Differences b/w rural hospital vs. a large city hospital

[3KittiesRN]

Hi everyone!!

I have a question for all you guys. I would like like to know what different experiences you have had working in either a rural hospital (i.e. 59 bed facility) vs. a large city hospital (i.e. 200+ bed facility). I may have an opportunity to work in a small rural hospital as a new grad in med-surg. I was wondering if I would be getting the same experience there as I would at a larger hospital? What is your opinion on the pros and cons of each? If later in my career I decide to work in a larger hospital, would my experience be up to par with the others who have always worked at larger facilities? I would really appreciate any insight you may have on this subject. Thanks! I look forward to any replies!

3KittiesRN

[mpccrn, BSN, RN]

i've worked ICU in both. bigger hospitals have much better toys to play with, usually see sicker more unstable patients. the skills you gain are immeasurable in this type of situation. now that i'm in a smaller hospital, i bring those skills with me and am able to adapt to changing situations a bit better than my coworkers that have only worked at smaller institutions. docs know my past, i worked with many of them at the larger institutions. they've told me several times that they are glad i'm taking care of their patients....or worse yet, "why can't you be taking care of my patient? i'd feel better if you were" i've been personally asked to care for a certain patient by docs because they were very unstable or difficult for whatever reason. if given a choice as i new grad....i'd bite the bullet and go to the bigger hospital, gain the skills and intuition that i could then take to a smaller hospital. i wouldn't change the choices i've made.

[auntrh]

I've worked both, big and small......... and have to say that I got the most experience at the small hospital. We don't have ICU, surgery, or OB, but we are rural and see a lot of traumas, etc. Remember, big things happen in small towns - we've seen gunshot wounds, stabbings, major mva's, etc. And emergency precip deliveries in an Er that doesn't even have a warmer......talk about experience. You get it when you don't have respiratory there to help you, you and two other nureses are the only nurses in the house, you are the code team, respiratory, housekeeping when needed, the IV start crew, etc. We occasionally get nurses from larger facilities that are exceptional - truely excellent in their focus area, ie cardiac, icu, etc. However, ask them to do an EKG, give a neb treatment, etc. and they don't have a clue. So, I would summarize by saying that yes, experience in a large hospital is great, however, I would say that the experience of a small, rural hospital is priceless! I feel comfortable with the unstable pt that was just stabbed multiple times, the kid with status asthmaticus, and the elderly person in CHF. I think that every nurse should have to work in a rural hospital and get a feel for what rural nurses go through on their shift.......

[SuesquatchRN, BSN, RN]

Heh. Our ED, nights, has an RN, LPN, and PA. You get a doctor for an MI or CVA - sometimes. Usually we stabilize and ship.