New Grads...Teaching Hospital vs Community Hospital

[Old.Timer]

As my name implies, I've been around for awhile, I'm over fifty. My early years as a new graduate were spent in a fairly large teaching hospital in a university town.

Obviously, situations and experiences vary greatly, but several of the recent threads and a comment by RubyVee reminded me of something I have always wondered about. What impact does the different atmosphere and priorities of a large teaching hospital vs a smaller community hospital have with regard to the development of a new graduate nurse. Do the new nurses typically experience significant differences in their overall feeling of acceptance and positive mentoring by the nursing staff, levels of confidence and satisfaction? Are they more able to develop respectful and collegial relationships with medical staff?

I have my theories and reasons why but think it would be interesting and enlightening to hear the thoughts and experiences of others.

[snowcone]

Community hospitals tend to foster a more chummy atmosphere among all levels of staff. Everybody knows everybody.

It is not unheard of to have nurses employed from graduation until retirement something that is virtually unheard of in larger city hospitals where turnover is frequent and encouraged.

It's not unusual to be working with the same medical staff that cares for you or your family in time of medical need. You may have the same doctor that delivered your children delivering your grandchildren. You may be assigned the same nurse with each admission if you are a frequent flyer.

There's more giving back to the community, less lateral violence and more long standing friendships formed.

[nebrgirl]

One of the "advantages" of a community hospital is in fact there is more people knowing everyone, on the other had learning experiences are limited, just because more serouis cases a quickly transfered.

[dizzybee]

My experience is as a new grad at a teaching hospital. Yes, the medical staff is often changing because the residents and interns are new every few months. And it makes for some interesting times when you have a new grad RN and new interns/residents, but there always seems to be enough experienced nurses around when you need them! We do get to know our attending MD's, as they are generally the stable ones that stay on the units.

I would think at a community hospital things would stay "as they have been" for years and years. Even after 5-10 years there you could still be seen as "the new nurse" and that would be a bit frustrating.

Plus, lots of experiences and interesting cases at the university hospital. It can be overwhelming at first, but you get some good habits and ideas of what you are looking for from these cases.

[helster83]

This issue has also been something I have been putting some thought into recently. I have worked in both environments.

I worked in a major level one trauma center in NYC as a new grad this year... and I was very disappointed with my experience. I had a preceptor who had zero patience for me as I was trying to learn (I was doing a 13 week orientation in the neuro- ICU, 8 of those weeks were on the actual floor). Anyway it didn't work out very well for me, learning became stunted, and that was it.

Before getting this position, I worked as a nurse's aide at a local community hospital. Honestly I felt more comfortable in my own skin, everyone knew me, when I was in the ER the nurses wanted to show me things.

Beforehand, I thought level 1 trauma center is the place to be the best nurse. Now I don't know. I suppose it all depends on your experience at hand. Some people I met on orientation at the major hospital loved it, others looked like depressed zombies or were suffering from the same conditions as me.

For me, I think I'm better off working small at a community hospital and building up from there, if I want to in the future.

[elkpark]

I've worked in both types of settings, and both have advantages and disadvantages.

[laurenicoleRN]

I have found that teaching hospitals are more willing to spend money than community hospitals. The teaching hospital I worked at was about to replace every single hospital bed, buy brand new top-of-the-line telemetry monitors, and had just had computers installed in the hospital rooms for the nurses to use for electronic MARs. It was nice to work somewhere where management wasn't constantly harping about the budget!!

[ReWritten]

I'm a new grad in a community hospital. I definitely agree that it's nice to have the whole "everyone knows everyone" feeling.

The downside is the poor funding we have compared to big teaching hospitals. I work night shift, and I'm lucky to have an aide. Especially the last few weeks our floor as been completely full... makes things pretty difficult and frustrating. Also, our pharmacy closes at 7pm. If we need a medicine not in the machine, we have to call House Supervisor to go find it for us.

And yes, don't get anything 'big' or 'interesting' cases, since they tend to be shipped out to a bigger city.

[elkpark]

I have found that teaching hospitals are more willing to spend money than community hospitals.

(That's because, historically, teaching hospitals have had more money to spend -- the Federal government has, for generations, given them extra money (not available to community hospitals) to compensate them for the extra expenses involved in the teaching functions they carry out.)