Yes, it makes sense. I started working in a community hospital in the boondocks. I worried that I wasn't good enough or had learned enough to be able to work at a huge city medical center. I was wrong, and so are you. And, I'm going to tell you where you are wrong.
In this past close to a year that you have been out of school you have been learning some very valuable skills. Among them are how to prioritize and organize your work shift. That is just as important as knowing how to manage the care of a patient with COPD, CHF, or Pneumonia. In fact, it is one of the things many employers want you to learn in that first year that so many of them require before letting you transfer intensive care units. How much prioritization and organization did you actually learn in school? Think back over the last year and be honest.
Now, here's something that you're going to find out when you go to a big city medical center to work on one of their medical units. Most of the patients are probably going to have COPD, CHF or Pneumonia. Surprise! When I finally got up the nerve and went to work at a big city medical center (and I didn't have any problem getting hired even though I thought
my Boondocks Community Hospital background was going to work against me--boy! was I wrong) I found that I was getting patients with most of the same kinds of medical diseases. There were a few differences since my big city hospital served the city.
- We got an awful lot of people who were homeless and indigent. When they came through the door, they were usually pretty sick and sometimes on their last legs. They had multiple medical problems. I got to see what happens first hand when people can't afford health insurance and are truly poor.
- We had a huge staff of social workers to address all the social problems that came along with the patients. Discharge planning takes on a huge significance. I found out first hand and many times over how to deal with a comatose patient whose family couldn't make decisions on care. I learned what was involved in getting a court order for guardianship for people who had no relatives to make medical decisions for them when they couldn't.
- We already knew about the "news" in town before it hit the TV and radio because the patients were coming to our hospital.
- Those diseases that you've never seen in a patient before you're still not likely to see all that often at the big city medical center either!
- They had great teaching resources and more advanced practice nurses than I ever knew existed. These nurses were constantly having inservices or classes. So, yes, there are learning opportunities.
- The bigger the hospital, the more your name gets lost among all the other employees and you get to be an "employee number" and a warm body.
Don't put down your current hospital or the work you do for them. Mark Twain said, "It's not the size of the dog in the fight, it's the size of the fight in the dog." That pretty much sums up the American spirit, I would say. Your practice and how you practice is all up to you. Whether you work in a little rinky dink place or a huge corporate giant, it still is all about how YOU
do your job. If you have the capacity to learn, then you will adapt as a situation calls for it.