ER Nursing in a Smaller Hospital?

[victoria3594]

Hi everyone!

I am looking for some advice. I graduate with a BSN degree in April, and I am thinking about looking for a job in critical care. My plan since I started nursing school was to go into public health, but I did not enjoy my placement there and honestly, I got pretty bored. 

My thing is, I am not overly in love with the hospital environment and am feeling lost, but something about the ER excites me. With that being said, I feel I would be overwhelmed at a bigger hospital and would much rather enjoy some place smaller. I live in a small town with a small hospital, so I'm wondering; how different would my experience be? I know we could still get some crazy stuff, but has anyone else worked at a large and small ER? Positives? Negatives? All advice is welcomed. Thank you!

[Ariemay82, RN]

It all depends on the facility. Also your coworker are a big part of the equation. I work night shift in a small hospital ER and we don't get a whole lot of craziness but when you get a critical patient you have to have good resources especially if you are unfamiliar with the course of treatment. Food for thought not many ERs hire nurses without experience. Good luck!

[canoehead, BSN, RN]

I've worked in a small 7 bed ER and it was much more challenging than my current 25 bed. In a small ER you are it...security, housekeeping, lab, social work. If the secretary called in, it was just me and the janitor. You need to know all your equipment and protocols because you won't have anyone with you to problem solve. Also, small ERs tend to get everything, so pediatrics, burns, labor and delivery, they are yours until you stabilize and transfer. 

[FNPxAbyss318]

I started in a 12 bed ER in the first 8 months of my nursing career and learned a great deal. At the 8 month mark a lot of what I was learning became redundant and I ventured to a level 1 trauma. I worked with a lot of older individuals and my peers thought I was "crazy and for sure would be back". Needless to say, I never returned and thrived in the collegiate environment learning soooo much more..When you find yourself in space with no more room to grow--move on! With that being said, in the beginning of your career you will learn the ED algorithms for chest pain, abdominal pain, STEMI, codes and etc. Get those down pack and understand the "why" of what your doing. Not just completing the tasks.