More Nurses are Choosing Jobs in Nontraditional Settings

If you're a nurse these days, you're a hot commodity. Nurses have a lot of choices as to where they work. And many nurses are choosing nontraditional settings rather than hospitals.

Nurses can work in extended care facilities, community health centers, doctors' offices, rehabilitation centers, private companies, home-care agencies, wellness centers, private homes and colleges. The list goes on.

Contributing to all those choices is a widespread shortage of nurses. With not enough people to go around, those in the field have the luxury of being selective about where they work.

"There's already a shortage and it's only going to get worse," says Carol Cooke. She works with the American Nurses Association (ANA). The ANA represents 3.1 million registered nurses.

One factor in the shortage is fewer women entering the field because they have a lot more career options than in the past, Cooke says. And the challenging work environment scares some people off.

"It's a number of things," Cooke says. "The nursing workforce itself is aging...and the number of nurses coming into the field isn't sufficient to replace those who are retiring."

"It's a worldwide shortage," says Susan Erjavec. She works with the faculty of nursing at a university.

"It's the standard demographic shift. More people are getting older, more people are entering the health-care system and it's difficult to keep up with that demand."

The National Center for Health Workforce Analysis is a federal agency that tracks the U.S. health field. The center predicts that by 2020, there will be a 40 percent increase in demand, but only a six percent increase in supply.

Too few nurses at many hospitals means long hours and heavy workloads for those who are there. That stress pushes some to look at other options.

"It's a vicious cycle, because as we lose nurses, it makes the working conditions worse," Cooke says.

Some additional places nurses find work is in other health-care settings, such as foot care clinics. Some work with employment insurance agencies, doing assessments on people who are off on work-related injuries. There are also nurses working for insurance companies.

Education, administration and research are areas that many nurses move into. Basically, any place related to health might employ people with nursing backgrounds.

"There are nurses who have gone to work for pharmaceutical companies because they can build on their knowledge base of anatomy, physiology, biology and pharmacology from their nursing programs," says Robert Calnan. He's the president of a nursing association.

"There are nurses who work selling medical supplies and equipment. Because they've got their background, they can launch into these sorts of things."

It tends to be experienced nurses who work in nontraditional settings, says Sheila Dresen. She's dean of the faculty of nursing at a university. She says most of her graduates go into acute care settings (hospitals).

"It's primarily because they are seeking a base of experience in an acute care setting to solidify their skills," says Dresen.

"And because it's an environment that supports a new graduate. There are a lot of other kinds of people in the environment who are involved in patient care delivery, from other disciplines. And so it's a comfortable place for a new graduate to start his or her practice.

"Nontraditional settings tend to require nurses to practice with more independence," Dresen adds. She points out there often aren't many co-workers from whom to seek guidance, so experience is important.

"In rural and remote areas...for example, where there aren't a lot of physicians in practice, and there are nursing stations that are hundreds of miles from the nearest acute care hospital and patients are airlifted out by helicopter -- that's an example of a nontraditional setting."

Calnan points to himself as an example of a nurse who has worked in many settings outside hospitals.

"I look back on my 25-plus years, and I started in a hospital working in a surgical area," says Calnan. "Then I went to a critical care area. Then I went into cardiology. Then I had the opportunity to teach. Then I went into the medical area. Then I went into nursing administration, and now I'm in nursing politics.

"What other kind of career can give you that kind of variety and opportunity?" asks Calnan. "People can really paint their own path of what they want to do."


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