Clinic (Doctor's Office) Nurse vs. Hospital Nurse

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I just accepted an offer in a Pediatrician's office for quite a large healthcare system in our city and I am beyond thrilled! :) It has been 18 months since I have been in the workforce due to medical issues (3 major surgeries) but I am all recovered and ready to rock 'n' roll!

:up:

I was a Public Health Nurse in health department and loved it. This position has great hours (M-F 8:30am-530pm with one set day off weekly, working 1 weekend a month 8am-12 noon.) and seems to have a very accepting friendly staff. The nurse manager is extremely welcoming and I am hoping all will be a good fit for me.

My question is....what is your personal preference, hospital or clinic nurse? I tried out hospital work and found that the whole thing was so overwhelming, nurses would frequently cry on shift, be so exhausted that they couldnt function, and there was plenty of nurse "bullying." To me it was horrifying and just an unhealthy environment. In a doctor's office setting I was able to BREATHE, accomplish tasks and not feel like I was being pulled in 100 directions, and did not experience the "nurses eat their young" mentality. I know people say that right out of school you lose your "skills" if you work in a physician's practice setting but I feel like I thrive in it.

What is your personal opinion on this?

I recently made the switch to ambulatory nursing and enjoy it so far. There are stressful days but they are no where near that of the med/surg floor I worked on. I do miss using some of the more technical skills. I like getting to know my patients over time, seeing them learn and grow. I like teaching them how to manage their health issues. I don't regret switching to a different area in nursing.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
The hospital is where actual RNs are needed. As far as I'm concerned, it's what defines the profession.
Hospital employment has been on the decline for nurses over the past few years as more treatments, procedures and tests have been shifted out of the hospital setting. Furthermore, the bean counters have been actively looking to shift more care out of the hospital due to cost effectiveness.

Outpatient nursing care is the wave of the future. There are not enough Nursing Jobs at the exalted acute care hospital for every nurse who would like to work at one. Embrace the changing tides... Adapt or die.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

First of all, as the Commuter indicated, the trend in nursing is away from centrally located acute care hospitals and into community nursing, ambulatory care, free-standing day surgery centers, and the like. A more detailed description of the trend is here in the IOM Report on the Future of Nursing.

Having worked in both environments, the stress level between hospital and clinic or office was like night and day. You can get crazy busy, but it's fairly predictable even in a walk-in or on call environment. I disagree 100% that a nurse's skills are not utilized, though. It gives you a chance to develop a different set of skills, and a well-run office or clinic is a joy to work in most of the time.

I will say that I sometimes felt guilty that I wasn't using my bedside nursing skills and missed that. Now I work in private duty and really enjoy working bedside again. Nursing has it's downsides for sure, but the ability to move to different environments at each stage in life has been a huge plus for me.

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Specializes in family practice and school nursing.
I don't work in primary care so what I say has somewhat limited validity, however I have been going to the same PCP since I was a kid (like many people) and I've been through on clinicals so I know what it's like. What I noticed the MAs (people who fill the nurse role) doing there does not indicate RN licensure except maybe to educate. Comparing their jobs was a consolation to the OP who is leaving the hospital to work in the clinic setting. An MA can be trained to do an EKG. You say you do IVs, yet there are plenty of states who allow MAs to do this with training. You say you start Foleys, yet patients (uri reten, BPH, s/p surgery) are taught to catheterize themselves at home - and it doesn't take a 2 year nursing program either. The hospital is where actual RNs are needed. As far as I'm concerned, it's what defines the profession.

Nope. Worked in hospitals for 2 yrs, primary care drs office for 15 yrs, and as a school nurse for 12 yrs. All 3 positions requre nursing skills , different ones at times, but still nursing skills.

We catherize students, administer tube feeds, and use insulin pumps in school. We did IV's , blood draws, minor surgical assisting, and alot more in the drs. office. Granted we don't use chest tubes, or IV's in school but you better be sharp on your assessment skills so you can determine if that student's bellyache is a "get of class" pass or appedicitis!

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Nope. Worked in hospitals for 2 yrs, primary care drs office for 15 yrs, and as a school nurse for 12 yrs. All 3 positions requre nursing skills , different ones at times, but still nursing skills.

We catherize students, administer tube feeds, and use insulin pumps in school. We did IV's , blood draws, minor surgical assisting, and alot more in the drs. office. Granted we don't use chest tubes, or IV's in school but you better be sharp on your assessment skills so you can determine if that student's bellyache is a "get of class" pass or appedicitis!

I couldn't agree more!!! ;)

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The hospital is where actual RNs are needed. As far as I'm concerned it's what defines the profession.[/quote']

Ok so do you think that the MA's in your PCP's office can do everything you do in the hospital setting?

Like I said before I work PRN in a clinic. Some of the things I do like vitals and weights an MA can do. But one thing I can do and thank goodness I have this skill is assessment. MA's are not taught this skill. Not to give too much detail I had a patient who was in for an appointment and I was asking general questions. I noticed several things wrong with this patient. Nothing overtly obvious but things that I have seen before as an RN. Well I had the patient lay down and I ran out and got the MD and called a rapid response to our clinic. The patient was having a CVA. And he didn't presentation wasn't typical. He was given clot busters and the damage was reversed. I've also had several other times where I've had to rush patients over to the ER adjoining the clinic or call a rapid response or even a code. Because I went to nursing school and I am an RN I can pick up on subtle changes in patients. I doubt an MA has this skill.

So OP enjoy your out patient job. Your skills as a nurse will be utilized there too.

Sent from my iPhone using allnurses.com

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I'm an ED nurse through and through.

I don't want to do anything besides ED hence, I'm gonna be a hospital dude forever.

I like the pace, variety, and patient turnover of the ED. I don't want ongoing relationships with my patients but I don't want a desk job either. I like to be up and moving around (having spent nearly 20 years as a desk jockey).

I like the wide variety of physicians that I work with and working with MD residents is a special treat that I would sorely miss.

I certainly don't want the 5-day, 40-hour, 0800-1700 lifestyle... blech.

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Ok so do you think that the MA's in your PCP's office can do everything you do in the hospital setting?

Like I said before I work PRN in a clinic. Some of the things I do like vitals and weights an MA can do. But one thing I can do and thank goodness I have this skill is assessment. MA's are not taught this skill. Not to give too much detail I had a patient who was in for an appointment and I was asking general questions. I noticed several things wrong with this patient. Nothing overtly obvious but things that I have seen before as an RN. Well I had the patient lay down and I ran out and got the MD and called a rapid response to our clinic. The patient was having a CVA. And he didn't presentation wasn't typical. He was given clot busters and the damage was reversed. I've also had several other times where I've had to rush patients over to the ER adjoining the clinic or call a rapid response or even a code. Because I went to nursing school and I am an RN I can pick up on subtle changes in patients. I doubt an MA has this skill.

So OP enjoy your out patient job. Your skills as a nurse will be utilized there too.

Sent from my iPhone using allnurses.com

Thank you!! ;) Way to go on using the nursing skills!!!

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I know this is old ....but my take:

I'm currently in a hospital ...hasn't quite been a year. I do enjoy it, but it's med surg and I'm tiring quickly of the kinds of patients I see. Mostly COPD, pneumonia, joint replacements, and dementia with quite a few people simply waiting for placement at a nursing home after their "acute care" is resolved.

I am passionate about peds/babies, so I think it'll be a whole new world when I make my way into that. Passion in a job really goes a long way.

I also want to do a little travel nursing once I'm in a specialty I really love.

Having said all that ....I could still see myself one-day working in a doc office or something like an outpatient chemo center or something ...it does seem like acute care would burn you out eventually, and considering there's so many options in nursing, I find it relieving to know that we can always switch to another area if we want! Even if I enjoy the hospital now, it's nice to know that's not all there is. Same goes with those who only know what it's like to work in a dr office ...it may benefit them to know that they could always try acute care or another area.

I think the awesome thing about nursing is we can jump around if we want to! How many career paths can you do that in with just one title of RN?!

and since I've barely begun ...who knows where I'll end up. And I think all areas of nursing are nursing. It's all real, just all different skill sets. And as long as you enjoy your job, who cares what some people define a real nurse as. The RN position is very diverse in this day and age!

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