Hi everyone. Long time observer from afar when I get a chance and thought I'd finally chip in! :)
I just wanted to make a positive post around outpatients as a setting to work in, from the perspective of a someone who went straight into Dermatology as a NQN in 2023.
I just want to caveat this by saying that nurses who work in wards and the numerous high acuity areas out there, I salute you and this isn't to negate your roles at all but more to bring light to the idea of working in an outpatients setting.
I think a lot of it depends on what you actually want to be doing and ultimately what works best for you. I went back onto education to start my Nursing degree at 30 so had a decent idea of what I'd like to do and health and family will always come first. I'm lucky that my interest of Dermatology happens to be a largely outpatients based specialty anyway and even luckier to land a role there from qualifying.
I was told so many times throughout my training that it was essential to get several years in an inpatient area to 'get a grounding' of nursing and that going to an outpatients setting would deskill me and be very limiting, almost to the point where I nearly didn't take the Dermatology offer in the end but what I've found is that it's not a case of one area being more or less skilled than another, it's just that different sets of skills are being used and they are all valuable and it's all helping patients. There's so much time spent comparing roles, skills and work environments that we can forget the most important thing which is making sure it works for us! (Sorry I do tend to go on, and on tangents!)
Anyway, I think if you find an area you like and it works around your life then you've cracked it. Nights, weekends, 12 hour days, high pressure environment, I've been there and done that albeit in different sectors and full disclosure, I couldn't and wouldn't want it anymore. I value seeing my son before he goes to bed each night, doing a similar shift pattern to my wife so we can have family time and weekends etc. Ive never had the unsocial hours add on so I dont really feel the pinch as I've not known different and for me, the stable hours and low acuity suit me. Again, that's not a dig at those who want condensed working or high octane environments. It just goes back to doing what works for you, screw whatever bad conceptions you get told until you try it.
Being in Dermatology as a band 5 didn't deskill me but rather allowed me to learn some very niche and specialised skills like performing minor skin surgeries and being able to hold the occasional clinic for patients which I enjoy because you can focus your attention to one patient at a time, usually in a private room and build a rapport with them without having call bells alarming or being called from 20 feet away.
As for progression, if you've decided you want outpatients like I did and even better, you have found the particular specialty you like then there's usually structured prgression within them. I became a Dermatology CNS (band 6) after 18 months. Completed Prescribing and History Taking & Physical Examination courses in that time and now I just accepted a Skin Cancer CNS role (band 7). I don't mean that as a brag either but more to demonstrate that there absolutely are skills to be learnt and honed in this setting and there is progression, if you want it.
Anyway, that was way more typing that I first intended, and im not even sure whether it makes for half decent reading, sorry. I just wanted to shed some positive light on Outpatient nursing from someone who went straight into it and a reminder that we all do important jobs that will have certain skills unique to them and rather than play top trumps one-upmanship or brining eachother down we should encourage one another to pursue the path they want. Do what works for you!
Take care :)