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STUDENT EDITOR BLOG

'I don't want to work in a hospital. There, I've said it'

  • 21 Comments

I feel a bit naughty for saying that I wish to work in a different setting than a hospital.

People have been known to laugh at this statement so I’ve started keeping it to myself. I have been asked what kind of nurse doesn’t want to work in a hospital. Someone even once told me I’d be wasting my skills and knowledge in the community. Well, this kind of nurse doesn’t want to work in a hospital.

”Someone even once told me I’d be wasting my skills and knowledge in the community.”

I always wanted to work in elderly care. I love working with older adults and I’m passionate about providing excellent care, but I don’t feel I can provide the standard of care I want to in a hospital setting. It may sound cheesy but I want to make a difference. I know many nurses do provide excellent care and I am forever grateful for their dedication and skills. My community placement opened my eyes to the difference I can make out there. I can support people to stay in their own homes for as long as possible and help them in making decisions that are right for them. This isn’t an easier choice as some say – but a different choice.

Community and primary care roles require a different set of skills to those of a hospital nurse and I will never understand the opinion that I am often faced with in acute settings - that community nurses are deskilled. I’ve never felt as excited about nursing as I did while I was on this placement; I spent the majority of time with community nurses visiting people in their own homes. I enjoyed this immensely but I also spent a week with two different practice nurses.

“The nurses I met were intelligent, autonomous decision makers who had great respect from their patients.”

Practice nursing seems such an undervalued and under-advertised role. The nurses I met were intelligent, autonomous decision makers who had great respect from their patients. Their skillset was wide and their knowledge on long-term health was fantastic.

How do newly qualified nurses become practice nurses? I’m not quite sure if I’m honest. I don’t think this is uncommon either. I follow a number of practice nurses on Twitter and I’ve even spoken to a couple to gather their opinions and experiences. Can newly qualified nurses become practice nurses?

Yes, they certainly can.

It will be a steep learning curve but with dedication and support it seems to be possible. We’re facing a shortage of practice nurses and I’m sure fresh-faced enthusiastic recruits can really contribute to this highly-skilled and knowledgeable area.

”We’re facing a shortage of practice nurses and I’m sure fresh-faced enthusiastic recruits can really contribute to this highly-skilled and knowledgeable area.”

Will I become a practice nurse or a community nurse? I have no idea. They’re very different roles and both have pros and cons.

What I’m trying to suggest is that you do what you want and not what other people think you should do. Neither is right or wrong or better than the other option. Nurses in acute and community settings should be equally valued. Everyone has opinion on my career and I value people’s advice but my opinion is what counts the most.

Vicki Abrahams is Student Nursing Times’ adult branch student editor

  • 21 Comments

Readers' comments (21)

  • Thoughtful piece and absolutely right to flag up the many skills you need in the community, preventing people from being admitted to hospital. As you may know the Queen's Nursing Institute recently published 'Transition to General Practice Nursing' to help nurses new to that role - including those who are newly or recently qualified - it's on the charity's website.

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  • How refreshing to read such an article. I feel exactly the same. I want to deliver compassionate and safe care to my patients. When I work in an acute setting most shifts I come off, I feel that I haven't provided the quality care that I wanted to, why? Short staffed and overworked!

    In my group of 4 people at University, all of us want to go straight into the community. The Acute is under so much pressure and nurses are expected to do so much more now. I know for certain I would struggle to care for 12 patients in one shift. Is it even safe??

    Community for me, we are all made different this is why some are A&E nurses and others are surgical or Medical.

    I don't think you deskill in the community, you just learn new and varied skills. I have had people say you should go into the Acute before you head into the community. But my heart is in the community, this is where I can actually spend time with my patients.

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  • I agree i have just completed a community placement and i loved it. There was time to talk to your patient explain things. I will be heading off to the community when i qualify.

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  • MaziPJ

    I'm on my community placement right now and I love it!!!! I would dearly love to become a Health Visitor or a District Nurse (yep from one end of the scale to the other). Unfortunately I've been told I need at least a year or two ward experience before they would even think about me :/

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  • I have been nursing a lot of years and most of it not in a 'hospital'. I was a midwife...in a former life.. so some very acute obstetric stuff so I can walk the walk etc. I thought hospital nurses had stopped looking down their noses at the community...but perhaps not...and with regards to 'skill' ...I have worked autonomously (that is no Doctor...no crash team...often no colleague to hand to confer with) just me and my PIN number...sadly the care my mother received in a hospital was on occasion mystifying ...or so it seemed as the nurses were 'mystified ' by blood results, and a selection of simple diagnostic tests...and referred me constantly to the very busy Doctors who seemed mildly surprised that I knew/was concerned about a falling Hb level...perhaps it's just me but out their in the 'community' you need to be a Registered Generalist (not necessarily an expert) which I have found requires considerable skill & knowledge.....I am sure my 'community' out in the wilderness colleagues would agree...

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  • I find it hard to believe that so many people would not wish to work in the community. I couldn't bear to return to the wards now. Maybe my days of 12+ hour shifts are over, maybe I don't like being confined to one place. But it is different and I have to say that it took me at least 3 years to get to a stage where I was reasonably confident without having to ask somebody else before I made a decision. I've been doing it nearly 5 years (older peoples' mental health) now and still feel as though I'm only scratching the surface of learning. You are very much on your own at times, but there is always somebody to ask at the other end of the phone; and if it's an emergency situation, you act as you would in any other emergency, and get help PDQ. Managing your caseload can be challenging and you have to be able to change tack quickly if the situation changes, you have to be able to prioritise. It is so worth it to be able to keep people out of hospital or full-time care if at all possible; and your relationships with them and with families are much longer-term. Thank goodness we all like different things. I would be useless in A&E, for example, where everything goes so fast. And you do need a certain amount of experience, so keep at it, MAZIPJ, you'll get there.

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  • A&E, I mean, of course. Don't tell me my PC is doing predictive text now.

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  • Well don't feel naughty.....there are so many worthy organisations awaiting your energy ,knowledge and commitment. Enjoy your new found career.

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  • Victoria, that's really encouraging to hear your thoughts and comments on working in primary or community care. If you are interested you may wish to look at the Health Education England District Nursing & General Practice Education and Career Framework. Good luck finding the right pathway for you.

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  • Well done you for being so confident! I really do want to work in acute settings but alot of people have tried to persuade me to go into mental health nursing and others just assumed i was, they were shocked to hear im just adult branch! I know its not the same but i do think i understand a little bit how you feel when other people try to tell us we're heading down the wrong path, claiming our skill set is wasted in our chosen fields. Dont give up! You know whats best for you! Its not solely based on skill sets or talents but enjoyment and preferences! This will be our careers for decades (hopefully lol) to come, it needs to be what WE want! Your article was inspiring, I'm glad i'm not alone :)

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