology nurses are skilled in managing a range of treatment-related symptoms like pain, nausea, fatigue, and emotional distress, aiming to improve patients' comfort and quality of life.
    • Patient education: Oncology nurses play a vital role in educating patients and their families about the disease process, treatment options, potential side effects, and self-care measures.
    • Coordination of care: They coordinate and collaborate with various healthcare professionals, including doctors, social workers, and therapists, to ensure a holistic and multidisciplinary approach to patient care.
    • Psychosocial support: Oncology nurses provide emotional support and counseling to patients and their families, helping them cope with the emotional challenges, anxiety, and uncertainties that cancer brings.
    Oncology Nursing in other rankings
  3. 3
    Emergency nurses work in high-pressure situations and must be prepared to handle any medical emergency that comes through the door.
    Emergency nursing is a nursing specialty that focuses on providing immediate care to patients who are experiencing sudden illness or trauma. Emergency nurses are trained to handle a wide range of medical emergencies and work in fast-paced, high-pressure environments such as emergency departments, trauma centers, and ambulance services. They are responsible for quickly assessing patients, providing appropriate interventions, and coordinating care with other healthcare professionals.
    • Specialized training: Emergency nurses undergo specialized training to enhance their skills in critical care, trauma management, and emergency procedures.
    • Rapid assessment and triage: Emergency nurses must be skilled in rapidly assessing patients' conditions, prioritizing care, and determining the appropriate level of urgency.
    • Trauma care: Emergency nurses are trained to provide immediate care to patients with traumatic injuries, including stabilizing patients, administering emergency medications, and assisting with surgical interventions.
    • Emergency procedures: Emergency nurses are proficient in performing various emergency procedures such as starting IV lines, inserting urinary catheters, and managing airway and breathing interventions.
    • Crisis management: Emergency nurses must be able to remain calm and focused in high-stress situations, often making split-second decisions to save lives and minimize complications.
  4. 4
    Pediatric nurses care for infants, children, and adolescents, who require specialized care and attention.
    Pediatrics nursing is a specialty within the field of nursing that focuses on the care of infants, children, and adolescents. It involves providing healthcare services and support to children with various medical conditions, ranging from routine check-ups to managing complex diseases and injuries.
    • Emotional Resilience: Pediatrics nurses should possess emotional resilience to handle the challenges of working with children who are sick or undergoing medical procedures.
    • Child Development Knowledge: Pediatrics nurses require a deep understanding of child development to provide age-appropriate care.
    • Family-Centered Care: Pediatrics nurses work closely with families to ensure their involvement in the child's care and provide support and education.
    • Specialized Assessment Skills: Pediatrics nurses need specialized skills to assess and monitor children's vital signs, growth, and development.
    • Pediatric Pharmacology: Pediatrics nurses must have knowledge of medications and dosage calculations specific to children.
  5. 5

    Surgical Nursing

    Florence Nightingale
    Surgical nurses work in the operating room, where they assist in complex procedures and must be knowledgeable about various surgical techniques.
    Surgical nursing is a specialized branch of nursing that focuses on providing care to patients before, during, and after surgical procedures. Surgical nurses play a vital role in the operating room, assisting the surgical team and ensuring the safety and well-being of patients.
    • Advanced knowledge: Surgical nurses must have advanced knowledge of surgical procedures, instrumentation, and techniques.
    • Critical thinking skills: They need to possess exceptional critical thinking skills to anticipate and address potential complications.
    • Attention to detail: Surgical nurses must have a keen eye for detail to ensure accurate and precise care during procedures.
    • Strong communication skills: They need to effectively communicate with the surgical team, patients, and their families.
    • Ability to work under pressure: Surgical nursing can involve high-pressure situations that require quick thinking and decision-making.
  6. 6
    Neonatal nurses care for premature or critically ill newborns, who require specialized attention and monitoring.
    Neonatal Nursing is a specialized branch of nursing that focuses on the care of newborn infants, particularly those who are born prematurely, have medical complications, or are at risk for developing health problems. It involves providing comprehensive care to the newborns and supporting their families during their initial stages of life.
    • Intensive Care: Neonatal Nurses are trained to provide intensive care to newborns, including monitoring vital signs, administering medications, and managing life support equipment.
    • Developmental Support: Neonatal Nurses focus on promoting the optimal development of premature infants and babies with medical issues, providing specialized interventions and creating a nurturing environment for their growth.
    • Family-Centered Care: Neonatal Nurses support and educate the families of newborns, providing emotional and practical guidance to ensure the overall well-being of both the infant and their loved ones.
    • Collaboration: Neonatal Nurses work closely with a multidisciplinary team, including physicians, respiratory therapists, occupational therapists, and social workers, to create a comprehensive care plan for infants.
    • Neonatal Resuscitation: Neonatal Nurses are skilled in neonatal resuscitation techniques, ensuring they can provide immediate and life-saving interventions for newborns who experience difficulties in breathing or require resuscitation.
    Neonatal Nursing in other rankings
  7. 7

    Cardiovascular Nursing

    Florence Nightingale
    Cardiovascular nurses care for patients with heart disease, which requires specialized knowledge and skills.
    Cardiovascular Nursing is a highly specialized field of nursing that focuses on the care and treatment of patients with cardiovascular diseases. It involves providing comprehensive care for patients with heart conditions and vascular disorders. The purpose is to assist patients in managing their conditions, preventing complications, and promoting overall heart health. Cardiovascular nurses work closely with patients, their families, and other healthcare professionals to ensure effective care and recovery.
    • Advanced knowledge of cardiovascular anatomy and physiology: Cardiovascular nurses have a deep understanding of the structure and function of the heart and blood vessels.
    • Expertise in managing cardiac medications and interventions: They are skilled in administering and monitoring medications, as well as performing advanced cardiac procedures and interventions.
    • Ability to interpret and analyze cardiac monitoring: Cardiovascular nurses are proficient in reading and interpreting various cardiac monitoring devices to assess patient conditions and detect potential complications.
    • Proficiency in cardiovascular assessment and diagnostic procedures: They are trained to conduct thorough assessments, including physical examinations, and perform or assist with diagnostic procedures related to cardiovascular health.
    • Knowledge of patient and family education: Cardiovascular nurses provide education and support to patients and their families regarding their condition, treatment options, lifestyle changes, and self-care strategies.
    Cardiovascular Nursing in other rankings
  8. 8
    Mental health nurses work with patients who have psychiatric disorders, which can be challenging due to the stigma surrounding mental illness.
    Mental Health Nursing is a challenging class in Nursing School that focuses on the care and treatment of individuals with mental health disorders. It is designed to equip nursing students with the knowledge and skills necessary to provide holistic care to individuals with psychiatric illnesses.
    • Emphasis on Assessment: In Mental Health Nursing, there is a strong emphasis on conducting thorough assessments of mental health status, including psychological, emotional, and social factors. Students learn various assessment techniques and tools specific to psychiatric evaluations.
    • Understanding Mental Illnesses: The class covers a wide range of mental illnesses, including mood disorders, personality disorders, schizophrenia, and substance use disorders. Students learn about the signs and symptoms, etiology, treatment options, and nursing interventions for each disorder.
    • Therapeutic Communication: Effective communication skills are essential in mental health nursing. Students learn techniques for building trust, active listening, empathy, and therapeutic responses to effectively interact with patients experiencing mental health challenges.
    • Legal and Ethical Considerations: Mental Health Nursing explores the legal and ethical aspects of care, such as patient confidentiality, informed consent, and involuntary hospitalization. Students learn to navigate the complex ethical dilemmas that may arise in the field.
    • Psychopharmacology: Understanding psychiatric medications is crucial for nursing students. They learn about the common medications used in mental health treatment, their mechanisms of action, potential side effects, and patient education related to medication compliance.
    Mental Health Nursing in other rankings
  9. 9

    Geriatric Nursing

    Linda Richards
    Geriatric nurses care for elderly patients who often have multiple chronic conditions and require specialized care.
    Geriatric Nursing is a specialized field of nursing that focuses on providing care to elderly patients. It involves managing the unique needs and challenges faced by older adults, including age-related health conditions, chronic illnesses, cognitive impairments, and end-of-life care. Geriatric nurses play a crucial role in promoting the overall well-being and quality of life for elderly individuals.
    • Patient Population: Elderly individuals (typically aged 65 and older)
    • Holistic Care: Provides comprehensive care that addresses physical, psychological, social, and functional aspects of aging
    • Geriatric Assessments: Conducts specialized assessments to identify the specific needs and risks of older patients
    • Care Planning: Creates customized care plans based on individualized needs and goals
    • Chronic Disease Management: Manages common age-related chronic conditions such as hypertension, diabetes, arthritis, and dementia
    Geriatric Nursing in other rankings
  10. 10

    Forensic Nursing

    Virginia A. Lynch
    Forensic nurses work in legal and criminal justice settings, where they collect evidence and provide medical care to victims of violence or abuse.
    Forensic nursing is a specialized nursing field that combines medical expertise with legal investigation skills. It involves providing healthcare services to individuals involved in criminal cases, such as victims of violence, sexual assault, child abuse, and accidents. This specialty also includes working closely with law enforcement agencies and legal professionals to collect evidence, testify in court, and provide expert opinions on medical matters related to the cases. Forensic nurses play a crucial role in ensuring justice and providing support to both victims and the legal system.
    • Training: Forensic nurses receive specialized training in forensic science, law, and criminal investigation techniques in addition to their regular nursing education.
    • Evidence collection: Forensic nurses are trained in proper evidence collection techniques, including preservation and documentation.
    • Victim support: Forensic nurses provide emotional support and crisis intervention to victims of violence or abuse.
    • Forensic examination: They conduct forensic examinations to gather evidence related to criminal cases.
    • Forensic documentation: Forensic nurses document their findings in a manner that is admissible in court.

Missing your favorite specialty?


Ranking factors for difficult specialty

  1. Complexity of patient care
    The level of difficulty in managing and treating patients with complex health issues, chronic illnesses, or medically fragile conditions. This may include the coordination of multiple treatments, therapies, and medications, as well as the overall management of the patient's care plan.
  2. Acuity of patients
    The level of critical care required by patients in a particular specialty, including patients with life-threatening conditions or severe injuries who require constant monitoring and rapid interventions.
  3. Emotional intensity
    The degree of emotional and psychological stress that comes with caring for patients with severe illnesses, trauma, or terminal conditions, as well as their families.
  4. Physical demands
    The level of physical labor required in a specialty, such as lifting, transferring, or repositioning patients, administering treatments, or performing procedures.
  5. Scope of practice
    The range of clinical tasks, procedures, and responsibilities required for a particular specialty. Some specialties may require additional education, training, and certification.
  6. Interprofessional collaboration
    The degree to which nurses in a specific specialty must collaborate with other healthcare professionals, such as physicians, therapists, and social workers, to provide comprehensive patient care.
  7. Shift length and scheduling
    The impact of extended shifts, on-call hours, night and weekend shifts, and other scheduling demands on work-life balance and overall job satisfaction.
  8. Technological demands
    The level of technological expertise and adaptability required in a particular specialty, such as managing sophisticated medical equipment or navigating electronic health records systems.
  9. Continuing education requirements
    The need for ongoing professional development and education to stay current in a specific specialty, including new treatment options, clinical guidelines, and research findings.
  10. Job market and competitiveness
    The availability of job opportunities and the degree of competition among applicants in a given specialty, which can influence job satisfaction and career growth.

About this ranking

This is a community-based ranking of the most difficult Nursing specialty. We do our best to provide fair voting, but it is not intended to be exhaustive. So if you notice something or Specialty is missing, feel free to help improve the ranking!


  • 187 votes
  • 10 ranked items

Voting Rules

A participant may cast an up or down vote for each Specialty once every 24 hours. The rank of each Specialty is then calculated from the weighted sum of all up and down votes.


Trendings topics

Don't miss out on the currently trending topics of StrawPoll Rankings!

More information on most difficult nursing specialty

Nursing is a highly challenging and rewarding profession that requires dedication, compassion, and a wide range of skills. Nurses work in a variety of settings, from hospitals and clinics to schools and community centers, and they specialize in different areas of care. While all nursing specialties are demanding, some are considered to be more difficult than others due to the complexity of the patient population, the intensity of the work, and the level of expertise required. When it comes to the most difficult nursing specialties, opinions vary depending on the individual nurse's experience and perspective. However, some specialties are commonly cited as being among the most challenging. These include critical care nursing, emergency nursing, oncology nursing, and neonatal nursing. These specialties require specialized knowledge, advanced skills, and the ability to work under high-pressure situations. Critical care nursing involves caring for critically ill patients in intensive care units (ICUs). This specialty requires nurses to have a deep understanding of complex medical conditions, advanced life-support techniques, and the ability to manage multiple patients simultaneously. Emergency nursing involves providing care to patients with acute medical or traumatic injuries. Emergency nurses must be able to think quickly and make decisions under pressure, as they are often the first point of contact for patients in life-threatening situations. Oncology nursing involves caring for patients with cancer, a complex and challenging disease that requires specialized knowledge and skills. Oncology nurses work closely with patients and their families to provide emotional support and manage complex treatment regimens. Finally, neonatal nursing involves caring for premature and sick newborns in neonatal intensive care units

Share this article