What to Expect From a Career in Nursing

woman in hospital bed holding a baby. The nurse is standing at bedside as if she just handed the baby over to the mother.

Are you considering entering the medical field as a Registered Nurse? Before jumping headfirst into a new career, you should first know what to expect from a career in nursing. 

Being On-Call 

Although you might not officially be on-call, you’re always on call. Staff members are consistently sick, people quit, the census varies, and it can be hard for the nurse manager to staff accordingly. This especially rings true when you’re working in a hospital, and many floors may need your support. Thus making the chances of being called in on an off day high. Additionally, most employers will require (and sometimes it can even be a state-wide requirement) for you to agree to come in if there’s a natural disaster. As an RN, you have a duty to save lives, and you’re employers take that to heart. In addition to this, you can on-call where you’re paid to do so (getting called in or not), and those opportunities are generally worth it. 

Holidays 

Do you love the holidays? You may want to kiss those goodbye as an RN working at a hospital. I know it seems harsh, but it’s true. When working in a hospital, there’s typically a system called the “holiday pool.” RN’s vote for which holidays they care about the most, then the nurse manager takes that into account as well as the holidays worked the years prior. However, it’s common that those not working the holidays are on-call in case someone calls in sick, so days off don’t genuinely exist. There will be many Thanksgivings, Christmas’ and New Year’s Eve’s spent with your work family. 

Extended Shifts 

Although going from paper to EMR has reduced extended shifts significantly, there will still be countless days where you’ll have to stay late. Gone are the days of coming in when you’re required and leaving right at the end of your shift. Sometimes rounds take longer, and sometimes it’s an emergency. Always be prepared to stay late just in case. 

Acuity 

Acuity, acuity, acuity… There’s nothing like coming into your shift to see that you’re at your minimum acuity and number of patients. The same rings true for the max. As an RN, when you see your assignment, there’s either excitement or utter worry. What does Acuity mean? It means that not only do you have the legal state limit number of patients, you’re also at the highest number of “toughness” when it comes to how poor the patient is doing or how much assistance they need. There are a few things that affect the acuity level such as fall prevention, number of tubes/IV’s, gastrointestinal function, and more. Unfortunately, there isn’t a universal nation-wide calculation for patient acuity levels (yet). 

High Census 

A high census is an excellent thing for the hospital, but it’s typically very hard on the staff. Everything takes longer (tests, results, etc.) and, it usually means you’re at your capacity. 

In 2004, California implemented a new law requiring all hospitals to limit the numbers of patients nurses could treat at a time. The limits vary depending on the hospital setting and unit. For instance, the ratio in an operating room is 1:1 while a psychiatric ward can have up to 6:1, and pediatric and emergency-room units can have up to 4:1. Once the unit hits capacity or the nurses hit capacity, the floor has to shut down until the on-call RN’s are called in, or patients are discharged. — Nursing Licensure.org

CEU Requirements 

Upon graduating and securing your RN, schooling never truly ends. You’ll be required to keep a certain number of clinical hours as well as a set number of Continuing Education Units (amount dependent on the state you’re registered in). You can learn more about CEU’s in our recent article: Nursing CEU’s – Continuing Education For RN’s.

Self Care

You’re likely thinking of becoming an RN because you like helping people and making a difference in the world. What you don’t realize until you’re knee-deep in the trenches is that being an RN is incredibly rewarding, but also extremely emotional. You’ll experience highs and lows no one could ever prepare you for. However, it’s all worth it at the end of the day. One thing you can do to prevent burnout is by exercising self-care

Advancing Your Career 

One of the many great benefits of being an RN is the opportunity for growth. Unlike many 9-5 jobs where you advance when someone retires or quits, as an RN, you have the opportunity to take additional classes to obtain certificates. Such certificates can advance your career, or you can “quickly” advance your career by going back to school, dependent on what you want to do. To learn more about your options, check out our article: Furthering Your Opportunities in Your Nursing Career

Did we miss anything on what to expect from a career in nursing? Let us know a few things you wished you knew before starting your career in nursing in the comments below.

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About the author

Ashley Carty

Ashley Carty is a seasoned medical professional with over 8 years of experience working at the top hospitals in Southern California, including Hoag, Saddleback Memorial, and UCSD.

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