Magnet Status

[loveishope]

I work at a small rural hospital. It is a critical care access hospital. We have 22 beds, ER, and an SCU. The hospital is not JCAHO accredited; it is run by the state. We do not follow core measures. I use to work in a large hospital which had magnet status and was JCAHO accredited. Small rural hospitals are run so differently than what I'm use to. There is no education department. The only floor is a med surg floor and some rooms in the back that are called SCU, which is really ICU because there have been patients on drips and vents. And the med surg nurses take care of the SCU patient and their other patients as well. Have any of you had experience with this? Also, there is no physician in the hospital at night, just a PA or NP in the ER. This is so very different from what I am accustomed to. Should I stay or look elsewhere? I want to protect my license.

[Esme12, ASN, BSN, RN]

They have to be accredited somehow, by someone, to get government money ie: medicare. Working in a critical access hospital is VERY different from any other environment. I don't like the ICU patients being cared for with other patients...What is that nurses patient load? In critical access small hospitals not much is kept in house that requires critical intervention. You don't need an MD in house the NP or PA is sufficient as long as there is also an MD available on call. Who answers codes and intubated when necessary.

It's a tough environment in smaller facilities as the burden really rests on the staff. Do you have adequate back up in supervision? Who is ACLS certified? Yes, I guess you are slightly more at risk in this setting and I always advocate carrying Malpractice no matter where you work. It's hard to judge from just what you said but I do become concerned when ICU patients can't be cared for properly if they are vented.

It's not an absolute run scenario....but I'd exercise caution....:)

[klone, MSN, RN]

I used to work in a smaller community hospital. Like yours, it was accredited by the state, not Joint Commission. There is a lot to learn from working in an environment like that, and I wouldn't dismiss it out of hand (btw, I don't think Magnet really has anything to do with it).

[HouTx, BSN, MSN, EdD]

I agree with PP - don't discount the quality of care provided by smaller & rural facilities. I a previous job, I worked with rurals for many years. At first, I was definitely influenced by my 'big city' frame of reference... basically, high tech means quality. I quickly discovered that this is a fallacy. High tech is needed to support more complex medical care, but does not really have any influence on the quality of nursing care. Our scope of service is not really defined by technology.

Small & rural facilities are much less defined by disciplinary "silos". They have a much more multi-disciplinary approach and greater opportunities for involvement in things that are beyond the reach of staff nurses in larger organizations... such as working with meaningful projects and quality efforts. The type of things that can really make a difference in your resume if you are looking for career advancement in your next job.

FYI, ANCC's "Pathway to Excellence" (http://www.nursecredentialing.org/Pathway.aspx ) program is a certification similar to Magnet, but definitely achieveable for smaller facilities. You may want to talk with your Nurse Executive to get the ball rollling - a task that is much easier in a small facility without the added layers of management in a larger organization.