Hospital Nursing vs. Clinical Nursing
Depending on the setting, hospital nursing and clinic nursing can be very different. One of the most significant differences is the acuity of patients. Obviously, hospitalized patients require a higher level of care than a clinic can provide. More monitoring is needed. However, occasionally a patient may present to a clinic with an acute or emergent issue, so nurses must be prepared to handle more complex patients and be able to stabilize them for transfer to an acute care setting.
Both clinic nursing and hospital nursing can be busy. However, they are different kinds of busy. While hospital nurses are busy in that they have complex patients to care for with many nursing interventions needed, clinic nurses have a higher volume/ patient turnover to manage throughout the day. Multi-tasking is crucial in clinic nursing as nurses must not only provide hands-on care, they may also have to address messages from patients and perform telephone triage and follow up calls.
In the clinic setting, nursing tasks may not be as complex as in the hospital. Again, this may vary depending on the clinic setting. But in a primary care clinic setting, for example, tasks such as tube feedings, complex wound care, trach care, etc. are not usually performed. Some tasks that may be done in the outpatient setting can include injections, IV infusions, catheter placements, and simple wound care. Again, every clinic setting is different, and required tasks may vary.
Clinic nursing is also very autonomous. Sometimes an outpatient department may only have one nurse. While more autonomy can be empowering for nurses, the absence of collegial support can present a challenge. Nurses frequently bounce ideas off one another and ask for advice on clinical concerns. Although physicians are more likely to be present in the clinic setting, nurse-to-nurse collaboration may not always be available.
The types of patients seen in outpatient surgery depend on the setting. Outpatient or ambulatory surgery centers perform minor procedures in which patients are released the same day. Duties may include those of OR/recovery room nurses. However, some surgery clinics function much like a primary care office. Patients are scheduled to come in, meet the surgeon for a consult, and discuss surgery options. From there, surgery may be inpatient or ambulatory, depending on what type of procedure is needed.
A significant job duty of surgery clinic nurses is education. Nurses assist in explaining the procedure to the patient, discuss the pre-surgery instructions, review post-operative expectations and procedures, and answer any questions the patient may have.
Surgery clinic nurses may also assist with in-office procedures such as incision and drainage or excision of a skin lesion. They may help set up instruments, assist the surgeon during the procedure, and perform wound care afterward. They also provide valuable patient education in caring for the site after leaving the clinic and set up any necessary follow-up appointments.
Another difference between hospital and clinic nursing is that in the clinic, the primary focus is generally on preventive health. Education on various topics such as a healthy diet, diabetic living, blood pressure management, etc. are things clinic nurses must educate their patients on. Education in the hospital setting also occurs but is often tailored to the acute problem a patient was admitted with.
When first starting out in the clinic, nurses are often surprised as to how much it is run like a business. For the most part, nurses have little to no business training in school, so when it comes to sending and receiving company emails, learning applications such as Excel and PowerPoint, and taking and sending patient messages, it's an entirely new skill set that must be learned.
Nurses in both the clinic and hospital setting are critical in the patient care continuum. Both areas have different clinical focus but are crucial in comprehensive healthcare delivery.
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