Critical Access Hospitals

[alswjdzla]

Hello Nurses,

I just got an interview for a Critical Access Hospital. It is a small hospital in a rural area.

I was just wondering if this type of hospital is considered acute care setting.

Another question!

I am thinking about applying to SNF, rehab, or long-term care facility as well. I want to work in hospitals, preferably in ER or ICU later on after I get few years of experience as an RN. Where do you guys recommend the most? Working in which facility would help me the most to land a job in acute hospitals?

Any advice would be appreciated! Thank you :)

[meanmaryjean, DNP, RN]

Critical access hospitals are indeed acute care. In fact, I think there's a lot to be said for starting out your career in one. You may not see the variety of patients as you might in a larger facility, but you will deal with crises, do patient teaching, help with procedures, and generally become a jack-of-all-trades in the process. The really nice thing is that you are caring for folks in your community- people you will see in church, the grocery and at Little League games. That right there is a huge satisfaction.

We have eight CAHs in our hospital group, and I have been privileged to visit them all in the course of some research I did last year. I found the quality of care to be good, and the sense of community and teamwork excellent. I hope this information is helpful to you.

[lxpatterson]

I started my career in a rural acute care hospital, rotating between inpatient acute medicine and ER. I think it's a great first job because medical staff and senior nurses are usually fairly invested in getting you, a new grad, up to speed. Compared to a city hospital, where the pool of nurses is much larger, the smaller pool of nurses in a rural center requires nurses to be competent in many roles. Therefore, staff will put more into teaching and mentoring because no one wants to be stuck with an incompetent colleague overnight when there will only 3 RNs in the building. But as you pointed out, you probably will not have much sexy stuff like thoracics with multiple chest tubes or central lines with pacemaker wires, etc.

In your first year you should probably be more concerned about building basic competency like getting your ACS response and ECG interpretations down, having the ACLS algorithm memorized cold, foleys, NGs, basic ADL care, etc. I think once you are confident in your practice, you will be less concerned about how an teaching hospital ICU might view your resume and more likely to have actual experiences to impress an interviewer.

[alswjdzla]

Thank for the comments! Then do you guys think working in a critical access hospital is better than working in an acute rehab?