To follow my dream.

[RNhere]

Hello everyone, I graduated from nursing school 2 1/2 years ago. I struggled to find my first nursing job. I almost gave up on nursing but my hopes were renewed when I landed a part time position at a doctor's office. I love my job but I want to follow my dreams.

I recently saw a job posting looking for community Nurse. Its only requirement is a BSN degree. When I graduated nursing school, my dream was to work as a community nurse. However, all the positions so far have asked for at least a year of clinical experience. I did not want to work in the hospital only to get the experience. I have experience working in a doctor's office. I am a very patient person. I will wait for my dream to become a community nurse for as long as it takes. Are there any nurses who started their careers as community nurses? How long did you wait to land a community nurse position? Can I apply to this position? Are there any advice you can give me? Thanks everybody.

[OCNRN63, RN]

I worked for several years in home health and in home hospice. Without that hospital experience, it would have been very difficult to manage my job. I dealt with all kinds of things, from patients on CADD pumps with morphine or dobutrex, to calls in the middle of the night because a catheter is no longer draining (those calls always come from patients who live in sketchy neighborhoods), to patients whose IV is no longer infusing, to having to pronounce death.

It can be done, but you should be prepared for a very steep learning curve. It may not be what you want to do, but I would reconsider avoiding working in a hospital. A year or two on med-surg will help you with your skills and help open doors that might otherwise remain closed to you.

Good luck in your endeavours.

[RNhere]

Thanks for your advice. what I do not understand is why we can't start out as community nurses without working in the hospital.

[loriangel14, RN]

Because you need to work independently and use your judgement. You develop that judgement through clinical experience.

[OCNRN63, RN]

Thanks for your advice. what I do not understand is why we can't start out as community nurses without working in the hospital.

You can, but without those years of experience, your assessment skills aren't at the level of someone who has that experience. In home care, you are the eyes and ears of the doctor, who isn't able to be there. S/He is counting on you to assess your patient accurately; s/he won't care that you're new. Not just that, but it is the rare new grad that is capable of stepping in and being comfortable functioning without a safety net. Maybe you're one of those individuals...I don't know. I know that even with several years of experience, I found it kind of scary being on call in the middle of the night, knowing that if someone paged me, it was all on me. If someone needed an IV re-start or had a CVAD that was occluded, I was the one who had to fix it, etc.

Being a home care nurse requires you to be a jack-of-all trades. I haven't even mentioned having to deal with family dynamics up close and personal. And the pager...I wrote an article for a nursing magazine many years ago about being paged constantly one night. (The pager died an untimely death by the end of the article.)

As I said, you may be one of the few who can dive right in with no problems. I don't know you or how you handle stress, like non-stop pages, or pages for stupid stuff, like the time a nursing home nurse paged me at 0100 to get authorization to send a patient to the hospital after a fall. When I said, "OK go ahead and send him in," she said, "Oh, we sent him to the hospital five hours ago. I didn't want to bother you then." (Yeah, I would much rather get paged at 0100 that 2000. More like she forgot to get authorization at the time, so now she was calling to cover her butt.)

[loriangel14, RN]

You will also need the experience and background to deal with family dynamics, other members of the health care team and being confident enough and experienced enough to know when to speak up and advocate. All things that require experience.

[RNperdiem, RN]

What if you replaced the word "dream" with the word "goal"?

Dream job implies that if you wish hard enough then maybe your dreams will come true. A goal implies you working towards getting what you want out of life, no fairy godmother required.

How then do you plan to reach your goal? Have you called the employer about this community nursing job and asked what specifically you need to know and be proficient in?

If community nursing is your goal in nursing, find out now what you will need to get there.

[Farawyn]

What if you replaced the word "dream" with the word "goal"?

Dream job implies that if you wish hard enough then maybe your dreams will come true. A goal implies you working towards getting what you want out of life, no fairy godmother required.

How then do you plan to reach your goal? Have you called the employer about this community nursing job and asked what specifically you need to know and be proficient in?

If community nursing is your goal in nursing, find out now what you will need to get there.

Exactly. And you don't "wait" for your "dream" you go get it. Get a year of hospital experience and pursue community health after.

[Jules A, MSN]

What if you replaced the word "dream" with the word "goal"?

Dream job implies that if you wish hard enough then maybe your dreams will come true. A goal implies you working towards getting what you want out of life, no fairy godmother required.

How then do you plan to reach your goal?

Exactly!! Whenever I hear people talk of following their "dreams" there is usually some impractical and passive component to the whole scenario. I'm about exploring options, strategizing, working hard and lining things up to result in the desired, realistic, outcome.