Choosing a hospital to work at as a nursing student

  1. Hi,

    I'm pursuing an 18-month honors BSN program at my university where local hospitals 'sponsor' students' tuition in agreement for a 2-year work contract following program completion.

    We have been given the opportunity to choose preferences for these hospitals who are to sponsor us and I'm a bit undecided. Please help me out here:

    1) Is it a good idea for a newly graduated BSN student with an RN to dive right into a big trauma hospital? Like Santa Clara Valley Medical Center in San Jose, CA

    2) OR is it better to stick to a smaller community hospital like El Camino Hospital in Mountain View, CA? This, by the way, seems to be a highly rated hospital but I"m sure.

    3) OR is it better to just go along with an HMO like Kaiser?

    My intution tells me that I should probably go to a better established hospital that has something I'm interested in specializing in eventually. Would you say I'm somewhat right or could you steer me in the direction of some good guidance and advice?

    I really need any input here since I don't know what to do. I like the idea of working in a trauma center but the idea of a big hospital sort of scares me. Liekwise, I feel that I might gain valuable experience in a smaller hospital known for its quality of nursing care.

    Any ideas, thoughts, opinions would GREATLY be appreciated. THANKS!
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  2. 17 Comments

  3. by   Harmony213
    It all depends on what specialty you think you might want to do when you graduate. The small hospital might not have as many choices. Personally, I think hospitals w/ trauma centers offers good experience. I work on Ortho as a tech and when the trauma center is at our hospital (it switches every year), we get more of a variety of things on our floor rather than just the total hip and knee replacements. I would prefer to work at a big hospital just because there are more opportunities and it seems like better learning experience even.
  4. by   begalli
    Quote from azzurra29

    My intution tells me that I should probably go to a better established hospital that has something I'm interested in specializing in eventually. Would you say I'm somewhat right or could you steer me in the direction of some good guidance and advice?
    I think your intuition is right! The thing is, that all three of the hospitals you list are established in the area that you are talking about. All three places are very different as well.

    Kaiser is someplace that I will never work. It's a personal thing with me and my feelings about giant HMO's. I know a few nurses who work for and are happy with Kaiser. I also know a few RN's who left Kaiser unhappy and have left for what they perceive to be greener pastures. Kaiser Santa Clara does some teaching. Many of the docs are from Stanford doing their residency there. Kaiser claims to be not for profit, but they are the richest not for profit HMO/hospital in the nation.

    El Camino Hospital is KNOWN for their excellent patient care and their excellent employee relations. El Camino is a private community hospital who does next to no medical teaching. They do have specialty areas in which they excel, but you will be dealing mostly with private docs. ICU and med/surg here would be good.

    Now VMC, on the other hand, is a HUGE teaching county hospital. I worked for VMC for 8 years in a department other than nursing before becoming an RN. I LOVED Valley. I still do, but it's not where I work (but I'm considering per diem!). This hospital is affiliated with Stanford. Many of the attending docs teach at Stanford Med School and hold dual attending positions at VMC and Stanford. The resident docs rotate from Stanford to VMC to the VA in Palo Alto. It's an excellent place to work in ICU, ER, Spinal Cord trauma and rehab, Burn, Pediatrics, and NICU. I would NOT recommend med/surg here. At VMC you will see stuff unique to the population of the south bay area. This is an incredibly diverse hospital. When I worked there, the language bank for translation services spoke over 100 languages! This is a unique place to work. The employees are very devoted to this hospital and to their commitment to the community.

    My choice of hospitals were the some of the same as yours when I graduated several years ago. I chose a large level one trauma center because of the fact that it was a teaching facility. Not only do we learn from the residents and attending docs, but they learn from us. The whole atmosphere in a teaching hospital is just that...teaching. Nurses, docs, everyone is accustomed to having students learning all the time. I know I'm mentioning alot about the docs, but I feel it's very important. Nurses who work at these large teaching facilities are also highly adept at dealing with and teaching students (both nurses and docs). I think this is great for a new nurse. I think you will get more support in a large teaching facility.

    Your choice should depend on what area of nursing you want to get into eventually if you don't already know.
    Last edit by begalli on Mar 8, '05
  5. by   azzurra29
    Quote from Harmony213
    It all depends on what specialty you think you might want to do when you graduate. The small hospital might not have as many choices. Personally, I think hospitals w/ trauma centers offers good experience. I work on Ortho as a tech and when the trauma center is at our hospital (it switches every year), we get more of a variety of things on our floor rather than just the total hip and knee replacements. I would prefer to work at a big hospital just because there are more opportunities and it seems like better learning experience even.
    Thanks for the input!
  6. by   azzurra29
    Quote from begalli
    I think your intuition is right! The thing is, that all three of the hospitals you list are established in the area that you are talking about. All three places are very different as well.

    Kaiser is someplace that I will never work. It's a personal thing with me and my feelings about giant HMO's. I know a few nurses who work for and are happy with Kaiser. I also know a few RN's who left Kaiser unhappy and have left for what they perceive to be greener pastures. Kaiser Santa Clara does some teaching. Many of the docs are from Stanford doing their residency there. Kaiser claims to be not for profit, but they are the richest not for profit HMO/hospital in the nation.

    El Camino Hospital is KNOWN for their excellent patient care and their excellent employee relations. El Camino is a private community hospital who does next to no medical teaching. They do have specialty areas in which they excel, but you will be dealing mostly with private docs. ICU and med/surg here would be good.

    Now VMC, on the other hand, is a HUGE teaching county hospital. I worked for VMC for 8 years in a department other than nursing before becoming an RN. I LOVED Valley. I still do, but it's not where I work (but I'm considering per diem!). This hospital is affiliated with Stanford. Many of the attending docs teach at Stanford Med School and hold dual attending positions at VMC and Stanford. The resident docs rotate from Stanford to VMC to the VA in Palo Alto. It's an excellent place to work in ICU, ER, Spinal Cord trauma and rehab, Burn, Pediatrics, and NICU. I would NOT recommend med/surg here. At VMC you will see stuff unique to the population of the south bay area. This is an incredibly diverse hospital. When I worked there, the language bank for translation services spoke over 100 languages! This is a unique place to work. The employees are very devoted to this hospital and to their commitment to the community.

    My choice of hospitals were the some of the same as yours when I graduated several years ago. I chose a large level one trauma center because of the fact that it was a teaching facility. Not only do we learn from the residents and attending docs, but they learn from us. The whole atmosphere in a teaching hospital is just that...teaching. Nurses, docs, everyone is accustomed to having students learning all the time. I know I'm mentioning alot about the docs, but I feel it's very important. Nurses who work at these large teaching facilities are also highly adept at dealing with and teaching students (both nurses and docs). I think this is great for a new nurse. I think you will get more support in a large teaching facility.

    Your choice should depend on what area of nursing you want to get into eventually if you don't already know.

    Wow, thank you so much for your valuable input! It's great to hear from someone who actually has worked in the Bay Area and knows these hospitals. This has helped me tremendously; I am leaning heavily toward Valley Med (which I used to live right next to and I'm thinking about a backup choice. Would you happen to know anything about Los Gatos Community Hospital?
  7. by   begalli
    I don't know much about LG Community nor do I know anyone who works or has worked there. I could be wrong, but I don't think they are a teaching facility. I think they are private with private docs.

    You are familiar with the area though. Not my cup 'o tea with patient population. I think Los Gatos also does a lot with sports. They are the "offical hospital of" such and such professional team (including my beloved professional soccer team). They're big on ortho and rehab I think.

    We are very fortunate to have so much opportunity to practice nursing in this area. Be sure to check out base pay rates and benefits as well. All are not equal.

    Good luck with your choices!
  8. by   Nancy2
    Quote from azzurra29
    Wow, thank you so much for your valuable input! It's great to hear from someone who actually has worked in the Bay Area and knows these hospitals. This has helped me tremendously; I am leaning heavily toward Valley Med (which I used to live right next to and I'm thinking about a backup choice. Would you happen to know anything about Los Gatos Community Hospital?
    Los Gatos Comm. is a Tenet facility or was last year. It is a small community hospital that gets a lot of affluent patients from Los Gatos and Saratoga. It is not a teaching facility. The pay and benefits are excellent! They are also the only non-union hospital in the South Bay.
  9. by   begalli
    azzurra29,

    Be careful. Overall and historically, Tenet DOES NOT have a good reputation with bedside nurses across the nation or the federal government.

    12/02 - Tenet hospitals in California are putting patients at risk by providing 14 to 20 percent fewer hours of direct care to patients, spending 26 to 30 percent less on labor costs, and using 34 to 65 percent more temporary nursing staff than other hospitals in California do, according to a new study of the corporation's staffing practices.
    http://www.nurseallianceca.org/resources/research.cfm

    I don't know, I just can't see me working for a healthcare CEO who makes this:

    Jeffrey C. Barbakow
    Tenet Healthcare
    $22,785 per hour, $116.4 million for 2002 (hourly pay if he worked 14-hour days every day of 2002)
    Doesn't include new stock options with potential value of $72.4 million
    http://www.usatoday.com/money/compan...-ceopay2_x.htm

    ...while the nurses who work the bedside struggle for decent working conditions, wages and ratios (now that the California nurse to patient ratio law has taken effect, ratios should be better).

    These for profit hospital corporations are all about the monetary bottom line and not about the people who bring in that bottom line.

    Nope, couldn't do it.

    But it is an option for you, azzurra29.
    Last edit by begalli on Mar 9, '05
  10. by   NurseFirst
    Quote from begalli
    i think your intuition is right! the thing is, that all three of the hospitals you list are established in the area that you are talking about. all three places are very different as well.

    kaiser is someplace that i will never work. it's a personal thing with me and my feelings about giant hmo's. i know a few nurses who work for and are happy with kaiser. i also know a few rn's who left kaiser unhappy and have left for what they perceive to be greener pastures. kaiser santa clara does some teaching. many of the docs are from stanford doing their residency there. kaiser claims to be not for profit, but they are the richest not for profit hmo/hospital in the nation.

    el camino hospital is known for their excellent patient care and their excellent employee relations. el camino is a private community hospital who does next to no medical teaching. they do have specialty areas in which they excel, but you will be dealing mostly with private docs. icu and med/surg here would be good.

    now vmc, on the other hand, is a huge teaching county hospital. i worked for vmc for 8 years in a department other than nursing before becoming an rn. i loved valley. i still do, but it's not where i work (but i'm considering per diem!). this hospital is affiliated with stanford. many of the attending docs teach at stanford med school and hold dual attending positions at vmc and stanford. the resident docs rotate from stanford to vmc to the va in palo alto. it's an excellent place to work in icu, er, spinal cord trauma and rehab, burn, pediatrics, and nicu. i would not recommend med/surg here. at vmc you will see stuff unique to the population of the south bay area. this is an incredibly diverse hospital. when i worked there, the language bank for translation services spoke over 100 languages! this is a unique place to work. the employees are very devoted to this hospital and to their commitment to the community.

    my choice of hospitals were the some of the same as yours when i graduated several years ago. i chose a large level one trauma center because of the fact that it was a teaching facility. not only do we learn from the residents and attending docs, but they learn from us. the whole atmosphere in a teaching hospital is just that...teaching. nurses, docs, everyone is accustomed to having students learning all the time. i know i'm mentioning alot about the docs, but i feel it's very important. nurses who work at these large teaching facilities are also highly adept at dealing with and teaching students (both nurses and docs). i think this is great for a new nurse. i think you will get more support in a large teaching facility.

    your choice should depend on what area of nursing you want to get into eventually if you don't already know.
    well, not exactly. in fact, i recently walked by a poster at ech saying they were publicly accountable because they are public. i first thought that meant that they were on a stock exachange. but, i just read their history, which is available on their website. ech was established by taxing the local folks in the ec hospital district. like i say, you can read more about it on their website.

    ech is considered to be one of the most technically advanced in terms of having had a computerized system for many years, among the first, for documentation, ordering labs, etc. they also have a system called vocera--which means that the person who has a vocera can converse from anywhere, no matter where they are. just a phone call will do it. very nice for tracking down nurses who can be in so many different places.

    i'm curious--what program are you in? what school? i have a friend who is in a similar program, through sfstate, sequoia hospital and la canada college; but i suspect sequoia wants first dibs on those folks!!!

    nursefirst
  11. by   begalli
    Quote from nursefirst
    well, not exactly.
    thanks nf! i knew that ech had private docs. i wasn't sure or not if the hospital itself was private. and now that you mention it, i remember something being in the news many years ago about the taxing of the community to expand the hospital.

    i have nothing bad to say about ech. the doc i chose for me and my son's healthcare work out of ech. this is the hospital i choose for my own health.

    i will add that it was an icu nurse at ech who helped me make my decision to go into critical care during a day i spent with him while i was in nursing school.
    Last edit by begalli on Mar 10, '05
  12. by   EDHRN
    Hi Azurra,

    I'm going into the same program and have the same questions you do! I've gone back and forth on the pros/cons of the different hospitals, but can't decide b/w El Camino and VMC. I don't know anything about Los Gatos Community Hospital, but it's VERY close to my house, so that's a plus! What do the seasoned nurses out there recommend? Have any of you, other than those who have already commented, have any suggestions/recommendations? (particularly if you've already worked at these hospitals)
  13. by   Nancy2
    I worked at VMC for 16 years and loved it!
    It is a fabulous teaching hospital. It has it's own culture. It is very supportive for the most part with the learning process. It is also very large and can sometimes be overwhelming. I don't have any personal expeience with ECH but I had a friend who worked there in employee health for a few years and she thought it was great too. I also have friends who have worked at LGCH and loved the smaller environment. I guess it really comes down to what kind of environment your looking for and what your career goals are.
    Good Luck with your decisions!!
    Nancy2
  14. by   begalli
    Quote from Nancy2
    I worked at VMC for 16 years and loved it!
    Do I know you Nancy? I worked at VMC from 1992 - the beginning of 2000 ( I left because, for me, nursing school + work = chaos!).

    I was not a nurse, but I was very familiar with just about every single floor and unit in that place. LOVED when they built the new wing! As employees, we toured the OR's, NICU, Pedi, and the ICU's before they even opened. I remember moving weekend as well when they transferred all the ICU and NICU patients over. Talk about road trips!

    The state of the art NICU was VERY impressive and the rooms on the pedi floor were remarkable with bathtubs in the rooms and beds for parents....and the play room!! Very, VERY nice for a county hospital!

    There are some floors though that I DO NOT miss at all....those would be the 3rd and 4th medical floors and the 2nd floor med/surg that moved to where TCU used to be.

    Gosh, GREAT memories of that place! I need to get back there to say hello to some long lost friends. I haven't stepped foot in the place for probably 4 years!

    It has it's own culture.
    Very true. And it's good.
    Last edit by begalli on Mar 10, '05

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