First job: Community or Teaching Hospital?

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Hello all,

I have two wonderful offers for my first job. Both are for ICU, my first choice. My only dilemma is which to accept.

One is at a smaller community hospital a few hours away from where I live now. The staff is phenomenal and after shadowing I just know that I would be happy there. But I am concerned that because it's an older facility without as many resources I won't get to see as many high acuity cases as they will be transferred to the larger hospital across town.

My second option is the larger level 1 trauma center where I completed my clinicals. I can see myself being perfectly happy here as well. Plenty of access to resources and a good foundation to establish myself as a nurse.

My short term goal is to finish 2yrs in a hospital and obtain my BSN so I can start traveling. I think the larger teaching hospital will expose me to more learning opportunities and make me a better traveler therefore I should chose it; however I am having a hard time ignoring that "hair-raising-up-on-the-back-of-your-arms-you-are-home" feeling I got at the community hospital.

Any advice appreciated, especially those of travellers. Thanks in advance to everyone!

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Specializes in Family practice, emergency.

If your intention is traveling, I would take the larger hospital. You can always take a travel contract with a community hospital later, but you won't necessarily get to go the other way. I have noticed at teaching hospitals there is more of an emphasis on nurse training and assistance in certifications... so this may also be helpful to a future traveler. Good luck!

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Specializes in NICU, PICU, PCVICU and peds oncology.

That's true, but then there's the reality that small community hospitals are often the first point of contact for critically ill or injured patients who require stabilization before they can be transferred to a higher level of care. During that time, the staff will be doing a lot of interventions without the full array of supplies and equipment - and access to consultants - of the bigger centres, and the ability to work effectively in those situations is a great learning experience. I've listened in on a lot of calls to our referral centre where rural hospitals have the responsibility for keeping the patients alive until help arrives. You can clearly hear the organized chaos in the background as the fight for life is occurring. And most of the time they do a fantastic job of it. So that's another way of looking at it.

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