Small ER VS Clinic?

[MassRN1991]

I need a little advice for some nursing fellows if you all don't mind!

Here is my situation:

I currently work in a health clinic in the city of Boston. I recently transferred clinics and as a result, different departments as well. I went from an UC department to an Adult/Family Medicine department. The clinic in which I am at now, increased my pay by $6 and hour, will certify me in ACLS, PALS, as well as IV's. The department staff itself is fine but the flow is much slower than I am used to. While applying for this before I was offered, I was applying for a travel job. Recently, I was offered a position.

I was offered an ER position in a small, small town in South Dakota. I nailed the interview. She was honest with me, said they're small and sometimes they don't see many patients but on other times, they're busy and need to use their critical thinking skills because of the lack of resources. It is a 9 month opportunity, however, I am worried that the pay is a little less than half what I am making now and not sure if the ER experience in a small town will help or hold me back in the my future. I need a nurses advice, especially seeing as I have a few days to make my decision. What do you all think?

Please advise! I like honesty (=

[ERnurse19]

So, I am not traveler, just happened to float across this as I am interested in traveling.

I used to work in a small, small (2000 ppl) town in South Dakota. The majority of my time spent at work was playing games, reading books, and trying to keep myself educated and not bored to death. It was not my flow, though I learned a lot when things did come through the ER cause we were a level 4, stabilize and ship out. We also handled the floor pts which was usually 0 to 2 pts.

I know work in a relatively busy ER in MN and love it! The hospital is actually what gave me the interest and experience to be able to get into another ER.

If you are interested in learning more on the South Dakota end, I can give you some insight. But good luck to you, whatever you decide!

[MassRN1991]

Hello!

I would love to have a little more insight if you have it. I need to make my decision very, very soon! Thanks, anything would help!

[ERnurse19]

Idk what you want to know. But I was there for almost a year and a half. I got through it by telling myself it was just a stepping stone job. Everything is so spread out in SD, had to drive a hour to get to a bigger grocery store or a Walmart. If you can handle the slow pace for a while, I'm sure it can help you further your work.

[twinkletoes53]

I am a retired RN. When I read your note, I was attracted by the fact that Boston was going to certify you in PALS, ACLS, as well as IVs. All skills that you will use now & in the future, no matter what field of nursing you find yourself working in, in the long run.For the educational value alone, I would decide to stay in Boston for now. Down the line, if you decide to work @a small ER, the skills you've learned now will be put to good use, as well.

Good luck with whatever you decide.

[akulahawkRN, ADN, RN, EMT-P]

I agree with twinkle toes. In a small ER you may not have high volume but if you're the only access in an area, you might get high acuity with little resources. Scary but could be a heck of an education.

I recommend making a list of the things you like and don't like about each and go with that. For what it's worth, Boston sounds like a better investment, so to speak.

I work in the ER of a small critical access hospital and this is a lot of what we get daily. We stabilize and transfer but we don't have the luxury of having a lot of transport resources either so we often have to really stabilize, treat while waiting a while, and transfer. Believe me, it is one tough education if you're new.