ED nurse personality that is noticeably different from that of the obstetric, med/surg or psych nurse?1
Ask any nurse why she chose a particular specialty and you'll hear a variety of reasons, along with some inspiring stories; although I have never heard anyone say, "Well, I took a personality test that indicated I was born to be a gastroenterology nurse."
How I Made My Decision
In my own situation, many years ago as a senior nursing student in my last trimester in a diploma school program, I was starting the interview process for my first real nursing job. Because critical care nursing required advanced technical skills and close collaboration with a variety of professionals and seemed more highly valued than other specialties (after all it paid more), I thought this was the specialty I should choose.
The key word here is should. This was a purely cognitive decision. Technical skills were not my forté. Fast-paced, highly intense medical crises were just not my cup of tea. Therefore, genius that I am, I rationalized, that's all the more reason I should do critical care, so I can improve upon these weaknesses.
Right after my interview, in which I was actually offered a position in critical care, I started my 3-month psychiatric rotation. My class was fortunate to be part of a new program that divided our clinical time between an acute adult partial-hospital program, a community hospital inpatient setting and a state hospital. This kind of nursing was fascinating, challenging and exciting to me. And, I am not making this up, I marveled that a nurse can do this kind of work and get paid, too! OK, I was naíve.
Best Fit for Me
Psych/mental health nursing was a match for my personality, strengths and interests. I was like a sponge wanting to absorb every aspect of both the clinical and class experiences. I enjoyed meeting the patients and their families. To me, it was a privilege to listen to their lives and witness their emotions. Learning to understand their patterns and behaviors led to a greater effectiveness in helping them make some of the necessary changes in their lives. Seeing how the mind can influence the body was an "Aha" experience for me in that it led to an interest and appreciation of holistic medicine.
Unable to ignore this strong attraction, I set about to pursue this specialty, against many odds. The nursing administrator who had interviewed me declared "What a waste" when I declined the critical care position. Even my own family could not understand why I didn't want to do "real nursing."
What Does Myers-Briggs Say?
Perhaps with additional classes and good mentoring, I'd have become a decent critical care nurse. However, decent is not acceptable to me or to most of the nurses I know. I'd have felt like a weak link in the chain of care and my self-esteem would have suffered. Like trying to walk in the wrong-sized shoes, I could do it, but not for long. It was not a good fit.
There is not a great deal of research correlating personality with choice of nursing specialty. Personality testing, to my knowledge, is not standard for screening candidates for specialties.
Nurses who have taken the Myers-Briggs Type Indicator® have found themselves in one of the 16 types based on Jung's four scales of:
1. (E) Extraversion versus (I) Introversion;
2. (S) Sensate versus (N) Intuitive;
3. (T) Thinking versus (F) Feeling; and
4. (J) Judging versus (P) Perceiving.
While all of these functions exist simultaneously in all of us, one feature in each scale is usually dominant.
According to U.S. Department of the Interior statistics, most nurses demonstrate either an ESFJ (helper-provider) or an ISFJ (nurturer-protector) configuration in the Myers-Briggs inventory. (For more, visit www.geocities.com/lifexplore/mbtypes.htm)
This same instrument was used as part of a study that compared burnout levels of ICU and non-ICU nurses.2 The Myers-Briggs found most of the ICU nurses in the sample to be sensing (S), feeling (F) and perceiving (P) while the non-ICU nurses were predominantly intuitive (N), feeling (F) and perceiving (P).
The SFP nurse values autonomy, freedom and making things happen. The nurse with the NFP type values integrity, healing and facilitating growth for others.
Several healthcare trainers have been using the DiSC® Personal Profile System to promote understanding of one's own behavior in the context of a specific work environment.3 This self-assessment model identifies four dimensions of behavior: dominance (D), influence (i), steadiness (S) and conscientiousness (C).
The person who scores highly in the dominance style likes action, quick decisions, immediate results, problem-solving, troubleshooting and being in charge.
Does this sound like any of your co-workers? Nurses with this profile tend to choose fast-paced, intense specialties like the ED, critical care, OR or leadership roles in management.
A high (i) influence score describes a person focused on people and establishing relationships. This individual seeks a work environment of compatibility, teamwork, openness, optimism and creative ideas. Many like to talk and tell stories. This is the type of nurse who would say, "The best part of nursing is the people, i.e., the patients, the co-workers, the team."
Nurses with a high (i) may gravitate to psych/mental health, oncology, med/surg or pediatric nursing.
The steadiness (S) types emphasize cooperation and coordination with the team to accomplish all tasks at hand. These are the loyal, dependable co-workers who strive to create and maintain a stable work environment. They prefer the status quo, but will accept change if they are made aware of good reasons for it. There is a predominance of this personality type across all types of nursing, but especially in the non-critical care specialties.
This is the nurse who shows up, quietly does the work, develops her skills and goes home. These individuals are our quiet heroes.
Ensuring quality and accuracy, upholding standards, attention to details, analytical thinking, weighing the pros and cons, and taking a subtle approach to conflict are traits of the conscientiousness (C) profile. Although these qualities are present in every nurse, our nurse researchers, continuous quality improvement staff, some nurse-faculty members, critical care nurses and administrators personify these characteristics in the workplace.
Most nurses are a blend of all the aforementioned types with predominance in one or two of the DiSC profiles. Knowing your observable behavioral traits and whether you perceive your work environment as favorable or unfavorable is a valuable tool to help you find the best fit for success in nursing.
Which Specialty for You?
Nursing specialties, more than 120 of them at last count (see www.nursing.center..com), are chosen based on several factors. There are nurses who have chosen specialties due to their own experiences with illness. A second-career nurse, who was diagnosed with breast cancer as a young woman, was so impressed with the nursing care she received, she changed careers to become a home health nurse.
Listen to your instructors! Nursing faculty members often recognize your personality strengths before you do. One of my former roommates in nursing school was an average student until her critical care rotation where her highly exacting, demanding instructor praised her outstanding work.
Several advanced practice nurses will tell you they never believed they could pursue and complete graduate school, but were encouraged by instructors, nurse managers or co-workers to "go for it."
There are many nurses who unknowingly influence the career and subsequent specialty decisions of the women and men in healthcare. Students have told me about relatives, neighbors and office or school nurses whom they admired and chose to emulate.
To find a career specialty that is the right fit for you, take a personal inventory. Most people find the Myers Briggs or the DiSC useful. Write a list of your strengths, interests, likes and dislikes. Pay attention to the inner voice that draws you to a certain kind of nursing.
Understand that your skills and personality traits can be applied to a variety of nursing specialties. Go for what fits you and the ideals that called you to nursing in the first place.
1. Haylock, P.J. (2003). Charting the course of your nursing career. American Journal of Nursing 2003 Career Guide, 103(1), 33-36.
2. Cash, D. (1996). Levels of occupational burnout, personality type, and coping processes: A comparison of intensive care and non-intensive care registered nurses in primary care hospital settings. Unpublished doctoral dissertation, University of San Francisco.
3. Carlson Learning Co. (1997). Personal profile system, DiSC dimensions of behaviorT. Minneapolis, MN: Author.
Rita E. Miller is a certified psychiatric and mental health nurse and motivational speaker. Currently, she is a therapist in the private practice of Dr. Peter Thomas & Associates in Wyomissing, PA.