Can you be a nurse without working in the hospital? Please help.

DoeRN · Oct 2, 2008

Why can't you try a birthing center at another hospital? Or like an OB office?

SunnyAndrsn · Oct 2, 2008

How about home health?

I'm sorry this is so long, but I am in dire need of some help. I have posted this in 1st year nursing but need some real help so I have posted here too. I just read the "paying dues" thread, so I realize that many of you will flame me for not wanting to pay my dues in the hospital. Instead of flaming me for it, I really hope you will overlook your feelings on that and give me some advice instead. Please.
I have posted here before about how I was hired as a new grad on the birthing center of our hospital - the one job I had thought for a long time was the one for me. I actually chose to go to nursing school with that goal in mind. I am an "older" new grad at 44, having raised 4 sons. All through school I did my clinicals in the hospital thinking "I am so glad I don't have to do this" - be it med-surg or ortho or whatever. I did fine but I really hated it. I just don't feel a calling to do it. I had and still have no interest in hospital nursing other than the birthing center.
So as some of you know, I oriented on days and, although it was very, very difficult and much different than I had expected, I was gradually getting it. I had some tough times but nothing that any other new grad wouldn't have had. Then they switched me over to nights and the bottom fell out. I was almost completely unable to sleep during the day, at all. I would try to nap during the day on my first night but couldn't. So I would go in and work 13 hours, come home and sleep for about 2 to 2.5 hours total, then be unable to sleep any more that day. So I would have to work another 13 hours on 2.5 hours sleep in the past 36 hours. It was unbearable on me, and also very hard on my sons - three of whom are still at home. My 10 year old was very negatively affected. My husband could tell I was on the edge of collapse but tried hard to be supportive. I only lasted on nights for a couple of weeks before I realized that I would end up in the hospital myself if I kept doing it. I spoke to my nurse manager and she was very nice, but told me it was nights or nothing, as they had nothing open on days. I very sadly bowed out and am now unemployed.
I am absolutely reeling now. I am questioning everything. I really thought it would be the right thing for me, and it may have been if I hadn't had to switch to nights. Everyone is telling me "go to med surg! go to ortho! etc" and the truth is, I would rather not be a nurse than do hospital nursing on any other floor. I don't mean to knock nurses who do this - I have a TON of respect for them in fact. I am just not one of them. At this age, I know my abilities and limitations.
All through school my clinical instructors told me that pt education was my strength - especially childbirth, breastfeeding and newborn care. How do I use this strength - and this nursing license - without working on the birthing center? Please, please don't tell me to suck it up and work med-surg - I can't and won't. I don't mean to be unflexible, but it would be like telling a double amputee to suck it up and walk anyway. Not the best analogy, but it just is not for me.
Can anyone tell me what they would do in this situation? Lactation consulting would be at least 2 more years of extensive schooling and I don't feel I can do that at this time. I need a paying job, but don't see a lot of light at the end of this tunnel. Are there any physician's office nurses out there? I could use some advice on that. Please help. Thank you.

Noryn · Oct 2, 2008

It may be really difficult. Dayshift generally is a preferred shift but what hurts you is your lack of experience. Why don't you apply for some prn or part time day shift positions on birthing units in your area? It may be a pay cut but clinic's generally work dayshift, so inquire at local offices. Be sure to tell them how much you feel this is your passion.

queenjean · Oct 2, 2008

Lactation consulting also requires many hours of breastfeeding instruction/pt contact, which you aren't going to get if you don't work the floor.

It takes a while to adjust to nights. Did you try sleeping pills--ambien or benadryl come to mind. Was your family respectful of your need to sleep? Did you have a quiet environment? Do you have to work full time, or could you just work part time, maybe two shifts a week, not back to back? Have you explored other hospitals--they might have day shift options available for new grads, though honestly, it is very unlikely. In the hospital, you do have to pay your dues so to speak--typically night shifters are offered a day shift position before a new grad is, but sometimes night shifters don't want it, and there is indeed a day shift position available.

Have you explored working for an OB or a family practice office that does OB? What about teaching childbirth classes, breastfeeding classes, and newborn parenting classes? While those in and of themselves might not be a full time job, you might be able to teach other classes through the education department of the hospital: safe sitter, CPR, NRP, first aid, car seat checks, classes that would bring you up to full time.

What about the health department? WIC does a lot of pregnancy, nutrition, and breastfeeding education. Many health departments have some sort of program in place that supports at risk mothers--pregnant and parenting teens, for example.

You still have options available, but refusing to work in the hospital does limit them somewhat, not only in terms of job options but also in terms of gaining the experience these other positions require. You might not be able to get full time, or you might have to drive a little. But you just gotta do what you gotta do. Good luck!

MB37 · Oct 2, 2008

Is there only one birthing center/L&D unit in town? How far away is the next hospital? Have you tried hospitals, or just a free-standing birthing center? What about postpartum units or newborn nursery, if they have these separate? Check out OB/GYN offices, although they may not want to pay for an RN. If you absolutely can't find an other mother/baby type of job anywhere, start thinking about what your deal breakers are. You CAN'T work nights, because it makes you physically ill. That unfortunately limits your options. You don't want to work med-surg - but could you make yourself do it for a year if it was the only day job you could get? What about other specialties? Do you think you could do Peds? Or critical care? Or ER? Or OR? Mental health? Definitely keep looking for your dream job, but understand that a lot of us have to be a little flexible with either hours or specialty when looking for our first job. Look into home health, but around here they want med-surg experience first. If you need an income, and your options are do a year of M-S or do a year in another area you aren't interested in, I'd probably do the year of M-S just because it will open more doors later on. I know it's not what you want to hear. Keep looking though! Check out jobs in the paper as well as online, go to every website you can find. Good luck!

S.N. Visit, BSN, RN · Oct 2, 2008

I think you ought to look into clinics (Peds, GYN, general physicians clinics). No night shifts, no weeks ends or holidays. They pay less, but the hours are a huge benefit!

Also look into PRN at hospital L/D's. You can get the day shift experience without working nights if your ultimate goal is working at the birthing center.

Cfitz · Oct 2, 2008

Thanks for the input so far, I really appreciate it.

To answer some questions - yes, I tried Ambien, and I slept no more than 2.5 hours with it, then felt like heck for the rest of the day. I tried everything including sleepytime tea and warm baths and everything else mentioned. I have learned that I am not a day sleeper, period.

I will be making a visit to our health dept. on Monday and seeing what they might have that I could do. I will also be calling the OB offices and asking around. I'll get this figured out, even if I am taking a (very) non-traditional path to get there!

Thanks for not being hostile or negative - I realize that the majority of hospital nurses work incredibly hard and for impossible hours, and in some very very difficult circumstances and again, I have the absolute utmost respect for you all. I just don't think I have the staunch toughness it would take to do what you guys do. Like I said, I know my limitations really well, and if I have to jeopardize my health or the wellbeing of my family to be a nurse, I just can't be a nurse. So I will keep plugging to find the perfect situation and I will compromise when and where I can. Thanks again.

jjjoy, LPN · Oct 2, 2008

I hear ya. I can relate to the sentiment of preferring to not work as a nurse than to work the floor. That was ultimately my choice. It took several long frustrating months of job hunting to get an offer in a health related position that while not a dream job was something I could do day in and day out without my mental and physical health being at risk. I decided that given MY strengths and weaknesses, it made more sense for me to head a different direction than what would be usual for the majority of nursing grads. My current job utilized my health care background but does not require a RN license.

Given your strengths and preferences, I'd suggest looking into Department of Health positions such as public health nursing or health clinic positions. Find out if there are any specific mother/baby programs such as those for teen mothers. In my area, to get a job with the County Health Dept is a lengthy process and there's low turnover, so to get a job there means either lucky timing or persistently pursuing it over time while working another job. Or take that approach to try to get back into some kind of birth center. That is, get a good enough job doing whatever and then just keep at whatever local possibilities are out there so you're in a position to find and take a lucky break.

It will all be worth it if you can find something that really works for you!!!!

sean5732 · Oct 2, 2008

A nursing degree and some experience can be used by the individual to what they want it to be. Get a little experience and go back to school for School Nursing specialty... all days and summers off. Go work for the local, state or federal govt in an office job that requires healthcare background. Pervert it to whatever makes you a happy and productive person.

nrsang97, BSN, RN · Oct 2, 2008

Home health is a good option if your strength is pt education. You could also like others mentioned try OB/GYN offices. What about ambulatory surgery. Day surgeries like outpt EGD/Colonoscopies/Lap choles? That would be day time hours. Or try to get into OB units as evening staff 3-11p. Is that a option? Good luck to you.

Quaffetti · Oct 2, 2008

I understand your night shift problems. I did nights for three years and I will say hands down it was the worst three years of my life! I was always grumpy, couldn't sleep days, etc. Will never do it again.

There is nothing wrong with not working in a hospital. In fact, I think you're smart to not work in a hospital.

I would look into clinics. I know several nurses that have spent their entire careers as clinic nurses and they are very happy. The pay is less, but money isn't everything.