Best way to avoid bedside care?

[Lemon Bars]

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!

[TheCommuter, BSN, RN]

Options to avoid the bedside:

1. Methadone clinics

2. Group homes for the developmentally disabled

3. Occupational health

4. Blood banks

5. Jail intake centers

[RNperdiem, RN]

Talk to the RNs in your clinic. They might be able to provide useful contacts and inside information (maybe find a job opening not advertised).

From my patient experience, most of the RNs I found working in outpatient and office settings were NPs.

[roser13, ASN, RN]

Most MD offices/clinics in my city have primarily stopped hiring RN's. They hire NP's and medical assistants.

[bgxyrnf, MSN, RN]

I don't see how one could be a competent triage nurse without having worked in an emergency department and developed the experience to distinguish between 'sick' and 'not sick,' especially with kids. It can be pretty tough even with experience. Of course, I don't really understand the role of triage in the clinic setting so perhaps it's simply my ignorance.

If you don't want to do bedside care, the ICU is not the place. While many of the patients are not so fragile as you imagine, many of them are and many of them are total care which can be draining.

One role that might suit you is that of diabetic educator. It's probably a tough job to land as a new grad because it's a landing zone for experienced nurses looking to get away from the bedside.

I've known a couple of new grads who landed clinic jobs but in each case they offered something unique to the organization which offset their lack of nursing experience.

You might find school nursing to be more your cup of tea and that is a role into which I've seen new grads hired on occasion.

[KatieMI, BSN, MSN, RN]

To be good at nursing role in clinic, one needs to have bedside experience, IMHO. Maybe not long years of it, but it is still necessary.

Where I live, options include home care and chronic dialysis (may be place dependent, but at least Davita takes new grads without experience in Midwest - strictly for outpatient, though) and some mental/behavioral health. Another way is to go straight to Masters' for NP or education (last one is more complicated for first job search).

[hppygr8ful, ASN, RN, EMT-I]

Another thing to consider is that these non-bedside jobs pay far less than bedside nursing and don't expect annual raises. I recently went back to psych nursing in an acute in-patient setting because I love psych and the money is far better than I was getting from those non-bedside jobs.

Hppy

[nynursey_]

If you're absolutely positive that you have zero interest in bedside nursing (hospitals, SNFs, LTACHs, LTC) then I don't think hospital experience is a must. It will hone your assessment skills and clinical skills but if your goal is to work in a clinic for the rest of your career then it's not particularly pertinent. Not every nurse desires to run the every day rat-race of floor nursing. And I don't blame them.

As for career options, consider these:

1. Urgent Care

2. Clinic

3. Private Practice (Primary Care)

4. UR (Utilization Review)/CM (Case Management)

5. Public Health (Education Focused)

I hope these suggestions help! Good luck in finding that right fit!

[elkpark]

If you're absolutely positive that you have zero interest in bedside nursing (hospitals, SNFs, LTACHs, LTC) then I don't think hospital experience is a must. It will hone your assessment skills and clinical skills but if your goal is to work in a clinic for the rest of your career then it's not particularly pertinent. Not every nurse desires to run the every day rat-race of floor nursing. And I don't blame them.

As for career options, consider these:

1. Urgent Care

2. Clinic

3. Private Practice (Primary Care)

4. UR (Utilization Review)/CM (Case Management)

5. Public Health (Education Focused)

I hope these suggestions help! Good luck in finding that right fit!

In my experience, UR and CM jobs require a significant amount of clinical experience in order to be considered a qualified applicant.

[Farawyn]

I would say NO to SN unless you are Jen-Elizabeth. :)

You are working alone, and there's downtime until there isn't. Most SNs have years of experience.

[westieluv]

In my experience, UR and CM jobs require a significant amount of clinical experience in order to be considered a qualified applicant.

Most of them also ask for prior experience in UR or CM along with general clinical experience. In my area, UR is a difficult, competitive area to get into. It seems that everyone is looking to get away from the bedside these days, and those with the most experience "win".

[nynursey_]

In my experience, UR and CM jobs require a significant amount of clinical experience in order to be considered a qualified applicant.

You may be right. I more meant for insurance companies since much of it is policy based. But it would definitely require looking into more.