When I graduated I took a job in my small town at our smaller hospital. It had just gone through the process of merging with two larger hospitals in the area. I LOVE my job on med/surg (good nurse-patient ratios)- LOVE my schedule which works very well with my family (plus twenty-four hours a week is considered "full time" and has full benefits!) I have great my co-workers...so what am I complaining about? Well, over the past year I have seen the acuity level of our patients go way down. Part of the problem is that we have lost a few doctors to larger cities but a mostly it is because our new merged management is consolidating things. For instance all our our heart patients are being transferred to the largest of the three hospital where they just finished building a heart center. Now there is talk that they are thinking of our facility as a future rehab-type facility. Just recently they began sending the swing bed patients (ie could-be-in-the-nursing-home patients) from both the other hospitals here.
Don't get me wrong. I love old people. But I feel like my skills are really beginning to suffer. I have had only two chest tube patients IN SIX MONTHS. Only two in traction. Seems like all the patients either have CHF or pneumonia.
Soooo...I am in a dilemma. Do I stay here, five minutes from my house, ride the wave and adjust my expectations. Or do I transfer, put up with a probably less-than-ideal schedule/shift and have a 30-40 minute commute one-way? Also, there is no guarantee that the nice conditions I now work under will not also change with the prevaling administration. Any thoughts?