The availability of nursing jobs is greatly influenced by the patient flow. Given the choice of working inpatient or outpatient, which would you choose?

The health insurance industry dictates whether a particular surgery or medical procedure will be covered on an inpatient or an outpatient basis. In recent years, outpatient care is on a dramatic increase. That said, which is more appealing, inpatient or outpatient nursing?

The availability of nursing jobs is greatly influenced by the patient flow. Given the choice of working inpatient or outpatient, which would you choose? They are polar opposite work environments in many ways.

Nursing Workforce

Before evaluating where to work, it is interesting to look at who is actually employed in the nursing profession. There are about 3 million nurses currently employed in the U.S. Of that population, almost one million are over 50 years old.

Traditionally, especially the in aforementioned over-50 group, a nurse’s first job was on an inpatient unit with a rotating shift schedule, including every other weekend and holiday. Sound familiar? This is no longer the norm. Times have radically changed.

With the evolution of healthcare and the changes in what is done on an inpatient versus outpatient basis, career choices for nurses have changed.

Inpatient Care

There will always be an inpatient population. In this healthcare climate, the patient acuity in hospitals has dramatically increased overall. Patients are sicker when they are admitted to the hospital.

Health insurance plans dictate who stays overnight and who goes home the same day. Doctors exercise some input, but must clearly and concisely justify their healthcare plan for a patient in order to qualify for coverage.

While inpatient care is traditionally thought to be in an acute care hospital setting, there are other facilities that qualify as an inpatient status. They include: residential treatment center or halfway house, extended care facility or nursing home, hospice facility and birthing center, among others.

Pros

• Provides continuity of care by delivering healthcare to a consistent patient population. Nurses aim to care for the same patient assignment while a patient is in the hospital.
• There is financial benefit of a significant salary differential pay for off-shifts, weekend and holiday coverage.

Cons

• Long work hours with the advent of many 12-hour shifts on many inpatient units
• There is most often a rotating, rather than permanent, shift schedule. Working different shifts can be stressful and exhausting
• Holiday coverage, especially on major holidays, affects family and recreational activities

Outpatient

What are some of the outpatient employment choices? There are jobs in hospital-based outpatient departments, private doctor’s office, freestanding health clinics, urgent care centers and home care to name a few options.

Pros

• A consistent work schedule is the norm, usually daytime hours with some coverage into the early evening, depending upon the job
• Usually no weekend hours, but some jobs might require such coverage
• An evolving schedule and changing patient population avoids monotony on the job
• Nurse managers in an outpatient setting have an added benefit of supervising a staff that is content with their schedule and work flow. This makes it less challenging, in one respect, to effectively manage a patient care unit

Cons

• With the evolution of healthcare turning to more outpatient care and procedures, the tempo in such a unit and the patient turnover is fast-paced

What is the Decision?

The decision about whether to work in an inpatient or outpatient department is a personal choice. It is based upon lifestyle, professional experience and personal influences like family responsibilities. Another huge factor is, of course, the availability of job opportunities in either situation.