Does size matter?

NCgirl · Feb 20, 2004

I'm just an anesthesia student- no experience on admission boards. But IMHO, I think most schools would be more impressed with experience from the largest hospital, b/c that's where the highest acuity will be. Good luck!

WntrMute2 · Feb 20, 2004

I have found three hospitals that I am interested in working to get critical care experience. Two of the hospitals have 200 beds, and one hospital is 750 beds. The big hospital is also a "teaching hospital" and a "Magnet Recognition for Excellence in Nursing Services from the American Nurses Credentialing Center (ANCC).". All three hospitals have critical care units, and I am sure that they each have plenty of cases.
My question is does it does the size of the hospital, does a designation as a "teaching hospital" matter, does it matter that it has a designation "Magnet Recognition for Excellence in Nursing Services from the American Nurses Credentialing Center (ANCC).", or is the only thing that matters that you get experience in a busy critical care unit?

Not only will the admissions board have a favorable opinion on your choice, you will learn more, have more autonomy, and you probably will be expected to be a smarter, beter nurse. All things good for your future as well as your stay in the ICU.

ThinkingAboutIt · Feb 20, 2004

Thanks for the reply.

Are you saying you think the big hospital that is has a nursing magnate award, and is a teaching hospital would be better experience, looks like better experience, or its both for me?

On the applications for admissions to a CRNA school is it routine to include detailed information about your employer... "Magnate Nursing..", "Teaching Hospital.."," 750 bed hospital.." on the application? And the CRNA schools will consider this better experience because the experience was from a "Teaching Hospital", "Magnate Nursing Hospital", "Big Hospital"?

rollingstone · Feb 20, 2004

I'd start out at the large teaching hospital.

ThinkingAboutIt · Feb 20, 2004

How much is working a "teaching hospital" worth? Suppose I can get a better deal (more pay, better benefits, etc) from a non-teaching hospital or smaller hospital? Do you think that it is still worth it to go to the "teaching hospital"? In the scheme of GPA, GRE, certifications, and experience where would this rank?

WntrMute2 · Feb 20, 2004

How much is working a "teaching hospital" worth? Suppose I can get a better deal (more pay, better benefits, etc) from a non-teaching hospital or smaller hospital? Do you think that it is still worth it to go to the "teaching hospital"? In the scheme of GPA, GRE, certifications, and experience where would this rank?

One more time, GO FOR THE TEACHING HOSPITAL, ignore the benifit picture and GO FOR THE TEACHING HOSPITAL. I've done both and there is no comparison!!!

ThinkingAboutIt · Feb 20, 2004

One more time, GO FOR THE TEACHING HOSPITAL, ignore the benifit picture and GO FOR THE TEACHING HOSPITAL. I've done both and there is no comparison!!!

Wow, that quite a statement of support. In an earlier post you said, "have more autonomy, and you probably will be expected to be a smarter, beter nurse. All things good for your future as well as your stay in the ICU. "

So, is just the autonomy and expectations that you will perform that makes a teaching hospital better? Money is a difficult thing to pass up.

pghfoxfan · Feb 20, 2004

Sorry, my mind must be in the gutter today, because when I read the title of this thread, "Does Size Matter?" I shouted out HELL YEAH!

WntrMute2 · Feb 20, 2004

Wow, that quite a statement of support. In an earlier post you said, "have more autonomy, and you probably will be expected to be a smarter, beter nurse. All things good for your future as well as your stay in the ICU. "
So, is just the autonomy and expectations that you will perform that makes a teaching hospital better? Money is a difficult thing to pass up.

OK,

1) expectations will be higher, forcing you to dig a little deeper into pathophysiology, pharm etc.

2) Patients will undoubtably be sicker and the interventions will be more cutting edge, ask any small hospital ICU nurse how many high fequency jet ventilators have they handled, how many patients have been on nitric oxide, how many bedside abdominal washouts have they participated in, any continuouse cardiac output monitors? You haven't titrated inotropes until you can watch the curve change right before your eyes as the drip is adjusted.

3) You will be called upon to make more decisions on your own and will be expected to know when the resident wants something stupid and to refuse to carry the order out. You will be an integral part of protecting that patient and initiating interventions instead of making sure that the private doc is happy and you don't step on any toes.

4) Are you sure the money is that different? The private institution I worked at paid far less than the large teaching hospital I loved. Consider that doing something for the money is a lousy motivator and being a better nurse when trying to do anesthesia school is invaluable. I could see the difference between me and some of the others that came from smaller, less advanced hospitals (not to pat myself on the back too much).

5) Most schools have or will know about the kind of hospital you work in, my school was over 1,000 miles away and they knew all about it. If not, your resume would include the skills you developed and utilized, so a teaching hospital will give you more skills to list.

Roland · Feb 20, 2004

In reviewing nearly every thread in the CRNA forum the advice to work at a "teaching hospital" has been almost universal. In addition, I have personally had written contact with eight CRNA institutions and of that eight, SIX said that working at a teaching hospital was a MAJOR plus (one admissions guy said that it was probably worth as much as a quarter point increase in your GPA or more!).

RNBEAUTY2003 · Feb 20, 2004

I totally agree with Dave. Teaching hospitals is incomparable to nonteaching facilites. Just think, if a patient is extremly injured and sick( life threatening situation)- why would they consider taking him to a small hospital. That patient would require state of the art technology, aggressive and sharp leaders and staff, and a variety of disciplines. Some small hospitals does not have a Neurosurgery team or advanced Interventional Radiology. So certainly without the high acuity patients, you'll lack the strong experience needed to prepare you for CRNA school. I know the money looks good, but you have to think about the long term goals. If you go to the teaching hospital, you will get paid more.....in the end. ( with more experience and considering other factors, better chances of getting accepted into CRNA school)

I'm not in CRNA school at this time, but I'm planning my path wisely. Will begin SICU in May ( in large teaching hospital- transferring from Trauma Unit IMC).