Oh my gosh!!! (found the rural nursing forum)

ruraluprn · Aug 28, 2003

This is so neat! A forum for rural nurses. I too work at a CAH we have a total of 24 beds 9 of which are designated Swing Beds. We do not do OB except for emergency deliveries in the ER. We have a 2 bed ER. We do not have an ICU...we call it a monitored bed unit. Our average daily census is 7-8 patients but we occ. get down to one or two (that includes the swing beds)

Swing beds do make money...the paperwork is a pain though.

I love working at our hospital, I have been able to do a little of everything from working in the ER to riding on the ambulance with an unstable transfer and also the less exciting things like taking care of the patients awaiting the nursing home beds.

It is true one or two people on medical leave cause a staffing crisis. I am currently the acting director of nursing since our DON retired and we are unable to recruit a DON. We have had to use some agency staff this summer to meet our staffing needs, our census would go up when everyone wanted vacation.

:eek:

Becky

NurseKimberley · Aug 28, 2003

Well I'm the SDC here, which at least in rural places is a catch-all for a little of everything. I do staffing (we use agency a lot, can't find anyone out here), teach CNA classes, and generally do administrative junk under the DON. You really have to have an appreciation for this type of thing to be able to handle the rural setting.

ruraluprn · Aug 28, 2003

So true,

Nice to meet you...I never thought of using our SDC to do scheduling :-) Our supervisors and DON have always done it!

Becky

NurseKimberley · Aug 28, 2003

Sounds like a great place to work :)

Tell your SDC to count his/her lucky stars!!!

Dave ARNP · Sep 19, 2003

I worked as a NP at a Rural Hospital right after I graduated.

16 beds, 1 OR, 2 beds in ER.

Facility never keeps more than 1 MD's at a time. 1 for general, and 1 who does surgery. Current surgeon is 77yrs old. Let us pray!

No OB/ICU. All rooms are cardiac, as they all are monitored up! Any chest pain gets you admitted, if you have so much as 1 risk factor, you board a chopper. (risks... HTN, CHF, HLD...)

1 RN, 2 LPNs, 2 CNA's. Thats their staff.

Did I mention, they use a whole lot of MS04?

-David Adams, ARNP

-ACNP, FNP

mazz · Mar 31, 2004

I am amazed to know that there are hospitals smaller than this one (15 acute and 3 ER beds). We have alot of swing bed pt's also. Honestly speaking, in actual time and resources I swear the swingers use more than acute patients ever do. We currently are having a problem with beds being taken up by LTC patients- a very frustrating thing! I didn't go to nursing school to work in a nursing home and that is alot of what we do, unfortunately. But we do rehab, and it is great to see the old folks getting stronger and more independent. But when they start to bring their own recliners in, it means they have been here too long!!!!!

Some things you see or learn in rural nursing that you will never learn in a big city (I worked in big cities before coming here)

1. You CAN transport a patient to the ER in a wheelchair in the back of a pickup truck when your 2 ambulances are out on calls.

2. Cattle and sheep drives are still done on roads and highways- and they will move out of the way! So don't stop and wait for them to move because they won't- drive through them (slowly).

3. Cowboy poker is not as mundane as it sounds. It involves a table, chairs, four really stupid or drunken volunteers, and one very large bull in an arena. Have I said enough?

4. In a fight, the horse is going to win, every time.

5. There are some towns in the U.S. where you can't buy underwear.

6. There is still such a thing as a social admit; and pipes being frozen is a good enough excuse to extend your hospital stay by a day or two.

Whoops! gotta run! Time to go burn my ditches.....:angryfire :angryfire :angryfire :angryfire

gwenith, BSN, RN · Mar 31, 2004

Sorry but when you talk small rural hospitals I think we Aussies might have you beaten. I worked in one place that had just two beds but was basically an outpatient department - if someone was admitted to a bed one of the staff did overtime for the nightshift. We have places that are just nursing stations with one nurse and that is the only medical help for hundreds of miles - except of course for the flying doctor. Check out some of the Aussie links I posted if you want to see how small we can make a "hospital".

mattsmom81 · Apr 28, 2004

Wow...some of you folks are 'really' rural in comparison to me. I'm only 20 minutes or so without traffic from the nearest 'big' hospital.

glad I found this forum and nice to read everyone's posts...food for thought. :)

lgowan · May 17, 2004

OMG! And to think all this time I thought I worked in small hospitals (89-97 beds)! :rotfl:

I guess you have me beat! I do enjoy the smaller hospitals though. You can get a lot of good learning there. In a bigger hospital where you have so many specialties, the experience is VERY specialized. In the smaller hospitals you get a little bit of everything! After talking over the years to people who have worked in bigger hospitals, they say I would work well in a bigger hospital because of the broad range of experience. Thanks to rural hospitals!

Lisa :)

critcarenurse16 · Jun 24, 2004

I JUST found this forum!
(Got to get away from the "Off Topic" forum more often!!!!)
I'll be posting here more often. (Be afraid. Be very afraid.)
Just for the books. I work for probably THEE smallest hospital in Massachusettes! We've just been designated a "Critical Care Access Facility". No one knows what the heck that means except that we get full %% in Medicare reimbursements. But because of this, we can only have 15 acute care patients in the hospital at one time. . . including the med/surg floor, the maternity floor and the ICU/CCU (where I work).
Total beds in our hospital??? Let me count in my head (which really hurts by the way!). . . . 32 beds including the E.R.
Yep! We're a small, rural, community hospital. And I'm still surprised to find that we all have a job there because. . . because. . . because. . . there are days when we have less than FIVE patients in the whole facility! One time, not too long ago, we only had one!
I love my job! Can't ship the really sick ones out fast
enough!
Cheers to you all! :)
Ted

My faciltiy just applied for crit. care access - one stipulation is that you live in an area that gets more than 80 in. of snow per yr. (FYI) :uhoh21: Unfortunately my area beats that number threefold so just try to get to the hospital when you need too :rotfl:

tknrn · Jul 6, 2004

I also work at a rural hospital in Northeast Missouri and we are also designated as Critical Access. I am the ER Supervisor and so I work the ER when I'm scheduled to work. We are not union so we have call offs when the census is low as it has been recently:) Our CEO requires that 4 nursing staff bee on at all times but that includes the ER, OB, ICU and the floor..We are the closest hopsital for approximately an hour so we get hit hard in the ER usually. Working in a rural hospital seems to have it's own challenges..the most frustrating is that people in the community seem to think that when they hit the door to the ER they should be seen immediately...oh well such is life in a small community..

it is nice to know that there are other people out there that work the way we do...thanks for sharing:)

CardioTrans, BSN, RN · Jul 6, 2004

Now see, Im like the other poster and thought that the hosp that I work at was small. We have 152 beds. I guess it is small in comparison to the one I can from was a major teaching hospital here in the state.