You’ve read every, “What does it take to be a nurse?” blog. You’ve checked yourself against every list of skills a nurse should have. Patience, compassion, dedication: check. You know this is your future, but you’ve been so focused on becoming a nurse that deciding where to work is the least of your concerns. But as you get further along in the process of becoming a nurse, you’re starting to think about the type of nursing work you’d like to focus your career on.
One easy way to narrow down your search is to decide whether you want to work inpatient or outpatient care. This high-level distinction categorizes all your options. Depending on what kind of patients you want to work with, what kind of schedule you want to have and what kind of impact you want to leave, choosing inpatient or outpatient care will help you find the best place to utilize your skills.
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Inpatient vs. outpatient: Definition
The primary distinction between inpatient and outpatient care is the amount of time a patient will spend in a facility. Typically, inpatient focuses on patients who are admitted for an overnight—or longer—stay. Because of this extended stay, these patients will require lodging and food. Typically you’ll find inpatient care services at hospitals, drug rehabilitation centers, birthing centers, psych wards and nursing homes.
Outpatient (sometimes called ambulatory) care is the quicker of the two—patients are usually able to get in and out with what they need in a day. This includes scheduled visits to clinics, most trips to urgent care, home visits and in many cases emergency care.
There is a bit of gray area with this—a simple clinic visit could result in a doctor ordering a stay for additional observation. Also, there isn’t a neat dividing line based on location or type of facility. For instance, hospitals will offer both inpatient and outpatient services—the duration of the stay is the key factor.
Inpatient vs. outpatient: Patients
Most inpatients are dealing with acute ailments or medical issues. They cannot recover at home and must have access to 24/7 care. Kids with pneumonia, moms in labor, those with severe depression and recovering addicts are all examples of inpatients. As you might expect, in many of these cases patients are undergoing stressful and painful situations—and some might not want to be there at all. As a nurse, you must be prepared to deal with the acute emotion that comes with an acute condition.
In the past, the standards for being admitted as an inpatient were much lower, but as operations become less invasive and the cost of the average hospital stay increases, more patients are drawn to outpatient care.
Aside from exceptions sometimes found in emergency and urgent care, outpatients are considered ambulatory—which just means they are still able to function with basic ease on their own. They can range from your grandma after knee surgery to a high school athlete getting a physical. While these patients are not usually critical, nurses working with them still have a great deal of responsibility. Compared to inpatient care, they tend to oversee more patients at a time and often make more decisions on their own.
Inpatient vs. Outpatient: Hours
The 24/7 nature of inpatient care means night shifts, weekends, and holidays. Though this often deters people from inpatient or outpatient emergency care, many nurses testify to the unsuspected benefits of it. Working three 12-hours shifts over the weekend may sound rough, but having an entire week off allows many nurses to be with family, travel, and pursue other passions. It may take a day or two to recover from this kind of schedule, but if you are the type of person who likes to work hard and get it done, it might be the path for you.
To some, however, nights, weekends and holidays are worth a lot more than potential incentives from an employer. If that’s you, rest assured that most outpatient facilities operate during regular or extended business hours. That doesn’t guarantee you’ll be able to take every holiday off—a lot will depend on your employer and the type of outpatient facility you work at—but you can generally expect to have a more standard work schedule.
Inpatient vs. Outpatient: Impact
Every patient has a story. No matter where you work as a nurse, you will be a part of that story. Whether you work inpatient or outpatient care will determine what role you serve.
Outpatient nurses often see dozens of patients a day. Julie Morison, owner and director of the eating disorder center HPA/LiveWell says one of the challenges of outpatient care is the limited time spent with patients.
“Relationships are built between providers and patients,” Morrison says. “Turnover interrupts that relationship.”
Morrison adds that the recommendations you provide in an outpatient setting are often left to the patient to follow through with. If they don’t, it can be difficult to feel like you're making an impact. This is particularly true when compared to inpatient settings where issues get resolved under close supervision—patients don’t really have the option to ignore healthcare provider recommendations.
On the other hand, outpatient care typically also increases the sheer number of patients you care for. If you are the kind of person who is energized by meeting new people and small acts of kindness, outpatient care may be just what you’re looking for.
For those who may prefer building deeper relationships with their patients, inpatient care may be more appealing. You’ll have the opportunity to be a part of their recovery stories from beginning to end—and that can come with some pretty powerful moments, both good and bad. When a patient passes or is discharged, it can be difficult to move on to new patients.
Like anything else, there are pros and cons to each side, but in the end, your role as a nurse is not much different than your role in life. Whether you’re an introvert, extrovert, sensitive or energetic, you will have good days and bad days. You will impact your patients and they will impact you.
Are you in or out?
When it comes to choosing a career direction, it can be helpful to think about what inspired you in the first place. Was it spending a week in the hospital as a sick kid? Was it your hometown nurse—the one in the butterfly scrubs? Either way, it probably wasn’t the hours or location that made you want to be a nurse but the ability to care for others.
You will work in a variety of settings throughout your career. You will like some more than others, and, thankfully, you have time to figure it out. If you’re still looking for direction, try volunteering to see what kind of environment suits you best. Start exploring your options in our article “8 Nursing Volunteer Opportunities to Help Bulk Up Your Resume."
1Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, [accessed October, 2019] www.bls.gov/ooh/. Information represents national, averaged data for the occupations listed and includes workers at all levels of education and experience. Employment conditions in your area may vary.
