Have you ever been looked down on because you don’t work in the hospital?

[happyhippo]

For those working in outpatient primary care offices, have you ever being looked down because you don’t work in the hospital? 

Background: I have been a nurse in a level 1 trauma center stroke/neuro unit for almost 2 years now. I never knew what it was like working as a nurse before the pandemic but I can tell you that I am burnt out.

I love being a nurse but...

I feel more and more burnt out and underappreciated every day.

I question about being a nurse more often than I should. 

I dread going to work everyday.

I feel extreme anxiety before work and it interferes with my sleep, my mood, and just my overall wellbeing.

I get cranky with my family.

I tried to work on my hobbies outside of work like painting and etc but none really helped with my anxiety.

I just feel extremely trapped. It took me a while to finally decide to leave the hospital and move to outpatient.

I got hired as an outpatient primary care nurse but the office is a mix of concussion clinic and acute care walk-in. After I got hired, I feel like I dropped a big weight from my shoulder. I could finally think positive about my future and my nursing career. I really believe that moving away from the hospital helps tremendously with my mental health.

When I broke the news to my coworkers, some of them seemed to talk down on nurses who work in outpatient clinics, especially those with years and years of experience. For example, they would say something like "you're going to get so bored", "what do you even do there? Just vitals?", "you're not going to learn much."

I also have plan to go back to school part time to become an FNP. And my coworkers said, "you're going to make clinical decisions, the hospital is better environment to learn." They gave me the look like I’m weak and I will not be a good NP. 

All these comments about being an outpatient primary care nurse kinda made me feel like I'm not enough to become an FNP and I won’t be a good one because I don’t have enough hospital experience. Do you ever experience the something similar? 

[Hoosier_RN, MSN]

7 minutes ago, RNperdiem said:

In my academic medical center, some of the new grads I met there told me that the clinical instructors in their program looked down on hospital bedside nurses. Their attitude seemed to be that bedside nursing was a low-status position, and that as a nurse, they need to use hospital nursing as a stepping stone to something else and advance their education. 

That was going on when I was in nursing school back in the day...it's got to stop. Not everyone can be an educator, manager, data specialist, CRNA,or NP.  There has to be someone at the bedside, and an incentive to help them stay there.

[Jedrnurse, BSN, RN]

52 minutes ago, RNperdiem said:

In my academic medical center, some of the new grads I met there told me that the clinical instructors in their program looked down on hospital bedside nurses. Their attitude seemed to be that bedside nursing was a low-status position, and that as a nurse, they need to use hospital nursing as a stepping stone to something else and advance their education. 

Yeah, let them run around in their white lab coats and holding their clipboards in a hospital with no staff nurses - how's THAT going to turn out?

[Murse05]

I was able to see past this misconception early while still in nursing school. I avoided many of the stigmas and pitfalls by choosing to work in the specialty that I loved from the get go. To many nurses get sucked into soul sucking environments for various reasons at the start of their careers, only to see the years fly by. At the end of the day the best nurse is the one who genuinely cares about the patient. Burn out is real and noticeable. Sure I couldn’t their job but they wouldn’t be able to do mine either. That’s the beauty of having a specialty. 

[Hoosier_RN, MSN]

1 minute ago, Murse05 said:

I was able to see past this misconception early while still in nursing school. I avoided many of the stigmas and pitfalls by choosing to work in the specialty that I loved from the get go. To many nurses get sucked into soul sucking environments for various reasons at the start of their careers, only to see the years fly by. At the end of the day the best nurse is the one who genuinely cares about the patient. Burn out is real and noticeable. Sure I couldn’t their job but they wouldn’t be able to do mine either. That’s the beauty of having a specialty. 

Depending on when you started, that could be done. Many new grads coming out with limited job prospects, and will take/have to take what's offered. Many moons ago (1993) when I started, grads pretty much named their specialty and were picked immediately for hire. There's only a shortage of nurses in pockets of the population and in certain specialties. Overall, there's a shortage of experienced nurses willing to put up with the crap at lower pay. Many experienced nurses retired/noped out when the covid pandemic started

[2BS Nurse, BSN]

I don't care what people think. Most RNs I talk to want to get OUT of the hospital! 

[T-Bird78]

Actually, yes I have. I’m also “just an LPN” so I get that too.  Anyway, I’ve only worked ambulatory my entire career because I wanted my evenings/weekends/holidays off to be with my kids. There was a comment on this site years ago that directly said ambulatory care nursing isn’t real nursing, so this forum has been down that road LOL.  I was pulled from my office to work inpatient last year during heavy COVID loads, so I spent 7 weeks working inpatient. One of the floor RN’s was retiring and someone asked if she was going to retire or take “an easy job, like working in a doctor’s office.”  I stopped her real quick and told her it’s not an easy job. The nurses on that unit had 5-6 pts each; we see 40-50 a day (up to 60) in my office. We’re a surgical specialist so we’re doing in-office procedures, minor surgeries, pre and postop care, room terminal cleaning, high-level disinfectant of scopes, autoclave instruments, phone triage, calls, prior authorizations, pharmacy issues, and so much more. I will say this:  it’s a different kind of crazy. Inpatient certainly has its difficulties but it’s a contained bubble of crazy; ambulatory has so much fluctuation and outside influence. Other docs will call and beg us to work people in, we’re being double-booked, docs get held up in surgery and are late to clinic, the schedule says they’re coming in for one thing but they pull out a laundry list of 10 different complaints, and we get screamed at by patients about mask wearing and by families because only one person can come to their visit. We don’t get pooped on like inpatient does, but we’re not sitting around eating bonbons either.  And when I tell people I’m a nurse, they immediately ask what hospital, when I tell them not a hospital but a doctor’s office I immediately get the ‘oh’ and they look disappointed. 

[Jedrnurse, BSN, RN]

6 hours ago, T-Bird78 said:

 And when I tell people I’m a nurse, they immediately ask what hospital, when I tell them not a hospital but a doctor’s office I immediately get the ‘oh’ and they look disappointed. 

I wouldn't wish inpatient hospital nursing on my worst enemy. If you told me that you worked in a practice like you described my response would be: "Good for you! You sure are lucky!"

[kbrn2002, ADN, RN]

I never worked a single day in the hospital setting in my 20 years of nursing.  Never wanted to. I had a job as an RN lined up already in the LTC I worked in as a CNA pretty much the minute I told my employer I was going to nursing school. I stayed there because I wanted to, not because there were no other options.

At that time new grads could walk into their preferred place of employment, including going directly to the nursing manager of whatever hospital floor they wanted to work on and pretty much be hired on the spot.  Every single graduate in my class had a job before we graduated much less passed the NCLEX. Except for the one girl who was expecting and decided to not work until after she had her child if she was going to work at all, the option of becoming a stay at home parent appealed to her and as her husband's family business was  owning a construction company she didn't need the working income. 

And yes, I was looked down on by some in my cohort for not choosing a hospital job.  To the point that I slowly stopped contact with the couple of girls that we all swore would remain life long friends after school. I got tired of them looking down on my LTC job and trying to talk me into coming to work at the hospital they both chose.  I never let anybody's opinion of my job affect my choice to avoid the hospital but of course it bothered me some back then. Somewhere along the way it stopped bothering me at all.

[Davey Do]

When we allow others to "make" us feel a certain way, we are giving others control over our lives.

It is we who are responsible for how we allow others' comments to affect us and our emotional reactions to them.

"My happiness does not depend on what others do or say or what goes on around me. My happiness is the result of being at peace with myself."

[JBMmom, MSN, NP]

I think that people should remember that when people put forth their opinions about other people's lives, whether it's their career, their family, their life choices, etc. it's rarely really about that issue. People that need to criticize others and/or put down their life decisions are saying more about themselves and unhappiness with their own life than they are about the person they are criticizing. Don't let what other people express as opinions about your life influence how you see yourself. 

[nyteshade, BSN]

OP, do what makes you happy and what makes sense for your life situation. Even in the hospital, you get nurses who think they are superior to other departments like ICU > med-surg. 

Personally, I think you may have a future advantage securing a FNP mentor when you are ready to begin grad school in a clinic setting. 

If you really are worried about losing certain skills or knowledge, remember that life-long learning can occur anywhere if you make the the time for it. 

[PoodleBreath]

On 3/3/2022 at 5:45 AM, T-Bird78 said:

 And when I tell people I’m a nurse, they immediately ask what hospital, when I tell them not a hospital but a doctor’s office I immediately get the ‘oh’ and they look disappointed. 

I just read yet another article about the toll of the pandemic on healthcare workers that centered on the idea that nurses only work in hospitals. It's frustrating and depressing to feel so invisible. The toll of the pandemic has been intense in my field - first because of the corporatization of healthcare - and then of course diminishing resources, no PPE, decreasing support, vanishing staff, working alone, and of course being mired in this tragedy in the homes of dying patients and having to navigate the pain of the entire family, which is complicated as all get out - sometimes for hours at a time alone. 

Not to mention staff in SNFs, ALFs, memory care, who have years-long relationships with their patients. I have gone in to take care of hospice patients and seen staff weeping, alone, struggling at half-capacity to care for 20-40 severely ill patients, many who feel like family to them. 

Healthcare workers in outpatient settings, communities and schools also have those long term relationships with patients and are just as invested in their well-being, learning their secrets and fears, and feeling incredibly invested in protecting them. With the same lack of resources and support as anywhere else. And since the pandemic, having to face some very highly agitated patients while alone in a room with them. And no recognition. My first job was in a clinic and I couldn't hack it, it's hard work.

There's no question that the conditions in hospitals are brutal. But healthcare doesn't start and end in the hospital. It starts and ends in homes, in clinics and schools and then hopefully leads patients back out again into their homes and community. I wish there was a way to bring more support to those of us working outside of the spotlight.