Big Fish, Small Pond Syndrome

[FireStarterRN]

I was talking to a nurse friend of mine yesterday. We were discussing the dynamics of a big hospital vs a small hospital. Also we discussed bigger units vs smaller since we've worked in both.

I got tired of working in the small hospital. There were some big fish there who had carved out niches for themselves, had never experienced a larger pond, and definitely had grown to be big fish in that small pond by eating smaller fish. But, in a smaller hospital, there are fewer places for us little and medium sized fishes to hide.

Some nurses stay forever in a unit or hospital, and they literally create an ecosystem that supports themselves and the validity of their worldview of both themselves and others. It's similar to the Emperor's New Clothes. Who's going to challenge the Emperor when he can condemn you to the dungeon or the gallows? He and his advisors will continue to perpetuate their illusory world no matter how inaccurate it is. The Big Fish of nursing also must have his or her political allies in order to be successful.

All of this is accentuated in a small hospital. I'm finding where I'm working now has a healthier dynamic. I've been working on a large unit with many busy nurses and one personality is not able to dominate the workplace as easily. People seem less ensconced in their social roles. But, even so, this same dynamic can occur in any hospital unit, since most of them are relatively small social units.

[EJSRN, BSN, RN]

I was talking to a nurse friend of mine yesterday. We were discussing the dynamics of a big hospital vs a small hospital. Also we discussed bigger units vs smaller since we've worked in both.

I got tired of working in the small hospital. There were some big fish there who had carved out niches for themselves, had never experienced a larger pond, and definitely had grown to be big fish in that small pond by eating smaller fish. But, in a smaller hospital, there are fewer places for us little and medium sized fishes to hide.

Some nurses stay forever in a unit or hospital, and they literally create an ecosystem that supports themselves and the validity of their worldview of both themselves and others. It's similar to the Emperor's New Clothes. Who's going to challenge the Emperor when he can condemn you to the dungeon or the gallows? He and his advisors will continue to perpetuate their illusory world no matter how inaccurate it is. The Big Fish of nursing also must have his or her political allies in order to be successful.

All of this is accentuated in a small hospital. I'm finding where I'm working now has a healthier dynamic. I've been working on a large unit with many busy nurses and one personality is not able to dominate the workplace as easily. People seem less ensconced in their social roles. But, even so, this same dynamic can occur in any hospital unit, since most of them are relatively small social units.

Did you find you gain more experience from a bigger hospital? I work in a small hospital, and I am afraid that when I go to travel nursing I wont know a thing because I havent really seen much (or at least I feel that way)

[wooh, BSN, RN]

Did you find you gain more experience from a bigger hospital? I work in a small hospital, and I am afraid that when I go to travel nursing I wont know a thing because I havent really seen much (or at least I feel that way)

I think you're going to gain experience no matter where you work, but it's definitely going to be different kinds of experience. A bigger hospital, especially with a lot of medical teaching, is going to have lots of cutting edge technology. Of course, if it's the place to go with no insurance, you're going to learn to make do without the "luxuries" (pill cutters, supplies in general) that other hospitals have. I think the thing I gained the most from at a small hospital was the variety. Bigger hospitals can specialize the units. A smaller hospital won't be so specialized, so you won't just get respiratory or renal, you'll get everything, even if you won't see the higher level of care you'd get at a bigger hospital. So to me, bigger hospital, you'll get a more specialized but higher knowledge, but at the smaller hospital you'll be more of a "renaissance" nurse, with a little knowledge about everything.

[FireStarterRN, BSN, RN]

Did you find you gain more experience from a bigger hospital? I work in a small hospital, and I am afraid that when I go to travel nursing I wont know a thing because I havent really seen much (or at least I feel that way)

At a small hospital you are a jack of all trades and have to be very flexible. I got good experience there, but limited in some ways. At a bigger place they do more variety of surgeries and procedures, which is great to know. So I got good experience at both. Definately at a small hospital you have to have a lot of independence. We were our own charge nurses and unit secretaries often.

[moongirl]

Did you find you gain more experience from a bigger hospital? I work in a small hospital, and I am afraid that when I go to travel nursing I wont know a thing because I havent really seen much (or at least I feel that way)

In a small hospital I got more exp. with the scary stuff. At 0200 you are "IT" and you have to handle whatever comes down the pipe, often stablizing/keeping someone alive until the copter shows up.

[Jules A, MSN]

As everyone has said there are pros and cons to both. I have either the best of both or the worst, lol. One of my jobs is in a rural area where everyone knows everyone else, their kids etc. It kind of creeps me out but since I'm a transplant I get to enjoy the family atmosphere without them really being able to be all up in my business. :) We all know what to expect from each other, our strengths/weaknesses and for the most part everyone works pretty hard. If you are able to fly under the radar and stay out of the gossip mill this is a great spot.

My other job is in the city. There is way more money, technology, supplies and a variety of people which is nice. The bad thing about city nursing, imo, is that since there are so many opportunities in such a close proximity people tend to come and go quicker. At my facility I don't think they screen new hires really well and we end up having to weed out quite a few doozies and there are also the perpetual orientees. I swear some people just show up for the week long 9-5 paid orientation. :)