small community hospital or big teaching hospital as new grad??? pls help newbie

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    i have a slight problem. I applied for an ER job at a medstar hospital. went for an interview ( small community hospital) and i strongly believe i will get the job. I also applied at UMMc for thier CCU or Imc position but havent gotten an interview yet. I got an offer from Maryland General(med surg floor with peds and vents..)..great benefits but turned it down ( bad reviews from people) . my problem is that people tell me that as a new grad ( i graduate may 06) ..it will be better if i go to a teaching hospital like UMMC or Hopkins instead of a small community hospital even if the teaching hospital ofers me a med surg floor. I dont know what to do. BTW i also have an interview at Hopkins and they only offered a tele floor with rotating shifts which i absolutely hate.
    I dont know what to do...pls help? WHAT ARE THE PROS AND CONS OF COMMUNITY HOSPITALS VS bIG TEACHING HOSPITALS? AND WILL MY DECISION AFFECT ME IN THE LONG RUN? Sometimes i wish i had waited till i passed my boards before applying to hospitals..i have a c onstant headache now.
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    Don't take the tele position if you already know you'll hate it.

    The UMMC position will give you learning opportunities you won't get at the smaller place, and you'll see the cutting edge of medicine, but you need to decide where you'll be happiest. Write out a pro and con list for both places.
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    My first nursing job was in a small community hospital and I loved it! Got experience there that I never would have received anywhere else - everything from being the mother-baby RN to pediatrics to med-surg to ER to a skilled ventilator unit. Made me a "jack-of-all trades" nurse so to speak, a great background for an ADN educator.
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    I agree. Yes, a big hot-shot facility can be great, but it can be overwhelming for newbies. Not to mention you'll be fighting tooth and nail with all the other new people to get procedures/experiences.

    I got to do lots of stuff at a small, commuity based hospital that I would have never gotten at the "Big Name" across town.
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    I have never worked in a big hospital. But I can say some positive things about a small hospital.

    1. Its harder to get lost.
    2. You get to know your co-workers on all shifts pretty quick, and the employees from other departments.
    3. You learn to be independent.
    4. You learn to be very creative in problem solving since you may not have all of the equipment like in a big hospital.
    5. You see everything on one floor. There isn't a ortho floor, a peds floor, etc. Its all in one so you get so much experience.
    6. You never fell like a "number". Your administrator and DON will know your face and your name, and maybe even possibly how many kids you have and their names.
    7. Small amount of employee turnover.

    The cons of a community hospital that I can think of are:

    1. Poor pay.
    2. Poor staffing.
    3. Everyone knows everyone's business and where everyone lives.
    4. Your patients are your neighbors and belong to your church. (Some may think that is a good thing)
    5. Lack of equipment.
    6. Outdated equipment.
    7. No pharmacy outside of bankers hours
    8. You have to mix and label all of your piggy back meds. Nothing comes premixed. This is very time consuming.
    9. Paper charting as opposed to computer charting.
    10. There isn't always a doctor in the hospital. No, not even in the ER.


    Thats all I can think of. I liked working for a community hospital for the most part. They have their pro's and con's. You should work where you think you will be happiest, not where there is a position available. Good luck w/ graduation and boards!


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