Nursing beyond the bedside-for new grads? Help!

Nurses New Nurse

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I am a new grad currently working in the hospital. But I really, really do not like it. I'll admit I'm not as excited to be a nurse as I'd hoped. I'd really like something non-bedside but it seems those jobs are rare for new nurses. I don't have enough hospital experience yet to move on to something better, but I also do not have the mental and physical stamina to be at the bedside for a year or two. I'm not young, I have a family, I'm a career changer, and I was naive in thinking I could get an 8 hr/day job. I'd really appreciate any advice or recommendations anyone has on finding something outside of the hospital. I'm not opposed to a desk job or something behind the scenes. Maybe it's a fairy tale, but I'm hoping for less stress, less standing, less lifting, more potty breaks, more opportunities to eat like a normal person, less patient contact, etc. I'd love to find my niche, I just don't want to wait 2-3 years. Maybe if I was younger...

I second the above.

Teaching requires experience, and the best teachers have some amazing stories to tell from their bedside days.

Doctors' offices are the land of the medical assistant. The only nurses I run across in that setting from my experience are NPs. I have known a few RNs, but they have the experience to do telephone triage and perform conscious sedation with monitoring.

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Specializes in ER, progressive care.

What about infectious disease/employee health? Those nurses typically work during the daytime and work 8 hr shifts or less. You could also look into nursing research positions.

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However, psych is just as physically demanding as your current position, plus there is a greater risk of injury.

I worked in inpatient psych & psych emergency for 4 years & was punched in the arm ONCE, which was partially my fault. I have been working in med/tele for 5 years now & cannot count the number of times a confused patient has assaulted me. We have multiple nurses on modified duty at present, some related to patients assaulting them. Just last week a patient slung a call light into my right shoulder blade when I turned to leave the room because she was adamant that I was the nurse from the previous shift who "manhandled" her.

To say that there is a greater risk of injury in psych is not only false information, but it feeds into the misconception that psych patients are more violent than non-psych patients. The truth is, psych patients are more likely to be the victims of violence as compared to the rest of the population - FACT.

Please be careful with your advice, especially to new nurses. Implying that working in psych will increase one's risk of injury is just plain irresponsible, especially as an "Asst. Admin".

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Specializes in Psych ICU, addictions.

I stand by my statement.

Like you, I've worked a few years in psych and emergency psych. I've only been assaulted once, but I've seen many incidents of violence against other staff. While most injuries incurred are minor, I've had to send staff to the ED as a result of patient violence.

That being said, psych is not bad as people may speculate: it's not as though there's the equivalent of a barroom brawl every two hours. Most days are unremarkable as far as violence and injury goes, even when there's a patient escalating because it's usually addressed immediately. Psych is a lot safer than most people realize...I've always said it's safer than working the ER because at least in psych, patients are screened for weapons, the environment is contained, and staff are specially trained in deescalation and handling crises. Whereas in the ER anyone can walk right in and go ballistic, and staff are not always equipped to handle it.

Most patient populations in psych are not violent.

However, some psych populations are more acute than others and carry greater risk due to the nature of psychiatric illness. Some patients are more prone to violence than others--after all, one of the main reasons people get admitted to psych facilities is for actual or risk of danger to self and/or others. And some psych patients can be very unpredictable.

Violence can just as easily come from the 80 year old woman who's delirious, the 8 year old child with ODD who was told "No" or the formerly calm 30 year old who's now angry that he was 5150-ed, as it could from the 6'7" hulking bruiser who's upset with the world, the patient hallucinating due to detox, or the patient with paranoid schizophrenia who thinks we are out to hurt him. A patient who has been placid and cooperative for the last two days can unexpectedly turn, rip the phone off the wall and go violent because he was told something that he didn't want to hear (two staff went to the ED as a result of that incident). And warning signs of escalation may not always be present, or may be so subtle that they are overlooked or discounted.

I'm sorry that you are having a bad experience with violent patients in a non-psych setting. I agree that psych patients are often the victims of violence outside of the facility. I also agree that other specialties do have a potential for violent patients. But IMO, that doesn't negate the fact that in psych there is an overall increased risk of violence and therefore possible injury.

OP: best of luck whatever field you decide to go into.

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@ loriangel14

What I thought was, since nursing is such a wide and diverse field, as many nurses told me before I went into the profession, that one could get a job in a dr's office, research, informatics, outpatient clinics, public health, home health, schools, etc. What I thought was...that one doesn't have to work in the hospital as a bedside nurse if one doesn't want to. As I have already admitted, I was naive in my thinking. Or perhaps, under-informed. I'm not sure what your intent was when you posted your response, but I suppose I should have expected at least one nurse to say "Duh, what were you thinking?!" when I asked for advice. Ah, the field of nursing...such diverse personalities as well. (:

To everyone else who offered advice, I am grateful. Thank you! Lots of different options to explore.

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Specializes in Acute Care, Rehab, Palliative.

I'm sorry if I came across as being rude. That was not my intention.You were asking for work that didn't involve patient contact. I thought that was a little odd as you went to school for nursing. Nursing generally involves caring for patients.You seemed surpised that nursing would involve patient care and being on your feet.

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I was asking for work that wasn't hospital bedside, not work that didn't involve patient contact or zero standing. I went into nursing because I wanted to care for patients. Just not quite the intensity that bedside nursing offers, which as most nurses know is rather demanding/exhausting. It's not really that odd that someone would want to work away from the bedside. I wasn't surprised at all that nursing would involve caring for patients. (;

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I have empathy for you. I wanted a rewarding 2nd career, not something that might shorten my lifespan....My story sounds similar although I'm not looking to get away from physical work (I've lost 15 pds my first 2 months) and I'd like more time to talk with my patients instead of passing pills although there are days when I think I could go back to a desk job and be happy. The jobs I think I'd be good at often require experience in jobs I don't think I can handle, for ex. working in OR often requires yrs of ER experience. Right now I'm working on a LTC dementia unit - I have 8 hr shifts but it's 3-11 & every other weekend - I never get to see my family and by the time I sleep in on Sat I rarely feel like I have a whole weekend off. Day shifts are hard to come by and full of more drama, at least where I'm working. I'm also trying to explore my options so it will be interesting to see other people's suggestions. I have thought about a hospice house, oncology, day surgery centers, Endoscopy/colonoscopy centers, and wound care clinics (I would love to pursue this). Wish dr's offices paid more, I need to get out of debt before taking a pay cut. Some of the desk jobs I've heard about still require yrs of experience -case workers for insurance companies or Medicare auditors/educators for hospitals. I'm sure there is more out there that I do not know about but how do you find the information? Not willing to go into more debt by going back to school until I pay off what I already owe (unless it is the 10 wk wound care/ostomy class) - there are no guarantees I'll like those jobs any better and being in any more debt would be crushing. I hope some more helpful comments come in ...

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I worked in inpatient psych & psych emergency for 4 years & was punched in the arm ONCE, which was partially my fault. I have been working in med/tele for 5 years now & cannot count the number of times a confused patient has assaulted me. We have multiple nurses on modified duty at present, some related to patients assaulting them. Just last week a patient slung a call light into my right shoulder blade when I turned to leave the room because she was adamant that I was the nurse from the previous shift who "manhandled" her.

To say that there is a greater risk of injury in psych is not only false information, but it feeds into the misconception that psych patients are more violent than non-psych patients. The truth is, psych patients are more likely to be the victims of violence as compared to the rest of the population - FACT.

Please be careful with your advice, especially to new nurses. Implying that working in psych will increase one's risk of injury is just plain irresponsible, especially as an "Asst. Admin".

In addition to seconding everything that meriwhen said, I would also add that, based on my decades of experience in inpatient psych (several states, adults and kids, different populations) "injury" may not involve violence directed at a staff member -- in my experience, staff often get injured in the course of restraining agitated clients simply by virtue of the "wrestling around on the floor" aspect of those incidents, not that the client was trying to hurt anyone. While I have not seen a great many people get injured over the years by clients who were trying to hurt someone, I've seen lots of staff injured in the course of dealing with agitated and out-of-control clients.

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I am a New Grad Aswell and it was daunting- I'm in Emerg but in Ontario, Canada we have a 6 month supernumerary mentorship program so it's basically like your last year of nursing but you get paid and have RN next your name. This program is a lifesaver I would never of made it on my own in ER. My new grad transition was insane- it was a vertical learning curve and I don't even work trauma yet. You can spot a New Grad from a mile away looking like a deer in the headlights, all clumsy, discombobulated and frankly just thankful we haven't killed anyone . But we all adjust.

Could you explain the source of your discontentment more. is it just all the less than glamourous things we do in nursing (bed baths, changing adults, other bodily fluids) or is it just because your are new and burning out adjusting to the demand placed upon nurses with time management and juggling 100 things at once while Mr. Smith is yelling for pain meds even though they were just given 1 hr ago? Or is it too physically demanding and you can't lift, roll, turn work 12 hours (despite getting all those days off!) ?

Have you considered dropping down to part time to get that time off you need and letting all the things your learning "soak in" more? Have you spoken to your Nurse Educator/Manager/Old nursing Professor or even a Veteran RN about this for advice and having them possibly going through another mentorship period/ offering a resolution or using the Employee Assistance Plan in some creative way ? Is it the surgical setting? Is it your hospital (try a new one?) What area did you like while in nursing school? Ambulatory care clinic is not physically demanding and has excellent hours such as Day surgery (which is a smooth transition from your current Surg Environment), my classmate got hired in there as new grad.

consider the dialysis clinic?

Utilization Coordinator?

Case Manager?

Insurance Companies?

Public Health/School

Community Nursing not necessarily home care either

Go to college and take that 1/2 semester course for Infection Control (whom we all love dearly) or Occupational Health?

Long Term Care - alot of desk work balanced with direct patient care but definitely no turning lifting rolling, 8 hour shifts decent pay lots of delegation and frankly your the boss.

I did a placement in Complex Continuing Care/Palliative Care. In my particular placement there was only 1 RN on the floor of 24 patients in a resource role. We didn't have a patient load, 8hr shifts, we still did direct patient care but it was more in a Charge RN role Ie we did all the abnormal assessments, rounded, did all the labs, order entries etc. The LVN/LPN/RPNs did the brunt of the work (though we did help but not all RNs do). Have you considered Sub acute/Chronic care setting?

Hope this helps.

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Could you explain the source of your discontentment more. is it just all the less than glamourous things we do in nursing (bed baths, changing adults, other bodily fluids) or is it just because your are new and burning out adjusting to the demand placed upon nurses with time management and juggling 100 things at once while Mr. Smith is yelling for pain meds even though they were just given 1 hr ago? Or is it too physically demanding and you can't lift, roll, turn work 12 hours (despite getting all those days off!) ?.

Yes, it's all of the above! I'm not a fan of the baths and fluids (who is?), but mostly it's the fact that I'm new and already feel whittled down to a nub at the end of the sustained intensity of my 12 hour shifts. Lifting/turning/etc. is hard on my body, but that's minor because I can usually get help. I've only spoken to friends, family, peers rather than educators/managers/professors because right now I'm sort of in the phase of just trying to figure out IF there's something out there better. I'm thinking probably not given that most of those jobs require experience. I think I've resolved myself to sticking it out and sucking it up for a few years to gain the necessary experience to be able to move on into that niche I so dream of. You and others have offered up several great options for non-bedside positions that I will continue to explore. I can begin networking now and laying down those foundations for later employment.

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Look into home care nursing. Less stress, more flexibility. I hated hospital nursing too and really like home care. Stick out you job for at least a year, though.

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