View Full Version : Career Paths

01-28-2008, 12:05 PM
Hi All!

I'm a new BSN graduate awaiting to take state boards. I've not started working immediately as my husband will have to change jobs soon and we have 3 small children. So, with all this time, I'm trying to decide where to start my nursing career.

So my initial question is, do all nursing careers start on the hospital floors?

I've never felt that I'd be a good fit, although there are a few areas I wouldn't mind trying out (Psych and critical care for examples). However, I see myself more in community, hospice, technology, and other areas. Are employers for these other areas looking for experienced nurses?

I realize that the experience will be better in the long run, but with my family situation, I don't want to try to commit to something I might not be able to fulfill starting out.

Any insight into this would be greatly appreciated!!


01-28-2008, 03:10 PM
First of all:

we have 3 small children. So, with all this time


Ok then - anyway -

I'm sure not all nursing careers start out on the floors, but I'm betting that the majority do.

I've never regretted the 6 months of med/surg that I had and do honestly believe that it better prepared me for critical care. But that's just my personal experience.

What do you mean by not committing to something you might not be able to fulfill? Do you think you could stick it out for 6 months - 1 year?

If not, you could always try to get a job in an area that you prefer.... if you find that you aren't getting hired for those jobs due to lack of experience, you could always then go to med/surg/tele, etc and go that route to eventually end up where you want to be.

Good luck!


01-28-2008, 11:35 PM
I put in two years on a surgical floor and though getting burnt out was what led me to the position I am in now I loved every minute of everything I learned. I also think that it helped develop my people skills and learn how to really deal with families and the patients/residents themselves. Working in longterm care is something I didn't think I'd be doing but I love it. Each day I go in I feel I make a little brighter for each person there (it also helps if you have great people to work with too!) A hospital floor is a good starting point and to get your confidence too.
Good Luck with everything:cheers:

Mother Jones, RN
01-29-2008, 12:03 PM
I think that it's a good idea to get some solid med/surg nursing under your belt before you go and do anything. Knowledge about basic bedside care makes up the building blocks of your nursing career. :nurse:

MJ :pepsi:

01-31-2008, 11:34 AM
Ive had my license for 3 months now and I work in the recovery unit. At my hospital, the recovery is considered a critical care setting.

There are times when I like it, but for the most part, I wish that I would have started out as a floor nurse to gain more experience and confidence.

I hope that this does not discourage you. If you want to be a critical care nurse or work in another specialty unit, go for it!

02-29-2008, 03:32 PM
I know that the idea of going onto a hospital floor can be overwhelming...believe me I was there. All throughout nursing school, I promised myself I would NOT do med/surg nursing. I HATED med/surg clinicals (looking back it's prob. related to the fact that it was intimidating) however, when I graduated school I quickly realized almost all the jobs I was looking into required at least 1 year of previous experience. So I reluctantly decided to get a job on a med/surg/tele floor. I'm def. glad that I did. I have learned SOO much!! My skills have continued to improve. But word of caution. I've only been in nursing 1 1/2 years now and I'm already feeling burnt out. My pt. load as of lately has been INTENSE. So with your three kids, it might be a good idea to go part time just b/c after work you are exausted...I don't think I could do it if I had kids. But your prlly stronger than I am!!

03-01-2008, 06:01 PM
I think that it's a good idea to get some solid med/surg nursing under your belt before you go and do anything. Knowledge about basic bedside care makes up the building blocks of your nursing career. :nurse:

MJ :pepsi:

AMEN Sister..... AMEN!

03-02-2008, 09:57 AM
You don't have to start there but it is best to have at the very least 6 months of med/surg experience.

03-02-2008, 09:15 PM
OK, I'm going to be the voice of dissent:

Yes, there are a lot of things that you learn on a med/surg floor, and a lot of it is transferable. And if you want to do something like hospice or home health, the likelihood is pretty high that they'll want some med/surg experience...

BUT it is not the only way to get experience. It is not even the best place to get experience, if what you want to do has little or nothing to do with acute care.

More and more nursing is in non-tertiary settings. A lot of the skills that are mentioned: prioritizing, observational skills (i.e. seeing when a patients condition has changed, even a fair amount of the technical skills can be gotten in other places. What hospitals tend to have more than other places are a pool of health care workers who you can easily learn from and (generally) better new grad training.

What I think is really unfortunate is the attitude that LTC is for people who can't "cut it" in acute care. (It's also unfortunate that the setting tends to be less well paid, as it is crucial).

I never worked in med/surg. Most of my clinicals were in the hospital, and I ended my accelerated program with over 300 hours in an ICU over the course of 10 weeks. However, when I graduated I went directly to a VA skilled care center that also had a hospice and palliative care unit. Admittedly, this may not be the same as working in a private SNF as we have tons of MDs, therapists (OT, PT, KT, Nutrution, some mental health), our own pharmacists etc (well, we have all those things during the day during the week), aids who can do dressing changes, place foleys/straight cath, and who do a lot of the hands on care, and no issues with supplies, etc), but there have also been times when I have had acuity similar to a hospital, and as someone who did work mostly weekends/evenings, I became quite skilled at not only assessing my patients, but figuring out what it was important for the on-call provider to know (and at least 1/2 the time tell them what I wanted them to do).

I also continued on with school as I started working -- a post-bacc PhD program, which, back in the day, they said no one should go on for a graduate degree in nursing w/o working for oh, 5-10 years first. That attitude too is changing, and there is recognition that just like other fields, we can go straight though school.

I am now doing a palliative care fellowship in a position that is usually for an NP, and I'm holding my own in the main. I may not be the best bath bather, NG tube placer, or IV starter*, but I know how to talk with various providers, I know how to assess and make suggestions for pain management. I know how to help patients and their families figure out what is really important to them in the time they have left--I know how/am learning how to take care of these very complex patients and their families, body, mind, spirit and within the context of their lives and needs (while also developing clinically relevant research questions, but that's another matter).

So, a long rambling post, but all I'm trying to say is that there is more to new grad life than working in a hospital. If that's not where you plan to wind up, it may not even be the best use of your time (and think of it another way -- is it fair to the hospital and co-workers to go into an environment that you know you plan to bail on?)

just my $0.02 :curtsey:

03-03-2008, 05:48 AM
Hi All!

I'm a new BSN graduate awaiting to take state boards.

...So my initial question is, do all nursing careers start on the hospital floors?

...However, I see myself more in community, hospice, technology, and other areas. Are employers for these other areas looking for experienced nurses?

...Any insight into this would be greatly appreciated!!


Hi Yourself! And welcome to NV.

Congratulations on that BSN. Please let us know how the NCLEX goes for you.

No, not all nursing careers begin in the hospital. Mine certainly did not. I became an RN after many years working as an EMT. I continued working in the back of an ambulance as an EMT/RN both before and long after I gained my first "hospital" job in a critical care/step-down unit for cardiac patients (including those pre- and post-CABG). After a while I became a hospice RN and then a hospice RN case manager. I later became a life flight RN and a house supervisor. When the time came, I gave up flying around while taking care of patients. I work solely now as a house sup in flying around a medium-sized hospital trying to take care of nurses.

In my opinion, hospice, home health, psych, and long-term nursing necessitates a previously established and solid foundation of patient assessment and treatment skills because of the complexity of patient care and the usually highly autonomous practice of the nurse. I cannot speak to the entry level skills expected of community (public health) or clinic nurses. Neither am I familiar with that which is required of nurse informatics.

Again, welcome and congratulations.


03-07-2008, 08:31 PM
Thank you everyone for responses.

I find myself still really struggling to decide where to go and what to do.

For the first time in a long time I'm enjoying spending time with my kids and running my house the way I want. My big kids are getting into school and school activities and my "baby" is such a learning sponge I can barely keep up with her. However, I know there will come a day when we'll need more money, and I didn't go to school for nuthin'! :D (Besides, I'm beginning to miss nursing!)

I think starting in the Med/Surg unit really does seem overwhelming to me, but it's true that I wouldn't have to start at full time. And I really did enjoy my experience on a telemetry unit during my senior courses. But also as Marachne pointed out, how fair is it to a unit that I sign up knowing I'd leave sooner than later?

At anyrate, I think I'll be looking for somewhere with an excellent mentorship program as I think I'll be pretty rusty from not practicing for so long.

Again, Thank you all for your experience/opinions!