Small hospitals/units bigger drama hotbeds?

[Emergent, RN]

I'm working at 2 hospitals, one very tiny. The drama level there is amazingly high. The are plenty of personalities at the bigger one, but people are very busy there, plus one personality is unable to have as big of an impact.

The tiny hospital has a lot of down time. When it does get busy, it lacks resources to be efficient or organized. There seems to be as disproportionate percentage of rogue personalities there I've noticed. And, the people who've worked there most of their career, frankly, wouldn't survive in a busier place.

I can't believe the amount of childish interpersonal squabbling there. Also, the skill level of some of the docs who work there appears questionable to me.

What are your experiences? What about clinics, those can be small and claustrophobic. Smaller units, also, can foster this as well. Thoughts?

[Scrubs_n_sirens, MSN, RN]

Meh. There's drama everywhere. I did feel like there was more when I worked in a small ICU as opposed to a bigger ED. Keep your head down, don't let me drag you in, and you'll be fine.

[Boomer MS, RN]

My experience was identical to yours. Three large Level I EDs: busy, busy, busy with some rare down time. One small 15 bed community ED with lots of down time, which was boring for me. I felt this down time contributed to disproportionate amount of time spent on Facebook, surfing the web and some individuals holding court. I agree there can be drama everywhere. The Department nursing leadership plays a most important role. In my situation, there was no authentic leadership in the smaller ED. Others' mileage may vary.

[brillohead, ADN, RN]

I think a lot of it depends on management. In a small unit, you can also have a bigger sense of "family" where people look out for each other. And in a large unit, you can have a lot of "strangers" who are more apt to gossip about people they don't feel a close connection to.

It all comes down to the mood of the unit itself, which in many cases comes down to how it's managed.

[AceOfHearts<3]

I agree that it probably varies a lot. I work on a small unit in a large hospital. I love my unit, especially when I hear other friends on different units complain about the drama and lack of help. We've had nurses float to my unit and one day one stated how surprised she was how 2 of our nurses jumped in to help her and how "that doesn't happen on many units". Made me super proud of the teamwork on my unit. I had what ended up being a rapid response the other week and before even having the chance to ask for help another nurse heard me in the room as she was passing by and just jumped in (this was before the rapid was called).

[NurseMegP, BSN, RN]

I work on a small unit in a big hospital and we've got a great sense of teamwork. I would hate to work on the other units on a regular basis who are full of themselves and not big on teamwork. I think part of it has to do with having a good manager who fosters teamwork, the other part is just not working with self-involved jerks.

[KatieMI, BSN, MSN, RN]

My experience is quite opposite and I feel that, although there is indeed drama everywhere, the places with the following chatacteristics are most affected, independently of the size:

- plenty of free time (read: nothing else to do);

- weak and inept leadership

- stable "core" of staff plus frequently changed outsiders

- predictable routine and environment

- excessive support services

In other words, if people come to work to sit about, have breaks and gossip, that's what they will have to do, and there will be drama. Running 12 hours like a chicken with its head cut off for everyone has its own internal benefits, one of them is not having any time for high-school like follies.