Are you really not a "real nurse" unless you work in acute care?

[tenderfootjoe]

I am an RN in a peds clinic, and it seems nurses who work in outpatient settings are not looked at as "real nurses" by their acute care RN counterparts. Is there a future in outpatient nursing?

Also, what are some ways I can "stay current" with my nursing skills as much as possible while working outpatient? I may want to work outpatient my whole career. However, I do want to stay up to date/marketable just in case I one day decide to move into the acute care arena.

[Shiveaget]

I have been working in home health and corrections for the past year and a half in California. I have been wanting to get some experience in acute Care but all the job postings require one year of Acute Care experience. Kind of hard to get the experience when I no longer qualify as a new grad or experienced nurse.

[Libby1987]

In school, we have learned that care continues to shift away from inpatient and more toward the outpatient setting due to shorter hospital stays, higher overall acuity, and lower costs.

it means sicker/more complex patients for everyone.

I admitted a patient with Ca and resistant infection with a PleurX drain with an output of 1L. Rather I stopped the drainage at 1L. 500ml is the recommended max but he was still symptomatic. This was in his remote rural home. Multiple calls later, take off a liter. Alrighty then.

Due to his neutropenic state he was considered safer at home and so we take them.

[Caffeine_IV]

It would be more likely to hear someone say you aren't a "real" nurse when your role requires minimal to no patient contact (clinical educator, case management, insurance RN, etc). Of course you are still a real nurse in these positions as well.

I do think there is some type of unspoken nurse hierarchy within the hospital.

[RNrhythm, BSN, RN]

I am a BSN new grad and a lot of my peers have career goals outside of acute care, such as school nursing and case management, so I don't think that most people see acute care as "real" nursing and other specialties as secondary.

However, I see how someone could get the impression that acute care is emphasized. That is the role people first think about due to TV.

Also contributing to this perception is the seemingly short window a new grad has to move directly into acute care. Once you lose your status as a new grad (too long since graduation or too much experience as a sub-acute RN), we lose access to new grad positions. I have seen new grad positions require that the applicant have less than 6 months compensated experience as an RN. This scarcity of access contributes to the prioritization of the acute care role.

[RNperdiem, RN]

I think of the acute care after passing the NCLEX as something similar to residency for doctors. We gain a lot of knowledge in school, but honestly most of what we actually do is learned on the job.

Acute care is becoming the place where a lot of us go though orientation and go to work to gain proficiency in nursing.

Many places outside of acute care can't/don't give the training. They look for nurses with acute care experience who can be put to work quickly.

[Graduatenurse14]

There is a diploma school attached to a large academic/research medical center that has that type of attitude for sure. I heard an instructor say something to her students about "winding up working in a nursing home."

I was an aid on the a unit where they had clinicals so I was familiar with their attitude overall which sometimes was not good when it came to doing ADL's or communicating with the "lowly aids."

[NursesRmofun, ASN, RN]

You could work prn on a pediatric inpatient unit.

[NOADLS]

There is a diploma school attached to a large academic/research medical center that has that type of attitude for sure. I heard an instructor say something to her students about "winding up working in a nursing home."

I was an aid on the a unit where they had clinicals so I was familiar with their attitude overall which sometimes was not good when it came to doing ADL's or communicating with the "lowly aids."

I had an instructor just like. Needless to say "losing my skills by sitting around doing nothing" sits well with me. The majority of the class was actually buying into it and dreading the possibility of ending up at a nursing home.

[nrsang97, BSN, RN]

Where did you hear that? Nursing has many specialties. Anyone who told you that is full of it.

My thoughts exactly.

[sallyrnrrt, ADN, RN]

Crus, and certifications...trust me I am a real nurse of over four decades, in a clinic setting 💕

[vintagemother, BSN, CNA, LVN, RN]

I've worked in ltc settings since becoming a nurse. It's too bad that some people don't recognize the work one does in ltc. Because of our current economic climate, many pts live in ltc. The work we do there is very important to the people we provide nursing care for.

People who don't understand this are ignorant to reality. I won't argue with them, I'll just keep on doing what i do with pride. Ltc nurses make a huge impact on pts lives, I think.

[Here.I.Stand, BSN, RN]

Yes, you do!

Ltc nurses make a huge impact on pts lives, I think.