Hospital or Private Practice - What Nurses Need to Consider When Making This Vital Decision

By: Grant Eckert

In any career, there are a number of decisions to make. Within the nursing path, there are a number of directions you can take when you are first starting out, often resulting in different career paths and positions. The first and most vital decision you will make is whether to enter the hospital setting or the private practice setting. Both have their rewards, as well as their limitations, so this is a choice you need to spend time on making.

When You Choose the Hospital Setting

Any graduate of nursing school is probably going to be flooded with offers from hospitals and hospital type settings. And with the hiring bonuses they offer, these offers can be quite tempting. Here are the main benefits of talking to these human resources departments:

· Often unionized workplaces - Once you're into these hospitals, you're nearly guaranteed steady work for the rest of your life. Your wages will be raised yearly and your benefits will be negotiated regularly.
· Possibility of promotion or transfers - In a larger hospital setting, you will be able to change your position as your experience increases. Most hospitals will post jobs in other departments with preference given to those already in similar positions or with more years on the job.
· Variety of work - You can start out in one position and then transfer to other positions as your knowledge increases or you simply want a change of scenery and patient care.

But as with any setting in which you would choose to be a nurse, there are downsides too.

· Problems dealing with seniority in the beginning - Since seniority tends to be rewarded, as a new nurse, you might find that positions are slim and the hours are poor until you have a few years of experience.
· Fast paced setting, high patient to nurse ratio - While this can also be a benefit, the fast paced setting and high patient ratio can be exhausting for some nurses, often leading to burnout.

When You Choose the Private Practice Setting

If you're looking at joining a private practice as a nurse, you will find that there are just as many benefits as there are problems with this arrangement.

The benefits include:

· Regular hours - Because you are only working when the doctors are there, you can establish a more regular schedule. This works well for nurses with families that need their care.
· More chance for patient interaction - When you're only dealing with one patient at a time, you can feel more connected to the patients you do meet.
· Smaller patient population - This allows you to learn and to remember patients that come in regularly. You also can have less stress than in a hospital setting.

But the disadvantages to this setting are:

§ Lack of unionization in many cases - This can cause your job to be at risk for termination at any time, regardless of seniority. Your benefits will also be decided by the practice management instead of being supported by a union representative.
§ The pay can be less - While some practices pay better than others, the pay is often much less in a private setting as the revenue can be smaller.
§ There are fewer jobs - You might not be able to get into a higher position as a private practice nurse, plus the number of jobs available is fewer.

Whether you choose the hospital setting or the private practice setting, you will still be able to do what you do best - care for patients. However, most nurses find that one setting is a better fit than another. And that decision is up to you.

Benefits Play a Big Role in Nurses’ Employment Decisions

By E’Louise Ondash, RN, contributor

There’s no doubt about it. Benefits are important to nurses when they consider where to work or whether to remain with an employer, but the benefits they want can vary with age, marital status, health, family situation and career path.
“You need to have flexible benefits (because) there is a much greater emphasis now on balancing work life, and because throughout the life cycle of your career, you’re going to have a need for different benefits,” explained Veronica Zaman, RN. She is executive director of workforce development and talent management at Scripps Health in San Diego, California, a nonprofit community health system that employs more than 3,000 nurses. “We have an aging workforce and we also have a multi-generational work force—new grads who are coming to nursing as a second career.”

Scripps Health has given a lot of attention to benefits, she added, and it watches what the competition is offering.

“The trend a few years ago was to have huge sign-on bonuses, and there are some pockets where that is still a strong attraction. We offer a strong flexible benefits plan so we can focus our efforts on retention rather than bringing people through the door for signing bonuses.”

Ask nurses and they’ll tell you that they expect other benefits beyond major medical, according to Ric Spurgeon, RN, a Seattle nurse and caseworker for Medicare recipients for a large insurance company.

“The benefits are a huge deal, especially since many nurses are single mothers,” he said. “They want items such as subsidized child care, long-term care insurance, legal insurance, retirement accounts, pension plans, employee stock plans and several choices of medical and dental insurance.”

Although not a single mother, Spurgeon likes having six medical plans from which to choose. He said he picked one that meets his needs.

“Your choice will depend upon your state of health, utilization and where most of your expenses lie—whether it’s medications, hospital or doctor visits because of chronic conditions. I prefer a health savings account (HSA).”

Spurgeon uses pre-tax deductions from his paycheck to fund an HSA.

One St. Louis nurse who works part time as evening nurse manager at a large teaching hospital, continues to “toy with thoughts of retirement.”

“I look at it seriously every six months,” said Patricia, a 40-year-veteran who asked that her last name not be used. “But as long as working is still something I enjoy and I have a schedule I can manipulate, I find it hard to justify giving up the great medical coverage we have at the price we pay. So I suppose you could say that insurance is certainly a factor in keeping me working at the moment.”

Even though she works only two days a week—the minimum to receive benefits—Patricia has health, vision and dental insurance, vacation and sick time, tuition reimbursement and an employer-matched 401K. And although she has remained at the same hospital since her 1967 graduation, “I continue to get lots of recruitment-type mail from other hospitals,” she said. “The information I get always highlights benefits, so I can only assume it’s pretty important. Interestingly, the tuition reimbursement and the 401K seem pretty important to young nurses also.”

A national telephone survey of 250 nurses, conducted in October by Aflac Insurance, confirms that benefits play a big role in the decision-making process for nurses when determining where they should work. Nearly nine out of 10 of the nurses said a hospital's benefits package is one of the most important factors when determining where they choose to work.

More than half of those surveyed reported that they would switch jobs solely based on benefits.

Some nurses even want so-called “voluntary” accident and disability insurance; that is, they are willing to pay the full premiums if their employers offer it.

Nursing Scholarship Programs Funding

Scholarships are financial aids provided on the basis of academic merit awarded to an institution or an individual for the purposes of furthering their education. They are offered by governments, colleges and private, and other outside sources. They are generally awarded based on the financial need, academic achievement, athletic achievement, community involvement, nationality or ethnicity of the individual. Like grants, they do not have to be repaid.

Nursing Scholarships and grants are provided to compensate for the critical shortage of nurses around the globe.

Many Nursing Scholarship Programs provide tuition fees, required fees, other costs including required books, clinical supplies, laboratory expenses, research facilities, etc., and other scholarship benefits. Preference is given to qualified applicants with the greatest financial need who are enrolled full-time in an undergraduate nursing program. Nursing scholarships or loans are not only granted to the needy and with the highest grades.

Nursing scholarships are given in exchange to: practicing full time as primary care nurse practitioner in a community, teaching in a nursing school, employment as a nurse administrator in health care agencies, working for the Department of Health, service for a period of 2 years at health care facilities, and/or assist in the area of mental health research.

The major sources of nursing scholarships for students are the state and federal governments. Some are sponsored by individual donors or private organizations. Since they often have more nursing scholarships funds available, more and more federal dollars are used to promote underserved areas for nursing students who can commit to service after graduation in a medically underserved institution or region.

Professional nursing organizations, such as the American Nursing Association (ANA) and other active political voices, and many colleges and universities with nursing program, have built up generous scholarship and grant funds for both undergraduate and graduate nurses because of the lack of funding across public and private sources. These grants are administered to nursing scholarship programs to help shore up flagging nursing programs, provide needed funds for new facilities, and provide money to hire more well-trained nursing faculty.

Nursing scholarship forms can be accessed online or you can obtain copies from schools’ financial aid offices. Requirements must be completed at favorable dates or deadlines. They are in first come first served basis. You can explore the web to be able to find what kinds of nursing scholarship programs are offered. You can also find them in private sector loans, grants and other assistance that your local service organization provides.