opinions on outpatient RN jobs

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I am a new RN grad that is three months in to a position at a LTC/SNF, and I absolutely dread going into work everyday. The workload is intense, and very demanding, and for a new grad, it only makes the situation worse. I have a lot to accomplish in an 8hr evening, and I never get to take my breaks, because I am constantly running around doing something. It also doesn't help that I feel very unsupported by the staff there. I feel like the workers feel as if I'm incompetent, unskilled, and just plain stupid. And some of the nurses aren't too friendly either, which doesn't necessarily encourage me to reach out and ask questions. This is my first nursing job, and I am feeling very discouraged. I primarily took the position because it's for a company I worked for, for many years and the pay they were offering me was impossible to beat as a new RN. They offered me a salary I would have been stupid to refuse, compared to what other places wanted to pay me as a new grad. I am making $38/hr. Which is amazing for a new grad! $11 more than what other facilities (subacute, outpatient clinic) wanted to pay me. But I hate the hours, and I absolutely hate the job, and it's highly affecting my mental health, and sanity. I dread every day that I have to walk into that place. I know it's the job, because on my days off, I am so much more at ease, and can actually think straight. I keep telling myself it's the job, not nursing. The first year after licensure is always the hardest, but being in this environment/setting where I am uncomfortable and feeling unsupported makes the transition 10x worse.

I am highly considering going per diem at this facility, and looking for another full time job. I was offered two positions at other facilities. One is for a subacute rehabilitation center, which I think may be a good fit. I get proper training with a preceptor, and will have a similar experience to a hospital setting. It was day shift 7a-7p 3 days a week. The other is working for a big medical practice with many multi-specialties (they have three offices). They were offering me a "float position", where I can gain experience in all specialities, working with physicians, and assisting with procedures, or they mentioned working in their infusion lab, administering medications to chemotherapy patients. This job was M-F 8:30a-5p, weekends and holidays off. They only require 1 Saturday a month, in which I would get a half day during the week. Both facilities offered $27/hr, which is a significant pay cut.

I am also looking into some hospital RN positions at nearby hospitals, and dialysis centers (some don't require experience and provide training). I know people say it's not smart or wise to start in an outpatient setting as as new RN grad, because it can really lessen your opportunity for growth in the future, but I feel SO incredibly burnt out being where I am. And I am only 3 months in! I don't know if it's bedside nursing, being significantly understaffed, the atmosphere of LTC nursing, the lack of support, or if it's just the difficult transition from student to RN, but I think for my mental health and sanity, taking a lower paced job, with more stability and organization would be better for me to get my head on straight and figure out what my niche in nursing is. I'm just conflicted because its a big difference in pay, but I also can't go through my career thinking about which job is going to "pay me the most", regardless if I hate it or not, because money really can't buy happiness!

Any opinions and or thoughts would be greatly appreciated!

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Specializes in Pediatric Periop.

I work in an outpatient surgery center and I love my job. My pay is pretty good (I live in CA, so it is more than you were offered for outpatient), and my hours are awesome- no weekend, holidays, or evenings, but the best part is I really love my job and the people I work with. If you already know you hate it, you risk burnout staying where you are. However, $10.00 is a big pay cut, so you'll have to consider that big time with your finances. Another thought is that this position has significantly limited my ability to move to an acute care position. I started here as a new grad, but most inpatient positions want acute care experience. There is a lot to think about, but for me the outpatient benefits outweigh the downsides.

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@Nurse Gonzo if you don’t mind me asking what is the starting rate in the outpatient surgical setting in Cali? I’m in jersey and was offered a position in the ambulatory surgical setting. I am coming from ER.. I’ll be doing pacu and preadmission for first 3 months then moved to charge and coordinator. I know Cali is comparable in pay to NJ/NY region..

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Specializes in Critical Care; Cardiac; Professional Development.

What are your long term goals? I ask this mainly because going outpatient early in your career may sideline you from anything else you are hoping to do. Most of the jobs away from the bedside that still pay well require a certain number of years of bedside experience, even if you have the advanced degree in time.

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2 hours ago, Nurse SMS said:

What are your long term goals? I ask this mainly because going outpatient early in your career may sideline you from anything else you are hoping to do. Most of the jobs away from the bedside that still pay well require a certain number of years of bedside experience, even if you have the advanced degree in time.


hey my long term goals are to save my knees, back and most importantly save my license. I’ve worked ER for 5 years On night shift. I have my CEN. But being 26 with 3 kids and my youngest being 7 months just isn’t working for me anymore. I’m done with hospital requirements certain holiday rotation, every other weekend, short staffed, unpredictable environment. I work in a comprehensive stroke hospital here in the north east region. Average ER visits per day range from 175-250 persons per day...

offer I received from prospective new employer

5 day’s a week, 6am-2pm, no weekends, no holidays, 6 weeks PTO, medical, dental, vision, 401k, life insurance, LTD, catered food everyday *yum*. The administrator told me most people come to these settings for a better lifestyle. Sounds like a plan to me. Everyone walks in and everyone walks out. You know what your getting everyday. No crashing patients, no unstable patients, no ADLs, no bedpans and urinals, no constant call lights, really not much medication administration aside from maybe Zofan and maybe a pre procedure anoxiolytic.
sounds like heaven? Yea pretty much from what I’m dealing with at the moment.

I just don’t want to low ball myself on a offer.. I would like more salary details on ambulatory surgical center rates from fellow rns on here..

things to consider.. everything is pre authorized and every patient coming into these settings have insurance so probability of them losing money compared to emergency departments are fairly low.

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Specializes in Pediatric Periop.
On 11/26/2019 at 5:23 AM, CassandraRN said:

@Nurse Gonzo if you don’t mind me asking what is the starting rate in the outpatient surgical setting in Cali? I’m in jersey and was offered a position in the ambulatory surgical setting. I am coming from ER.. I’ll be doing pacu and preadmission for first 3 months then moved to charge and coordinator. I know Cali is comparable in pay to NJ/NY region..

So, my starting in Cali was $30/hr, but that was me as a new grad. I'm now between $35 and $40/hr, but word has it that those with more experience, such as yours in the ER, are making more.

Oh, and don't count on no more bedpans! ? It doesn't happen often, but the occasional PACU pt might need it. Much less often though!!

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Where is that job offer? maybe I'll go for it:)

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