A little clinical exp....

[eaglenurse2b12]

I feel that it has been crucial for me to have some experience in the clinical setting, before I attempted nursing school. I Hope to work in the ER setting one day, and I am lucky to have been an ER Tech for the last 4 years. I am in my 4th semester of a 2 year program. As I get closer to graduation.....I find myself at a crossroads.

Working in an ER, I have gained the trust and friendship of the people I work with. It is uncommon for the ER I work in to hire new ADN nurses. Yet, I have already been offered a position....informally by my manager....and of course pending my passing the N-CLEX! As time draws nearer, I am questioning whether or not this would be a wise move. I work in a small critical access hospital. There is a fair amount of "action", but nothing like a big city ER. There is a program at a large hospital....60 miles from home, called "Transition to Specialty Practices", it is for ADN students(new grads), to learn ICU and ER, with placement at the end of a 4 month training period. Do I try and complete it and get experience, then try to get a bob closer to home later on?

Anyone out there have any advice for me, based on their experience? I know taking a job close by may rob me of some exposure. I want to do what is best for my career, but will need to make some sacrifices, in order to train at a larger hospital....

[PixieRN1]

I personally don't think working at a small hospital will ruin” your career. If you later decide to apply to a major medical center, you still have valuable ER experience. More than another new grad. And I personally feel there is value in starting out in a new position where you may not be as likely to be exposed to trial by fire.

Some small hospitals are still wicked busy. And if a patient is too unstable for a squad or a flight to another facility, they may still come to you for rapid resuscitation and blood products before being shipped out the door and being flown to a bigger facility; that is what our local hospital does, although I have never worked in their ER (once upon a time I interviewed there and was filled in).

Your hospital may still have a cath lab and handle STEMIs. They may stabilize strokes. If it's in the country like we are, people still show up as passengers in cars after having a trauma in a tractor accident. Sure, the big stuff gets diverted, but some of it very much still shows up.

If you like this ER and the people, I can't emphasize how much that matters in your career. In my opinion, job satisfaction means a heck of a lot. Now, I'm not saying you should stay merely out of loyalty to them, and if you just can't imagine not having massive traumas as part of every shift, then of course you may want to consider a different location.

But a small hospital is not going to ruin your career. You are still in the department you want to be in and I doubt that you would be turned away for a job just because you didn't have the fanciest medical center on your resume as a new grad.

Unless you left something out, like you are wanting to go for an acute care NP or CRNA exactly one year after starting work, it's perfectly fine to stay where you are. See how it goes, go from there.

I've worked in small rural, medium suburban, and massive urban hospitals and I never felt like the small hospital experience hurt me in any way.

Best of luck with your decision.