Nursing Jobs Outside Of The Hospital...

TazziRN, RN · Dec 12, 2007

i admire floor nurses, that's not something i could do. i spent too many years in the er being able to concentrate on just a handful of pts at a time.

i jumped ship this year and went into home health. totally different than what i was doing before, and i love it! i know i'm burnt out, but i think i burned out a long time ago and didn't see it until this year.

i'm an rn case manager; all the rns at my place are. at other places a few rns are the case managers and the rest are field nurses. i do both. what i can't delegate to the lvn because of pt needs (ivs, etc.) i see myself. there's a lot of paperwork but i like it. we take turns being on call; one nurse who wants weekends off takes call m-f every week, and the rest of us rotate the weekends.

military spouse · Dec 12, 2007

I've had the following jobs outside of the hospital:

School Nurse

Adolescent Residential TX facility (twice)

prison

hospice

We just moved to AZ and I'm trying to figure out what I want to do and a big part of me wants to work outside of the hospital. I don't miss coming home bone-tired, and I've never felt that way in the above jobs. Tired? Yes. Bone-tired? No. Emotionally-drained? Yes. Boy, I think I've just convinced myself not to get a job in the hospital:lol2:

saphyre · Dec 12, 2007

I am an RN on a crazy busy med surg floor. I usually have 7 or 8 patients and rotate doing charge. I have one other nurse on the floor and one CNA. Staffing has been horrible. Acuity has been high. There are nights where I feel like I'm running around putting out fires non-stop. I work my butt off and leave feeling defeated. I got into med surg right out of nursing school for the experience. Have been there for two long years and am looking for the right opportunity to get out of it.

:uhoh3:

Daytonite, BSN, RN · Dec 12, 2007

i was a hospital staff nurse on medical and stepdown units for years before i changed to iv therapy and then got into supervision and management.

basically, an average day has a routine to it. i came in, got report where patient assignments were made and then started my shift which included making rounds on my assigned patients and then attending to making sure their medications, treatments, meals, and tests got done. as problems come up, you take care of them (i called it "stamping out little fires"). you definitely need to become good at organizing the work you need to do. that is probably the one thing that gets you through it all--that and understanding what things take a priority over others when a group of problems come together in a crunch. what i liked most about it was the challenges of organizing and getting all the work i needed to accomplish done each shift. that was always one of my primary goals. as time goes on and you become better at the various procedures that you will be doing, you become more confident and you have more time. (struggling with learning to do procedures for the first time takes up time. as you get proficient in them they take you less time to accomplish.) when you work on one unit all the time there are specific procedures that you will be doing most of your time, so you get good at them. you also have the same doctors admitting their patients to your unit so you get to know their routines and what they usually like to order for their patients. one of my biggest problems when i first started was starting ivs. after 6 months of struggling with it i finally, at the encouragement of one of my supervisors, took the lvn iv therapy certification course out here in california and within 6 months i was making improvement. now, many years later, it is a skill i have worked on and am very proud to have mastered. however, i saw many other nurses struggle with it in their own practices. we all have skills that will be difficult for us to master. how we deal with them is a personal thing. i was just never someone to let any grass grow under my feet. another skill i had trouble with at first was the maintenance of chest tubes, but i did my homework on them as well and became a bit of a unit guru on them.

i loved floor nursing and went back to it all the time. i did not like management. it was probably the routine of floor nursing that i liked about it. despite the fact that the patients change all the time you are still on the unit working with pretty much the same people although the staff does change from time to time as people quit and new people are hired. you know where things are and who to call when you have problems and concerns. i always liked having that stability.

from your screen name i was wondering if you were interested in oncology. since i am currently getting chemotherapy in my chemotherapist's office i thought i would tell you that he has an rn who does the chemotherapy for him. she's a hoot and i really like her. she works 4 full days a week for him (they don't see patients one day a week) and she works one day a week at one of the cancer hospitals here locally. she knows her chemo drugs, let me tell you. however, to do a job like she does you really need to have worked in a cancer center or on an oncology unit and know the chemo drugs. you also have to be good at starting ivs and knowing how to access piccs and ports. i have been hearing that city of hope, which is one of the cancer centers near me, is a terrific place for nurses to work. the nurse/patient ratio is low and they are focused on patient satisfaction. i haven't heard one nurse who worked there say anything bad about their experience there. and, i know that they only admit patients who have cancer and are being treated for cancer--period.

OncNewbie · Dec 12, 2007

Sometimes you learn more about the meaning of life from your patients than your own life experiences. Also, there's nothing like going home & saying to yourself, I really helped that patient & that family. I've felt this many of a time on the oncology/med-surg unit I work on. I enjoy working w/ hospice patients, I like being there for the patient and his/her family. This is one reason why I thought I might leave floor nursing (after my one year experience in the hospital) and go into hospice nursing. I want to learn more about hospice nursing before I go into it. I also thought I might enjoy psych nursing. I like comforting people emotionally, I enjoy listening to people, & sometimes the best thing you can do is listen.

I've learned a lot in Oncology. I access ports and discontinue PICC lines. I've learned so much and it's only been six months; I think this and the patients keep me there.

When I first graduated nursing school this past May, I wanted to become an Onc nurse & get chemo therapy certified. That has changed. I think the dynamics between staff members & mgt has been a little overwhelming for me. My preceptor was burnt out and hated her job. My boss is constantly calling people into her office, (including me) to find why this happened...ect.

I recently found myself in a rather overwhelming situation last week. Yesterday I was called into the office regarding the situation.

Here's the skinny... The patient's primary doctor complained that stat labs were not reported to him like they should have been. I told my two boss' that this piece of information was not passed a long in report. Another thing they asked me is why I didn't bladder scan the patient when it was initally suggested to do so. I admitted that I got immediately preoccupied, (I had a patient that was trying to climb out of bed naked). They then asked if anyone offered to help me. I said, no not until everything started to go down hill. My boss' told me that they were impressed with my charting of the event & were surprised that I was able to indentify crackles as a new grad. They also told me that anytime a doc orders IM or IV lasix that the patient needs to be seen, I nodded my head. My boss' said they are going to treat this as a learning experience and talk to everyone involved. Then we are all going to meet to discuss the matter.

I feel that the CRF & chronic liver failure patient was very acute and not an appropriate pt. for a new grad. I also feel that having all new nurses on, (w/ one experienced, LPN & thank god for the experienced LPN) was not good. Also, having a doctor that was yelling at me because I wanted to call report to the ICU even though it was shift change, was not helpful. I called ICU anyway and got my patient up there as fast as I could.

I was honest and only hope that I'm not going to make enemies because I told the truth. I'm trying to get my mind off of the situation but it's very difficult. Questions like, "Do you feel comfortable working w/ OncNewbie" were asked and I just wonder what does it all mean? Maybe I feel this way because it's my first time getting called into the office like this. Anyhow, I don't like feeling like I'm walking on thin ice all the time. I requested to work on days because I feel I have a lot more to learn & I honestly feel like I'll have more support on days. But I don't know if another job is in the works because this is all a little too much. I have a scholarship w/ the hospital and don't want to have to pay it back; which I will have to if I don't give them a full year. But money is not everything and my husband says but honey you're making so much money and it's true but money is not everything. What about getting back to why I went into nursing in the first place, to make a difference in people's lives.

bronxgirl · Dec 12, 2007

i am working in medical adult day care.. i am enjoying it very much. it is a m-f job, 8:30AM-4:30PM.. it is a much different pace than bedside nursing. i am very involved with the participants and their care givers. i work as a team member. the services we provide definately keep the particpants in their home and community versus a nursing home..i use my assessment skills alot.. since i am on my own. i do alot of teaching to the caregiver and usually we are the ones who communicates with the doctor and family about any concerns which often leads to early intervention and prevents hospitallization.a different type of nursing and has its own challenges and i find it very rewarding

Nur_1996 · Dec 12, 2007

I don't think I ever want to work in a hospital fulltime anymore. I have been out of that setting for about 6 years. Other than the hospital,I have worked at camps, schools, prision, hospice,some home health, ALF and LTC,offices and clinics.. I currently work 9-5 Mon through Fri. at a boys residental home for kids in trouble with the law. We are out in in wilderness, so its kinda like a camp, its also a school, and like prison all in one. I also help teach health related subjects to the boys, as well as take care of their medical needs. I pretty much set my own pace, so this seems to work for me.

NursieBSN · Dec 13, 2007

I work as a Hospice case manager. It is a whole new world. I did every form of floor nursing known to man and hated every minute. Hospitals chew you up and spit you out. I left and will NEVER look back. Having a strong clinical background, I never thought I could work Hospice, but once I started it all fit into place. I work Mon to Fri, no nights, weekends, holidays, or on call. I have a caseload of 12 patients, I set my own schedule for the week. I am required to make one assessment and one follow up visit to each pt. I load up my Mon and Tues with assessments so I can follow up the rest of the week. Am I busy? Oh yes, a different kind of busy, many things go wrong, and sometimes my phone never stops ringing. I also work as a team with home health aides and a social worker. My boss rules, doesn't care where you do your charting(computer charting) as long as it gets done. If my visits are done, I go home to chart, as long as I am available by phone, and I am getting paid for it. I have flexibility which I never had on a floor. I take lunch when I want, if I need to go to the post office, I can. Some of my patients are ornery, but most are grateful to see me.

My advice is to get out of the Hospital and find your niche. They make you believe you are not a 'real' nurse if you don't work a floor, don't feed into it. There are a lot of other options out there, go find yours!!

allantiques4me · Dec 13, 2007

I work in a residential center for abused neglected children with behavioral issues. I Love it!Its a campuslike setting in the city.5 minutes from home,KIds6through16.Mostly minor illness and injuries.Low stress.We have 3 houses,a pool,garden,gym,school,Playground.And school.Ive done med passes in all locales including on field trips!I work every weekend Which I love)And PRN on occassion.I hope to keep this job forever.