Why do small hospitals get a bad rap sometimes?

[deespoohbear]

I work for an 85 bed hospital here in the MidWest. Our hospital includes a 7 bed ED, 4 bed ICU/CCU, 5 LDRP, 10 psych, 22 skilled nursing beds and 30 general med/surg beds. I think we have a nice little facility, but when I tell people where I work I always get: "Oh, I wouldn't take a dead dog to ......" I know that our hospital is not perfect, nor are we equipped to deal with every type of medical problem but we do know how to do some things. I don't know why our facility has such a bad reputation. When I talk to other nurses who work at facilities that are about our size, they say they get the same replies from the public. Why is it that most people think that unless you are a 600 bed teaching facility you are not capable of giving good care at all? The doctors who work at our hospital know quite well what the hospital can handle medically and what it cannot. They are usually pretty good about transferring a patient to a larger facility when the need arises. I always talk positive about our hospital to other people to try and improve our image. I point out the positives of our facility. We are JCAHO accrediated and always do well on our state surveys. Any thoughts from other nurses on this topic would be appreciated. I would like to hear from nurses who work in small hospitals, and nurses who work in larger hospitals.

[Mofe'ny]

I also work at a rural hospital with $240,000 lawsuit! Gee, thanks;)

We are now slowly working out of that though. We were projected to be $13 million in the red and are only $1.7 million loss at the end of this fiscal year!

I have heard a lot more positive things lately, including letters to the editor about the wonderful care received. I work in the nursery/ Level 1&2 NICU, and we often get calls from the Level 3 regional unit telling us what a great job we have done stabilizing our babies. We have also taken referrals for the Level 3 center when they were almost over capacity.

My nursing school clinicals were at a hospital with >500 beds and I must say that I really love the atmosphere that we have in the little hospital better. I can't speak for the rest of our hospital but we have a lot of teamwork that wasn't at the regional center. I really believe that it depends on the staff and MDs to set the tone for the public's perception.

[nurs4kids]

Is it actually the size of the hospital or the location that makes the difference?

I come from a small town and have grown up hearing the horror stories of the local hospital. Have been blessed and only been a patient in ER once. I picked my pcp by hospital affiliation so that I would NOT have to use this hospital.

I work in a hospital with 250 IP beds and numerous clinic and OP beds. The hospital is in a major city, surrounded by several 700+ IP bed hospitals. We are the only primary ped hospital for hundred's of miles, so this may be the reason, but we do not suffer from the "small hospitals rap". We have a wonderful reputation. NOW, what is very irritating about the smaller hospitals is, as a previous post stated, they often hold their patients too long before transferring. We routinely receive kids who are septic because they have been laying in a rural hospital for a week with a ruptured appy, being treated for gastroenteritis.

I tend to think the public sees it like this: bigger hospitals have more $$. More $$ buys better technology. Better technology draws better doctors. Also, small hospitals are in small areas. When something goes wrong in a small town, everyone knows five minutes after it happens. Something goes wrong in a big hospital, in a big city, the word is not likely to reach all the areas it pulls patients from.

just mho

[Jenny P]

I work CV-ICU in a 500+ bed facility, and we frequently get transfers from small community hospitals outside our metro area. Of all of the small hospitals we get patients from, there is only one that has a bad reputation-- when we here we are getting a pt. from there; we know it will be sick, possibly septic, and we automatically assign that pt. as a 1:1. I have warned my husband and kids to not even THINK of going to that town because "if you have a MVA, you'll end up in that hospital, you'll probably die." I don't think it's the nursing care there; it just seems like that doctor "practices" medicine and hasn't a clue how to cure pts.