Help :(

This post is really interesting to me as an LGBT nurse working in a small community hospital in a relatively rural area. I agree with above posters that you can learn and see a lot in a community hospital. Unfortunately it is often due to a lack of funds and resources but I definitely have more autonomy than I did when I worked at a larger hospital. You will definitely get to use your clinical judgment! One thing that can be difficult as an LGBT person is moving to a more rural area where people are not as accepting of LGBT people. I have had a few issues with this but find that once people get to know me their views tend to change or at least they are not openly hostile. I would definitely do some research and ask around about how LGBT friendly the areas are. I really hope it works out for you both in the relationship and the job if you decide to move. Keep us posted!

As someone who has had a VERY eye-opening experience with rural communities (seen the stuff in the news in the past week about the LGBTQ teen who was forced by the high school principal to read from the bible as punishment? Yeah, that my community), you may also want to consider whether or not a rural community in Texas is going to be very gay friendly or overall a welcoming, tolerant community that you want to settle into.

Edited to add: Or, what LibraNurse just said above.

But, in defense of small community hospitals, I can only speak from the perspective of OB/newborns, but the nurses I work with now are some of the best, most competent nurses for stabilizing unstable patients that I've EVER seen. If I had a sick newborn or preemie, there is nobody I would rather have taking care of them than these nurses. NICUs get them after they've been stabilized. These are the nurses who have to resuscitate and stabilize them before they're transported.

I'm sure it's quite similar for unstable big people, too.