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First RN job in community instead of acute care? Am I crazy?

by kberg4 kberg4 (New) New

Hi everybody!

I graduated from nursing school with my BSN in May and am trying to make a decision about where I am going to begin my career. Some background on me - I am married, my husband works a stressful job 40+ hrs/week, has late night classes several days a week, and is gone (overnight) for work one weekend a month. We have a 20 month old son and are expecting our second baby next month. My plan was to start my career in acute care to get some experience, and then pursue my passion of women's health, get my lactation consultant certificate, etc.

I've worked part-time as a tech on a very busy, very short staffed Telemetry unit for the past year and have been offered a job as an RN after I return from maternity leave. Despite the craziness of the unit I initially accepted because I love the people I work with and love the buzz of the hospital. My husband and I have been very worried though about balancing the stress and hospital hours with our family life, especially with a new baby.

Recently I received another job offer at a clinic that works with at risk pregnant/young moms. It mostly doing education (which I love) on pregnancy, birth, lactation, and parenting. It's pays about $5 an hour less then the hospital (not ideal but we'd manage), but has very flexible, regular office hours. It seems like it'd be a much better fit for my family and my career goals, but I'm worried that by starting straight into community health instead of acute care I'd be limiting my career down the road.

Anybody have any advice or experience related to this? I've always heard that you have to start with inpatient care and get some general skills before specializing, but more and more I've heard of new grads jumping right into specialty fields. I don't want to make a decision I'd regret, but I also dont want to miss this chance if its whats best in the long run!

joanna73, BSN, RN

Specializes in geriatrics.

If you feel this position is something you would enjoy, take it. The old school of thought was new grads should begin their careers in acute care, but this is not the case anymore.

Patient care models have shifted towards community based care and will continue this way: home care, clinics and continuing care.

Good luck!

If I knew I wanted a career in outpatient women's health I'd take the relevant community position, and not look back.

ETA it doesn't matter how much they'd pay you if it doesn't work with your lifestyle.

Thanks for the input! I'm so torn! I love the unit I'm on, but I really don't see the schedule and workload fitting in my family life right now. I'm afraid that I'll get through orientation and have to leave...we've had alot of turnover this year and I'm sure the unit budget is feeling it.

I guess I'm afraid though that I'll never be a "real" nurse if I don't work acute care for at least a little bit even though its not my long term goal. Everyone I talk to though says go for the community job if its whats going to work better for us. I'm going to have to pray about it a little bit longer!


Specializes in oncology, MS/tele/stepdown. Has 6 years experience.

Real nurses work in the community too. I think you should go for it. It sounds right up your alley!


Specializes in Cardiac ICU, ER, PICU, Corrections.

Go for it! Not all nurses are in the hospital to begin with..or even at all! I started out in corrections and have had a great range of opportunities in my 9 years of being an RN.


Specializes in public health, women's health, reproductive health.

No you are not crazy. The community job seems as if it fits your long term goals as well as your current life/family situation. "Real" nurses can be and are found outside of the hospital.

joanna73, BSN, RN

Specializes in geriatrics.

Agreed. I am a "real" nurse and I work LTC. The stereotypes are tiring. Pursue the work you enjoy.


Specializes in Critical Care, Med-Surg. Has 7 years experience.

You do what works best for you. Whether it's because of a passion for it, scheduling convenience, pay scale, etc, or all of the above. There is no reason not to go for what you want. If all nurses worked only in hospitals, imagine how much sicker our population would be.

Congrats on graduation, and welcome to Nursing. :)