What is the appeal of the hospital?

[~Shrek~]

Why are so many New RN's so focused on working at the hospital? Is the pay better? Are the benefits better? Anytime I hear about a new RN working outside the acute care world, they want out. Why is the hospital so much more appealing than non-acute care?

The only thing that makes sense to me is the hours...4 days off with 3 days on is awesome--if you are working day shift. I would still prefer 40 hours on days than 36 on nights, any day.

[klone, MSN, RN]

Yes, pay is generally better, and it *is* nice only working three shifts a week.

But honestly, I think the draw is that most nursing students and new grads envision the fast pace of acute care to be "real nursing" and the other nursing roles like clinics, SNF, LTC, etc are "less than". It's also easier to go from hospital to the other areas of nursing, and more difficult to go from the other areas into the acute hospital setting.

[caliotter3]

New nurses are usually encouraged to get that "golden" acute care experience because it forms the basis of a solid competence from which one can diversify with ease.

[llg, PhD, RN]

All of the above.

Plus ... New grads usually want and need an extensive orientation program in order to function well -- and hospitals are usually the only places that offer such programs. Throw a new grad into the deep end of the pool without proper support, and he/she usually struggles. The jobs outside the hospital have historically not hired a lot of new grads and don't have strong orientation programs to help the new grad transition from school to professional practice.

[DavidDudley]

Everyone so far has given great responses to the OP question. For me personally, as someone who did NOT start off in acute care, I wanted to go to acute care to fully utilize and maximize my physical and mental capabilities as a nurse. Essentially I wanted top action and a feeling that I have had a strong impact on the world and not to merely just make a paycheck doing routine mundane work.

My nursing career started off by working on a subacute floor in a SNF, home health, and corrections... All non - hospital jobs and all those jobs made me feel the same way, bored and under utilized. I didn't have a love and passion for nursing until I finally started my career in the ER.

[DavidDudley]

In my case, the shift from non-acute care to acute care did not result in better pay. I actually took a drastic pay cut, like a 2 grand a month pay cut. However, I enjoy my current work environment so much compared to my previous one that it is a price that I pay gladly.

[LadyFree28, BSN, LPN, RN]

Yes, pay is generally better, and it *is* nice only working three shifts a week.

But honestly, I think the draw is that most nursing students and new grads envision the fast pace of acute care to be "real nursing" and the other nursing roles like clinics, SNF, LTC, etc are "less than". It's also easier to go from hospital to the other areas of nursing, and more difficult to go from the other areas into the acute hospital setting.

Although, I will say as a person who has worked outside of the hospital setting that has been recruited and have gotten hospital jobs after working outside of the hospital, it is very much possible to transition from outside of the hospital into the hospital; sometimes one is exposed to more clinical aspects in outside settings than in the hospital, and the capacity to teach and manage the patient holistically happens; one also gets to understand the inside outs of the "business" side as well.

Those clinical aspects and practice that I cultivated outside of the hospital setting have helped me transition into the acute care setting seamlessly; what helped me is "selling" those aspects in a résumé and navigating those aspects in the computer database.

I will say, if all outside settings had consistently comparable orientations; there may not be such a difference, IMHO.

[naptimeRN]

There are positives and negatives to both outpatient and inpatient. Generally, at least in my area, inpatient pays better. Also, based on my experiences, inpatient offers more variety and experiences. I work at a hospital and in an outpatient clinic and the outpatient clinic has become a bit monotonous overtime. Even in outpatient you can have poor staffing ratios (facing it now) which was my biggest complaint with hospital nursing. I think hospital nursing teaches people a lot! I learned so much (and continue to) in med surg because each shift there is something new.

[flyersfan88]

My future plans depend on acute care experience. My desire to stay at the bedside is slim, making 20+ patient loads in SNFs undesirable.

[RunBabyRN]

A lot of hospitals still do five 8 hour shifts per week; not all do three 12s.

For me personally, acute care:

Means I can move to almost any job, in or out of a hospital

Will help me get into my desired specialty (L&D)

Pays more than almost any other area of nursing

Means I could transfer with a system if I chose to do so

[CecileSF]

Being in acute care to gain experience gives you the option to move to other specialties and areas you desire. I would not mind working in outpatient, subacute, even administrative in healthcare, but they all want acute care experience first and most of them do not train new grads. Many larger hospitals do not consider other non acute settings as experience, so a person working in subacute for 3years would not qualify for many RNII jobs. That's just in the area I live in, I'm sure it's different where you live. It's not the pay, having acute care on your resume is an investment for your future career.

[BlueDawnRN, BSN]

Better nurse to patient ratios, better orientation, more support and more opportunities for advancement.

For example, I started in the hospital and my friend in LTC. I have 4-5 patients, she has 20. My orientation was 3 months, hers 2 weeks. I can transition to any specialty in the hospital but she can only go into administration within the same company. I have 6-7 other nurses on the floor to help me if my patient starts going south, but she only has 1 other nurse on the floor. I also have lots of support 24/7 like rapid response team, pharmacists, respiratory, docs, etc. As much as I would enjoy working with the older population in a LTC environment, the working conditions are much better in a hospital, at least in my area.

I love and am so grateful for my hospital job.