Career decision -- little or large?

[lazyrocking]

I'm currently an ADN student graduating this spring. My long term goal is to complete the nurse practitioner program. My dilemma is I've been offered a position at a larger hospital, med-surg floor for post op and also an emergency dept position in a much smaller hospital. The pay and benefits are comparable. The large hospital offers more in the way of acute care and the small hospital offers more opportunities to practice with more independence regarding decision making and skills. I do have many years of emergency experience in EMS. Which would be more advantageous as far as my plans to become a nurse practitioner???

[Burnie]

What are your going to specialize in? Med/Surg nurse practitioner? ER nurse practitioner? I think I would go after whichever one provides the broadest experience closest to the specialty you chose.

[orrnlori, RN]

I agree with the above post.

[Renee' Y-Y]

I personally, would select the larger institution:

1. Usually have more diversity & experience availability.

2. Tend to have a more organized nursing structure: Nursing Practice Council, defined process for policies & procedures, defined process for preparing for JCAHO.

3. Higher competency expectations for nurses.

4. Upper level administrators seem more professional & actually have degrees to match their level, which is in keeping, usually, with community norms.

Do keep in mind this is my anecdotal experience. I am currently working in a small hospital...my last day is 3-17...I'm going back to a large hospital for the reasons I just listed.

[lazyrocking]

Thanks very, very much. Your input is really valuable.

[nekhismom]

i say go large. They will more likely offer a preceptorship, which may help a lot with transitioning from an EMT to an RN.

[ManEnough]

Just out of curiosity, when you see hospitals listed by bed numbers, what is considered a "large" or "small" hospital?

[orrnlori, RN]

We have 949 beds. We are considered large I would think.

[purplemania, BSN, RN]

I agree with the above and would only add that the med-surg experience will provide opportunities to learn DIFFERENT things that what you have been practicing. The broader your scope the easier your course work might be as well.

[zacarias, ASN, RN]

949? Oh my...you must be in NYC or LA wow.

I would say that any hospital with 300 or more beds is "large".