Opportunity-rural hospital or urban hospital

[DesiderataRN]

Hello,

I have decided to return to the bedside after 10 years of working in administration. I have completed an RN Refresher Course. I now have the option to work in a small rural ED (12 beds) or a Washington, DC med/surg unit-(39 beds) at a teaching hospital. Each position has pro's and cons. I would like for feedback from nurses that are currently working in the clinical environment. Below are the pro's and con's of each. Thank you in advance!

Small ED

Pro's:

Close to home

Structured orientation (They are offering a new grad fellowship-I will be allowed to sit-in on a couple of their courses, float to other units (e.g. peds), preceptor)

Cons:

Low salary

Limited diverse pt population

Teaching Hosp

Pro's:

Access to latest innovations

Diverse patient population

Higher salary

Opportunity for advancement

Cons:

1 1/2 hr to 2 hr commute

Basic orientation (1 week hospital, telemetry course-all beds are tele capable)

[belgarion]

Just curious-when you say'rural' exactly how big is the hospital in what size of town? i worked in a rural facility (60 bed hospital in a town of 6800) and it was horrible. No pixis machines, antiquated computer charting, paper MARS, no supplies, ect. Is this the norm in a rural hospital?

The town and the hospital I work inare both smaller than the one you describe. We don't have a Pixis either. Each patient's meds, except marcs, are in a lock box in the room. The narcs are locked in a cabinet in the med room. As far as charting goes, ours must be pretty good. Most of the agency nurses who fill in say they prefer our system to either of the "big" facilities in the area. We have paper MARS but the "official" MAR is on the computer. We use the paper copies for lining out our time. We usually have supplies so that isn't a problem unless we get an admission on weekends with unusual needs.

All in all I think the lower stress levels, lower degree of acuity, and MUCH friendlier atmosphere make up for a lot. As I said before, the only reason I am looking around is that there are a couple of areas I want to get certified in and I know it will never happen where I am.