Community Hospital

I've never worked ICU, but I worked for several years in a smaller community hospital. They have "hospitalists" - physicians that are there, somewhere in the hospital, 24/7. They generally float to the various unit and are available for consults in other departments (such as an OB pt who is having respiratory issues).

I've also never worked ICU, but I work telemetry/PCU in a medium sized community hospital. I've never worked as an RN anywhere else, so I can't really offer a comparison, but overall, I've had a great experience at the hospital where I work.

I actually thought I was going to hate it when I started there, as I only had experience in clinicals and working as a PCT in larger teaching hospital. I thought the physicians were going to be difficult to work with, and practices were going to be out of date. I wasn't completely wrong about that, but for the most part, our hospitalists are great to work with, and although there are some things I find a little "backwards" there have been so many great things as well.

The people I work with are great, and it really does feel like a family, since it's so small, you get to know the people on your unit, as well as elsewhere quickly, and everyone has been so friendly and welcoming (granted, it is the south, too :) Also, especially at night, we have very little that we delegate. We don't have an IV therapy team, we do our own EKGs and lab draws, just to name a few. I don't know if it's true in every larger hospital, but where I worked as a PCT, there was support staff who usually did most of that. There also obviously aren't any residents, so RNs assist physicians with alot of procedures, and I've gotten the oppurtunity to learn alot from our physicians who enjoy teaching.

As far as ICU, I know my hospital doesn't keep the most critical of patients, so that would be one thing to consider, but we do only have one ICU, so I'm guessing you would see a wider variety of conditions than in a specialized ICU. Also, I'm guessing there would be even more oppurtunity in the ICU for procedures and such that might be taken care of by support staff in a larger ICU.

Anyway, to make a long story long, I'm really glad that I was "forced" to take the job I have now, because it's been great, and I think community hospitals are definitely worth considering.

Good luck with your decision!

I spent a summer in icu as an extern and off and on throughout my lpn year filling in. We are a small community hospital with a 6 bed icu. Most of what we see are critical patients who (for whatever reason) are not transferred to the larger hospitals in the area. Maybe because they are end of life, choose not to be transferred d/t insurance or funds, or are on the "less critical" end of the continuum. We have several large hospitals in our area, so most people are "shipped".

The other population we see a lot is overdose or suicide. 2 of the 6 beds are suicide precaution rooms and/or isolation rooms.

The regular docs make rounds to the unit. No residents. Our respiratory department does EKG's. The unit is also the telemetry center so any patients that are on telemetry on the floor are monitored in the unit. The icu nurses are also part of the Rapid Response Team, one of them will always be present during a code or other emergency. Also, our icu is total care, which in my area is pretty much becoming the standard. However, because we are a smaller hospital, the cna's will occasionally come back and offer to help if they have time.

I have loved my time at the small community hospital. Yes, as a PP stated, some of the equipment is outdated, some of the procedures are outdated, however, it is a "family", and I believe the patients also feel that they are part of the family. I know everyone I work with, even in different departments, which comes in handy when you could use a little help.

Good luck....I know its a hard a decision.

I also work in a small (78 bed) community hospital, in a 6 bed ICU. LOVE IT! Came from a large hospital's 43 bed M/S unit, and this really has been a nice change for me.

We have hospitalists, who come and see pretty much all the patients. A few of our docs come and take care of their own, mostly the surgeons. We also ship out some of the patients that need specialized care, and lot's of times we will have med/surg patients to take care of, if there is no bed out there. We also have to float to M/S, ER and OB. Oh, and the pharmacy isn't open after five, but if we need something the house supe can get it for us, or we can get it out of the Documed on M/S. No Pyxis here!!!

Hope this helps! :)