New Grad RN: Public health, Home Health, Outpatient Nursing Insight?

[lifelong learner-RN]

Hello all!

I graduated with my BSN in December 2021 and recently quit my night shift pediatric hospital RN position after 3 months of orientation. This was my first job after graduation and I learned a lot about myself. Here are the reasons that I quit:

• Unfulfilled with my day-to-day work; questioned my career choice of nursing and felt passion for it dwindle down/burning out
• Desire to build longer term relationships with my patients/community (for me, an hour to a day maximum with my patients, and then discharging to never see again felt unfulfilling)
• Major scheduling/staffing concerns
• Didn't thrive in high stress situations/patient deterioration (tended to freeze up-fight or flight response was always flight, and feeling super flustered)
• Unpredictability; anxiety coming into a shift not knowing whether the floor would be full or empty with varying degrees of acuity
• Unit drama (I know this is prone to happen in any type of work setting, so I prefer a smaller team or independent settings for this reason)

My strengths/interests: 

• I am innately a very empathetic individual, detail oriented, easy-going and a strong listener
• Enjoy building genuine relationships with others and aspect of educating/being a resource
• Ideal work environment is with a small team or independent where I have sufficient time to complete tasks
• Interested in preventative/holistic care and improving efficiency in healthcare and coming up with new/creative ways to complete tasks 
• Need more flexibility/predictability in scheduling than with hospital nursing

I'm really interested in a couple areas:

1. Public Health nursing. This is my top area right now as I am passionate about preventative healthcare and making a difference within the community on a bigger scale. I have reached out to local public health departments interested in shadow/volunteer opportunities. 
2. Home Health- This is another area I am very interested in as far as building meaningful, longer term relationships and having a bit more consistency in my scheduling. Main concern is not having acute care experience as an RN and possible dangers of entering others homes

Background: I have over seven previous years of caregiving experience spread between being a CNA, clinicals throughout nursing school and nannying. I am in my early twenties and am moving out of state within the year! I am using the next few months to really learn about specialties through shadowing/involvement–with this past job, I was not as picky and did not know myself/preferences in a work setting.

I would deeply appreciate any insight from those with experience in these areas, or any other outpatient area. This phase of transitioning to another specialty is exciting but very nerve racking–I've never not had a plan. If any of my strengths stand out to resonate with another area of nursing, please let me know!! ?

[monz1987, RN]

I have similar interests to yours and also looking for feedback, so am following the post. Hope someone can answer your questions 

[CrunchRN, ADN, RN]

Try clinic pediatrics.

[K897, BSN]

I'm following this post too

 

[lifelong learner-RN]

On 4/27/2022 at 7:18 AM, monz1987 said:

I have similar interests to yours and also looking for feedback, so am following the post. Hope someone can answer your questions 

If you're still active on here, check out my recent post!! Hope it all works out for you ?

[monz1987, RN]

Hey

thanks for update @lifelong learner-RN. I found a job at FQHC and it is much better than hospital setting. Thank for keeping us posted on your journey 

[lifelong learner-RN]

Update 2 years later:

I have worked at an inpatient addiction rehab center for over a year and LOVE it. Highly recommend for anyone who enjoys seeing patient progression/building relationships, is dissatisfied with bedside nursing, and prefers a laid back environment. Going to list the some reasons why you may want to consider this specialty:

- LAID BACK. Super laid back overall.  Patients here range anywhere from 18-60 or so years old, give or take (average is around 20's-40's). It is laid back and overall low stress which I love. In my first few clinicals and jobs as a new grad, it took some time to come to terms with the fact that I do NOT enjoy or perform well in high stakes/high stress life and death situations. You do need to have strong assessment skills, quick judgment/intervention at times as these patients can be fragile. 

- LOW ACUITY. My facility does not accept critically ill patients (they must be independent and stable). Any major medical issues come up, we send them out and they must be approved for readmission. The extent of our lifesaving measures are basically BLS, CPR, Narcan (have never needed to do any of these, as of yet). We do not have a crash cart. Anything beyond that is for EMS/hospital to take care of (less liability for me!). The most invasive thing I do is an occasional TB test, EKG or finger prick.  

- PATIENT RELATIONSHIPS. Patients are at the facility anywhere from 30-90 days, give or take. I genuinely feel that I make a difference in their lives and seeing the transition from day one is incredible. As someone who enjoys building relationships, it's a great turnover time.

- SCHEDULE/PAY. I am on an alternating schedule on night shifts, I basically work 6 days on with one day off in between the sets of 3, and then off for a full 7. Insane work/life balance. Whether I stay here long term or end up anywhere else, I would really push for an alternating schedule. I do not feel burnt out or exhausted after my 6 days on, whereas with past jobs, I was burnt out after a single shift. Nights have taken some adjusting and I never thought I'd be able to do it, but it really is not bad once you establish a routine. The "work to pay" ratio is phenomenal. If I were in school part time (honestly even full time), this would be very doable especially if PRN. I can get all of my tasks done plus doing extra, and still have a lot of down time.

-----------------------------

I have tried many areas of nursing in a short period of time- I am picky, LOL. To name a few I have tried L/D, pediatrics, home health, geriatrics and always faced burnout or dissatisfaction. I'm not one to settle with a miserable job and do not get emotionally attached to jobs (if I see major issues, I'm not sticking around). This is the first job that I have truly enjoyed, do not dread going into and feel that I make a difference. It is not perfect of course, but overall I do highly recommend; my worst shift here has still been better than an average day at most of my past jobs. 

 

Working here has been humbling in so many aspects. I have gained such an appreciation for my life and upbringing when I hear my patient's stories. I actually look at life differently now; any issue or inconvenience I can easily write off as a "first-world-problem" and move on from it fairly quickly. I now have so much empathy and understanding towards those who suffer with addiction and mental health issues. I have drastically improved in holding firm boundaries and communication skills. Seeing patients coming in with broken relationships, poor communication skills, immature tendencies, and failing in many aspects of their lives has really improved my self-awareness. Being involved in their treatment and them blossoming in all of these aspects is extremely rewarding.