Afraid to Leave Hospital Nursing?

When we’re in nursing school, it often seems that hospital nursing is the only type of nursing that anyone cares or talks about. Since hospital rotations are what most of us are after, a large number of nursing students probably groan and gripe about a rotation in home health, dialysis, or community health. While there are admittedly plenty of excellent skills to learn in acute care, there’s valuable education to be had in other settings, and those clinical rotations are equally beneficial.

Once we’re out in the field working real jobs, our attachment to the hospital doesn’t change, with many nurses still voicing the opinion that “real” nurses work in hospitals. But with 55 percent of nurses working in acute care, we may sometimes be led to consider what the other 45 percent of nurses are doing with their time and if we might be happier there, too.

The Hospital Has Its Place

Hospital jobs offer nurses opportunities to learn amazing and valuable skills, many of which can be applied in other settings. Learning how to manage four, five, or more acutely ill patients at a time is an enormous juggling act with numerous moving parts, and a job in med-surg, telemetry, or other acute care units can give nurses a chance to try their hand at such complexity.

Teaching hospitals offer nurses an environment where cutting-edge technologies and approaches are utilized. As sites of clinical research, academic medical centers allow nurses to get involved in testing and developing the next generation of medical care. These institutions often boast robust medical teams from multiple specialties, and nurses can participate in committees, working groups, and other special projects.

The Hospital Isn’t Everything

No matter how much value we place on acute care hospitals and the nursing care there, some of us are more willing than others to admit that the hospital isn’t necessarily all it’s cracked up to be.

Remember those four, five, or more patients that hospital nurses often juggle? Those nurse-patient ratios are often the result of questionable staffing approaches, leaving some nurses to practice in environments that can be downright dangerous for them and their patients. Unsafe staffing levels can lead to overwhelm, overwork, stress, burnout, and medical errors, and when they reach this critical level, bad outcomes can result.

Hospitals offer many nurses great opportunities to develop their skills and build amazing, robust, and satisfying careers, but the acute care environment isn’t for everyone.

What Else is There?

When the hospital is all we’ve ever known, thinking about nursing outside of acute care can lead us to ask, “Well, what else is there, and is there life beyond the hospital?”

The answer to the first question is that there’s a whole lot more to explore, and the answer to the second question is simply a resounding “yes.”

Ambulatory nursing is an umbrella term that encompasses more areas of nursing practice than can be quickly named and can include:

Physician and nurse practitioner offices
Specialty and primary care practices
Medical aesthetic centers
Home health
Hospice
Outpatient dialysis
Mental health and addiction facilities (residential and otherwise)
Case management
Outpatient cancer treatment centers
Women’s health

The Benefits Beyond the Hospital

While there are plenty of benefits of working as a hospital nurse, countless skills can be developed outside of acute care. For instance, home health and hospice nurses have to practice autonomously without other colleagues close at hand for advice and support, and legal nurse consultants learn to communicate with lawyers, review charts, and provide expert testimony in court.

Some nurses may like that patients and families come and go relatively rapidly in many hospital units. In contrast, other nurses might prefer a job where longer-term therapeutic relationships can be the norm.

For example, dialysis nurses have the opportunity to get to know patients over many years, establishing deep mutual trust and affection. Home health nurses might have the chance to work with specific patients for several months, seeing them regularly in the intimacy of patients’ homes.

There are some great things about working in an acute care hospital, and there are skills that nurses may be unable to learn elsewhere. On the flip side of that coin, there are skills and opportunities that acute care nurses never experience if they don’t take the risk of stepping outside of the hospital’s four walls.