Private Practice vs. Hospital: A Look at Nursing Environments

Regardless of where nurses work, they play a critical role in delivering quality health care. However, the settings in which nurses care for patients can differ significantly, and nurses should know which environments best align with their strengths and preferences.

A nurse practitioner (NP), for example, can work in a variety of settings. According to the American Association of Nurse Practitioners (AANP), the top five workplace settings for NPs in 2020 were:

  1. Hospital outpatient clinics: 14.3%
  2. Private group practices: 10.4%
  3. Hospital inpatient units: 10.0%
  4. Private physician practices: 7.8%
  5. Urgent care facilities: 4.3%

One way of examining where nurses can work is taking a broad look at private practice vs. hospital settings. These two environments differ significantly, with each offering unique features that can appeal to an individual nurse’s particular career goals, schedule and desired work-life balance.

Nurses considering preparing to advance their careers by pursuing an online Master of Science in Nursing benefit from reviewing different workplace environments to learn more about how they might align with their individual preferences.

Working as a Nurse in a Private Practice Setting<

While the demand for health care is growing across all settings, the demand for outpatient care is growing the most. According to a 2020 report by McKinsey & Company, the growth of outpatient or ambulatory care in settings such as private practices exceeds the growth of inpatient care in hospital settings. As a result, nurses who prefer working in private practice will continue to enjoy ample employment options.

Nurse practitioners who work in private practice also have the option to work independently. Those who opt to open their own practices assume the additional responsibility of managing a business and overseeing other functions, such as marketing and insurance reimbursement.

Time Spent with Patients and Shifts

One of the most significant characteristics associated with working in private practice involves the amount of time nurses spend with patients. The American Academy of Ambulatory Care Nursing describes working in ambulatory settings such as private practices as potentially involving:

  • Providing care over a patient’s lifespan
  • Providing care to a high volume of patients in relatively short periods of time

Analysis by McKinsey & Company also shows that nurses working in an ambulatory setting such as a private practice work relatively shorter shifts, with 70% of them working no more than eight hours at a time. Ambulatory settings such as private practices also offer more part-time employment opportunities to nurses than inpatient settings such as hospitals. In addition, the American Academy of Ambulatory Care Nursing notes that working in ambulatory settings can offer nurses the opportunity to work in telehealth.

Types of Care

The types of care that nurses provide in private practice vs. hospital settings can differ significantly. Even within private practice settings, the health issues patients present and the types of care nurses provide vary based on the setting and a nurse’s specialty. For example, according to the AANP, family nurse practitioners, who represent roughly 70% of nurse practitioners, can work in private practices performing diagnostic tests, treating chronic illnesses, creating treatment plans, prescribing medicine and treating injuries.

Working as a Nurse in a Hospital Setting

 

 

While health care delivery in inpatient settings is not growing as quickly as in outpatient settings, the demand for inpatient health care is still on the rise. Working in a hospital can present unique challenges. According to the Institute for Healthcare Optimization, one of the unique features of working in inpatient settings such as hospitals can be managing the competing demands of patients, as well as addressing challenging nurse staffing issues.

Time Spent with Patients and Shifts

National Nurses United notes that the United States has no nationwide limit on the number of hospital patients to which a nurse can be assigned. A 2019 report from Lippincott NursingCenter explains that most states allow individual hospitals to establish their own staffing standards. Therefore, the number of patients to whom a hospital nurse is assigned and how much time they can spend with individual patients can vary.

While inpatient nurses may work longer hours, they often work fewer days a week than private practice nurses, who work more “traditional” business hours.

McKinsey also found that the salaries of nurses working in ambulatory settings were up to 13% lower than those of nurses working in inpatient and emergency settings.

The U.S. Bureau of Labor statistics reports that advanced practice nurses, such as nurse practitioners, who work in hospitals may work on nights and weekends, treating patients who need 24-hour care. In addition, nurse practitioners who work in critical care, for example, may need to be on call even when they are away from work.

Types of Care

Like nurses who work in private practice, the types of health care that nurses provide in hospital settings and the conditions they treat can vary depending on the setting and a nurse’s specialty. For example, according to the AANP, one of the top practice settings for adult-gerontology acute care nurse practitioners and cardiology nurse practitioners is in a hospital; examples of these nurse practitioners’ top clinical focus areas include critical care and cardiovascular care. Neonatal nurse practitioners also primarily work in hospitals, providing advanced care to ill and premature infants.

Characteristics of Nurses Who Work in Private Practice and Hospital Settings

Examining the overall characteristics of nurses who work in private practice or hospital settings can be helpful to aspiring nurse leaders who may be managing or supervising nursing staff in those environments. For example, future nurse leaders may benefit from knowing the following results from the 2020 National Nursing Workforce Survey:

  • Nearly 55% of registered nurses (RNs) worked in hospital settings, while 9.7% of RNs worked in ambulatory settings.
  • Regardless of workplace setting, the nursing workforce is becoming more highly educated: 40.3% of RNs’ highest level of education was a bachelor’s degree in 2013 compared with 48.1% of RNs in 2020.
  • The nursing workforce is aging: 13.9% of RNs were 65 or older in 2013, compared with 19% of RNs in 2020.

As they advance their careers in any setting, nurses in leadership roles will need to confront and manage these factors, along with the growing demand for both inpatient and outpatient health care.

Advance Your Nursing Career to Work in Your Preferred Setting

The work that nurses perform is vital to achieving positive health outcomes in all types of settings. Whether they work in private practice or hospitals, nurses will continue to be central to our health care system. If you aspire to  , explore the University of North Dakota’s online Master of Science in Nursing to learn how the program can help you pursue your professional goals. Embark on a journey toward advanced nursing expertise today.

Recommended Readings

Essential Nursing Skills for MSN Students

How Long Does It Take to Get a Master’s in Nursing?

Nurse Practitioner vs. RN: What’s the Difference?

 

Sources:

American Academy of Ambulatory Care Nursing, What Is Ambulatory Care Nursing?

American Association of Nurse Practitioners, “A Day in the Life of a Cardiology Nurse Practitioner (NP)”

American Association of Nurse Practitioners, “Are You Considering a Career as an Adult-Gerontology Acute Care Nurse Practitioner?”

American Association of Nurse Practitioners, “Are You Considering a Career as a Family Nurse Practitioner?”

American Association of Nurse Practitioners, “Are You Considering a Career as Neonatal Nurse Practitioner?”

American Association of Nurse Practitioners, Business Resources for Nurse Practitioners (NPs)

American Association of Nurse Practitioners, Practice Management

American Association of Nurse Practitioners, The State of the Nurse Practitioner Profession 2020

Institute for Healthcare Optimization, Inpatient Nurses

Journal of Nursing Regulation, “The 2020 National Nursing Workforce Survey”

Lippincott Nursing Center, “Nurse-to-Patient Ratio: How Many Is Too Many?”

McKinsey & Company, “Future of Nursing: Supporting Nurses Across Settings”

National Nurses United, National Campaign for Safe RN-to-Patient Staffing Ratios

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners