Are There Jobs for Inexperienced RNs Besides Floor Nursing?

Wuzzie · Oct 22, 2016

And there is absolutely nothing wrong with starting out in a clinic or dialysis or LTC or psych or corrections. The OP hasn't voiced any long term plans that would make getting floor nurse experience important.

I think those of us who work in these environments would disagree with the notion that they are good places for new grads to start out. With fewer resources, less staff and generally no back up (particularly in ambulatory settings) new nurses will not have the experience necessary to properly assess and provide care for the increasing number of patients who 10 years ago would still be in the hospital. The myth that ambulatory patients are not sick needs to go away. High level assessment skills, critical thinking, time management, decision making and other nursing skills are most definitely needed in the ambulatory setting. These are best learned in environments with the ample resources that acute care offers. Our most successful nurses have had critical care and ED backgrounds. I don't see this changing anytime soon as the shift to ambulatory medicine will continue and we will continue to see an increase in the acuity of our patients.

Animaniacs, BSN, RN · Oct 22, 2016

I've been in med-surg and tele for more than 10 years as an RN. When people refer to floor nursing, do you guys also include ICU or any area/unit where the patient is admitted as inpatient? what about ER, can that be considered floor nursing, seems like most of what I hear as "floor" nursing is mainly from units like med-surg tele, orthox, and step-down. I don't like it when I tell other people nurses that I'm a med-surg tele nurse. They just look down on me,and then they ask me how much I make, and I tell them $xx amount per hour, and they have a smirked in their face and act like "I make so much more for doing an easier job as a nurse" if I win the lottery, man I'm gonna make those people eat their own ****.

but but yes there are jobs for inexperienced nurse besides floor nursing. Although it would be good to gain 1 year experience in a hospital. Places where I've seen new nurses hired are mental health, correctional/prison, public health. I know this one nurse with no experience hired by the state correctional facility and now she is a director of nursing after just 6 months into the job because her boss resigned and she took over it. Sometimes you just have to be lucky and land a good position, but for the most part you take what you can get in floor nursing.

TriciaJ, RN · Oct 22, 2016

I appreciate your comment. In my 40+ years I have never been called names like, "special snowflake" or "buttercup." I'm actually laughing. :) Yes, I did start this post. But I guess what I don't understand is the fact that if floor nursing is not for a nurse, then why is there something wrong with that nurse?? My posting was not asking to be ridiculed for any anxiety I may have toward taking care of 5-8 patients at a time. The posting was simply asking for any advice toward jobs that are available besides bedside nursing for inexperienced new nurses. Please re-read the title.

It's hard to tell from a post whether someone has a particularly bad case of new-grad jitters, or whether s/he is going to have a very hard time functioning at any nursing job due to crippling anxiety.

Many people came up with different viewpoints and solutions. Finding a less stressful new-grad job is only one solution and there may be a dearth of them in your area. One possibility would have been to ask for more help with orientation before throwing in the towel. But if you were certain this was not going to help, then so be it.

Another possibility is to seek professional help to tame anxiety levels. This isn't to extinguish all anxiety to make you a dangerously cavalier nurse; it just might make anything you do more manageable. It was just a suggestion and only you know if there would be any benefit. I'm quite sure no one meant to insult you or imply that being unable to handle floor nursing signified a personality deficit.

An internet forum is like a smorgasbord. Take what you can use.

TriciaJ, RN · Oct 22, 2016

You are wrong. In most markets of the US, there is no nursing shortage. It is irresponsible to continue to perpetuate this falsehood. This mindset is behind many new grads feeling so disillusioned and gob-smacked upon finding out that the nursing job of their dreams is not available to them immediately upon graduation.
Another aspect of this post: Do nursing schools no longer educate their students that graduating from school and passing NCLEX is only roughly the first half of their education? I remember it being made perfectly clear that my first 1-5 years working as an RN would serve as the rest of my education. The thought that one could, as a new grad, go into home health, school nursing, case management or any other independently functioning position was ridiculous. Personally, I do not ever want a new grad coming into my home to independently care for me or my loved one, nor would I want them making care management decisions on my case without ever having experienced real-life medical care.
The abundance of new grads here who are unwilling or unable to tolerate floor nursing is a direct result, in my opinion, of the above issues: the nursing shortage myth that won't die, and the failure of nursing schools to properly prepare their students for the real world.

I've mentioned in previous posts that I see a disconnect between nursing school and nursing. I precepted many students when I worked as a floor nurse. Some schools were very good at trying to prepare their students for actual nursing. Others were more interested in providing a "positive experience" and seemed unconcerned that their students were fated to be thrown to the wolves.

On this site, there are a lot of posts from new grads who are wondering what hit them. Their schools do not seem to be adequately preparing them.

dirtyhippiegirl, BSN, RN · Oct 22, 2016

I think those of us who work in these environments would disagree with the notion that they are good places for new grads to start out. With fewer resources, less staff and generally no back up (particularly in ambulatory settings) new nurses will not have the experience necessary to properly assess and provide care for the increasing number of patients who 10 years ago would still be in the hospital.

I HAVE worked in those settings. With new grads, even. They do just fine as long as there is some support in place. A new grad shouldn't be the sole provider in some bush clinic in Australia. I work in PAT and you know how many people have coded or almost coded in our clinic in the last two years? Zero. We are in a hospital, with six other RNs, several NPs, a doctor, a resident, (all in our clinic) and a hospital based rapid response team. It's not ICU level nursing. I've done that, too.

TriciaJ, RN · Oct 22, 2016

but but yes there are jobs for inexperienced nurse besides floor nursing. Although it would be good to gain 1 year experience in a hospital. Places where I've seen new nurses hired are mental health, correctional/prison, public health. I know this one nurse with no experience hired by the state correctional facility and now she is a director of nursing after just 6 months into the job because her boss resigned and she took over it. Sometimes you just have to be lucky and land a good position, but for the most part you take what you can get in floor nursing.

Let's see if I have this right. I'm a new grad with no experience. So I get a job in corrections. After six months the boss quits and now I'm the boss. Why is there no one senior to me who is qualified or wants to step into the boss's positon? How did it become mine in just six months? And this is supposed to be low-stress? I've actually worked in corrections. And med-surg, psych and ambulatory. And this scenario is giving me palpitations just thinking about it.

NurseLauraM · Oct 22, 2016

Hi Jack1971! There certainly are non-floor Nursing Jobs for inexperienced nurses. My first job was in an outpatient allergy and asthma clinic, and I loved it (the only reason I left was to go back to get my MSN full time). I feel that my quality of life there was much better than it would have been in the hospital - I never (or rarely) felt overwhelmed, had a lot of one-on-one time with each patient, and did not experience the high-pressure life-or-death scenarios you see on the floors. It also didn't hurt that there were no weekends, evenings, nights or holidays! You also get to see many of the same patients again and again, fostering more rewarding (in my opinion) long-term relationships.

My advice to you is to check out sites like craigslist. A lot of the smaller private practices don't want to pay for the 'bigger' ad spaces on sites like indeed so they post on craigslist, which is free. You could also call or e-mail practices you are interested to see if they have any openings. My friend was interested in school nursing and called all of the schools in the area. A lot of them didn't have openings at the time but then called her back a couple of months later with opportunities, or sub-nursing requests.

The beauty of nursing is that it is incredibly versatile. There is something for everyone. Best of luck!

Wuzzie · Oct 22, 2016

I HAVE worked in those settings. With new grads, even. They do just fine as long as there is some support in place. A new grad shouldn't be the sole provider in some bush clinic in Australia. I work in PAT and you know how many people have coded or almost coded in our clinic in the last two years? Zero. We are in a hospital, with six other RNs, several NPs, a doctor, a resident, (all in our clinic) and a hospital based rapid response team. It's not ICU level nursing. I've done that, too.

I'm sincerely glad you have had no emergencies. We've had 6 codes and about 20 rapid responses in the last year! We also tried to hire new grads in a residency program no less. Every single one of them flamed out because they either thought it was going to be a low-stress, easy job or they couldn't handle even the normal days. One very nearly killed a patient and it wasn't because she wasn't smart. She just didn't know what she didn't know.

I still stand by my position that many of the jobs people think are low-stress and well-suited for a new grad simply aren't and neither are they jumping off points until they go onto bigger and better things. Your hyperbole about bush clinics really isn't necessary. I've been doing this for long enough and have a broad range of experience (at least equal to yours) to have a valid opinion. We'll just have to agree to disagree.

AJJKRN · Oct 22, 2016

Yes, there is a nursing shortage where I live. Several of my classmates took jobs with $2500 sign-on bonus. I just accepted a position with a $3500 sign-on bonus. In other parts of my southern state, hospitals are paying $7000 sign-on bonus.
If you are having a problem finding a job, maybe you should consider relocating.
Most of my graduating class had job offers prior to graduation.

This is probably a sign of a lack of retention, NOT a nursing shortage. :yawn:

Libby1987 · Oct 22, 2016

I don't want to come across as snarky or disrespectful but I just gotta say, the speed in which acuities and doing less with more is increasing rapidly, having worked or being familiar with another field does not represent current up to minute understanding of a particular field.

We are being asked to provide such services as admin Lasix IVP out in remote home health. It's amazing what is being entertained in order to move patients to a lower level of care.

I've met with SNF administrators who are facing the challenges of bringing their RN's up to speed with the high acuity acute care transfers that they're facing.

I am currently personally training a new grad one on one out in the field as our experienced nurses are challenged with their increasingly complicated caseloads alone. That's with cutting them back as is feasible. She is a particularly well suited and highly recommended new grad who will receive a year's orientation starting out intensely with me. I'm finding that newer RN's with a year plus non acute experience really need the same, and we're working on it. But that's us with a clinically focused admin, not all agencies are as conscientious, as I was informed by the state and from what I hear in the home health forum repeatedly.

Our new referrals are fracturing, stroking and having major cardiac events within 24 hrs of hospital discharge before we can even get there to admit them. And the ones who last until we do are marginally stable. Those going straight to rehab unit in SNF are at least that fragile.

I'm coming from a place of real time experience. I can't say what it's like in psych or other areas of nursing but I do know HH and meet regularly with acute and SNF mangers as part of our continuum of care to improve our own preparedness and put tools and resources in place. I don't recommend anxiety mgmt from a place of criticism but from a place of knowing what nurses trying to transfer to another area are facing. It's not low stress for anyone in my experience.

LollygaggerRN · Oct 22, 2016

OP-

I was never a "floor nurse". Part of admission to my nursing school was obtaining CNA certification...and I detested every minute of it. I also knew that I could never take care of the same patient for 12 hours. I have so much respect for the nurses who do this, but it is just not my thing.

I love procedures and got hired into an ASC right after graduation. I have done hospital endoscopy. I am now in outpatient endo and it is truly my dream job. It is very fast paced and routine. My skill set is much more narrow than a floor nurse: I admit and recover patients, start IVs, provide conscious sedation and assist the physician. We do have new grads there at times. They do well. There are always other nurses and physicians available so no one is ever, ever alone.

Just something to think about. I never thought this is where I would be happy, but I truly do enjoy going to work.

Don't be miserable. Not worth it. Not at all.

caffeinatednurse, BSN, RN · Oct 23, 2016

LTC has been a good place for me to land, so far. I worked on a busy Med-Surg floor for 4 months after I passed my NCLEX, and I absolutely hated it, to the point where I quit without giving notice. I had 8 total care patients, usually no CNA and supervisors that were unapproachable at best.

Now I work on a busy rehab floor with anywhere from 11-15 residents. Residents w/total hips, paralysis, chemotherapy, radiation, terminal cancer, on hospice, etc. are the norm. So are PICC lines, nephrostomy tubes, Foley catheters, traches, etc. I love it, not because it's any easier but because I get to know the residents and their families. I have a general idea of what to expect when I come in. Things like new admits, falls and residents needing to be sent can (and usually does) happen during my shift, but it makes my med pass and day-to-day tasks easier when I know the resident and their family. They know what to expect, as well. The work environment is completely different, too: I always have 1 CNA, though usually 2, and even my more "hands off" supervisors will not hesitate to jump in and help out when I'm swamped. Most of them are the types that I can call with any question, no matter how "dumb" it may be, and they'll either have an answer or they'll be able to point me in the right direction of an answer.

A good floor/unit for a new grad is one that understands that you're a new grad. It kind of sounds like the last place you worked wasn't a great fit for you. Don't be afraid to try out LTC. I've learned more about the human body and nursing in LTC than I did at the hospital, though I still use those 4 months of experience to care for my residents who are there for short term rehab. Keep the things you've learned. Best of luck with your future job!