need career advice rural ER

veetach · Oct 29, 2004

I am thinking about applying for a position in a rural hospital. I have never enjoyed med/surg and have floated a few times (at a previous hosptal) to ER. I am considered very thorough but not the fastest on things like venipuncture and IV's. I possess a calmness in times of chaos--although I may be churning in the inside. Also, I do not like peds. Given my weaknesses and strengths would I be wasting my time to apply?

if you work in a small hospital you will most likely be the only RN. You may also be required to take care of other hospital patients (ie ICU, CCU or med surg) If you have good IV skills (no one will be able to help you out) especially with Peds, and a good foundation in emergency nursing then I wouldnt worry about it if I were you. In my experience, even rural emergency rooms get patients that are sometimes very unstable. Pediatric patients are just a part of the ER. What is it about them that you dont like?

Trauma-tizedRN · Oct 29, 2004

I am thinking about applying for a position in a rural hospital. I have never enjoyed med/surg and have floated a few times (at a previous hosptal) to ER. I am considered very thorough but not the fastest on things like venipuncture and IV's. I possess a calmness in times of chaos--although I may be churning in the inside. Also, I do not like peds. Given my weaknesses and strengths would I be wasting my time to apply?

If you don't like peds...stay away from rural hospital settings. The ones I have done assignments at had tons of kiddies as many of the rural folks tended to use the ER the family pediatrician. I won't do them again. But not just for that reason. It can be pretty scary being the only RN on, with one doc. Especially if the doc is not quite up to snuff in a real emergency. I worked with a radiologist that moonlighted from the city for extra cash. Nice guy but yikes, after a few unstable patients I was ready to get the hell outta there. Not to mention the delivering woman who walked through the door with the baby hanging from her crotch. Or the fact that we had a med room in the ER stocked full of narcotics, the doc sleeping in the call room and NO SECURITY. Every time the doors would swing open I would shiver at the thought of some local yokel with a gun wanting drugs in the middle of the night. Lots of drunks and odd ones came through those doors. Lots of drug seekers making the rural rounds after being refused at city hospitals nearby. I thought it would be a fun adventure after being a city nurse for so long. Boy was I wrong. My 2 cents. :o

Maggie in NC · Oct 29, 2004

I think it depends on if you have been in a rural hospital setting in the past and understand the way rural hospitals operate-which is entirely different than urban and suburban facilities. In a rural area, the chances of having an urgent care facility nearby are rare so, the hospital is the mecca of medicine after hours and on weekends.

It also depends on your definition of rural. Example: We're 100 miles from Atlanta in a very rural area of NC but, we have quick access to major trauma centers via helo and there are 5 hospitals within 50 miles of us. Now, if you're in Alaska and there isn't another facility near you for 100 miles...

How about asking to speak to the current nurses on staff if possible before deciding?

weetziebat · Oct 29, 2004

I worked in a 20 bed rural hospital, on night shift. I was the only RN (we rarely had more than 5 patients) and I had a CNA with me. There was also a two bed ICU/CCU that often had no patients. If it did the ICU nurse stayed in there.

I did mostly med/surg., covered the ER, relieved the nurse in ICU for bathroom breaks and took care of postpartum moms and babes. Anyone coming in in labor, we called the L&D nurse and she came in for that. Sometimes we would have emergency surgery done and then I would also do recovery. One big happy family!

You do need a good solid foundation in med/surg. We rarely had peds patients, except an occasional kid in the ER - but that was very rare. The larger hospital was 30 miles away, and if need be, the helicopter could have taken patients to a large medical center 200 miles away. That is what happened with most major trauma cases. We never saw them. We often got MVA's - some pretty nasty, but the EMT's would call as they went out so that the docs could be handy when the patients were brought in. The docs all were at home, but could be there in 5 -10 minutes if necessary, and they always were there waiting for trauma victims.

We had 5 doctors, 4 of whom were lovely. We won't talk about the other one :chuckle. Rarely it happened that I could not get the IV started for an OR case in the morning. The CRNA always acted like that was the worst crises of his life, which irritated me no end.

The best part of the job was the autonomy that I had. No management breathing down your neck. The worst part was, as someone else mentioned, the pharmacy keys were in my pocket, and the ER doors, although closed, could be forced open easily. Also, patients coming into the ER can't be turned away cause they look like drug-seeking weirdos:rotfl:. And, more often than you would imagine, there were no patients in the hospital but I had to be there, alone, in case someone came into the ER.

Never had any problems though and I really enjoyed the experience. Luckily the CNA and I became close friends and it was a pleasure to work with her. Think it all depends on the hospital and the area of the country. I really never felt in any danger.

Good luck with your decision.

payday · Oct 30, 2004

thanks for your helpful responses. We have a several larger trauma centers about 40 miles away and pt's are lifeflighted there. I think I would probably need more of a solid foundation before I go rural because with the size of the hospital, I doubt there's much of an orientation.

Larger centers take new grads and have extensive orientations but this short commute to the rural hospital is best for my family, vehicle, weather...