How Challenging is Switch from Hospital Nursing to Clinic / Ambulatory Care Nursing?

Nurses who work in an outpatient setting are called ambulatory care nurses.

Their job roles include taking care of non-critical patients, those in need for routine preventive care, patients with acute concerns, etc.

The regular training for the variety f the nurses is inpatient units.

Therefore, nurses can get a bit confuses when it comes to the transition from the hospital healthcare environment to the clinic settings.

Work Setting

When the transition occurs, many nurses feel what is called an “environmental shock.”

There is plenty of nursing staff in many hospitals, including CNAs, LVNs, and RNs, as well as physicians with different specialties.

The clinical settings are focused more on physicians.

There are different departments and therefore, there are different medical staff, such as medical assistants, receptions, administrative workers, etc.

In clinics, the nursing staff isn’t always as robust as it is in hospital settings.

Autonomy Level

Nurses who work in the outpatient work setting have a higher level of autonomy in their practice.

On the other hand, in hospitals, there are strict protocols nurses have to follow and they work according to doctor’s orders.

Therefore, numerous protocols are defined and all healthcare workers must follow them strictly.

In the clinical setting, nurses have a bit more room to wiggle.

For example, if a patient comes without a previously scheduled appointment with the physician, an RN may triage them and give them home care advice.

Nurses can also decide about vaccine administrations, and administer them without physician supervision.

Therefore, several challenging adjustments nurses come from the hospital must get used to.

There is no need for strict physician supervision in the clinics, and nurses can perform their duties within their scope independently.

Also, some nurses who go through this transition may struggle to find a balance between independent practice and the need for a physician consultation.

Work Load

Hospital nurses who want to transfer to the clinical setting must be prepared for the volume of patients in ambulatory care.

People tend to think that hospital nurses work more than clinical nurses, but that is a misconception.

Hospital nurses can take care of patients with critical conditions and can perform numerous other tasks such as discharges, medical administration, procedures, teaching, admits, etc.

Nurses who work in the ambulatory setting have an extremely large workload.

There are plenty of patients coming throughout the door with different needs and require different levels of care.

These nurses should be prepared for unexpected, similar to hospital nurses.

Also, nurses must be prepared to communicate with patients in person, but also through messages.

It is another difference because hospital nurses don’t always communicate with their patients through messages.

Clinical nurses routinely provide telephone triage and answer emails.

However, with the proper facility guidelines about all procedures, nurses can make a transition smoother and with fewer issues on the way.


Next, nurses must be prepared to adjust to the technical differences in nursing practices.

It is because patients in ambulatory care arent always acutely ill like in hospitals.

There are technicals aspects that nurses must be adjusted, and nurses sometimes miss their previous tasks.

For example, nurses who worked in hospitals are used to performing complex procedures such as taking care of patients on ventilators, received blood transfusions, etc.

Ambulatory care doesn’t require much of these procedures, and the nurse may feel as if they will lose their skills.

However, nurses must keep in mind that while they are focusing on some other aspects of care, they are improving them elevating their clinical skills and giving evidence-based advice.

Business Aspects

Another aspect that is very different between ambulatory care and hospital setting is that clinics focus more on a business aspect than on inpatient.

Running private clinics or large organizations isn’t different from running a company.

The work setting includes traditional office elements, including reception, phone calls, administration, mail, etc.

In medical clinics, there is a highly important customer service element.

Therefore, higher patient satisfaction means more clients and more revenue.

The business aspects primarily apply to primary care and private practice, but in some other work settings, you can find some degree, as well.

Every nurse who transfers from hospital to ambulatory care setting goes through the process differently.

The important is to stay flexible and open-minded and to follow facility guidelines.

Despite being a completely different setting, nurses are still able to provide the best care to the patient after they get used to the change.

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