[gacjumper]

I will be graduating in Dec. I live in a small town with a ten bed hospital. Is this a good place to start? There is a much larger hospital 45 min. away where I have been doing my preceptorship. I want to know if I will be able to develop my skills in a place where there is lower accuity.

[FUNNYGIRLRN]

I don't know about that. I think being in a hospital where there are fewer patients you will learn a lot more because there are fewer people for you to tend to and you can take time to really understand their conditons, research things you don't know and become really good at handling situations without a whole lot of other people around. In a bigger hospital you may have higher acutiy patients but you will probably be running your butt off just to get the basics done for them everyday. Just a thought. Any experience can be great if you work to make it that way. I am sure whichever one you choose will provide plenty of learning experiences. Congrats on your pending graduation! This is an exciting time. I myself graduated last December.

[imenid37]

Personally, I think it depends on you. I would prefer to learn a lot about one specialty. Others like a lot of variety. I know stevielynn works in a small hospital and she seems, from her postings, to thrive there. I think my place is small, about 100 beds, but we do specialize. I never really knew up until a few years ago that there were these very small facilities around. IN PA and MD where I am from, I don't think there are too many places w/ less than 50 beds. I suppose we are not so spread out as in other parts of the country. I wish you luck. It's great that you do have some choice. Either one has the potential for you to develoip some really great skills.

[Indy]

Depends on what department in this ten-bed hospital you're planning to work. ER's can be busy (and a good place to learn) no matter where they are. I'm of the school that almost any experience is valuable, just some in a more positive way than others.

[SeasideRN]

Ten beds is very very small. As a new grad, do you think that you would get enough exposure to different conditions or have opportunities to perform skills frequently enough to become proficient at them? Maybe you could speak to a nurse who works at this hospital and ask questions or shadow for a day.

Just the thoughts and experience of a fellow new grad :
I worked as a CNA during nursing school in a small community hospital, but decided to take a job after graduation at a very large teaching hospital in a major city. At the smaller hospital, there were often very sick patients but it was a lot of the same diagnoses (and often the same patients). The faster pace, higher acuity, and wider range of diagnoses at the large hospital has proven to be a great learning experience so far and I'm very happy with my choice. However, as someone else mentioned, it totally depends on you as a person. I am a high energy person who loves to be kept on their toes, while others may prefer a slower pace so they can spend more time getting an in-depth understanding of their patients. Best of luck in whatever you choose and enjoy your last semester of school... it goes by so fast!

[TazziRN]

Having worked in a 17-bed ER and a 3 to 6-bed one, if I were you I would choose the larger facility first. You will have a lot more backup as a new grad and more opportunities to learn about more things. You would then be invaluable to the smaller facility later because you'll be able to work independently without the backup.

[Shopgirl1]

Hi there!
I am a new nurse of 4 weeks and when I worked as a CNA, I was at a small community hopsital with 20 beds. I decided to go to a major hospital(900+ beds) in a major city,and it was the BEST choice I have ever made! I have learned so much in these 4 weeks then I would have learned in years at the small place. I figure that while i am young and spunky, I should rise to the challenge of being new at a huge place. The small place was great and I really love it, but anything critical was shipped to other places. We would have Heparin gtt's in the ICU, and now I am managing them on a general meds floor.
I really think that it is up to your advantage to go for the bigger place. Then, as the turnover and stress gets old, you can go back to the smaller place with alllll of this experience under your belt. But, you know whats best for you! Good luck in what you choose, I'm sure it will be for the best!

[RN1989]

Ten bed hospital? Chances are you will not receive the best education there. You will be cancelled when census is low. When there isn't enough staff, you may be left alone or with someone who does not have enough time and/or experience to be able to help you. Your resources at a small hospital will be limited. You would learn more and as an inexperienced nurse, your license will be safer at a larger facility.

[MeghanRN]

My thoughts:

I've been a nurse for 2 years. I worked the past year in a small hospital as well as a year of pedi private duty.

I'm kicking myself for not going to a large hospital immediately after graduation (although other circumstances did prevent me from this).

I just switched to a large level 1 trauma teaching hospital and I cant wait to get started. Floor orientation starts next week

I feel it was a huge mistake b/c I wasnt able to develop skills as much as my other peers with the same amount of experience. Personally, I'd recommend the large hospital, at least for one year. I dont think you will regret it at all.

Good luck in whatever you choose

-Meghan

[liljsmom02]

I have never worke in a big hospital and as a new grad 2 years ago I wanted to. I have friends that I went to school with that work in big hospitals. I was quite envious to hear about all their specialties. One works in the NICU another in oncology etc.... Having said that, I feel that I have become more diverse than them working on a 24 bed med/surg unit. I have no IV team to start my IV's. I have no residents doddling over my patients. I work at night so I have no respiratory therapist. We have no OR staff and are actually in the process of learning how to become 1st assists during a C-section in case the assisting surgeon does not make it to the hospital in time in the case of an emergancy c section.The only physician in the facility is the ER doc and he only comes to the floor during a code. My patients range from 30 days old to 105. I take care of resp/cardiac, oncology, pedi, surgicals, ortho's, neuro patients etc.....So my opinion is that the small hospital nurse does not get the opportunity to become specialized but definately becomes skilled in all aspects of nursing.