MAJOR Career Decision, Public Health?

Everline · May 4, 2018

Well...

Firstly, I am not in California, so I can't speak to how things are there. Sorry.

As to the rest, you really have to think about what your goals are and where you want your career to go. I knew I wanted to be a public health nurse when I was in nursing school, but my school was heavily focused on hospital nursing and strongly pushed us in that direction. My first nursing job was in a hospital and I was probably just as miserable as you are now. Most people told me to wait it out. The first year is really hard for most new nurses. I believe that to be true. And I think it probably is better to at least stay a year at that first job. However, I did not. I stayed 7 or 8 months and then I moved to an outpatient nursing job and got my life back.

It is important to note here that I did not have a goal of ever being a hospital nurse again. My goal was to become a public health nurse and I took the outpatient job as a step in that direction. I eventually became a public health nurse and intend on doing this in some capacity for the rest of my nursing career. Public health is quite broad and there are a lot of different things a nurse can do. Most of the nurses I know in this specialty have done several different things over the years, working in different clinics and with different populations. But in general, while you will probably get great working hours and excellent benefits, you are not going to be making the big bucks and your opportunities outside of public health might be limited.

You have to ask yourself what "furthering" your career means to you? Any specialty you go into can have its limitations if your nursing goals are outside of it. And remember, most nursing jobs are stressful in some capacity and moving to another job puts you in that brand new learner's stage again that can be so uncomfortable. Good luck to you whatever you decide. Public health nursing is my passion and I love it. I hope you find your passion too! There is no reason to be miserable when nursing offers so many different opportunities.

babeinboots, MSN, NP, CNM · May 6, 2018

Hi! I'm also a fairly new RN that works in acute care, almost 7 months in at a busy L&D unit. Although I love my job and coworkers, I know my body cannot handle the schedule, stress and physical demand of the job forever. I recently started the process of obtaining my PHN cert in hopes of becoming a PHN in the maternal newborn community. I would also most likely take a small pay cut but the schedule and benifits are totally worth it to me.

My plan is to keep my acute care job PRN so I can keep my skill sharp and have the option to return to acute care full time if I want to later. Can you go Per diem at your current job? A specialty change is definently a big decision and I understand your hesitation but life is too short to be miserable. It's your life, not your parents. Good luck!

terfernay · May 8, 2018

Hello! I've been a nurse now for about 4.5 years and my career started off very similar to yours. My dream in nursing school was to become an L&D nurse and then a CNM. My first hospital job was as a mom baby nurse and even though I loved working with the population of women and babies I hated working in the hospital. It's a very stressful and chaotic unpredictable environment and it was taking a serious toll on my mental health as well. I stayed there for about 1.5 years trying to stick it out because it was "my dream job" and all my friends and coworkers told me it would get better with time. It was very hard for me to leave because I thought I was giving up on my dream but I did eventually find a PHN position doing maternal child health and have been working here for the last 2.5 years. It has been such a great learning experience working with families in the community and very rewarding! I really do appreciate the perspective PHNs get because they work with people in their homes and communities vs just in their hospital room. My mental health and work life balance is a lot better as well. Going into public health is a career move that I never anticipated but I think I've become a more well rounded nurse because of it. I've decided it's time for me to think about my next career move and will now be starting WHNP school in the fall and truly believe the experiences I've accumulated from working with women in both the in-patient and community settings will be an asset in my NP career. Basically what I'm trying to say is you never know where your career will take you and the beauty of nursing is you can always change specialties as long as you're willing to try something new. If you're able to I'd recommend staying at your current job at least one year just because the first year with any job is especially difficult and reach out to coworkers, mentors, employee assistance, etc for support but if you absolutely cannot stand going to work and it's negatively affecting your mental health then it's not worth it! You can always find a new job as a nurse and all nursing experiences will contribute to your knowledge and expertise in your new role whatever it may be. Good luck with your decision!

KRN20188 · May 23, 2018

Everline, thank you for your reply. I believe after careful consideration I am going to take the job and get my life back. Do you know of any companies who generally hire PHN nurses? I have heard of Nurse Family Partnership and the county, however I am hoping there are more options out there for me and other nurses trying to thrive in Public Health. Thank you for any help/ information!

KRN20188 · May 23, 2018

Terfernay, Thank you so much for your kind reply. Is there any companies who you know hire public health nurses that I can keep in the back of my mind to apply for in the future? I am researching them right now in the Southern California area and there doesn't seem to be an abundance of open positions. Thanks in advance.

KRN20188 · May 23, 2018

Thank you for your kindness and thoughtfulness. I wish I could do Per Diem, however this position I am taking is full time so I would have to do PRN 4 times a week to keep my internal employee status where I am currently. I never would want to work 6 days a week, so sadly it would not be an option.

terfernay · May 23, 2018

Terfernay, Thank you so much for your kind reply. Is there any companies who you know hire public health nurses that I can keep in the back of my mind to apply for in the future? I am researching them right now in the Southern California area and there doesn't seem to be an abundance of open positions. Thanks in advance.

I would try looking into county, state, and federal government jobs. Many PHNs are government employees. Do you have a local public health dept? You could also look into school nursing, community health clinics, free clinics, family planning clinics, migrant health clinics, refugee clinics, etc depending on the area you work in and the type of job you're looking for.

kgreeno · May 25, 2018

I would try looking into county, state, and federal government jobs. Many PHNs are government employees. Do you have a local public health dept? You could also look into school nursing, community health clinics, free clinics, family planning clinics, migrant health clinics, refugee clinics, etc depending on the area you work in and the type of job you're looking for.

I second looking into government jobs! I am a county employee and work as an immunizations nurse for a county heath department. It's a fabulously rewarding job and, while the money is not what you would see in a hospital setting, it is a position that allows for excellent work-life balance (I work M-F, 8-4, which was a must for me with some personal circumstances - a messy divorce with two young kiddos).

flufffyo1 · Jun 13, 2018

Unfortunately, I am not an experienced nurse. I am a new grad that has just been hired into public health with a local county (also in California). I can assure you I also had the issue of choosing between what everyone else told me to do versus what I truly wanted to do. With a little encouragement from my PH professor, I chose public health despite the risks. Public health job security depends on the current economy. In 2008 when the recession hit, many PH nurses and county workers were laid off due to budget cuts. That is something you will need to consider. Good thing for you is that you have previous work experience at the hospital. If something like 2008 happened again, I'm sure you will be able to find a job elsewhere. Job security is never guaranteed, no matter where you go or what you do. You just have to have faith that things will be okay.

That being said, I ended up following my heart because I am the type of person who knows that if I don't belong somewhere (ie. the hospital), I will be wasting my time there.

diasmiles · Jul 15, 2018

Hi. I recently transitioned to public health nursing in LA after 14 years of bedside nursing. Consider applying for LA County. There are so many different opportunities within the county for PHN's. When I was a new grad I worked for a large hospital that although I liked working there the unit I worked in caused me lots of tears and anxiety. My parents wanted me to stick it out but I couldn't do it. I decided early on in my career that in order for me to be the kind of nurse I wanted to be I had to be happy. Good luck.

saheckler, PhD, RN · Aug 21, 2018

It sounds like you took the job! How's it going? I think that the field of nursing has so many opportunities in so many areas, it's totally reasonable that you followed your heart. The cost of continuing to be that stressed and miserable is too great. The only risk is making yourself less hirable for clinical nursing positions in the future, since you'll lose your skills being out of that environment. However, it sounds like you hate it anyway so no loss! I left hospital nursing after 6 years of being really miserable and trying multiple units (inpatient oncology, med/surg/ortho, outpatient oncology, dermatology clinic) and although some were better than others, I really was unhappy and felt lost the entire time. Now I'm a health educator at a wellness program and about to go back for my PhD (either in public health or nursing, in which case I would study public health issues) and I haven't looked back for a second. I met nurses who had been in nursing for 20, 30, 40 years and had been miserable since the beginning. You only have one life; don't waste it being miserable unnecessarily. Good job following your heart and making a scary decision that probably felt really destabilizing. That's not an easy thing to do, but it's worth it to avoid a life of misery! At the very least it will lead you to other opportunities and you'll grow professionally and it will be a step in a better direction. Cheers!