Community Hospital vs Level One

well i am working at a smaller er right now, been at a couple of smaller ones in the last few years. will start at the trauma center next month prn. anyway, the thing with smaller er's, from my experience and what coworkers said-at comm hosp u will sometimes get a good lull in the middle of the night, and most trauma will not come knocking at the door unless ems has no option and lifelight is grounded. most emergencies get sent to the bigger hosp-as we do not do icu-so anyone critical, intubated, multiple drips, sick pedi, mi's, burns, etc-it all goes. and yes, sometimes we get to play for a bit to get them stablized enough to go. it is also a tremendous strain on our ems system for them to drop the pt off initially, then come back in a few hours to take them on a longer trip. on occasion we must call in an extra truck just to do the transfers. the other big factor is that u are a skeleton crew, esp at night. we run 9 rooms, 1 nurse in triage, 2 in back-most of the time without a tech. we do not get unit secretaries in the er at all. so if one person is in the room, another is trying to answer all the phones, run interference with the doc and all the pts that come to the desk, put in all the orders, and try to do their own pt care too. when we get anything major come in, we get the nursing super to come down and sit at the desk while we are in with that pt. few few resources. this is about how it is at more than one of the smaller er's that i worked at. so some big ques for u might be on amt of pt's they transfer out, what is staffing like, and who is your back up. good luck with your decision!:)

I work at an itty-bitty rural hospital. It is quite a different thing to be the only RN in the ER when you get a bad trauma patient. No anesthesia, an oncall RT, no surgery, maybe two or three units of O- in the lab... sometimes you're the only RN in the ER. Add to that you're usually working with a family practice doc who is just trying to pick up a little extra cash, and you can certainly have a stressful experience.

I worked many years at a Level I trauma center, and just used to kind of sigh when a patient from a rural hospital was brought in (many times with a 22 ga IV in a patient with a gunshot wound to the chest). Now that I know what they're up against, I have much more respect and understanding.

Anyway, good luck to you.

Sorry. I meant to say that sometimes you're the only RN in the entire hospital (with responsibility as the supervisor and the pharmacist as well as overseeing the LPNs on the medical unit).

I've worked in both, and I agree with you there is quite a bit of stabization going on at the community hospitals, with less support.

Depends on how far away the level I is............is it close enough that level I traumas are transported directly to the level I???? and in that case you won't get any.