Will You Work in a Hospital?
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Over the last ten years, seismic changes have been sweeping the healthcare industry. From the rise of HMOs to advancements in drugs, genetics, and medical technology, these factors—for better or for worse—have significantly changed patient care in many ways. One of the most prominent changes has been in the venue of care.

The Continuum of Care
One of the major shifts in the philosophy of patient care has been the move to the concept of The Continuum of Care. The Continuum of Care is a framework for the delivery of healthcare services in a primary-care environment, with a focus on health as well as illness and injury. This represents a paradigm shift from the problem-oriented medical model of diagnosis and cure to the perspective of holism and prevention, with an emphasis on self-care.

The Resulting Revolution in the Nursing Profession
Prior to this revolution, the hospital was the focal point of patient care, as well as employment for nurses. In fact, according to the Future Needs Project of the American Nursing Association, the hospital setting is decreasing as a place of employment for nurses, from 67% in 1992 to 60 percent in 1996 with further declines expected.

On the bright side, employment for nurses has broadened to a diverse variety of venues. With the shift to the Continuum of Care idea, patient care, and consequently the place of care, is looked at along a timeline of the patient's lifespan—from birth to death. As a result, opportunities for nursing positions have emerged in such non-hospital settings as birthing centers, rehabilitation and therapy facilities, schools, retirement communities, nursing homes, and in-home healthcare.

What does this mean for you?
In general, this revolution equates to nurses having more choices as to the places they work and the types of patients they work with. So, will you work in a hospital during your career?

Probably. And you probably should. The hospital is still the primary place where you can acquire the broadest range of skills and experiences. This broader professional experience at the outset will enhance your career down the line, allowing you the flexibility to work in the places that match your particular interests be they pediatrics or geriatrics. In the end, the revolution in healthcare will allow you to take control of your nursing career and develop it in ways that best suit your goals.

This article was adapted from Careers in Nursing,
by Annette Vallano
Published by Kaplan, Inc. and Simon & Schuster, 1999