By Melissa Wirkus, associate editor
New nurses have a variety of choices and decisions to make when it comes to selecting an avenue for their nursing career. From working in large teaching facilities to practicing in smaller rural and community hospitals, it is important to choose the setting that most closely matches your needs, career goals and personality characteristics as a new RN.
You may have chosen your specialty, or figured out your ideal hospital setting, but it is still important to do your research to ensure you get your nursing career started off on the right foot.
Looking at Facility Types, Settings and Sizes
Most nurses start in an acute care setting, with probably 80 percent or more of new graduates taking this route, noted Karen Siroky, senior director of education for AMN Healthcare.
“There are also many non-traditional settings that nurses can explore such as long-term care, rehab, hospice clinics and dialysis,” she said.
Once a nurse decides that he or she wants to go into a traditional acute care setting, there are also many other factors that must be researched such as the size of the hospital, the patient population, specialties offered and location.
“When looking at traditional hospitals, they can easily be broken down by size,” Siroky said. “Hospitals with more than 500 beds typically offer a larger variety of service lines that you may choose from. These facilities are mainly located in the major metropolis centers found throughout the U.S.”
Smaller hospitals typically have 200-500 beds and still have a variety of services lines, and are located all over the nation. Those with fewer than 200 beds are usually located in smaller towns or are more specialized facilities.
“An important thing to know is that the far west region of the country usually doesn’t have the biggest hospitals,” she noted. “It is usually the bigger cities like Houston, Miami and some on the East Coast that are home to these health care centers.”
Teaching versus Community-based Hospitals
Another way that new nurses can look into choosing the right hospital is to research the practice setting to determine whether they want to work in a teaching hospital or a community-based hospital.
“Teaching hospitals generally have interns and residents,” Siroky explained. “There might be a great emphasis on education and learning. RNs will have a lot more interaction with the medical staff in these types of facilities.”
This is where it is important for nurses to think about their learning styles and what kind of work environment they want to practice in.
“Some like the teaching hospitals because of the greater sense of community and opportunity to learn,” she said. “The downside that many RNs note is that nurses do not get to take on as many responsibilities because the interns need the practice.”
For RNs who prefer to work with just one or two doctors and value the independence that this profession provides, a community-based facility may be the right avenue to explore.
“In community-based hospitals, nurses tend to have more independence and receive orders that cover a greater scope of practice,” she said. “Some prefer this independence as well as working with just one physician.”
Researching Your Options and Following Your Heart
Once you have an idea of the type of facility and setting you want to start your career in, you should think about your specialty and other factors such as staff and nurse-patient ratio.
“I encourage all new graduates to look at the nursing structure, nurse leadership, clinical ladder and educational opportunities when deciding on a hospital,” Siroky said. “The nurse-patient ratio is important to look at also. And, if you have a particular interest you want to pursue, such as neonates or cardiac, it is important to do your research on what hospitals excel in your specialty.”
In the end, when choosing the path to begin your career, it is important to ask yourself what factors are most important and to stick with your gut feeling.
“No matter where you get your experience, you are going to take so much with you as a new nurse,” Siroky concluded. “Gaining a good year of experience or more at your first facility is so important, and by researching your options you can better your chances that it will be a good fit.”
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