Small hospital stopping services?

[7vt0*8]

Hi all,

I've been a nurse for about a year now and recently switched hospitals to a small hospital of about 70 beds within the area. I recently found out that in January they are stopping Endo services. No EGDs or colonoscopies, and possibly stopping abdominal ultrasounds. I am a little upset about this because I did not know about this when I was hired in August. I like the hospital, but am wondering if this will have any harm on my med-surg experience and getting hired in a hospital in the future. The hospital also doesn't do cardiac caths or see dialysis patients. I like the hospital, but just don't like some of its limitations. It seems to be getting more limited. Let me know what you think. Thanks in advance.

[elkpark]

Small community hospitals, especially in rural areas, typically offer a limited range of services. Some are little more than urgent care centers with some beds. It's just not feasible, financially or staff-wise, for every hospital to offer every service and treatment. Smaller hospitals often focus on stabilizing people in the ED and, if the problem is anything at all exotic or complicated, transporting them to a higher level of care. Whether that is something that appeals to you is a v. personal decision. I started out my career many years ago in a small, rural, community hospital that offered a v. limited range of services beyond pretty basic, general diagnostics, surgeries and med-surg care, and some low-risk OB. If you had anything seriously wrong with you, you would definitely want to be somewhere else -- but the nearest big-city, full-service hospital was a couple hours' drive away. People preferred to stay in their home community if possible. I had a great experience there for the few years that I stayed.

Best wishes!

[7vt0*8]

Thanks for the reply. Can I ask, how did working in a small hospital affect your ability to work in a larger hospital in the future? Did it affect your chances of getting hired coming from that background?

[brownbook]

I agree with elkpark.

I never worked in a small rural hospital but know of other nurses who did. They had no problem being hired in larger acute care hospitals. In addition they had several skills other nurse did not have. They did their own lab draws, did their own respiratory care, did their own EKG's, etc. Nurses in large hospitals may not have these skills.

I just want to make sure your's is the only hospital in your immediate area? We had three hospitals in our medium sized city. One day the smaller hospital closed with no advance notice to staff.

[7vt0*8]

I am concerned of that happening too (closing down the hospital). No, there is a larger hospital about 35 minutes away that has about 180 beds. That was actually my first job, but I ended up leaving there due to a not so good situation with my manager. I chose the rural hospital due to its community setting but am concerned about the increasing limitation of services.

[klone, MSN, RN]

IMO, working at a critical access hospital should not affect your ability to get a job at a larger facility. Critical access hospitals often see a little of everything, and the nurses are required to float everywhere, so they tend to be quite versatile. That's a good quality to have.

[7vt0*8]

Thanks. It's not so small as to be considered critical access, but pretty close. There are a large number of med surg beds and there is a "step-down" ICU (not a full blown ICU, but close). But thanks, that does make me feel a bit more assured.

[elkpark]

Thanks for the reply. Can I ask, how did working in a small hospital affect your ability to work in a larger hospital in the future? Did it affect your chances of getting hired coming from that background?

I went from a position in my specialty at that hospital to a job at the large VA medical center in the nearest decent sized city without any difficulty. I wouldn't expect that to hurt your future opportunities. As klone notes, the kind of range of experience and responsibility you have in a smaller hospital, and the flexibility and versatility that results from that, can often be considered (and presented as) an advantage.

[7vt0*8]

Thanks for your comment, it's truly helpful and well appreciated.

[LovingLife123]

I agree with elkpark.

I never worked in a small rural hospital but know of other nurses who did. They had no problem being hired in larger acute care hospitals. In addition they had several skills other nurse did not have. They did their own lab draws, did their own respiratory care, did their own EKG's, etc. Nurses in large hospitals may not have these skills.

I just want to make sure your's is the only hospital in your immediate area? We had three hospitals in our medium sized city. One day the smaller hospital closed with no advance notice to staff.

I work in a big-city, large, teaching hospital. We do all of our own lab draws, ekgs, bladder scans, all of it.

We don't even have an IV team. Cost cutting measures!! Lol

[canoehead, BSN, RN]

I've done very small hospitals, for example labor and delivery with only one RN assigned to the unit, and ER with the same staffing. If help was needed I had to call for it. Working that way develops a whole different set of skills. You need to be able to delegate, and maximize use of the people you have. The maintenance guy can answer phones, direct traffic, and put lab results on charts. You need to be prepared with equipment, and knowledgeable, you won't have time to look up things, and there's no one to ask. Most of the quick thinking I had to do involved respiratory equipment, so I got good at that part.

When you interview emphasize your resourcefulness, ability to delegate, and management of crisis as a team leader. You can always learn new equipment, but those other skills are much harder to teach.

[7vt0*8]

Thanks, I really appreciate this post. You're right in the ability to be resourceful and to think quickly are good abilities to have.