Don't want to work in a hospital- what to do??

RNDreamer · Oct 28, 2007

informatics, Lactation Consultation, Nurse Attorney,...here is a list of nursing careers I found that may be helpful...

http://www.discovernursing.com/nursing-careers

RN1989 · Oct 28, 2007

There are jobs for RNs that don't involve patient contact, however usually to GET those jobs you must have hands on clinical experience outside of nursing school. There are so many things that you simply do not learn until you are out of nursing school. Until you get the OJT, it is difficult to work as an RN in a non-pt contact role because you have to have an extensive knowledge base to draw from. Nursing school education is entry level, it is enough to get you in the door but it isn't complete until you are able to use that knowledge in the real world.

Even if you were to go to someplace like a doctor's office, you still are going to be working with sick people, including persons with frequently undiagnosed MRSA and TB. If you don't want to work any at all hands on, I am not sure what to suggest. Even teaching is usually going to require you to have clinicals at the hospital with students.

You mentioned that you felt OK dealing with the blood of a DM pt because they didn't have a communicable disease. This kind of thinking can hurt you. EVERYONE must be treated as if they had a communicable disease. That is why we now use gloves and other PPE to protect ourselves. You simply cannot look at a person or a diagnosis and be assured that they don't have something.

If you are unwilling to get any kind of clinical experience, I really am unsure as to what RN jobs to refer you to. The vast majority of nursing jobs and those that are most plentiful and easy to get, are direct patient care jobs. You mentioned patient education and writing. There are non-nursing degrees that you can get and do this. Some people with BS in Biology get jobs writing healthcare info for various companies. However these jobs are more difficult to get into than your run of the mill RN job.

I would suggest that you sit down and write out your life goals. Why do you want to be a nurse? What do you want from nursing? What do you expect to recieve from nursing as a career? What things are you willing to do for a job? What things AREN'T you willing to do in/for a job? How much time and energy do you want to put into a job? What kind of responsibility are you willing to take for a job? Where do you expect to be in 6 mos, 1 yr, 3 yrs, 5 yrs, 10 yrs, etc? What skills do you posess that are marketable to employers? What do you need to do to reach your personal and career goals?

Nursing is a very hands on environment in almost every setting but like I said before, without the clinical experience you will find it more difficult to obtain those positions. When you are a nurse, EVERYONE looks to you for advice. If they know you are a nurse and someone cuts their finger at a party, you will probably be called to "doctor" the person. When some little old lady bites it at the store and is laying on the floor bleeding from a gash on her head, the public expects healthcare personnel to assist. If there is an incident and you do not render aid as a good Samaritan, you can get into big trouble, especially if you are a nurse and you stood by and did nothing and someone finds out you are a RN. As a nurse, it doesn't matter if you work in the hospital or not. There is going to be someone, somewhere that is going to present themselves in need. And you may or may not know the person but you will have to make a decision about helping them.

If you truly do not enjoy this, and/or at are not willing to take the risk, do yourself a favor and find a degree that will help you obtain your goals while still stimulating your mind. Nursing in today's healthcare environment is more stressful than it has every been. Turnover is high. Nurses are leaving nursing to find jobs in retail, elementary education, and banking, among others. You do not want to finish your degree and see the truth about the hard work and determination that it takes to be a nurse when your heart isn't in it. When you become a nurse, there are certain obligations to the public that you have, whether you want them or not. If you are truly as unhappy and disillusioned as your post sounds, I doubt that you will be happy out in the real world. It takes a lot of heart to be a nurse. If your heart isn't in it, then it takes a lot of tolerance to be a nurse and you will be miserable in the meantime. Make sure of what you really want from life before you continue further down this path.

AprilRNhere · Oct 28, 2007

I didn't read all of the previous post...so if I'm repititious, sorry. If the risk of infection is forefront on your list...remember at least in the hospital we know. You can work pt care anywhere else and not know it and have contact with things.

Daytonite, BSN, RN · Oct 28, 2007

With a BSN you can get into case management for insurance companies and HMOs. These are basically utilization review activities and don't involve much or no patient care.

AmericanChai · Oct 28, 2007

You can't avoid those things as a nurse unless you work in really specialized care. And even then patients may have undiagnosed conditions as PP stated.

I am a student and work with some LPN's and other staff in nursing homes and doctor offices. One student who works in a large GP doctor's office said they had four MRSA cases just in one day, and that it is not rare in their office. My child has a gtube and such patients are at risk for MRSA around the tube site, especially those who are recovering from malnourishment or serious disease. When my child had a suspicious infection that I thought might be MRSA I rushed her to a pediatric urgent care. She was never swabbed for it and it did eventually go away with standard treatment so I will never know. But my point is that even at this pediatric urgent care that normally deals with colds and pink eye and stitches can have MRSA and other contagious diseases brought in to the clinic.

Would you be at all interested in being a school nurse? That might be one lower risk job where you would probably just see mostly scratches and fevers.

RheatherN, ASN, RN, EMT-P · Oct 28, 2007

I agree with the other "poster" that said to not continue with what you are doing if you hate it that much. i do not care for med-surg at all, but i know that i have to have that OJT before i can "move -up". sure you could get lucky somewhere with some job, but probably not.

Besides, do you realize how many ppl you come in contact with on a daily basis that you have no idea what they have? the carts at wmart with the parents that let their kids suck on the part you hold on to, no clue what they have at home, or have been exposed to. and in those types of situ's, ur not using any PPE.

Its not that horrible i promise. heck yeah all of us were nervous at one time or another and still are at times, but if this is what you really want to do in life, you either learn to deal with a stint in med-surg, or go else where.

NOT trying to cause an argument or anything, just tellin it like it is.

GL!!!

-H-

Epona · Oct 28, 2007

Thank you everyone for all the honest and helpful advice. There is a lot to nursing that I like so I am going to stick it out for now. You all made some very good and realistic points. You are right. I have always liked science, medicine, nursing and helping people. I'll see it through for now. :) Have a blessed day... Epona

HealthyRN · Oct 28, 2007

I have been a nurse for a year and a half and I still have some of that fear of infectious disease. It does become easier and more routine though. And if you apply the fear in the correct way, you will learn to always protect yourself and practice good handwashing and hygiene. Sometimes you can't tell if someone has an infectious disease just by looking at them or just because the chart doesn't say, so remember to always protect yourself. I always make sure that I leave my nursing shoes at work so I am not dragging all of those germs in my home. I strip down and take a shower as soon as I get home.

There are lots of other options in nursing outside of acute care. But don't let anyone fool you- you need the acute care experience to get these jobs. So, what you have to decide is if it is worth it to stick it out for a year or two to get the experience.

dria · Oct 28, 2007

with a bsn you can get into case management for insurance companies and hmos. these are basically utilization review activities and don't involve much or no patient care.

it was good of you to bring this area of nursing up daytonite, however, cm in the insurance arena has changed. ur is just that ur, and cm is cm.

from http://nsweb.nursingspectrum.com/cfforms/guestlecture/insurancenurses.cfm

a nursing insurance career in managed care is best suited for individuals who want more regular hours and business experience. benefits include flexible work arrangements in a corporate environment, professional development, ongoing training and certification programs, and much more. more important, nurses continue to build and use their clinical experience and remain focused on personalized patient care, a key point that is often overlooked by medical professionals outside the insurance industry.

nurses who work for insurance companies need the same education, practical clinical experience, and judgment as those nurses working in medical facilities. these nurses play a crucial role in the managed care process by applying their clinical background and expertise to the constant interaction they have with patients, physicians, specialists, and other healthcare providers. they use their clinical knowledge and internal resources to analyze whether a member is being given the right care, in the right setting, for the right cost. there are a variety of nursing career opportunities in insurance, including precertification, concurrent review, discharge planning, and case management.

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case management nurses play a key role in health and disease management programs, which are designed to identify patients with specific medical conditions or diseases and help them manage their health.

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here's more on what we do:

from http://www.ccmcertification.org/pages/13frame_set.html

case management facilitates the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. based on the needs and values of the client, and in collaboration with all service providers, the case manager links clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable. this approach achieves optimum value and desirable outcomes for all-- the clients, their support systems, the providers, and the payers.

it is essential for any cm to have a strong clinical background in order to understand the many illnesses and injuries they will encounter, evaluate appropriateness of care received by the client, and anticipate potiential complications. cms working for insurance companies must possess this background, and are eligible to sit for the ccm exam. this is definitely not the place for a new grad!

RNroseshea · Oct 28, 2007

Well, I would suggest that you find your niche when you get out of school. At times when I was in school I thought blood was freaky or icky but once I started my student nurse job during school at a children's hospital, it was not a problem. I now start IV's, perform blood draws, change diapers with blood, etc. As far as others telling you to that you are delusional, I don't think so, as many others out here have felt as you did and still make wonderful nurses. You don't have to get a job in the hospital if you don't want to. The beauty of nursing are the opportunities so do what makes you happy sweetie! There are a lot of opportunities out here in nursing and I am glad that you you are brainstorming now..which means that you are thinking ahead! Utilize standard precautions with everyone.

Good luck and God bless you!

Idon'tcodgerdodge · Oct 28, 2007

I was lucky enough to score a job in oncology research. My title is Oncology Research Coordinator. I work in an office next door to a doctors office comprised of 12 oncologists. We enroll their patients on our research studies. I love the fact that I still get some patient contact, but only when they have an appointment with the doctor. Other than that, I'm in my office doing paperwork, making phone calls, etc. I absolutely love it!! I didn't really know that was an option for RNs, but it is and I make more money now than I did as a med-surg nurse. Not to mention working 7-330, no weekends, no holidays..