Metro or Rural ER?

[Evilfeline007]

I'm a nursing student in Canada and I have spent my entire life wanting to be an ER nurse. I guess I always assumed I'd have to go work at a level 1 trauma centre in a big city because I sort of assumed rural ER s would be boring. I don't know why... People hurt themselves everywhere.

I met a new grad who works rurally (like 6 hours from nearest level 1 and 3 from the nearest small city hospital) and she said it's awesome because you get all sorts of crazy things coming in (accidents from hunting, snowmobiling, logging, etc).

So I guess my question goes to all the ER nurses out there... Which do you prefer and why? Id much prefer to live in the country, but will I be missing something when I work at a 30 bed hospital?

[Medic09, BSN, RN, EMT-P]

I've worked small city ER, and rural clinic and ambulance, as well as air ambulance. Overall, I prefer the rural setting. It really is a matter of personal preference. Here's my take: All the really definitive care is in the metro centers. You won't be sending a patient from the rural ER to cath lab or surgery. You may not even get to initiate stuff like thrombolytic care in some places. BUT, in the rural setting you initiate the critical steps before handing the patient to a transport team for the trip to definitive care. In the rural setting it is harder to keep up some skills; but when you get to use them, your actions are decisive in their effect to stabilize a patient and keep them going till they get to a higher level of care. In the rural setting you have fewer people to fall back on if something doesn't work as planned. So the limitations can be frustrating, and it is harder to stay sharp and up-to-date; but you provide a unique service. Of course, the environment is a big plus in the rural setting as well. Personally, I think the best route is for a provider to get the exposure and experience of the big city for a few years, and then take that to the boonies.

[LG1137]

If you want to live in the country, do it. You will get plenty of ED experience with time. The metro may offer an intense learning environment, but you are definitely not handicapping yourself by going rural. Just be sure to come back here and share your stories with us!

[hiddencatRN, BSN, RN]

I definitely prefer the city setting. But if you prefer living in the country, you might prefer working in the country too.