Really Disappointed

[shavsha]

When I graduated I took a job in my small town at our smaller hospital. It had just gone through the process of merging with two larger hospitals in the area. I LOVE my job on med/surg (good nurse-patient ratios)- LOVE my schedule which works very well with my family (plus twenty-four hours a week is considered "full time" and has full benefits!) I have great my co-workers...so what am I complaining about? Well, over the past year I have seen the acuity level of our patients go way down. Part of the problem is that we have lost a few doctors to larger cities but a mostly it is because our new merged management is consolidating things. For instance all our our heart patients are being transferred to the largest of the three hospital where they just finished building a heart center. Now there is talk that they are thinking of our facility as a future rehab-type facility. Just recently they began sending the swing bed patients (ie could-be-in-the-nursing-home patients) from both the other hospitals here. Don't get me wrong. I love old people. But I feel like my skills are really beginning to suffer. I have had only two chest tube patients IN SIX MONTHS. Only two in traction. Seems like all the patients either have CHF or pneumonia.

Soooo...I am in a dilemma. Do I stay here, five minutes from my house, ride the wave and adjust my expectations. Or do I transfer, put up with a probably less-than-ideal schedule/shift and have a 30-40 minute commute one-way? Also, there is no guarantee that the nice conditions I now work under will not also change with the prevaling administration. Any thoughts?

[Anaclaire]

My sister commuted 45 minutes each way to a large hospital for over 2 years. She had a baby at home and a husband who is old fashioned (he didn't help much at the house). She finally decided to apply at the local small hospital, 5 minutes from her home, and has said she wishes she had done it much sooner. The patients are not the critical types and she knows her skills will suffer a bit, but she expects to live in the small town forever. Therefore she is happy with her decision. I'd say if you plan on staying in that town for your entire career and can change your focus in such a way as to accept and really get into caring for your changing patient population, then stay where you are and enjoy it. I'm telling you, the commute can get really old really fast. By the way, I have heard the same complaints about commutes from several other nurses. Good luck in whatever you decide. Oh yes, I do have some friends who work in a hospital in a very large city... they work weekends only. It takes them 1 1/2 hours to get there. They share a hotel room together (3 of them). They have been doing this for about 3 years and are happy with it. They have a standing reservation at the hotel and receive discounted rates too. Just a thought. Best wishes, Anaclaire

[OrthoNutter]

I drive 45mins to work each day....it's nothing really. I'd rather do that and work at a hospital with decent acuity so I can keep my skills up, than work at the hospital that's "just up the road".

[ceecel.dee, MSN, RN]

We have both at our small hospital; usually 2-4 skilled swing bed patients and the rest are acute. Our aids typically get asigned the SSB pts, and it is pretty good revenue for the hospital, as long as we don't need those beds for acute patients. If we do, then out they go.

Could you split the difference? Take a PRN position at one of the bigger affiliates and keep your regular hours at the more convienient place?

There is alot to be said for enjoyment of mental stimulation on the job, and it sounds like you miss it. Good luck!:)

[ERNurse752, RN]

I was going to suggest the same thing...could you keep your current job, and pick up some prn hours at a bigger hospital to keep up your skills?

Good luck! :)

[BBnurse34]

If you love your job you should stay. To me enjoying my job is the difference between giving safe care and giving great care. No one should feel like less of a nurse just because their patients aren't that acute.

[teeituptom, BSN, RN]

Howdy yall

from deep in the heat of texas

Do what ya goyya do, do some perdiem over at a bigger facility

[Dr. Kate, BSN, RN]

There's always the option of keeping current via classes journal reading. Consider getting and maintaining certification.

Skills don't really go away, all that happens is that you have to think through the skill rather than just doing it.

[studentdeb]

I would stay at the current job. I drive 40 min each way to work and would love to be 5 min away from home. Also, if I enjoyed my job, had a good schedule and was close to home, that would too good to be true.