New graduate RN jobs outside the hospital?

amjowens · Aug 24, 2008

What facts would those be?
The reality is that most jobs require a strong clinical background, one that simple nursing school clinicals won't cover. While there are many and varied jobs outside of the hospital setting, the people that GET those jobs typically have plenty of experience to pull from. Hiring a new grad without hospital experience is frequently thought of as a costly mistake.
So, while it's appreciated that there are many avenues to choose with an RN license, they are not all open to new grads, nor should they be. The new grad who chooses a shortcut (meaning without a chance to develop those strong clinical skills--and don't kid yourself into thinking nursing school prepared you) is usually the one back on these boards in no time, saying "I don't know what went wrong, I got my dream job, but I didn't know what to do when the real problems hit..."

Obviously, I'm writing from a student's perspective. I wrote nothing about clinical readiness of nursing students.

I do know the trend in health care is going toward outpatient settings and shortened hospital stays. I've gotten this information over the years, just from reading news and being aware of the world around me, so it's kind of like general knowledge. The hospital where I do my clinicals currently has a hiring freeze. The dialysis clinics, hospices, home health, and other outpatient jobs, though, are hiring.

I do know that there's a wait list at many schools to study nursing, and I proposed a concern that possibly these students down the road will be competing for clinical training in the hospital. Could be wrong here, but business trends seem to rule the course, and with the demand for nurses outside the hospital, there might be some place outside the hospital setting that would hire a new grad.

For me, I value experience. I plan to be a nurse practitioner, and want to work in a hospital as a RN to gain experience first. I do know of many programs that offer dual BSN/MSN programs for nurse practitioners if one already holds a degree in any field. Nobody, though, is really "perfect" at their practice without years out on the field.

RNsRWe, ASN, RN · Aug 24, 2008

amjowens: I don't disagree with what you wrote, with the exception being the idea (if I'm understanding you correctly) that increased use of outpatient settings means decreased use of hospital stays. While the trend may be toward utilizing multiple outpatient placements, the reality is also that the need for hospitalizations in general has increased.

People today are sicker, for longer periods of time, than in the past. At one time people got sick, stayed in the hospital and then died from the severity of their illness or injury. Today, most of those same ailments that killed people relatively quickly are now managed to the point that they stay alive (and frequently needing continued treatment) for much, much longer than they ever did. Those outpatient settings didn't really replace the hospital in the big picture; it made it possible for those patients to continue to be treated and survive (without the use of the hospital as a residence).

Home health, dialysis centers, diabetes centers, and even hospices are not the end of the patient's hospitalizations. Far from it, it often means frequent returns to the hospital. We fix 'em and ship 'em back out to return another day.

I'm surprised to hear of any hospital in a hiring freeze, as I've only known hospital staffing offices badly hurting for new hires. Perhaps it's a regional thing? Many hospitals have closed and merged; NOT because of the lack of patients as a whole but because of the lack of funding and reimbursements by government programs and private insurers. A hospital will close its doors when it cannot make the bills, but when it does, it sends out TONS of patients to other hospitals who have to try and make it work (sometimes before THEY close).

I sometimes wonder about the wisdom of our "progress" in increasing the length of human life beyond what is frequently reasonable or feasible. We have the ability to keep people alive in situations (and for lengths of time) that at one time was unheard of. Doesn't mean I want to return to the turn of the 20th century, of course, but sometimes I just think we've sometimes gone too far in the practice of saving every life for as long as technically possible. The burden on the healthcare system is incredible.

The lack of funding and reimbursements is incredible, too, but I guess that''s another post altogether!

And I applaud your interest in higher education. But for what it's worth (and I'm sure you know this), NONE of us are "perfect" no matter HOW many years in the field! We just increase the likelihood of 'getting it right' and decrease the odds of screwing up :)

zahryia, LPN · Aug 24, 2008

If bedside nursing isn't her thing, what does it matter? Not everyone goes to school with the career goal of working at the bedside. Why worry about getting to practice and develop skills that are not in line with your career goals?

Uh, someone woke up on the wrong side of the bed. She was just asking what the role entails.

RN1121 · Aug 24, 2008

I'd think that finding a position outside the acute care setting without any previous acute experience may be challenging; but obviously not impossible.

It depends on where you live, what resources you have, how far you are willing to travel to work would come into play. Many employers for alternative RN positions are requesting atleast a year of acute experience. You may get very lucky and find one that is willing to work with you.

Let's see, lately I saw ad's for flu vaccine nurses (obviously temporary), plenty of home care opportunities, LTC, doctor's office, clinic work, outpatient surgical center, school nurse......There are so many options for you to work outside the hospital.

I worked Med/Surg right out of nursing school for a few months, wasn't comfortable with that; went to LTC, home care, L&D, and then stumbled upon a great opportunity performing utilization review. I work no weekends, no holidays, no evenings. I have regular hours, stable income. Great opportunities for advancement. I was very blessed to have gotten my foot in the door with that position. Direct patient care is not what I want to do. Clinical experience isn't for everyone. So I understand what you mean!

The best part of being a nurse is that you have all these options open to you. If you don't like one job, try something else until you find the right fit. I believe when you are a nurse, it's important to be content with your chosen specialty.

Aniroc · Aug 26, 2008

Take your time in figuring out what areas of nursing you may be interested in. You're just starting so keep all of your experiences in the back of your mind as you progress through your educational career. I always assocaited nursing with hospitals, but have come to love nursing in the public health sector and in home health care. I also just had an interview with a private travel medicine clinic and earlier this month an interview at the prision providing primary care! There are many opportunties out there for resourceful people! If you can think of it, there is probably a nursing position for it!