Some nurses have never worked one day inside a traditional acute care hospital during the entire length of their nursing careers. How could this possibly happen? While I cannot speak for other nurses, I will provide an answer to the question that multiple people have asked: "Why don't you want to work at a major hospital?"
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I've been asked the same question by members of allnurses.com, real-life coworkers, and even some of my own family members: "Why aren't you interested in working at a major hospital?"
My relatively short nursing career consists of experience in long term care, rehabilitation (acute and sub-acute), and psych. For the past two and a half years I've been employed at a small specialty hospital that provides acute rehabilitation services, and to be honest, I think it's wonderful when a patient discharges to home with the ability to walk and talk when he was bedridden and unable to speak just two weeks ago.
My career is about to traverse into a new chapter when I enter the realm of developmental disabilities nursing starting next week. Twelve years ago, when I was 19 years old, I was employed as a direct care staff member and caregiver at a group home in a residential area that housed six developmentally disabled clients. I mostly enjoyed working with this particular patient population and will be thrilled to finally work as a nurse in this specialty.
Meanwhile, let's venture back to the original question. . .Why do I not want to work at a major hospital? Honest introspection is a major part of my career decision. In addition, my experiences while attending clinical rotations during nursing school at multiple hospitals in two different states cemented my choice to avoid acute care like the plague, especially after seeing how appallingly the nurses were being treated. After much painstaking self-reflection, I realize that an acute care hospital job is not for me. Some people would interject and say, "Well, you'll never know unless you try it!"
To be perfectly blunt, I know my personality is not compatible with acute care. I'm a mellow type B girl who does not like responding to codes. I dislike dealing with changes in condition. I detest taking off orders that constantly change on the whim of the doctor, nurse practitioner, or physician's assistant. I cannot stand constantly performing procedural skills such as IV starts, Foley catheter insertions, nasogastric tube drops, or blood draws. I despise having to drop what I'm doing to address a stat order. I do not look forward to constant interaction with physicians, families, dietary staff, visitors, RT, and other people.
I hate the liability involved with acute care. I do not enjoy the idea of not knowing exactly what I'm going to walk into. I do not like making decisions NOW, and in acute care the nurse must make decisions NOW. Acute care involves a pace with which I'm not comfortable. I'm not an adrenaline junkie. My preferences include low acuity patients, low liability, minimal stress, and the same old routine. I know that several years of acute care hospital experience would be vastly beneficial to my career as a nurse. After all, you don't know what you don't know. However, if I would likely be unhappy during those years, why follow through with it? If I could steer clear of the acute care hospital for the remainder of my career, I'd be content.
Some uninformed people insist that real nursing only takes place inside the walls of the acute care hospital setting. People can think whatever they darn well please. As long as I'm happy, secure, and comfortable with the work I'm doing, that's all that matters to me. Patients outside the hospital setting need nurses, too.
