I am a new grad looking for a job and one the things I am looking into is a public health. I was wondering if go into public health right off the bat will I become typecast as a PHN and not be taken seriously if I wanted to go into acute care later on? As a PHN after having a adequate experience would it be possible to get a in quality improvement position at a hospital also, or would it be better to start in acute care. If I ended up going to LTC what are the chances of being typecast also?

Also, another question I know LTC is generally looked down upon by nursing peers as lesser nursing but what is the view on being a PHN?

i have never heard the word "typecast" in reference to nursing before this thread. I'm used to seeing in refer to acting - where the casting agent (and public opinion, I guess) prefers to see an actor in a particular role. But this would based on opinion and perception. Nurses are not 'cast' into jobs, we're selected based upon concrete qualifications such as experience, expertise & credentials. So... my response would be "yes, it would be difficult to prove that you are qualified for a job if you have no concrete evidence to support that claim".

The acute care (hospital) environment is very different from other settings. Nurses working in non direct-care jobs (such as quality) in a hospital need to be familiar with how everything works in order to be effective. For instance, they need to understand the clinical documentation system in order to accurately develop data collection systems. If they are working with physicians, they need to have in-depth understanding of how medical staff is organized and governed.

LTC bears a closer resemblance to acute care, as it is also an inpatient environment.... LTACs are the most "hospital-ish" settings since they focus on the care of acutely ill patients also - complete with all the high-tech that characterizes hospitals. So, if you're interested in acute care but jobs are hard to find, you may want to look into LTACs.

Best of luck to you as you launch your career.

If your heart is in acute care, do your best to get into acute care immediately after graduation. It isn't impossible to get into acute care after exclusively working in a SNF or Community Health, but it is not easy, either.

Grayson, I am currently a PHN and have been so for about 1.5 yrs. If Public Health nursing is your passion do it if you are uncertain I recommend getting some hospital experience first. In 2009 my first job was in a hospital on a Med/Surge floor. It might not be where you will stay but the knowledge and experience you will gain is priceless. Also many of the best nurses I have met are those with many different areas of nursing under their belt, especially ER or ICU nurses. Their knowledge base seem to me much more developed. Best wishes to you which ever you choose but remember as they tell us in school nurses can do anything so don't feel you must stick with one job only.