May I vent about rural hospitals? LONG rant!

Brownms46 · Feb 10, 2003

Matttsmom...you're a better woman than me...for sure! I would have called my agency...told them what the deal was, and told the DoN...supervisor...and anyone..else I would be leaving, if they didn't get a qualified ICU nurse...and or at least a couple of techs in that unit! That God that was a one nite deal!

God Bless you for keeping your :cool: ! Wait a min! What was a new grad doing on nites????

2ndCareerRN · Feb 10, 2003

I feel for you mattsmom.

I was recently offered a travel assignment to a rural hospital. Seemed like a good deal, until I asked about other staffing. I would have been the only RN in the facility from 5p-5a. granted there would have been a few LPN's and aids, but I did not feel like being the House sup, pharmacy, L&D (we just send them out), ER, and pushing all the IV meds for the facility.

I really don't know how they plan on filling that position, unless it is with someone that has a lot of rural experience, or someone with no experience at all.

At least you made it through the night, and it sounds like it will be your one and only night at that facility.

bob

nightingale, RN · Feb 10, 2003

She can only handle the 1 vent patient... so I need to take the other 4 patients and 'help' her with her one.

Anywho, thanks for letting me vent ya'll...I LOVE the freedom and flexibility of agency work but I'm learning to stay clear of these small rural hospitals...I seem to get the same kinda crazy trip every time...guess I'll learn someday, eh? :roll [/b]

Holy Moly! Kinda makes ya glad your an agency nurse.. I hear ya loud and clear!

I guess the minimal criteria has been met by staff, no one was hurt so they want want to "Hire ya".... :rolleyes:

YOU are wise to stay clear of that facility.

Thanks ofr sharing your story...

mattsmom81 · Feb 10, 2003

Thanks for listening guys...It's been awhile since I went 'way out in the county' and I forgot that THE most important question to ask is what are the credentials of my coworkers...thanks for the reminder! :)

This new grad was all puffed up they were letting her in the ICU...I gave her the CYA talk with plenty of warnings...reminded her she would likely be alone at night in this ICU very soon...her eyes got real big and hope she's thinking about what I told her.

mattsmom81 · Feb 10, 2003

Originally posted by 2ndCareerRN
I feel for you mattsmom.

I was recently offered a travel assignment to a rural hospital. Seemed like a good deal, until I asked about other staffing. I would have been the only RN in the facility from 5p-5a. granted there would have been a few LPN's and aids, but I did not feel like being the House sup, pharmacy, L&D (we just send them out), ER, and pushing all the IV meds for the facility.

I really don't know how they plan on filling that position, unless it is with someone that has a lot of rural experience, or someone with no experience at all.

At least you made it through the night, and it sounds like it will be your one and only night at that facility.

bob

I hear ya, Bob. Glad you asked the right questions before you got stuck in that place. They LUV to snag new nurses and get them in that job...someone they can blame them when the shyt hits the fan.

nightingale, RN · Feb 10, 2003

This really makes all the traveling I do to and from Denver less painfull. Even the "big" hospital in town sends out the "really sick ones"... yeah but who takes care of em in the meantime?

mattsmom81 · Feb 11, 2003

Ever get the feeling some of the less experienced country docs just kinda 'experiment' with patients? They were anxious for my input...but I also am aware I REALLY shouldn't practice medicine without a license...LOL!

Had a 19 yr old with acute abd pain and WBC of 30K...the docs paniced, rushed her to surgery...found nada...then left her paralyzed on a vent for a day trying to figure what to do next...I do my asessment...it's like...guys...she has acute abd signs...foul vag discharge...sexually active...abd explore was negative...why have we not done a colp and cultured her up for PID?? And please let's extubate her b4 she has complications of mechanical ventilation!! The doc says uhhh...I can't extubate her...her CO2 is 4...I reply "Yah but it's respiratory not metabolic...did you know you have her on a rate of 36? ( altho I don't know WHY)

I suggest she is BLOWING OFF the CO2...and ask permission to wake her up, begin a wean schedule,observe, and extubate her if/when ready....He says "Do you know how to do that?"...I say sure I do. :)

The docs were like...uhhh...OK...good idea...thanks for your help...nice to have a 'real ICU nurse' here....hmm.

While it feels good to be appreciated.... Yup it's a little scarey at these country hospitals.

Makes me appreciate even the jerkiest of docs at my big facilities who DO know what they are doing and why despite their arrogance. (Can't believe I'm saying THAT) LOL!!

Maybe I'm being a little hard on them...they are young docs...probably trained in a big teaching hospital with lots of experienced docs and nurses around to help them...then relocated to the boonies (maybe on a rural med school scholarship program) and got a culture shock. Can't help but feel bad for patients way out there though...

Thanks for this forum...nice to be able to vent to other agency/travelers. We really have to hone our CYA skills don't we?! LOL! :roll

Gotta kid in college in this part of the county and know where I'll be if he ever ends up in THIS place...Mama won't leave his side til he's transfered OUT. :stone

KaroSnowQueen, RN · Feb 11, 2003

mattsmom, i live three blocks from a small rural hospital where they couldn't find their butt with both hands if you gave them a "you are here" map. I drive 45 miles one way to the nearest large city(both for work and for medical care) just because I have been a pt in this hospital and they scare me to death!!!!!!!!!!!!!!!!!!!!

Had an old old old doc who kept them in the dark ages for years and years. He finally semi retired and now there are young docs, but no offense, both the foreign docs and the home grown ones, are so insecure, it seems, in their knowledge that it is frightening.

We refer to our local small rural hospital as the bandaid station and I have told my hubby and kids to lie and say our insurance doesn't cover coming three, and to ask to be transferred out ASAP if they ever end up there.

I know many many docs in the bigger hospitals may not be on the ball either, but there are plenty more to choose from and find second opinions from if you happen to want one. I agree with you, the level of knowledge in these country hospitals is frightening at times.

mattsmom81 · Feb 12, 2003

Hi Karo...I do like the friendliness of a small rural facility, but I agree...it is worrisome when a loved one becomes a patient in them. I don't blame you for choosing the bigger facility...I would too.

Even if your doc is fairly good, the staff comes into question too.....who would ever put a new grad into ICU as staff without requiring some clinical orientation/precepting? Quite dangerous.

I would make the drive to Denver too Nightngale! :)

eddy · Feb 13, 2003

Originally posted by mattsmom81
who would ever put a new grad into ICU as staff without requiring some clinical orientation/precepting? Quite dangerous.

Sadly, it was probably either that or you were going it alone. They probably figured 2 is better than 1. Unfortunately, this is not really the case.

On the flip side. I have had some pretty good experiences in the rural hospitals out my way (some bad too... but...). The ones here have nurses that more or less float to every unit. They seem to know their stuff, but there are just so few of them. I feel for these communities. I fear many of them will lose their local facilities in the near future as it is becoming near impossible to recruit young nurses out in BFE. Ultimately the health and safety of the communities they serve will suffer as a result. It's a shame.

scherzo · May 5, 2004

This post is over a year old...but I am a new member of this board...and upon reading the replies, I am not seeing the words "SAFE HARBOUR" anywhere.

I have been an RN in a rural hospital. Yes, they can put you in some really compromising positions. Safe Harbour is a regulation that says, "this situation is unsafe and I am making you aware of this." You are making them formally aware of the problem when you fill out the paperwork and submit it. If anything happens, it protects you from liability. The DON and the supervisor and everyone have formally stated that they know that it is unsafe but they have no other options. Most hospitals will do whatever it takes to avoid safe harbour because it increases their liability.