Nursing new grad wanting to develop trauma/ER skills: Better to start in rural ER or big city med unit?

[skihan]

Hello

I am currently graduating from a Vancouver,BC nursing school in a couple months, and looking for some opinions from experienced nurses here regarding where would be a good place for me to start.

The interest I have in nursing is for critical care and ER. I was wondering what you think would be a better option for a new grad nurse to develop nursing skills between practicing in a rural hospital or starting in a major city med unit. I have given myself two options.

Option 1: I have a job offer from a rural BC level 1 tertiary hospital med unit, with transferring to their ER in 3 months. The hospital is going to pay for my ER education, with 18 month commitment, with between $4,000 - $5,000/year in government subsidy for student loan forgiveness (not a big factor for me)

Option 2: I am currently finishing my preceptorship in a major Vancouver hospital med unit, and can apply for a position here once I am done. Or apply for other med unit jobs in Vancouver. If I were to stay in Vancouver, it may take longer for me to get ER training, but not too much longer.

I am more used to living in the city, but I am also open to living rural for a couple years as well. I am eventually planning on coming back to a big city.

So considering that I want to develop my nursing skills as quickly as possible, where do you think would be a better option? I realize there can be many individual and unit specific factors, but I want to hear some general consensus regarding what would be more appropriate.

Some of the factors I am worried about moving to a rural hospital are:

- Since the rural hospital is a level 1 community hospital, would I still get the acute care experience I would get in big hospitals?

- How would the rural hospital work experience considered if I want to work in a bigger hospital ER later on? Beneficial? or Less so because it was rural?

Thanks everyone!

[JKL33]

If you have the option, go big out of school unless you know you're never going to have any need or desire.

That experience will serve you well the rest of your career.

[Davey Do]

13 hours ago, skihan said:

Since the rural hospital is a level 1 community hospital, would I still get the acute care experience I would get in big hospitals?

I worked med-surg and ER in a small rural hospital back in the early '90's and it was called a band-aid station and not much more than that. Not that I didn't like it or learn a thing or two, but I never really felt like it was all that worthwhile of a learning experience.

I had worked at a larger township hospital in the '80's and, as an psych LPN who helped out in the ER now and again, I feel like I learned more there than at the small rural hospital.

So my answer to your question, skihan, is no, you probably won't get the experience you would get in a big hospital.

Good luck in whatever you decide!

[skihan]

16 hours ago, skihan said:

Thanks for the replies,

I am leaning towards staying in the city and trying to get my med experience here.

[ZooMommyRN, ADN, RN]

I started out in a very small ER in SW Florida, I saw WAY more fresh trauma there than I do now in a Level 1 Peds ER, the majority of our trauma cases now are what we call "recycled" and everything is basically done by the time they hit our bay. You can ask the managers what their numbers are and they type of patients they see the most.

[Subee2, BSN, MSN, CRNA]

How many beds are in the smaller hospital? "Smaller" is a relative word. I have worked in places from 35 beds to 759 beds.

[skihan]

On 3/23/2020 at 4:24 PM, Undercat said:

How many beds are in the smaller hospital? "Smaller" is a relative word. I have worked in places from 35 beds to 759 beds.

I would need to ask the manager but the rural hospital ER would have two nurses, with the med unit having 20 beds and 4 nurses.

[Subee2, BSN, MSN, CRNA]

Oooooh! Toy Hospital. Even smaller than the tiny places I worked way back. I enjoyed it but I had 10 years experience when I got there. Place that tiny isn't going to give you the intensive type if experience you will get in another place but might be fun for you in the future.