Team Inpatient vs Team Outpatient: Which Nursing Lyfe Fits You?

What if choosing between inpatient and outpatient wasn’t about picking a side, but about designing your career and your life? We open up about the real tradeoffs nurses face: the adrenaline and growth of inpatient care versus the predictable hours and long-term wins of outpatient clinics and infusion centers. From supplies magically appearing on the floor to the careful planning needed in clinic logistics, we share how workflow, resources, and culture shape your day and your development.

We also get honest about emergencies outside the hospital walls. Outpatient teams keep ACLS-ready, but the “code” is often 911, making triage judgment and escalation skills crucial. You’ll hear practical examples—saying no to unsafe diuresis orders, recognizing AFib with RVR and sending a patient to the ED—that show why critical thinking doesn’t belong to any one setting. For Clin Ones, we map out why inpatient builds the instincts you’ll lean on forever. For veterans, we explain why outpatient can preserve your energy without sacrificing impact.

Midway, our Medical News Minute spotlights a universal donor kidney breakthrough that could reshape transplant waitlists by stripping blood type antigens to create organs closer to type O. We translate what that means for matching, patient education, and collaboration across the inpatient–outpatient continuum. As transplant and cardiology leaders, we talk service-line teamwork, policy gray zones, and building trust between units so patients experience a true continuum of care rather than a handoff gap.

If you’re weighing your next move or mentoring someone deciding where to start, this conversation gives you clarity, examples, and a realistic picture of the work on both sides of the door. Hit follow, share with a nurse who’s on the fence, and leave a review with your take: #teaminpatient or #teamoutpatient?

Transcript

Welcome And Today’s Big Debate

Christopher 0:00

Hello, and welcome back to Nursing Life 101. We're so excited to have you here as we dive into the world of nursing, sharing our experiences, insights, and a little bit of fun along the way. I'm Christopher.

Colby 0:12

And I'm Colby. Together we're here to bring you the laughs, the lessons, and the real life conversations that nursing textbooks never prepared us for.

Christopher 0:20

And today we're tackling a topic that every nurse has an opinion on inpatient versus outpatient nursing.

Colby 0:28

Oh yeah.

Defining Inpatient And Outpatient Nursing

Christopher 0:37

Whether you're running the floor or running clinic rooms, this one's for you because both sides have their perks and their pain. So let's start with the basics. What exactly is inpatient nursing?

Colby 1:19

Inpatient nurses are the ones holding it down 24-7. We're talking bedside care, admissions, discharges, call lights, codes, and caffeine.

Christopher 1:30

Exactly. It's shift-based, team-driven, and honestly, it's where most of us start it.

Colby 1:36

And outpatient, that's the other side of the coin. You've got clinic nurses, procedural units, infusion centers, basically anywhere patients come and go the same day.

Moving From Inpatient To Outpatient

Christopher 1:45

The vibe is different. It's faster in some ways, but more predictable. So I will say, most people don't even know that they they very much know you have switched outpatient. I've kind of hinted, but haven't actually formally said. And this will this will have released by the time that I can officially say this. So I can I will say I have also officially moved outpatient. I was the interim manager, nurse manager of the transplant clinic, outpatient, since October. And Martin Luther King Day, January 19th, 2026. It's not the same day every year. Someone asked, they were like, Do you miss inpatient? And luckily, the differences between inpatient and outpatient are so like different that you you learn you you can learn quite a lot from both. And when answering the question in the interview, I was like, uh the way that the transplant clinic is ran, it's actually the the title is Transplant Infusion Center and Clinics. So there's an infusion center where we give so you can still in the out in the inpatient or outpatient give the same meds, but it's not as like rigorous as inpatient. Like someone comes in, very much similar to like the drip bar where they just come in not as casually, but they're coming in and they're walking back out. So you get to see that that perspective on an outpatient where inpatient, you know, you're seeing people day in, day out, day in, day out, day in, day out, until they're discharged. So that's one difference. Another is that you don't have the same resources. I won't say you have less resources. You don't have the same resources as inpatient. I just I can remember that in inpatient you you really were able to have if you if you ran out of IV tubing, you called like the G Storeroom and the G Store Room brought whatever you wanted.

Colby 4:39

Yeah, it was like a magic per fairy and it just dropped off what you needed.

Christopher 4:44

It was what what is the the room in Harry Potter? The room of Oh, I can hear all Harry Potter heads really yelling at me right now. The room of requirement.

Colby 4:55

Okay.

Christopher 4:55

I think that's it.

Colby 4:56

I have no idea.

Resources And Logistics: Floor Vs Clinic

Christopher 4:57

Oh, please tell me I'm right. Um But anyways, the it was like the room that whatever you needed, that's what the room was there. Yeah, it was there. That's not the case for outpatient. Outpatient, you have to be mindful and order the stuff and know that it's gonna take maybe a day or two to get here. And so you can't wait until Friday when you have one IV tubing left and expect to get it by Monday because they don't run 24-7 like a hospital does. So that's something that's different too. I think even management structure. Like you're kinda in a unique perspective, Colby, where you are like an assistant nurse manager.

Colby 5:50

But I'm also the only nurse manager.

Christopher 5:53

Right, exactly. So like it's interesting you're you're more of a dual role there, and you have a director that's over you.

Colby 6:01

Right.

Christopher 6:03

But for transplant outpatient or ambulatory, however you want to call it, there is no assistant nurse managers. There's just managers. Right. And we report uh to our director, and then our director reports to our administrator. But that director also has the inpatient nurse manager and the inpatient assistant nurse manager under him. So like it's it's just interesting to kind of see how that structure is a little bit different too.

Colby 6:36

Yeah, I would also say like on the on the topic of staff, you're working with a a wide range of different staff than some that you will only work with in the ambulatory setting versus what you would work with in the inpatient setting. Like, for example, at your clinic, you guys have MAs or medical assistants. CMAs, yeah. CMAs, yeah, certified medical assistants. And we don't we don't have CMAs inpatient.

Christopher 6:58

Do you have oh yeah.

Colby 7:00

We I I also don't have them in either of my departments, which is the TCAs. TCAs. What is the T Leggley?

Christopher 7:08

Never mind.

Colby 7:09

Okay. I was like, I don't think so. No, I work with so the I manage the stress lab, both inpatient and outpatient stress lab, as well as cardiac rehab, and we actually we don't have like patient care techs or our medical assistants in in that way. I have a cardiology technologist and they run like EKG and case machines and that kind of stuff. So they're not in the realm of like a a nursing assistant, quote unquote. Okay. They are they have like a different kind of certification and it's more like technology-wise in technologist instead of like a patient care technologist. It's it's just a little bit, it's a different realm and also work closely with nuclear medicine technologists who run cameras and do injections of different isotopes for cameras and you know, all that stuff. So it's wild. Yeah, there's a lot of staff that that make different departments and clinics and ambulatory setting work in in comparison to how inpatient really runs. I feel like you think inpatient, you're thinking nurses, patient care techs, and doctors and a in APPs. That's like the core core staff. Yeah, you know, outside of like ancillary, of course you have like phlebotomy and all that good stuff. But like for as far as like core staff, that that's inpatient, outpatient is a much wider array. I mean, cardiac rehab, I work with exercise physiologists, physical therapists, and nurses. So yeah.

Christopher 8:42

Yeah, I I you make a very good point. Like nursing has always been like you get involved multidisciplinary, like inpatient versus outpatient both. But I feel like there's a more intimacy to the multipl. The multidisciplinary relationships that you have outpatient than you do inpatient. I don't know if it's maybe it's because even more so. Like I mean, you made a very good point by naming off some of it, but like transplant does transplant has their own nutritionists, they have their own pulmonary functions, so respiratory therapists, they have their own echotechs, they have their own social workers, they have the surgeons, they have their own pharmacists, they have their residents, like all of these things, and I'm like, so like using all those different perspectives and being able to like I I really could sit and name like quite a few different people. And it's like when I was in inpatient, like I saw them, but I didn't realize how many people oh, like we have our own business people like that does financial authorizations for things, like yeah.

Culture Shifts And Policy Gray Areas

Colby 10:11

We it's you definitely work like work with these a lot of those people that you listed inpatient, but I do agree with you, like the intimacy. I think maybe because it's while it's a lot of disciplinaries, I think it is smaller groups and more of like consistent people. I do think like also an inpatient, like it's a lot of rotating out because it's we work in a teaching facility, and so there's people of all level, there's people, there's people of all levels, I should say, in their education or in their training. And so they have to rotate out things. So, like while we work with pharmacists and residents and even physical therapists, like you know, some of those people are are always assigned to one area. There's still a group of them that are also rotating out. When you're in the outpatient setting, I feel like it's mostly like a dedicated team of people, individuals, I should say, instead of just dedicated, we're all dedicated to the work. But as far as dedicated to the specific role, it's like the same group of people, it feels a little bit smaller. The it's definitely more intimate. We're definitely working even closer together in that setting. Or at least it feels that way because it's such a small, small lot of people, but smaller, it feels like a smaller group because it's the same people.

Christopher 11:19

Yeah.

Colby 11:21

Yeah.

Christopher 11:21

And I mean, there's there's something about just repetition. Yeah. The reason why people learn languages, they repeat things multiple times. The the way you remembered pharmacology, you probably repeated a couple of things. Like just all those things is it you you get to know people in a very different light when you see them on multiple occasions. But you know Colby had mentioned a little bit earlier, it's it's something different between inpatient and outpatient is that just the the whole time. Like time inpatient and time outpatient is different. And I think that will kind of segue to some pros and cons versus the two. And so that this kind of dabble. I will let a dabble debate. A dabble debate.

Colby 12:23

A dabble debate. We'll debate the pros and cons. So I'll take team inpatient and you can rep team outpatient.

Christopher 12:31

Perfect. Game on.

Colby 12:32

All right. The pros of inpatient. You see everything. It's full exposure to critical care, teamwork, crisis management. You build strong clinical instincts and fast, you have to. And let's be honest, you're never gonna get bored.

Christopher 12:49

True. But let me speak for the outpatient folks. There's better hours, usually no nights, and definitely no holidays, predictable routines, so you can actually have a little life outside of work. And you get to see long-term patient progress, which can be pretty fulfilling.

Colby 13:10

Okay, that's fair. But cons?

Christopher 13:12

Oh, I've got a few. Outpatient can feel repetitive. There's less adrenaline and sometimes less autonomy.

Colby 13:20

Meanwhile, inpatient cons, let's list them. Burnout, staffing chaos, charting nightmares. You leave a 12-hour shift feeling like you ran a marathon with a laptop.

Christopher 13:29

Or wow, or a cow. You know, it doesn't matter.

Emergencies Outpatient: When 911 Is The Code

Colby 13:32

Yeah. Basically, you feel like you've been going all day. I think I really, oh man. Okay, so as I as I mentioned before, like having the unique perspective of working both now. Inpatient definitely has pros. You and I think it's a great spot to start your career. You really are gonna learn a lot and learn it fast. But now, like the all the positives that you just listed for outpatient folks, better hours. Yes. Like it's so nice not having to be at the hospital at 6 30 in the morning and then staying there until 8 p.m. at night. Right. It's so wonderful to get to work at 7 30 or 8 o'clock and leave when the sun is still up because even in the winter. Even in the winter. It really is wild times for me. Because, you know, after 12, almost like 11 and a half, almost 12 years of inpatient nursing, I've never had to do that before.

Christopher 14:30

Right.

Colby 14:31

I've never gotten had to. I've never gotten to do that before. I also another wild thing is not having to work holidays. And like what a what a weird thing that is. Because again, I prepare I we've talked about holidays. I mean, you know, I used to make whatever switches I could to make sure I got, you know, off my New Year's Eve.

Christopher 14:52

And I fully little evil conival trying to get Yeah, yeah.

Colby 14:56

I will, I will do whatever I have to do. So it was really strange having both Thanksgiving and Christmas off and off New Year's Day this year. I didn't know what to do with myself. I was like, this is weird. I still did I still worked on either side of those holidays. So I didn't I could but the thing is I could have taken PTO.

Christopher 15:15

That's the thing. Yeah. And yeah, especially as management, you could have taken that as PTO.

Pros And Cons: Hours, Autonomy, Burnout

Colby 15:20

I could have. No, I didn't want to blow through all my PTO because it's the I will say my one gripe with outpatient, at least the way our healthcare system does it, is that you don't get paid holidays. And I get, I get why, because it has to be fair, probably for all employees. I'm sure that's what it is. But if I worked for a private office, a private clinic for a private office and I was the nurse manager and that office was closed for Christmas, like I can't work. And that's the same thing here. Like our clinic is closed for Christmas. I don't have the opportunity to work. I would, like, if given the opportunity, I would work Christmas. We, in order to, if we want the pet, if we want to get paid for that day, we have to pull it out of our PTO. It's not automatically paid out to us. And I think that is a little janky. My my personal opinion. I think that's a little shisty. I think if you're gonna choose to close the clinic, you should also give the paid holiday. But that's my personal opinion.

Christopher 16:15

I mean, as and you're you're speaking strictly as someone who works in the clinic, not a manager.

Colby 16:24

Correct. Because like you could just Yeah, we can we can fudge our hours, not fudge hours like fake it. Yeah, not fudge like fake it. We can work for it. Yeah, we can adjust. That's a better word. Not fudge. Sorry, that was a terrible word to choose. We can adjust our hours. Like, for example, like Christopher said, Why are you taking PTO? You could work for tens, which is so true. I think that was something I didn't think of in the time at that at that time. And I was just like, Well, I guess I'm gonna use eight hours of PTO for Christmas, but I worked the day before and the day after. No. So there are ways as management that we could work around, especially because we're salary, and so like we're gonna get paid, you know, no matter if we're working like an 80-hour week or if we're working our 40-hour week, we're getting paid the same amount. So we can make our own hours, you know, within within reasonable. I think they're like school, it's so wild. It's also really wild. And again, this could just be our health system, but the culture of outpatient versus inpatient, very different, is what I've learned.

Christopher 17:26

What do you mean?

Colby 17:28

So inpatient, my experience with inpatient very by the book to the T. My outpatient experience has been way more relaxed. Like it's a lot of things inpatient are too, I'll let you, I'll let you give your, I'll let you give it in a minute. But a lot of patient sorry, not patient, a lot of policy is purposefully left in a gray area and left to management discretion and manager interpretation of the policy. And inpatient is way more sh, I would say, strict with their interpretation or discretions. In my experience so far, an outpatient is the quite the opposite in that my director and and supervisors that I work congruently with have a looser interpretation in the gray area than I was expecting because I'm coming from a practice of m following things more strictly and taking the more severe approach versus in the f in the gray area taking a more relaxed approach.

Christopher 18:33

Do you think that's because of the fact that it's your director?

Colby 18:40

Like it could just be like my specific director's style of leadership. Yeah. It definitely and it's hard to say one or the other. Like you I would say my interpretation of what you've shared with me is that it might have been a little more loosey-goosey where you were prior to you coming in. And I think you're bringing some of your inpatient like strictness to to kind of clean clean up a little bit.

Christopher 19:12

Yeah.

Colby 19:12

Yeah.

Christopher 19:13

No, 100%. Yeah. Definitely what I'm doing. Yeah. But also like it does also help having like structure is important. And I you can we can have these gray lines or gray spaces, gray areas. But being able to say to your team, hey, this is a gray area, but in order to make it equitable, it is what I can see as equitable for everyone, I'm going to put this gray area in a little fence.

Colby 19:54

Yeah. I'm gonna make it black or white.

Christopher 19:57

Yeah. Or or at least darker.

Colby 19:59

Yeah.

Christopher 20:00

And you know, not charcoal gray, not smoky gray. I don't even know if those are too.

Colby 20:10

Heather gray is like a lighter gray.

Christopher 20:13

I'm like, I'm a guy. I see gray. But an another thing, kind of going back to what I was saying in the interview when I was like, this is really close to inpatient, is that the clinic is almost similar to inpatient in the terms of like you get the people in, you're rooming them, you're doing a little bit of a little mini assessment. And even when they come to like infusions, like it's they're coming, it's this one. They're coming in and they're getting their belatecept or thymo. And sometimes they have some type of reaction. And it's it's then that you really bring in a lot of your inpatient experience, and you're like, oh, okay. Call it when we can't call a like emergency response there in terms of the hospital in general. So it's almost like you're calling the ambulance, and they the ambulance comes in and helps out. So yeah.

Colby 21:30

Sorry. Go ahead and finish your thought. No, no, no. I'm good. Yeah. Well, when you say calling in the ambulance, that's another thing that's very different from inpatient versus outpatient. And and you know, a pro uh in in my eyes right now, it's a con, but uh, I'm so used to like if there's an emergent situation, we have everything we need right there. Right there. And we have like a system for code for code. There's a code phone, each department, somebody holds it and we will respond if there's an emergency, someone from each department. But I mean, truly, there's only so much that we can do in this situation. We still have to call 911, the rescue squad still comes, they take the patient to the emergency department or where wherever they need to go. Whereas, you know, in inpatient, obviously you are if you're dealing with a a code or an emergent situation. If it's an emergent situation, you have the Met team or your rapid response nurses that come, or you have the code team that comes if it's a full code. And that that is a whole different process. It's a huge difference than what what I'm used to.

Christopher 22:30

Right. And that's what I was kind of hinting at when I was like, we you have different resources.

Colby 22:37

Like it for sure.

Christopher 22:39

You're not completely alone. You're not in the desert with nothing but your pee to drink. But like you you do have other nurses, other nurse managers. Usually you're closer to physicians, and you can ask the physicians who can help run codes and all that stuff. So there's there's all those, and they're like readily available, but it is different not being able to have the what we call the red shirts come in and help out. Like it's it's wild. I don't know.

Colby 23:18

Yeah, it is, it is pretty crazy. I mean, we still have code carts. And everybody is required to be ACLS in my both of my departments, which is great. Yeah, and there's always a physician or an APP that could like technically run the code, even if we're all ACLS, we still usually buy our health system standard, but and yeah, we're not all really allowed to, but but if there's an APP or or a doctor there, they're they're kind of the ones that run it. But yeah, it was like we still have all the things, it's just processes are really different. And it's a little bit, in my opinion, it feels a little bit slower and that's a little bit scary. We had we were my the like I said, we will respond to any kind of like urgent thing going on in our building where the stress lab and cardiac rehab is, is also the cardiology clinic, as well as a few other clinics in that building, but it's mainly cardiology heavy in that building. And we had a patient that looked like shit getting checked in for just this like a regular old cardiology checkup. And we got called out to the lobby, and turns out the the man was in aphib RVR and was likely septic from having a foley. And yeah, so we, you know, and we had to respond to that. But it was it was very weird because it was like, oh, I am the Met nurse. And I also have like the most recent impatient care, not to say that like I was the most experienced because I work with a wide range of of experienced nurses with backgrounds all over the place, which is awesome. But I felt like I kind of like I was like, whoop, right it like flipped right back into like my impatient nurse hat. And it was act it actually felt good because I was like, I know what to do. And it's been a while since I've felt like instinctually knowing what to do because I'm in a big learning phase right now. But yeah, it was it was interesting because you know, we did everything we could to a point, and then we had to wait for the rescue squad to get there. So it was interesting.

Blood Types, Titers, And Transplant Analogies

Christopher 25:17

Yeah, I and and that's honestly like, and we'll talk about this in a minute, but I want to kind of give a little hint. Someone asked me, do I want a Clint One in the clinic? And I'll just leave it at that because we'll talk about this in a little bit. But yeah.

Colby 25:37

Yeah. Well, I think a good way to sum it up is let's be real though, outpatient nurses have lunch breaks that actually happen, which has been so fun that I get to eat when I'm hungry. That's probably the biggest pro.

Christopher 25:51

Oh, honestly. Yeah.

Colby 25:53

Yeah.

Christopher 25:54

You're probably right. Meanwhile, inpatient nurses eat their salad at the nurses station while hanging antibiotics.

Colby 26:00

No, just kidding, Jacob. Can't do that. I've never done that before. I've never eaten my lunch at the nurses station, Jacob.

Christopher 26:09

Oh no.

Colby 26:10

Uh lol. I've eaten every meal in my day at the nurses station.

Christopher 26:15

Well, it's funny because I have now I have a standing desk and I didn't eat yesterday until four o'clock. And I was I was walking back with a person and I was like, oh, I'll actually sit down and eat. And I stayed standing at eight the whole time.

Colby 26:31

I was like shoveling. Why did you wait until four?

Christopher 26:35

You know me.

Colby 26:37

Oh, Lord.

Christopher 26:38

I get busy and I my stomach doesn't give me any type of cues anymore.

Colby 26:43

I really shouldn't even I really shouldn't talk because I take a working lunch. Like I go, like I'll stop. Like if we're in a point where I don't have an like I have a break and test, I'll go heat up my lunch, then go to my office and log in and start answering emails while I'm eating. Yeah, okay. Yeah. But I still eat at an appropriate hour, which is wild because I used to not eat until four o'clock when I was working inpatient. All right, guys, it's time for your medical news minute, the part where we pretend we read more journals than just TikTok comments. Facts.

Christopher 27:20

Let's see what's new in medicine this week and how it might actually show up in our practice.

Colby 27:26

Universal donor kidney breakthrough.

Christopher 27:28

Researchers announced a huge development. Scientists successfully created a universal donor kidney.

Colby 27:36

Basically, they found a new way to strip the blood type antigens from donor kidneys so that they can match any recipient.

Christopher 27:44

Which could completely change the game for transplant wait lists.

Colby 27:48

Right. Imagine the impact for patients waiting months, even years for a compatible organ.

Christopher 27:53

It's still early, but as transplant nurses, this could be massive.

Colby 27:58

So have you I mean, this is your bread and butter. How many universal donor kidneys have we used at our health system?

Christopher 28:05

None.

Colby 28:06

What?

Christopher 28:06

No, yeah, yeah, yeah. Interesting enough. I'm surprised. We have not used any. But I have I've been doing a lot of research recently in terms of just shortening kidney stays and just trying to figure out how to, as I'm pretty sure this is a universal United States thing in the present moment. Hospitals are really struggling in terms of capacity because of these respiratory illnesses that are going around. Woof, yeah. And so, like trying to help decant some of the impatient people, I'm trying to find out some of like different ways to trial. I mean, really, medicine is not a perfect science, and it's, you know, you just kind of ask different things. But to not segue too far and bring it back, we have not used any of the universal donor kidneys. What does this mean for a transplant though? In terms of so as very basic, we have four different blood types. We have A, we have B, we have A B, and we have O. And if you didn't know that, that's okay. You must be in the first couple of weeks of nursing school. And that's okay. You'll learn, but that's all right. You you're you'll get there. And so with that, your body cannot take but certain types. Like if you are an A, you can't take an O. You can't take a B.

Colby 29:57

Right.

What It Could Mean For Waitlists And Care

Clin Ones Or Veterans: Who Fits Where

Christopher 29:57

Because it's not going to work. You can't take an A B. But interesting, interestingly enough, we have done some like so it's weird. There it there's this one it's called ABO Incompatible Kidney. But it's like how did they how did they say it? It was the the nephrologist, the transplant nephrologist loves to teach, and he also loves foot football. And so he was like, Okay, sorry, I I misspoke. It's actually non-A1 to B kidney transplants. And interestingly enough, when you are dealing with immunity, a lot of people think of, you know, getting vaccines. They they get vaccines, it helps them, the body recognizes the vaccine, and then that allows them to protect themselves because the body recognizes like the flu or COVID faster. And so in terms of immunity, like your body is really good at learning and it gets better over time, right? Well, it's not the same when it comes to blood. When you are born, if you are born A, you have absolutely all types of immunity against B. It doesn't matter if you have been introduced to that or not, you will constantly reject any type of B blood, right? That's why we have all these different types of blood. And so when you are looking at in terms of kidneys, in in terms of their transplanting, you normally, if you're an type A blood type, you would reject a B blood type, right? Well, interestingly enough, we can do something called non-A1 to B kidney transplants. And so that means that they have that it's a kidney that's a blood type A that can go to a person that has blood type B. So how does that work? Well, luckily one of our one of my transplant nephrologists was able to kind of help explain that a little bit more in terms of an analogy. And he he's a huge football like fan, and I can take it or leave it. But it's interesting how he put it. He was like, so when we're doing non-A1 to B transplants, we we draw different types of titers, and these titers are progressively less concentrated. So there's like a a one-half, there's a one quarter, there's a one-eighth, and there's a one-sixteenth, and I think there's a one thirty two or thirty-second. And in those moments, you have the it like it it's more dilute. And if you are not reactive to like a certain point, like if you are non-reactive to all the way, you're not, you're not reactive to one half, you're not reactive to one quarter, you're not reactive to one eighth, and even I think it even goes all the way down to like one sixteenth, you have a very good likelihood that your body will be able to accept this kidney. And the way that the transplant nephrologist talked about it was that think of a A1 kidney as a well, think of think of your body as a whatever whatever football team you want. But just because I have these particular teams in my mind, will will say, your body is a Denver Broncos stadium, right? And I'm sure there's probably a name, and unfortunately, I just don't know it of the stadium. But it's a Denver Broncos stadium. There are the they're packed out, they have every single stadium filled with majority Denver Broncos fans, right? Well, then we're gonna give you a kidney, and those kidneys are Seahawks. They're they're a Seahawk, the Seahawk football team. And in those moments where you have a Seahawk football team, you have either a non-A1 Seahawk football fan, or you have a A1 football fan. Okay. And so with a non-A1, no, let's let's sorry, let me let me risk let me start with the A1 football fan because it's it's pretty evident, right? So your body recognizes an A1 football Seahawk football fan as someone who is straight decked out, has the hat, has the jersey, has the face paint, has probably like three to four different signs. They have, I don't know if they have like like a foam finger, like, you know, it's it is overtly evident that this person is a Seahawk fan. And because of that, they you you can't you can't just sneak into the football stadium. Like it's obvious you're there. Like, you know, like so when you're obvious that you're there, you're able to, you're you're the titer that is like reacting at one half or one quarter or one eighth, right? And so the body's gonna be like, no, get out, right? Like you're gonna get hacled, you're gonna get terrorized, you're not going to be able to be James Bond and sneak your way in, right? Or my fun reference, you're not gonna be able to be Sly Cooper and sneak your way in. But if you're a non-A1 kidney, you are the football fan that has a little keychain attached to his or her belt loop, right? And that keychain says, you know, go Seahawks. And it's in those moments where you're like, oh, I don't know what type of fanny is because or she is, is because they have a shirt that kind of covers that belt loop, right? And so with immunosuppression and the immunosuppression drugs that we can give, you can actually trick the body to be like, oh, this kidney's fine. It's not type A because you're sneaking, you're you're Sly Cooper, you're sneaking in, you're doing the little shuffle around the the area. Like you're able to infiltrate the Denver Broncos Stadium without too many people realizing that you are a Seahawks fan. And that is why, like, it's so it's like we're we're almost on the cusp, right? We're almost there in terms of being able to completely trick the body into receiving kidneys that are not their actual blood type. But also, like being able to have this organ where literally it does not matter if you're A, if you're B, if you're A B, if you're O, like it is going to be able to work despite all of that. There's literally there are people there are more people that die in a year that get transplanted.

Colby 39:01

Than actually get a new organ.

Critical Thinking Examples From The Clinic

Christopher 39:03

And so like this could significantly help a lot of people.

Colby 39:07

How new is this research, do you know?

Christopher 39:10

It was Of course I do. I'm pretty sure I have it somewhere. The reason why the universal donor kidney becomes what it is is because they use enzymes to strip blood type and antigens from donor kidneys. And it effectively converts it to the universal type zero zero.

Colby 39:34

Oh, blood.

Christopher 39:36

Universal type zero. Universal type O, with the first successful human model transplant in a brain dead recipient, showing it functioned without immediate rejection. And breakthrough, a breakthrough that could revolutionize transplants by removing blood type barriers and reducing wait lists. So it was it was only done in Someone who wasn't living. I'm trying to see where it was done. What's UBC? UBC Faculty of Medicine.

Colby 40:09

University of British Columbia.

Christopher 40:11

British Columbia.

Colby 40:14

So Canada?

Christopher 40:15

Department of Pathology and Laboratory Medicine decided to do this. But this was, I mean, this was an article that was written in October of 2025.

Colby 40:25

Oh, so this is really recent stuff. Well, it's exciting for the future of transplant, and that's awesome if they could figure out how to do it successfully with kidneys and think about other organs that we could be successful and doing it in the future, you know, with the right research and studies. That I mean, alone of that I mean the kidney alone is gonna change the how how people survive, you know, kidney disease. But I mean, if we could expand on that and think of other organs that it would also work for, I mean, these are this is that's insane. It's incredible. Yeah.

Christopher 41:05

So I I was I was very shocked when I saw that.

Colby 41:10

Wow. Yeah. And that wraps up our medical news minute. Now back to the part of nursing, they don't teach in textbooks.

Christopher 41:15

You know, the real life stuff, caffeine, chaos, and care plants. So let's settle it. Inpatient or outpatient.

Colby 41:28

Hmm. Depends on who you ask and where they are in their career, I guess.

Christopher 41:33

All right. Let's start with our clin ones then. For clin ones or new grads, inpatient usually gives more exposure. You learn how to juggle priorities, you manage acute patients, and you find your voice.

Colby 41:47

100%. You get your hands dirty literally and figuratively. But if you start outpatient, you'll master communication and patient education early on.

Christopher 41:56

True.

Colby 41:57

All right. Well, then we have the veterans, which are people with at least a year of experience. Mid-level clinicians, they might crave stability. That's when outpatient starts looking really good.

Christopher 42:08

Yeah. After years of night shifts and holidays, outpatient feels like a reward for surviving the battle. Literally.

Colby 42:18

Let's bring back the question that someone proposed to you the other day.

Christopher 42:22

Oh, yeah, I forgot I'd say that.

Colby 42:24

Do you want to clin one in the clinic?

Christopher 42:27

So my first immediate response is no, they need to serve their time.

Colby 42:33

It's like nurses eating their young. They need to serve their time.

Christopher 42:40

But I still like it's not the nursing eating their young thing. Like I want you to be able to experience like there's critical thinking that you absorb when you are inpatient.

Colby 42:57

That you're forced to learn.

Christopher 42:59

Yeah, exactly. You're forced to learn it. Like you And there's something about practice. Like you you practice that critical thinking. You you put it out into practice. Like you're you're actually doing it day in, day out. Yes, it sucks that you have to be in for holidays. Yes, it sucks that you have to be there for weekends. But it's those moments that give you the full appreciation of when you come back to outpatient and you're like, oh, I saw Joe Schmoe when he first got his kidney, and now I'm seeing him come back outpatient. And you know, I see how the outpatient nurses are either triaging him to go back inpatient because he's still sick as a dog, or he's so much better and he's walking back out. Like there's an appreciation in the outpatient that you don't get to truly feel if you don't get the inpatient. Like that it's a continuum, it's a huge continuum.

Inpatient And Outpatient As One Service Line

Colby 43:59

I think also like it you have so much more perspective. I think starting inpatient, and then if your goal is to get outpatient, start inpatient, get the critical thinking skills that you were just talking about, understand how inpatient works so that when you go outpatient and you learn the other side of it, you have this unique perspective. Like you were saying, like someone comes in, and whether or not you're triaging, then you know how sick someone is, and you you see them come in, you're like, oh no, you're way too sick for us to do something at the infusion clinic or in the clinic. Like, we need to send you to the ED to be admitted to the floor. Like they we need to get a little bit deeper. And like that, having that knowledge base, it brings so much value to your outpatient skills. It's and it's not that you can't be a great outpatient nurse without inpatient experience, but the value and perspective makes you a more well-rounded nurse in the in the outpatient field if you have the inpatient experience.

Christopher 45:03

Yeah, I I I I agree. And so yeah, that's why that's why I though my immediate response was like kind of rude, but it's I will defend the whole I don't want to clean one. And not yet, at least. Yeah. I I have thoughts, but yeah.

Colby 45:26

I think it's a fair initial reaction and judgment call. I think what the only thing that I kind of had a little thought that just popped into my head is from working inpatient for so long, I saw a wide array of nursing capabilities. And some people are not cut out for inpatient. Yeah. And and I and I mean that in the nicest way, but like some people just don't have the they don't get, they just don't never the critical thinking just never really fully clicks in.

Christopher 46:00

But then why do you want them outpatient?

Colby 46:02

No, no, listen, just just let me finish. That or maybe it's not that. Maybe it's maybe it's that their time management isn't great and they're like they're incredibly book smart, but like they just can't get everything done because they're they're all over the place, they're unorganized. And not to say that those that though like that's totally untrue. That's so fake news. But and I'm not saying that as like, oh, well, there'll be better clinic nurses. The thing is, is uh the pace, like we talked about, the pace is slower, it's more routine, it's more predictable. Some people just thrive more in that kind of work setting than they would in an inpatient setting where it's like pretty much 24-hour chaos, you have to be prepared for any situation. Like you have you have to just be on your toes constantly and be ready to pivot and be flexible. Whereas inpatient, if you're not of the mind that is easily that can easily fall into that role, outpatient might be better for you. Is it again, is it the most ideal for your for a hiring manager? You're no, of course you want someone with some kind of experience and background. And so it would be like a special case that I would be like, okay, let's let me talk to where whoever they are, whoever what whoever's manager is managing them right now. You know, I know that we've definitely in my almost 12 years on inpatient on the floor, we had people that just weren't gonna cut it. And instead of completely firing them, they found them a different place that worked better for them in the health system. And sometimes that's the best situation for that that individual. And so if that means that I have somebody from the inpatient floor that I used to work on, and they say, hey, this person is incredibly intelligent, they're really smart, but you know, it's this isn't this is why it's not going to work out inpatient. Do you think you could have a clinic spot for them? Or do you think, you know, there sometimes there's a slower environment, helps people learn a little bit better. And then they then not to say that they wouldn't be an incredible outpatient or clinic or whatever nurse. So there's like special circumstances, I guess, that I would say, okay, for that Clint one. But no, in general, I think my first instinct would be the same as you. Like, no, I want someone with experience. Someone I don't have to explain like the very basic basics to.

Christopher 48:23

Yeah, that's yeah. It it's it's fun. I is I would love to hear somebody's defense to see if anybody had anything else to share on on that point of view.

Key Takeaways And Closing

Colby 48:40

Try to change my mind. Yeah, yeah. Try to try to change your mind. I like I said, I think the only thing that I could think of is that, you know, I had a a working relationship with the manager above them and you know, trusted that their opinion of this pay of this individual being better outpatient and that that sort of situation. Right. I do think, you know, that then that easily brings us to yeah, veterans, I'd rather have a veteran nurse than working in the clinic. And I think I've you know, and the pe like I said before, like you get to a point in your career, or some people, most people get to a point in their career where they crave stability. Well they, you know, a nine to a nine to five whatever eight-hour shift your clinic is open, like just works better for some people. We talk about this a lot, or we have in the past that you know, we're unique profession and that we most shifts are three 12-hour shifts or four, 10-hour shifts. But the rest of the world generally works five, eight hours. And so if you have a you know, family, you know, your kids are in school five days a week, or if you, you know, you have a partner, maybe they work a regular standard job that's five days a week. So sometimes, you know, moving from three twelves into a into a five-day-a-week job makes a sense for your lifestyle. Again, the predictability, the hours, uh a lunch break, all of these things. As someone who's worked so long at the bedside, I'm finally getting things that you know, normal everyday people get at their jobs. It's it's it's really nice. It's wild. Like who would have thought? Not me. Never in a million years.

Christopher 50:21

Right. Yeah, I I mean it and I I I hate to harp on this, but it's it's important. Critical thinking when you're outpatient is important. Like you you need to know like you said, you need to know when they're sick, and you can't do anything in the clinic. And there's something about there's there's nursing intuition that is bred when you are a veteran. Like you've seen things. You Yeah.

Colby 51:02

Yeah, I can give you a perfect example. It happened yesterday. We also do the IV diuresis in the stress lab from the patients that are upstairs in the cardiology clinic. So they tried to order 200 of IV LASIKs the other day, and I said no. I said no. I was like, I'd never even given 200 inpatient. I said inpatient, mind you. Wow. I was like, also this patient's kidney function. So this is the critical, this is the critical thinking, right? Right. Like I was like, that first of all, why are we doing why would you even order 200 of Ivy LASIKs? But second, look at the patient's kidney function. Right. It's in the toilet. So what are we? We're gonna give him outpatient ivy diuresis, an insane dose when he already has baseline kidney, kidney disease and and poor kidney function currently, because we got the labs. I was like, so we're gonna kill his kidneys and send him on his way? Yeah. I was like, heck no. I was like, first of all, why don't we try Bumex?

Christopher 51:57

Right.

Colby 51:58

Let's do AD of Bumex.

Christopher 52:00

Right. That's a good one.

Colby 52:01

Okay, so that's like that's one example of why critical thinking skills need to be in play. The other another example, we had a patient literally yesterday who was at the clinic and they were like, oh, she needs to be IV diarrhee. She sounds very volume up, she's not pee-dul, whatever her her lung stones are are wet and her weight is up. So they were like, Can we add her on? So we didn't add on, she gets wheeled into the into our triage room. And one of my the nurses gets her vital signs and her heart rate's like in the 120s, and they're like, wait a minute. They get her on the telemonitor and she's an AFib. So she's an AFib RVR, she's a volume up. They want to get, and I was at, I'm sorry, I'm gonna pump the brakes here. I was like, she needs to go to the ED to get evaluated. She's gonna get admitted. Right. And wanna know what happened? She went to the ED and got admitted. I was like, it's not like she's not AFib is not her baseline. 120s is not her baseline. We're gonna give her a bunch of LASIKs and she's gonna go home. No, she's gonna, she's gonna need multiple days of ivy diuresis. She's gonna, and if she doesn't convert once she gets the volume off and the and the dim demand of her heart working so hard doesn't flip her back into sinus, she might need to get cardioverted. If that's the case, then they need to do a CT scan and clear her left atrial appendage, make sure she doesn't have any clots. Like this is classic textbook inpatient scenario. And a nurse without experience, I don't know, would necessarily know that. They would just say, okay, I have orders for iV diuresis. I'm gonna give the iV diuresis.

Christopher 53:26

Unfortunately, you won't know that.

Colby 53:28

Yeah.

Christopher 53:28

And it it's nothing against you as a new nurse. It's just you don't know because you haven't you don't have the experience.

Colby 53:35

Yeah, exactly. It comes with experience.

Christopher 53:37

Yeah. As a manager, you see how both depend on each other. Inpatient stabilizes patients, and outpatient sustains their health long term.

Colby 53:49

They're two halves of the same system. And the nurses in each world share one big thing, the need for balance.

Christopher 53:55

Yeah. And it's fun because now I've And I will never I would never say this in and truly believe it, but I am my manager inpatients equal. Like we we are now both managers, even though she will always run circles around me. But like now I'm I'm conversing with her and having manager conversations, even though I was her assistant nursing. I was saying, like even more now. Yeah, it's different. And you know, now even much more now because I send patients to her and she sends patients to me. Like, you know, like it's these we're having these conversations. I I remember she sent an email about a patient that had a very, very poor care partner support system. And she was like, We need to come up with a plan. And I was like, Yeah, you're right. And so, like, I mean, the two of us were like, Yeah, you know, that's we gotta collaborate to figure this out.

Colby 55:15

Right. Because both teams are gonna be taking care of this patient. If the patient is ends up doing well from a health standpoint, you are probably gonna be the one that sees them more often. And but regardless, if they're inpatient right now, they need to come up with a plan now. It's very collaborative, that's for sure.

Christopher 55:35

So it's it's fun to kind of see that lens in in terms of like and the even in the assistant nurse management role in inpatient, when I would go over to outpatient that's that's actually one thing that I'm really hoping to kind of help bridge is that yes, we are very collaborative in terms of we send patients to each other, but outpatient doesn't necessarily converse with inpatient that much. Like if outpatient is doing activities, usually outpatient people go. If inpatient act is doing an activity, usually inpatient people go.

Colby 56:19

Oh, you want the staff to be more collaborative.

Christopher 56:21

If we are transplant, right? We should all be going to these things. We should all be collaborating to that's fun.

Colby 56:29

That could be a really fun outlook. And then I also I think would help with the patients, you know, because you have you your patient is inpatient, they're really sick, and they haven't been really sick yet. It's their first time, you know, kind of circling the drain after after or before transplant, and they've only worked with the nurses in the clinic, and now these inpatient nurses can be like, oh, you know, so and so, yeah, you know, there's there's there's that piece that brings some comfort when there's a connection that they can kind of make for sure.

Christopher 57:01

Yeah. I I think there's an importance in in service lines being true teams. Like, yes, there's inpatient and there's team inpatient, yes, there's team outpatient. I mean, we just kind of did that, but as a service line, we're all taking care of that one patient, that service line is, and so I should be able to be like a kidney patient comes to me and it's like, man, I'm really nervous. Like, I I I'm waiting for the call, but like I've really enjoyed your your team, and they've been really sweet, they've been really nice. I can say with confidence, oh, there are just as great people over there. Some of them are such, such, such. Like you'll have a great time with them. They I've I've broken bread with them in terms of an old church saying, you know, and like I think there's an importance to that because then it gives a little bit of like, oh.

Colby 58:06

I agree.

Christopher 58:07

I agree. Like, you know, like you can we can be together. And I don't know, there's just something about that. And I think they're you need to do better than that.

Colby 58:16

I love that idea. I would I I can't wait to see how and it's so it's like so cool having like you, you specifically, like having worked years with that team and patient and now are in the outpatient, like you're in such a unique position to bring the two together and really make that vision reality. And I I agree with you. I think that's it's such a it's such a good idea for the benefit of the patients. And you know, ultimately that's we go back to that. We want to deliver safe, expert, you know, patient care. And I think that's such a brilliant idea. And you are gonna be able like I can totally see you being able to like bridge that gap at the benefit of the patient, and that's awesome. Now I'm like, hmm, how can I do this for cardiology? Like, hmm. You think about that, but it it's got me, it's got me brainstorming over here, and I think that's so smart.

Christopher 59:08

Yeah. So ultimately, inpatient builds you and outpatient preserves you.

Colby 59:13

Oh, I like that. And every nurse eventually figures out which one feels like home.

Christopher 59:17

Yeah. All right. Class dismissed. That's a wrap for today's session of nursing life 101.

Colby 59:24

We hope this episode helped you see both sides of the nursing world because whether you're inpatient or outpatient, you're still part of the same mission.

Christopher 59:32

You can find us on Twitter slash X at NurseLife L Y F E 101, Facebook at nursinglife lyf e 101, or Instagram at nursing underscore L Y F E underscore 101.

Colby 59:48

Don't forget to subscribe, share, and leave a review. And tell us which team you're on. Hashtag team inpatient or hashtag teamoutpatient.

Christopher 59:55

Until next time, take care of yourselves, your patience, and your peace. Oh, enter peace.