On the trail of nursing’s pioneers

With the shift from predominantly acute to community-based provision for people living with chronic illnesses, nurses need to consider careers in non-traditional settings.

It was only when I started teaching an undergraduate community health course that I became aware of the general lack in knowledge about nursing career options.

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Nursing education programmes have to ensure that students are competent and adequately prepared to care for patients when they enter the workforce. This often means there is less emphasis on subject matter not directly related to meeting required competencies.

Nursing practice extends far beyond the traditional hospital bedside in a variety of settings. All nurses should begin where they can develop clinical skills and experience, and an inpatient hospital setting can help accomplish this goal. And most non-traditional community-based settings require acute-care experience, which is critical to the development of the novice nurse.

Finding the right fit

Many nurses enjoy working in the acute care and have no desire to work anywhere else. However, there are nurses who never find the right fit in traditional inpatient settings; they may dislike the fast-paced environment and rapid patient turnover and the unpredictable shifts. Just as not everyone is cut out to be a nurse, not every nurse is cut out to work in a hospital.

The healthcare system is currently undergoing a shift from predominantly acute to community-based care for the diverse population who are living longer with chronic illnesses. Nursing’s overall goal is to restore health, and to promote optimal healing and functioning of patients, and hospitals are not the only settings in which this can be accomplished.

Nurses can work in home health, clinics, shelters, rehabilitation centres, schools, the field of public health, military bases and cruise ships, to name a few. These non-traditional care settings may be perfect for nurses who desire more autonomy and flexibility in their careers.

Public health

New roles are emerging alongside the rapidly growing technologies, such as telemedicine and informatics nursing, used in healthcare. And, although public health is not a new nursing career, the changing healthcare system needs people who can assess the health of populations and plan care to improve the lives of entire communities.

Indeed, many of these non-hospital nursing career options that are developing are really not that new at all. After all, before nurses were formally educated, all of the care provided was in the home.

Non-traditional settings

After the development of formal nursing schools, nursing pioneers went to where the people who needed care were. In the US, Lillian Wald established home visiting for people living in settlement houses in New York City. From this, the first visiting nurse service was established. In eastern Kentucky, Mary Breckinridge travelled by horseback across the Appalachian mountains to provide prenatal and postnatal care to women and their infants.

Nursing education programmes should ensure that students are prepared to care for patients when they enter the workforce, and that they are also informed of career options in non-traditional care settings. This will help to attract and retain a dynamic and diverse workforce in nursing as our profession continues to develop in an ever-changing global healthcare environment.

Find out more

Lowey SE (2017) Nursing beyond the Bedside: 60 Non-hospital Careers in Nursing. Sigma Theta Tau International Publishing, Indianapolis IN.

About the author

Susan Lowey is assistant professor and advisement coordinator in the Department of Nursing at the College at Brockport, State University of New York, US



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