I'm in an RN program and I could use a little advice. Before starting the RN program, I worked in a hospital as a nurse aide in med-surg and hated it. I also work in a primary care clinic (mostly in pediatrics, some in family practice) as a medical scribe and I really enjoy it. It's early at this point and I just finished my rotation at a SNF, but I still dislike everything about bedside care.
I really like the patient flow and the vibe of the community clinic I work at. Patients come in, they get help, then they leave instead of needing to be tended to and monitored all day and all night. Obviously there are patients who need to be in hospital, and those hospital nurses are great, but I don't feel like that's a good fit for me personally. My clinic job is not easy and most days everyone hustles pretty much all day. We see about three patients per hour depending on complexity, but generally we see them one at a time. My previous job at the hospital was just crazy busy, especially for aides like me with 10 to 12 patients each. I'm never doing that again if I can help it.
Should I try for a new grad job in public health or primary care without doing time in a hospital first? I could probably do a couple years in hospital if absolutely necessary to gain experience, but I'd rather not. In the hospital setting I felt stretched too thin with too many patients to care for at once, and the nurses were not impressed with my performance (mainly my speed) even after a year. In the community clinic, it took only a few months before everyone respected me and wanted me to be their scribe. I'm very concerned that if my first job is in a hospital, I'll do poorly and get a reputation for mediocrity that might have a lasting negative effect on my nursing career.
I'm a bit torn by what I hear about the ICU. It's bedside care but only one or two patients at a time, and I've heard you get great experience doing detailed assessments which increases your medical knowledge. However the ICU patients are fragile and very ill, so they have multiple problems to manage and as a new grad maybe i would not have the necessary knowledge to care for them.
At the clinic where I work they just hired a new grad RN to train as a pediatric triage nurse, so I know at least a few of those jobs are out there. However, they tried this several months ago with another new grad RN and she quit for a hospital job saying she felt like she needed the experience. The veteran pediatric triage nurse does have misgivings about new grads in triage without hospital experience. The RNs in the clinic do mostly triage and case management but also help with catheterization, etc. I actually love talking to patients. My dream job would probably involve wellness checkups, triage and patient education.
Helpful advice is much appreciated. Telling me I'm lazy for wanting a day shift clinic job or that I simply won't be a real nurse if I don't do bedside care is probably less helpful, but if that's the way you feel go ahead and share. I'm so sorry for this long post I can't stop writing! Thank you for any help!
It seems I've seen more threads lately from potential nurses that don't really want to work as nurses. It may not be impossible to find work away from bedside nursing right out of school, but I don't think that it is likely. I guess my question to you and the others that are posting this question is if you really don't ever want to work providing patient care as a nurse, why would you even want to be a nurse?
Yep. And it bothers me. Get educated all you want. Go to the limit! But, damn, be a nurse in the mean time. Absorb it. It's cool knowledge.
Nope. I didn't enter nursing with an aversion to direct patient care. However, over time I began to strongly dislike patient care and recently left the bedside due to it.
But you took some excellent experience with you. And you are clearly bright and have good insight to yourself and your strengths and weaknesses. I completely understand your decision to leave the bedside but also think you made sure to do it appropriately. Guess I am saying you paid your dues, even though I'm not always a fan of the saying.
Specializes in Oncology; medical specialty website.
Home health, hospice, school nurse, camp nurse and health department to name a few other options. you also have contacts at the clinic you are at so maybe network to get hired there - even as a new grad. Most home health and hospice agencies want some experience but it's still possible. Dialysis is another option as some offer the training.
As far as UR or CM, at least where I live the RN has to have experience AND be certified.
Absolutely not to the first two. It takes an exceptional new grad to feel comfortable working independently in home health/hospice. Where do the medically fragile people in hospital go when they're discharged? They go home. Caring for the dying patient at home can require complex symptom management as well. In both cases, the nurse has to be able to function by him/herself, and do so confidently. A new grad likely doesn't have the skill set nor the fund of knowledge to do so. That's why the majority of home health and hospice agencies require prior experience.
I'm not saying new grads never get hired into either of these fields, but it's much harder to find positions in these areas for nurses who lack experience.
I'm glad I got into nursing to help people when they are at their worst. Even on my worst shifts I walk away knowing I made a difference. Good luck finding a job that works for you.
I loved working bedside... For 7 years... Until I didn't. When staffing became unsafe and management just got worse and worse due to budget cuts, nurses quitting and not hiring new nurses to fill those FTEs. We were stretched thin. Having to take more patients then safe, PICU pushing out patients on drips who are still PICU status, home vents, Trachs, chemo, DKAs on insulin drips changing fluids every five minutes, fresh post ops, traumas (level one trauma center), etc etc etc ... Not to mention all the new policies, procedures and paperwork we had to keep up with. No lunch, no water, no bathroom breaks. The catty high school crew always talking crap about people... Staying after a 13 hour shift to finally chart, then getting yelled at for not clocking out on time, Enough was enough. I loved loved loved my patients, but I was done being a floor RN. Now I'm in NP school and work outpatient.
Most MD offices/clinics in my city have primarily stopped hiring RN's. They hire NP's and medical assistants.
It's interesting how this varies among areas. The hospital-based Pedi GI clinic I work in, ONLY hires RNs. They recently added a BSN to that requirement!
The original question asked about avoiding bedside care, not avoiding all patient care or all direct patient care. My interest in nursing doesn't come from wanting to work behind the scenes developing policies for an insurance company or whatnot. I actually like interacting with patients, hearing their stories and providing guidance. Currently, as a scribe I have only superficial direct interaction with patients, though I do room patients, take vital signs, ask their chief complaint and sometimes ask survey-type questions. Also, I had a prior career involving teaching, so interacting or at least talking with people is a skill set I have developed. My point is that I consider triage, nurse visits for immunizations, patient education, and many other types of interactions to be patient care even though it's not bedside care. I like helping people and I'm interested in medicine/healthcare. I don't want to give the impression that I could have just as easily decided to become a stockbroker or opened up a restaurant.
Yep. And it bothers me. Get educated all you want. Go to the limit! But, damn, be a nurse in the mean time. Absorb it. It's cool knowledge.
I was just thinking about the massive amount of nursing stuff in my head. Knowledge is a good thing, but NURSING knowledge is far from cool. I know how to stick needles in people, know the difference between melena and hematochezia, and know how to suctions trachs:yuck:
It is really gratifying to see positive responses. I also applaud OP for knowing her mind and following what she believes is best.
How about Research? Be employed a university, deal with statistics, interview volunteers for various studies, maybe some bedside or clinical hands-on care.
Teach in a school of Nursing in a Skills Lab. Teach Fundamentals, Nursing Theory.
Correctional facility? You're working with patients in mostly a clinic situation, perhaps a small infirmary where you'd have inpatients who have casts or are post-op and discharged back to jail from a hospital but can't go back yet to general population. Of course some prisons have hospitals where they have inpatients with IV's and more hospital stuff than jail infirmaries. There are adult facilities, juvenile halls, male or female or maybe both, but not mixed.
Clinic spots have always been popular and hard to come by. They were mostly given to older nurses with longevity at the hospital, who could no longer work as hard as bedside care required. These days, I don't know who gets the clinic positions.
Farawyn
12,646 Posts
Yep. And it bothers me. Get educated all you want. Go to the limit! But, damn, be a nurse in the mean time. Absorb it. It's cool knowledge.