Yet another 'help me narrow down job fields' question.
October 1, 2012 11:04 AM   Subscribe

Job/grad school planning filter: health-related jobs editions. Nursing, public health, social work, or something else entirely? Help me narrow my options and get myself on a better career trajectory.

Not too long ago, I was an undergraduate anthropology major with a strong interest in medical anthropology. I ate up The Spirit Catches You and You Fall Down. I idolized Paul Farmer and thought a lot about how his ideas about holistic care and preferential options for the poor could play out in a US context. I did research on disability activism and identity, on activists' resistance to medical models. I took a class on violence as a public health concern, learned about harm reduction and epidemiological patterns of gun violence. Science and medical procedures interested me, and still do, but I'm more interested in social determinants of health, people's interactions with and relations to healthcare providers, and issues of health care access in underserved communities.

I knew that I wanted to do something with these medical/public health interests after graduation, but I saw pretty quickly that I wasn't going to get related work without experience. So I got an AmeriCorps position, at a health related but not explicitly clinical organization.

AmeriCorps was disastrous. Some of that was me being overwhelmed by the responsibilities of a real-grown up workplace. Some of that was my organization being unfocused,understaffed, and run by a terrible boss. Some of that was a complete lack of support from the higher-ups running my AmeriCorps program, and my organization being a poor match for AmeriCorps. In any case, I wound up quitting six months in, lost a lot of confidence in my ability to hold any job period, and decided to pursue other areas for a while.

Now I'm in a different city, working on my job-related neuroses in therapy, and realizing that I would really like to pursue health-related fields again. I'm sick of scraping together temping and babysitting gigs, and would like to get myself on a stabler long-term path. I'm currently taking one health related class at my local community college, and plan to take biology and statistics in the spring. The question is, to what end.

Ideally, I'd be in a job where I have varied responsibilities, don't sit at a desk all day, work with adult patients/clients, and look at health care issues in a broad context that takes social inequality, cultural considerations, access to resources, etc into account. In my really ideal world I'd like a position where I could do mostly direct care but also a bit of research, but I recognize that you need to work up to a job like that.

Fields I'm considering/have considered:

Nursing: I like the variety of choices within the field and the working with people component. But how do you determine whether you're going to like the field? It doesn't seem like the sort of thing you can 'test out' in an entry-level position first; by the time you get to clinicals you've already sunk a lot of money and effort in. Is there any way I could 'test out' the field in addition to informational interviewing?

Public Health: This seems to coincide best with my interests, but I'm not sure what the job market in the field is like. (I assume I'd be looking at health education or program design sorts of jobs, not epidemiology, biostats, etc.) I'm also terrified of the amount of debt I'd have to take on for graduate work. Is getting a masters' like this with an inconsistent work history a big red flag?

Social Work: Has the people components and big-picture analysis of social determinants that I want, I've done well at low-level social worker type tasks. (Client intake at a social service non-profit, helping with SSI appeal paperwork.) How could I work the medical interest in? What's funding like?

Things I am not interested in: graduate work in anthropology, medical school, counseling of any sort.

I'm already working on informational interviews of people in the field, looking for places to volunteer, etc, but how else would you choose between fields? Are there other careers that are in line with my interests that I'm missing here? Are there entry-level paying jobs I could get now that would give me a taste of any of these fields and help me narrow my options? What's the best way to leverage volunteer work in these fields into paying work?

Possibly relevant: I'm open to moving out my current city in the longer run, but probably not right now. There are many options for nursing or social work school in my area. Choices for public health are more limited, but I'm interested in some of the research that's happening at the one public health school in my area.
posted by ActionPopulated to Work & Money (10 answers total) 6 users marked this as a favorite
Best answer: Based on what you have said here, I think Social Work has the best potential to be the path you will like. You can be a social worker in a healthcare setting doing discharge planning and coordinating home services. Many hospital social workers also help patients find resources to help with bill payment and insurance. Some social workers also do patient advocacy, which sounds like something you would be interested in.

However if you are considering nursing, you totally can test out nursing in an entry level position first, be a Certified Nursing Assistant. Usually the classes are somewhere between 4-12 weeks long, and if you like your clinical for Certified Nursing Assistant, I think there is a good chance you will like nursing. If you hate your Nursing Assistant clinical, that is usually a good indicator that you will hate some major parts of nursing (not to say that there wouldn't be a niche of nursing you would like, but your clinicals in nursing school and first job after will probably make you miserable if you hate being a Nursing Assistant)
posted by mjcon at 11:31 AM on October 1, 2012 [1 favorite]

If you're seriously interested in nursing, you should become a CNA first or at least volunteer in a hospital. Definitely talk to a lot of nurses.

I wouldn't go into grad school unless you're really sure what skills you want and how to turn it into work.

Social work is an option. Do you know specifically what kind of social work? MSW programs are expensive and people with those degrees sometimes really struggle to pay back loans.

I would definitely recommend lots of work experience first, so you can figure out what you like to do and what you might actually get paid to do, and what kind of skills you need to obtain that kind of position.

Have you considered an MPH?
posted by discopolo at 11:39 AM on October 1, 2012 [1 favorite]

My dad is an LCSW Social Worker. I think you'd like it. He focused on mental health and work primarily in non-profits. About 15 years before retiring (at the age of 70) he worked abroad for the Federal Government as a DOD Therapist. He specializes in family counseling and learning disabilities. He ended up with top secret clearance because he was talking to people very high up in the intelligence community. The good part about it was that my parents got to live in Japan and Germany and do a shit-load of traveling.

Even so, doing what you want to do DEPENDS on interacting with government agencies and they're all FUBAR. Seriously, if you need everything to be organized, make sense, have a reason and come out even in the end, you will be endlessly frustrated with ALL jobs.

Husbunny used to be a nurse. This job can be rewarding, but it's very stressful. Nurses have all of the responsibility and none of the authority. More and more is being expected of nurses and just like the rest of us, they're being asked to do more with less. Husbunny burned out after ten years.

I think that you need to become more realistic about the conditions under which we all work.

Very frequently the people we report to, our managers and supervisors, are territorial idiots who are building fifedoms. Sometimes they're very bright and very nice, but they have expectations that are too high. Sometimes they're alcoholics. Sometimes they're inappropriate. Some may be great clinicians but terrible at keeping up with the paperwork.

Don't go into debt to fund any of your further education, as what you'll earn for any of the jobs you've described will barely cover your living expenses, let alone student loans.

If you can do your lower level work at a community college, then transfer to an inexpensive state school, that would be the best way to do it.

You can get an RN at many community colleges in two years.
posted by Ruthless Bunny at 11:50 AM on October 1, 2012 [1 favorite]

Best answer: Thirding the advice to try being a nursing assistant first. The coursework is relatively low-committment in terms of time and effort, and if you hate every second of it you can safely assume that you'll hate being a nurse. Nurses still have to do all the stuff the CNA does--vital signs, toileting and bathing, helping with ambulation, assisting with meals--along with the rest of their duties. Don't make the mistake of thinking that if you hate the duties of being a CNA, it's OK because once you're an RN it'll be someone else's problem. Of that misguided thinking comes bad, unhappy nurses. I still deal with the three P's (pee, poo, and puke) every shift. Really: EVERY shift. If that sounds off putting, bedside hospital nursing might not be the thing for you.

If a CNA job proves to you that you love nursing, make yourself indispensable to the nurses with whom you work. New grad RN jobs are extremely scarce, so already being a known, respected, helpful, hardworking quantity on your unit will go very far.

Feel free to MeMail me with any questions!
posted by jesourie at 11:55 AM on October 1, 2012 [1 favorite]

Have you thought about pharmacy? Depending on what state you live in you can probably get a job as a pharmacy technician without a ton of training. If you can handle the stress, then you might think about applying to pharmacy school. It's tough to get in, and it's a long 4 years of tough classes - but at the end of it, if you don't have too much student loan debt weighing you down, then you can make a nice amount of money and generally can get a job wherever you like. You may consider working to pay the bills and donating your services to a free clinic or similar organization at first. There are a lot of pharmacist jobs out there -- it's just that a large percentage of them super suck. Think night shift at Rite Aid. So your dream research / social services job will probably not be your first job. But those jobs are out there.

Seriously, though, check out pharmacy. Pharmacists are the overlooked member of the healthcare team. You'll be surprised at how much cool stuff pharmacists actually do. And no pee, puke, or poop!
posted by selfmedicating at 12:43 PM on October 1, 2012

I'm currently in grad school for social work and think you'd be a good fit based on all of your information, minus the part about the AmeriCorps disorganization. Plenty of social workers practice in hospitals and out-patient clinics, and many of them represent the poor and underserved as they navigate the medical community (who can often make them feel inferior or misunderstood).

Social work is also one of the few rising career fields, and an MSW is extremely flexible. Make absolutely sure to attend the cheapest program that's accredited, as this is a professional degree with a basic certification at the end. I live in NYC and the most exclusive, reputable social work program is a CUNY school, as opposed to Columbia's program that is six fold more expensive.

Lastly, your description of the AmeriCorps office sounds frustrating, but LOTS of jobs that handle underserved communities are like that. These offices are understaffed because they're simply aren't enough do-gooders who are willing to make smaller salaries and work longer hours. If you can't handle that sort of environment (and I'm not judging you if you can't; I cannot personally handle that sort of stress, which is why I have my eye on private practice therapy) then maybe social work isn't right for you.
posted by zoomorphic at 12:57 PM on October 1, 2012

Public health nurse seems to fit the bill.
posted by windykites at 1:32 PM on October 1, 2012

Hey, don't get down on yourself about the AmeriCorps stuff. Most of those orgs are screwed up and unprofessional. I've heard horror stories about AmeriCorps.
posted by discopolo at 1:55 PM on October 1, 2012 [1 favorite]

I'm voting for public health. You said that it coincides best with your interests. The job market is great in larger cities. If you're at all interested in living in DC, that would be a great place to find a job. The debt will be manageable once you find a job. No one will care about your work history before your masters, as long as you do some meaningful work while you pursue the degree.

Look into public health schools with programs in health behavior, society, health policy, management, and reproductive health. All of those sound like they might fit your interests.

The best thing about public health is if you find out two years in that you really want to be a nurse, well you can get that degree too. It's pretty common to meet people who have their MD/MPH or RN/MPH. It's truly, truly not as scary or overwhelming as you think. Good luck!
posted by saltwater at 4:47 PM on October 1, 2012

Best answer: As an RN who worked in a public health clinic/hospital for many years, I disagree about going the CNA route first. The CNA work would give you a sense of what hospital nurses do. Hospital nursing does not allow you to look at the big picture, for the most part. It is shift work and patient-centered. If you want big picture, socially conscious, etc like you said in your post. You are basically talking about healthcare that is population-centered, maybe with some direct patient care, you are thinking more about public health nursing. Getting your CNA will take time and money, and if you don't like it, that doesn't give you any information about whether you would like community/public health/clinic nursing.

If you live in a city, look at what kinds of services the public health department offers and what kinds of volunteer opportunities are available. Try to meet nurses in these clinics and talk to them. Some will be burned out hospital nurses just looking to put in hours/get to retirement, but some will have passion.

Agree that you should look into social work, but try to understand that it is a field often charged with making order out of chaos, and making compromises.

I try to talk people out of doing MPH degrees if they want to work in clinical public health because it is very hard to find work because they are usually looking for someone with a clinical background AND license (RN, LCSW, etc).

Sorry your first job sucked. You may run into that again, but soldier on. Good luck.
posted by artdesk at 8:36 PM on October 1, 2012 [1 favorite]

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