Nontraditional Careers in Nursing: Options for Nurses

Susan E. Lowey, PhD, RN, CHPN

Disclosures

March 15, 2017

In This Article

Inpatient or Outpatient Nursing Career: Skills and Education

Hospital Care

Whether a nurse decides to work in an inpatient or outpatient setting, both settings require a strong foundation of nursing knowledge and skills. The inpatient hospital setting is almost always the initial employment setting for registered nurses after they graduate from nursing school and successfully pass their licensure exam.

Inpatient hospitals offer a variety of units that focus on a specific patient care population, and this setting usually has multiple available positions at any given time of the year. The hospital setting enables novice nurses to begin to build their skills and experience providing nursing care. It also introduces nurses to other healthcare professionals through the interdisciplinary care model, which is imperative in promoting and fostering quality healthcare today. Hospital nursing allows nurses to work in the same setting on the same unit, which can offer a consistent level of predictability for daily work expectations.[8]

While these are some of the innate benefits that inpatient hospitals have to offer, there can also be some drawbacks. Hospital nurses often work longer-length shifts, have mandatory rotation between shifts, and may be required to work overtime or on-call. They may be exposed to various staffing-related issues, be subjected to horizontal violence or workplace incivility by nursing coworkers, and have various issues with administration.[8] Lastly, although most nursing positions in the hospital require an RN license for employment, more and more hospitals prefer to hire applicants who have earned a bachelor's degree in nursing.[9]

Nursing Care Outside of the Hospital

The outpatient care setting is broad and includes all jobs other than those found within the inpatient hospital setting. This can include outpatient specialty centers, physician offices, public health clinics, schools, ambulatory care centers, home healthcare, hospices, occupational health offices, college health centers, and correctional facilities, to name a few.[10]

Most outpatient care settings require at least a minimum of 1-2 years of experience in acute or inpatient care.[10] This is because the roles and responsibilities of nurses in outpatient settings often include a broader scope of care that requires excellent interpersonal skills and a sound knowledge of community-based resources. Nonhospital nurses must demonstrate proficiency in prioritization and organization because they most often work independently in most outpatient care settings.[10]

There are many benefits to working in an outpatient care setting. There is usually a greater level of autonomy and independence in these settings, which enables the nurse to perform his/her duties without as much daily oversight as in the inpatient setting. This can have both positive and negative results. For seasoned nurses, it can prove to be a more flexible environment that does not impose as many personal constraints. For novice nurses, this can be challenging and frightening as there may not be other nurses readily available on site to answer questions and help troubleshoot difficult situations.

Outpatient settings can offer more variety and interest to the daily workday.

Outpatient settings can offer more variety and interest to the daily workday. The patients and clinical scenarios that nurses encounter often differ from day to day, which can satisfy nurses who become easily bored in the same work environment. On the other hand, nurses who do not like surprises or do not like not knowing their daily activities ahead of time may not welcome this unpredictability.

There can also be a deeper level of involvement between the nurse and patient in the outpatient setting, which can enhance and promote the nurse-patient relationship and may lead to better patient outcomes. This is because nurses often have more prolonged interactions with patients in outpatient settings, bearing witness to personal issues and challenges that may not be disclosed to nurses in inpatient settings. However, the enhanced nurse-patient relationship can lead to increased levels of stress and burnout for the nurse when the relationship ends, particularly in an abrupt manner, such as patient death.

Both inpatient and outpatient nursing jobs have their pros and cons. The beauty of the nursing profession is that nurses are able to find their own niche and take advantage of the abundance of opportunities and choices for employment in a variety of settings.

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