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!
Think about OR or procedural nursing like endoscopy. You can probably go straight to the OR out of school and then you'll have experience to try other specialties. I only lasted 7 months on the floor. I hated it! I did an externship in the ICU in nursing school and knew I wasn't prepared as a new grad to take care of critical patients. Tried home health but didn't like it. I wasn't with the right company. Then found endo. This is where I belong and now I'm a travel nurse specializing in endo. Good luck finding your niche!
What state do you live in? I got into a new grad ambulatory program at Kaiser Permanente in California and the training is extensive! We are training in family, peds, nurse clinic, urgent care and specialties for 6 months with a preceptor, weekly classroom training and after our 6 months we continue with monthly classroom training. We are even being floated to GI lab and ED during our training.
I worked as an LVN in ambulatory for 5 years prior to transitioning into an RN role and it's definitely not a job for the lazy haha so ignore anyone who calls you lazy.
Personally, I wish I would have gone to the hospital because I'm craving that acute care experience but if ambulatory is what you want definitely pursue it!! The RN role is extensive in ambulatory and often times I've seen inpatient nurses transition to ambulatory thinking it'll be a vacation and a place to retire but they end up going right back.
We possess a different type of skill... We triage not only in person but over the phone without the ability to see, listen or feel. We care for patients of every age at every stage in their disease process, we educate, and we are seeing more and more acute patients in clinic! Don't let anyone tell you that you won't be a "well rounded nurse" if you don't work bedside! I used to beat myself down over this and now realize it's not true. The future of nursing is changing and the ambulatory care setting is growing day by day. We are even providing phone and video chat appointments/treatment for our patients which is revolutionizing the way we look at healthcare.
It's also dependent on how much you apply yourself. I stay up to date with my education (ACLS, PALS, NIHSS, EKG certs, etc) and love being able to pick the providers' brains right then and there while the patient is being treated. Our doctors are all so nice and love providing education because they depend on us and often times even ask for our input for treatment and management.
Our nurse clinic is completely independently ran by us (with a provider in clinic available in case we need to consult) so the level of responsibility, time management, triage skills and clinical skills is high. We provide diabetic teaching to all our newly diagnosed and chronic diabetics (insulin, diet, glucometer, lifestyle). We're even taking on home health patients who no longer qualify as being "home bound" and come to us for infusions. As far as wound care, we see everything! Even wound vacs, post op care (including drains), diabetic ulcers requiring unna boot compression, and it's up to US to decide the treatment and assess progression of the wound process. We see the usual immunization update so we have extensive knowledge of immunization schedules for both the pediatric and adult population. Additionally, we have a travel clinic so we are also expected to be knowledgable on travel vaccines and medication needed for travel.
I'm even doing port and PICC line care as well as removing PICCs in clinic, taking care and managing complex wounds and managing my staff (LVN's, MA's), back office intake, interdisciplinary collaboration with specialty departments and scheduling, etc. Want to call us lazy? We do our own EKG's, breathing treatments, back office tests, assist in minor surgical procedures, perform our own ortho supply fitting and even do our own splints. We have so much autonomy that often times it's even us placing the orders for the providers.
It's great experience so don't let anybody discourage you from it if you're passionate about it!!! If it wasn't for the fact that I'm truly passionate about trauma and hope to eventually land there some day, I'd gladly stay in my position because of the fact I have the ability to float around from so many departments so the exposure and experience is excellent!!
P.S. Choose wisely and don't let people on here discourage you because of "the crappy pay." I'm making a 6 figure income as a NEW GRAD without working any OT so the pay can indeed be extremely rewarding! Fully paid for medical benefits for myself and my family and did I mention I get a pension, too?
This actually sounds perfect! And I do live in California. I will look into the new grad ambulatory program at Kaiser!
Not to be rude but I don't think Nursing is for you. You should consider business or some other career. A lot of health care involves bedside care and well you know involves patients that you have to assess and come in contact with.. maybe you could be a secretary at the office! Lol... sorry hunny but I really don't think this is your thing and why make patients hate their experience when you land a job that you hate doing and feel miserable at? People can sense that.
Thank you for your response but many of the other responses have given me more ideas than ever. I feel that I can be a great nurse if I stay in outpatient care.
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!
Being a triage nurse isn't something that most people are advised to do right out of school. There are subtle things that you may not know to look for if you don't have the background that a hospital job gives you. I would be nervous about doing that and I've got 9 years experience (mostly in ICU).
Also, when you go to an ICU even as a seasoned floor nurse, you're given an extensive orientation (I got 3 months and I'd been a floor nurse for a little over a year). You won't ever feel like "I got this" until you have experience, no matter where you work.
If you work as a floor nurse, you're more marketable because clinic jobs and non-bedside jobs are somewhat hard to come by. Either you need the experience that you say you don't want, or the nurses who work those jobs stay there because you can work as a nurse in that capacity into your 70s, whereas at the bedside, most nurses can't hang that long because of the physical requirements.
You're not lazy, but you're cutting yourself off from opportunities because you don't want the bedside experience. That's why I loved the job I had at the facial plastic surgery office: the hours were good (but few), the patients were healthy, and they left after they were recovered. I couldn't have gotten that job, though, and done well, if I hadn't had the bedside experience.
I hear Kaiser's advice nurse system is set up where you're on a computer and there are pre-made questions to ask and "if this, then that" sort of thing, but I'm not 100%. However, I believe you still have to have the know how to advise patients properly, especially in a triage position.
Trust me, I didn't want to hear the "work a year on the floor before you move to a more acute specialty", but I'm glad I stuck it out.
Reading between the lines, she doesn't want to get her hands dirty, literally. How is she handling clinicals???
This is how you have a student say "I never gave an injection" the week before pinning! I think nursing schools are doing a disservice to the students and the profession. Orientation for a new grad should involve planning and time management, not teaching basic nursing skills.
Not to be rude or anything. But based on the way many people here lament about bedside nursing and the current state of hospitals, is it any wonder that some new grads are trying to avoid that environment??? Coupled with negative experiences during clinicals/externships I am not shocked many people are seeking non-bedside careers off the bat.
Not to be rude or anything. But based on the way many people here lament about bedside nursing and the current state of hospitals, is it any wonder that some new grads are trying to avoid that environment??? Coupled with negative experiences during clinicals/externships I am not shocked many people are seeking non-bedside careers off the bat.
Not me! While bedside nursing has its faults and limitations, I think that it will give me great experience as a graduate nurse.
There might be areas in the hospital that you would enjoy. We had several OR nurses hired as new grads, definitely limits your interactions with an awake patient. Pre-op/PACU might hire new grads, you only have them for a few hours. Endoscopy is limited interactions and you don't really need to hone your assessment skills for that.
As as for home health, a lot of my fellow new grads who didn't go through a combined program to get a BSN, went into home health. I only keep in contact with one but she loves it.
I think there have been a lot of great suggestions! Keep your head up and you will find your way in nursing; it is a very diverse field. I do however want to warn you against trying for a new grad ICU position. I think that you will find that even though it is only 2 patients, the ICU is extremely fast paced and more challenging than a normal floor due to the higher acuity. Don't get me wrong, a med-surg floor can be just as challenging, but you are definitely going to want floor experience, or at the very least an extensive externship, before starting as a new grad on an ICU.
Specializes in Flight Nursing, Emergency, Forensics, SANE, Trauma.
The great thing about nursing is the variety and choices we have (YAY!) Theres no shame in not wanting to do hospital care-- honestly don't ever let anyone tell you otherwise. Clinic nursing is real nursing.
School nursing may be an option. ER is awesome because I get new patients every few hours and get to use all my skills. Doctors offices. Peri-operative might be fun for you even.
nursestacey62
53 Posts
Think about OR or procedural nursing like endoscopy. You can probably go straight to the OR out of school and then you'll have experience to try other specialties. I only lasted 7 months on the floor. I hated it! I did an externship in the ICU in nursing school and knew I wasn't prepared as a new grad to take care of critical patients. Tried home health but didn't like it. I wasn't with the right company. Then found endo. This is where I belong and now I'm a travel nurse specializing in endo. Good luck finding your niche!