Dear Nursing Grads: Please go directly into Community/Public Health Nursing

First District Nurses in Melbourne
First District Nurses in Melbourne (Photo credit: Wikipedia)

That is, of course, if you are at all interested in this type of nursing work. Please do not believe anyone (and especially not your nursing professors who have probably not worked as a nurse anywhere since the 1970s) if they tell you to first work as a nurse in a hospital to “get experience.” That simply is not true. People can and do hire new grads for community/public health nursing. Hiring decisions for these sorts of jobs have more to do with the individual applicant—with his or her personality traits (flexibility, patience, humor among others), understanding of (or interest in learning about) community resources, passion for patient/community education and empowerment, and a personal value placed on prevention vs. costly curative/acute care. In your resume and interview remember to include any relevant work (including volunteer or service-learning before or during nursing school) experience in health and social service provision in the community. Do your homework before an interview—including making sure you understand important terms used in the job description. For instance, “harm reduction” does not mean sitting close to a door to escape from a potentially volatile patient…

Non-hospital places to consider when job-hunting: public health departments, community health clinics, nurse-managed community clinics, Health Care for the Homeless clinics, migrant health clinics, Indian Health Service clinics, home care/hospice agencies, nursing homes/long-term care facilities, school-based clinics (and school nursing in general), and occupational health clinics (including perhaps jail/corrections health care?). Similar to hospital residency programs for new nursing grads, some health departments and community clinics are piloting paid internships for new grads/new hires. Health departments in Wisconsin and North Carolina have examples of these.

And despite setbacks/job losses brought on by the recent Recession, health departments and community health programs are hiring nurses. And if the Affordable Care Act survives the caprices of the US Supreme Court, health care reform promises to bring a substantial increase in public health/community nursing jobs—or as the Future of Nursing IOM report states, it promises “to return the profession (of nursing) to its roots in the public health movement of the early 20th Century.” (pg 24).

If you are wondering whether going directly into public/community health nursing after graduation precludes you from ever getting a hospital job in the future—that is not the case either. Especially now with hospital systems’ focus on health care transitions, patient education, and patient care management/coordination, having had previous experience in public/community health nursing is an advantage. Hospital units always do additional training for any/all new hires anyway, so you can get back up to speed on the relevant patient care equipment, meds, etc.

Meanwhile, how to find jobs in public health/community health nursing? Like with any job search, working your personal contacts is important. Ask your community/public health nursing professor or clinical instructor (a fair number of students asked me–hence this blog post response). In the Pacific Northwest, here are places I recommend looking for jobs:

University of Washington School of Public Health online Job Postings (search with ‘nursing’ and there currently are six listings, including some cool-sounding Public Health Nursing jobs in Eugene, Oregon).

Public Health—Seattle and King County online Job Postings (some amazing ones currently for the Nurse Family Partnership among others—and yes, they do and have hired new grads).

Washington Association of Community and Migrant Health Centers online Job Postings.

And–thank you Paula for these suggested sites:

Washington State Public Health Association “New Job Opportunities” online postings

American Public Health Association online careers search (this one requires you to create an account but you don’t have to be/become an APHA member to do so. You can then upload/post your resume if you want–is easy to use and a relatively sophisticated job search system.)

Happy job hunting!

~p.s. For those of you who would love to go right into public/community health nursing but find yourselves in a hospital or other setting instead–don’t despair of ever being able to transition back into the community. Just try to find opportunities to volunteer in a community setting, doing health/social services sort of work. That will help you build your resume and skills for making the transition back out of acute care.

12 thoughts on “Dear Nursing Grads: Please go directly into Community/Public Health Nursing

  1. I’m so glad you posted this. Having spent one year as a hospital RN then 37 years (and counting) as an RN outside the hospital, I second your advice. In fact, if I were queen of the nursing world, students wouldn’t be allowed to step foot on a med-surg floor until after doing clinicals in community settings. Learning about health and illness in real life, outside the professional castle, is too important to be an education footnote. As far as job hunting, it might also pay to frequently check individual county websites and try to meet folks from these agencies. State and national public health association meetings (e.g., WSPHA in WA and APHA) can be good venues to connect.

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    1. Thanks for these comments and suggestions Paula. I added links to the WSPHA and APHA job postings sites in my blog post. I agree that it would be a great idea to require all ‘new’ nurses to first rotate through a public/community health job even if they end up working in acute care. It does remind me that we (including me) need to do a better job of educating (and entrancing!) undergrad students in their community health rotations.

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  2. Thanks so much for posting. I refuse to listen to the line of thought that you are not a ‘real’ RN until you’ve done that mandatory 1-2 years on a hospital floor. It’s simply not true, and I do not understand why this idea is continually pushed so hard. Working in Public/Occupational health is its OWN skill set – and while a med/surg background never hurts, I do not consider it an absolute. If you know you do not want to work in a hospital setting, why would you NOT then utilize your education in another area?! I have noticed that some states are now more eager to hire new grads directly into Public Health, and I could not be happier!

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    1. Hi Annie,
      I do think that the pressure to work in a hospital to become a ‘real nurse’ is lessening. Especially given the fact that our country is finally beginning the (enlightened) shift away from over emphasis on expensive and not very effective tertiary care. There are and will continue to be more and more jobs for nurses in community and home health care.

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  3. Thank you!!!
    I am in my last year of nursing school and am VERY interested in becoming a public health nurse. This is encouraging! I didn’t even know I could go into it as a new grad until I did research.

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  4. This post was very encouraging and helpful for me. I am in my last semester of nursing school of BSN, and am taking community health nursing. I LOVE this class so far. I didn’t know much about community/public health nursing until this class. As I’ve been doing research, I’ve been having hope about applying for jobs right when I graduate! I’m from Dallas and would also like to start my career in a prettier state (lol). Oregon looks tempting to apply!

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  5. Thank you for posting this. I will be graduating in May and have started to have anxiety about where to work. I am used to working banker’s hours (day shift, holidays and weekends off) but mentally prepared myself for nursing/hospital hours before I decided to go to nursing school. The closer graduation gets I am starting to believe I was lying to myself. Then there is the unspoken idea that “real” nurses have so many years of floor experience, even my adviser/instructor just told me the other day not to worry about a specialty now and to go into med/surg for a couple of years because it would give me a better background in recognizing signs and symptoms of certain illnesses. I have a case management and supervisory background dealing with various populations that community nursing encompasses including spmi, homeless,mrdd, substance abuse and corrections. I am torn because I don’t want to make a mistake career wise. On one hand I don’t want to be “pigeon-holed” if I don’t start in a hospital and on the other hand I don’t want to be miserable because of work-life unbalance. It is hard to buck tradition but I have done it before and it has paid off. Maybe this is one of those times again.

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    1. Don’t listen to the ‘old guard’ nurses/instructors! Well, listen to them for some things, but not on this issue. The healthcare system is shifting rapidly (or as rapidly as a huge system can shift) to be much less hospital-focused and more community-based. So follow your instincts and go directly into community nursing. Another option is the growing number of programs that link hospital to community care–care transitions and coaching–to avoid hospital bounce-back.

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  6. Hello, because this post is several.years old I don’t know of you will my comment or not. I have several statements and a question. In your “spare time,” I would appreciate your advice.

    As my youngest child began his high school years, I began to wonder what I would do with the rest of my life. Long story short I have always wanted to be a doctor. Because I am 53, nursing is my chosen field instead. I do have a BA in Finance but put it aside as I raised my children (and I would do the same thing again).

    I’m not the retiring type so I am moving forward with my ADN.

    Do you have any advice for a 53 year old nursing student?

    After my ADN, I plan on my BSN which should take about a year since I have previous credits.

    Thank you for any help, Beth

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    1. Hi Beth,
      Thanks for writing and ‘good on you’ for doing your ADN and then BSN! We need more people like you within our healthcare system and I trust you will like nursing. I relish my students who have had other careers (including the vital one of raising children), because they typically have a lot of life experiences and wisdom to draw upon. Good luck and let me know if there’s anything I can do to help from afar.

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