Jump to content

My Reasons For Avoiding The Acute Care Hospital

Nurses Article   (53,825 Views 71 Replies 585 Words)

TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1 Follower; 228 Articles; 317,362 Profile Views; 27,607 Posts

Some nurses have never worked one day inside a traditional acute care hospital during the entire length of their nursing careers. How could this possibly happen? While I cannot speak for other nurses, I will provide an answer to the question that multiple people have asked: "Why don't you want to work at a major hospital?" You are reading page 4 of My Reasons For Avoiding The Acute Care Hospital. If you want to start from the beginning Go to First Page.

Are you a credible source? Add your Credentials, Experience, etc.

159 Posts; 4,352 Profile Views

I like acute care nursing, but I don't like the way the hospital is being run.

I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can.

These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.

Agree with your statement about management and resources. I love my coworkers and my patients, but it's impossible to get everything done that management wants us to do. They are sucking my spirit out of me.

Share this post


Link to post
Share on other sites

RURN2O11 specializes in PCU/Telemetry.

39 Posts; 2,431 Profile Views

I've only been a nurse for 1.5 years & have only worked in acute care hospitals. However, I know for a fact I do NOT want to stay in this environment forever. While I am young & energetic I enjoy this type of work (telemetry/PCU), but it is very stressful at times & just not all that personal. I am so glad there are nurses who want to work in LTC & rehab & things like that as well as others who want to do acute care for their whole careers. My long-term goal is to eventually get into primary care as an NP or hospice/home health.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

366 Posts; 6,695 Profile Views

I like acute care nursing, but I don't like the way the hospital is being run.

I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can.

These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.

Exactly. It wasn't really the nursing tasks or skills or whatever you want to call them that I didn't like. I don't have trouble putting in foleys, hanging fluids, starting IVs, etc. I actually had a moment in the ER during school where I thought, "this would be awesome" (even though I found out in reality the RNs only responsibility during a trauma was to chart). Kind of like with the OR...at least here anyway.

I loved the patients most of the time because most of them are lucid, friendly, and grateful. I just never had time to spend with the patients. I was so sick of the management obsessing over the fine details that the elephant in the room was overlooked. Really, I don't have time to pee, but you want me to get how many hours of computer training finished on the clock, but without overtime? Not to mention pretty much the entire staff being stressed out which made for the most hostile environment ever.

I think the only people who really "glorify" acute care nursing anyway are acute care nurses.

Really, most of the public doesn't think about or care what kind of nursing you do. They see your scrubs, your nametag (RN) and then think you can tell them everything they need to know to cure their entire family....even if you have worked in a nursing home for 20 years.

Or maybe I'm oblivious to the glorification going on around me. Either way, that's glory I definitely do not want! Especially since there's no pay increase to go along with it.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

35 Posts; 2,060 Profile Views

Wow I totally agree with everything you said... I am constantly asked the same question, why won't I work in acute care.... well I never want to. Im happy in LTC and mental health. Thank you very much.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

1 Post; 388 Profile Views

I've been asked the same question by members of Allnurses.com, real-life coworkers, and even some of my own family members: "Why aren't you interested in working at a major hospital?" My relatively short nursing career consists of experience in long term care, rehabilitation (acute and sub-acute), and psych. For the past two and a half years I've been employed at a small specialty hospital that provides acute rehabilitation services, and to be honest, I think it's wonderful when a patient discharges to home with the ability to walk and talk when he was bedridden and unable to speak just two weeks ago. My career is about to traverse into a new chapter when I enter the realm of developmental disabilities nursing starting next week. Twelve years ago, when I was 19 years old, I was employed as a direct care staff member and caregiver at a group home in a residential area that housed six developmentally disabled clients. I mostly enjoyed working with this particular patient population and will be thrilled to finally work as a nurse in this specialty. Meanwhile, let's venture back to the original question. . .Why do I not want to work at a major hospital? Honest introspection is a major part of my career decision. In addition, my experiences while attending clinical rotations during nursing school at multiple hospitals in two different states cemented my choice to avoid acute care like the plague, especially after seeing how appallingly the nurses were being treated. After much painstaking self-reflection, I realize that an acute care hospital job is not for me. Some people would interject and say, "Well, you'll never know unless you try it!" To be perfectly blunt, I know my personality is not compatible with acute care. I'm a mellow type B girl who does not like responding to codes. I dislike dealing with changes in condition. I detest taking off orders that constantly change on the whim of the doctor, nurse practitioner, or physician's assistant. I cannot stand constantly performing procedural skills such as IV starts, Foley catheter insertions, nasogastric tube drops, or blood draws. I despise having to drop what I'm doing to address a stat order. I do not look forward to constant interaction with physicians, families, dietary staff, visitors, RT, and other people. I hate the liability involved with acute care. I do not enjoy the idea of not knowing exactly what I'm going to walk into. I do not like making decisions NOW, and in acute care the nurse must make decisions NOW. Acute care involves a pace with which I'm not comfortable. I'm not an adrenaline junkie. My preferences include low acuity patients, low liability, minimal stress, and the same old routine. I know that several years of acute care hospital experience would be vastly beneficial to my career as a nurse. After all, you don't know what you don't know. However, if I would likely be unhappy during those years, why follow through with it? If I could steer clear of the acute care hospital for the remainder of my career, I'd be content. Some uninformed people insist that real nursing only takes place inside the walls of the acute care hospital setting. People can think whatever they darn well please. As long as I'm happy, secure, and comfortable with the work I'm doing, that's all that matters to me. Patients outside the hospital setting need nurses, too.
When possible I think a nurse should have 2 years experience in the hospital. The skills u learn in the hospital is a huge benefit to the rest of his/her career. I have done hospital and non hospital nursing roles. When I work with nurses that do not have hospital experience I feel you see it in there assessment skills and organizational skills. I do agree with the post that there is a major sector outside of the hospital where nurses are using there nursing skills every day. Thank you for the article i enjoyed it so much I register. ;0)

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

7 Posts; 982 Profile Views

I am struggling myself after having moved from California back to the south where there are no staffing ratios. It is important to me to be an awesome nurse. I've been doing this for over 16 years and thus far I have never uttered the words "I'm too busy" to a patient. I feel like the current staffing with this level of acuity truly sets people up to fail. The experiences I have had with family members in the hospital and what I see as a staff nurse myself scares me to death!

Share this post


Link to post
Share on other sites

navyguyhm3 has 10 years experience and specializes in med-surg, urgent care, emergency med.

51 Posts; 1,767 Profile Views

Like all people...nurses have preferences on the type of practice they wish to do and what type of care facility they want to work in. Some because it fits with their knowledge, others because maybe they had the same issues and wish to use their experiences to help heal and care for others with the same issues or disabilities and then, some just want an easy job, where they can just slide by and get a paycheck. Myself, I take the opportunity to work at any type of facility/setting. It allows me to gain new skills and furthers my knowledge which can only make me a better nurse. There are many avenues to take as a nurse..hence many opportunities to make you that much more better and experienced in different aspects of nursing, therefore, I feel you shouldn't limit yourself to one type of care facility or nursing area..but again..it's based on individual preference.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

72 Posts; 5,574 Profile Views

Well written!! I wish I knew of all these other avenues besides hospital nursing that nurses can explore and enjoy working in. I fell for this same fallacy and am miserably working in acute care. The demands become greater and greater, while our resources and staffing keep getting cut. I almost quit wanting to be a nurse b/c of this kind of environment

Share this post


Link to post
Share on other sites

LisalaRN99 is a BSN, RN and specializes in Addictions/Mental Health, Telemetry.

158 Posts; 4,310 Profile Views

I enjoyed reading your post. I agree that not all nursing, or rather, "real" nursing only happens in an acute care hospital. I have only worked in hospital settings: Med/Surg, Telemetry, ICU, ER, and Psych. While some would argue Psych isn't "real" nursing either, I beg to differ! Just because you are not starting IV's, dropping NG Tubes, and giving bedbaths before or after a "Code Brown", Psych nurses must have knowledge and good assessment skills regarding the medical conditions many psych patients have. We also are giving medications of all kinds, although only orally or by intramuscular injection. And psych patients can "code" just like anyone else might anywhere. As a nurse, you must know how to handle a medical emergency. I went into nursing as my second career because I wanted job security that I felt I could only achieve in nursing. Nurses work everywhere. And now I am back in school in order to become a Nurse Educator. I have to for financial reasons, work as long as I can. I can see myself still working in some nursing capacity, such as teaching, well into my 60's. I do not believe in mandatory retirement as long as you are doing what you love, and I love nursing.

Share this post


Link to post
Share on other sites

joanna73 is a BSN, RN and specializes in geriatrics.

1 Article; 4,767 Posts; 43,525 Profile Views

Lol you're not alone OP. I could have written your post. I've worked acute care, and while I value the experience, I knew in nursing school acute care and emerg aren't for me. Could I handle it? Yes. Do I want to? No. I prefer areas where I can spend time with my patients and provide good care while teaching them how to live healthier. Fortunately, nursing offers something for all of us.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

3 Posts; 573 Profile Views

Wow, I am so glad there are other nurses that feel that same way. I have been a nurse for two years working in corrections. I am at that point where i want some new experience but the thought of acute care doesnt really appeal to me. I just fear that without acute care experience i will be limiting myself. I fear that 10 years down the road i will regret not getting experience in acute care, by then it will be to late and no one will wanna hire someone with no experience. I was thinking of taking small steps and apply to rehab hopsital or maybe medsurg to get my foot in the door and learn some new skills. Thanks again for helping me realize there are other nurses that feel the same way about acute care

I've been asked the same question by members of Allnurses.com, real-life coworkers, and even some of my own family members: "Why aren't you interested in working at a major hospital?"

My relatively short nursing career consists of experience in long term care, rehabilitation (acute and sub-acute), and psych. For the past two and a half years I've been employed at a small specialty hospital that provides acute rehabilitation services, and to be honest, I think it's wonderful when a patient discharges to home with the ability to walk and talk when he was bedridden and unable to speak just two weeks ago.

My career is about to traverse into a new chapter when I enter the realm of developmental disabilities nursing starting next week. Twelve years ago, when I was 19 years old, I was employed as a direct care staff member and caregiver at a group home in a residential area that housed six developmentally disabled clients. I mostly enjoyed working with this particular patient population and will be thrilled to finally work as a nurse in this specialty.

Meanwhile, let's venture back to the original question. . .Why do I not want to work at a major hospital? Honest introspection is a major part of my career decision. In addition, my experiences while attending clinical rotations during nursing school at multiple hospitals in two different states cemented my choice to avoid acute care like the plague, especially after seeing how appallingly the nurses were being treated. After much painstaking self-reflection, I realize that an acute care hospital job is not for me. Some people would interject and say, "Well, you'll never know unless you try it!"

To be perfectly blunt, I know my personality is not compatible with acute care. I'm a mellow type B girl who does not like responding to codes. I dislike dealing with changes in condition. I detest taking off orders that constantly change on the whim of the doctor, nurse practitioner, or physician's assistant. I cannot stand constantly performing procedural skills such as IV starts, Foley catheter insertions, nasogastric tube drops, or blood draws. I despise having to drop what I'm doing to address a stat order. I do not look forward to constant interaction with physicians, families, dietary staff, visitors, RT, and other people.

I hate the liability involved with acute care. I do not enjoy the idea of not knowing exactly what I'm going to walk into. I do not like making decisions NOW, and in acute care the nurse must make decisions NOW. Acute care involves a pace with which I'm not comfortable. I'm not an adrenaline junkie. My preferences include low acuity patients, low liability, minimal stress, and the same old routine. I know that several years of acute care hospital experience would be vastly beneficial to my career as a nurse. After all, you don't know what you don't know. However, if I would likely be unhappy during those years, why follow through with it? If I could steer clear of the acute care hospital for the remainder of my career, I'd be content.

Some uninformed people insist that real nursing only takes place inside the walls of the acute care hospital setting. People can think whatever they darn well please. As long as I'm happy, secure, and comfortable with the work I'm doing, that's all that matters to me. Patients outside the hospital setting need nurses, too.

Share this post


Link to post
Share on other sites
×