What is it like to work in a good hospital?

[Green Tea, RN]

One day I was doing chitchat with my co-worker. She said she wanted to work at another hospital located a few hours away, but she mentioned it was very hard to get hired into the hospital because no nurses leave unless they retire. It made me wonder what it is like to work in a good hospital like thst. I have worked on medsurg and in OR at a hospital, and definitely the experiences were unpleasant. High turnover, low pay, intentional short staffing, punishment on use of PTO, poor benefits, the list goes on. If you think you work for a good hospital, could you share what you like about the place?

[adventure_rn, MSN, NP]

22 hours ago, Green Tea, RN said:

she mentioned it was very hard to get hired into the hospital because no nurses leave unless they retire.

That's definitely a myth. All hospitals have a constant degree of nursing turnover for all kinds of reasons--people move, they go to NP/CRNA school, they drop down their FTE to spend time with their kids. Even units with relatively high retention (like NICU) have constant attrition and are constantly hiring. Granted, hospitals with lower turnover may have fewer positions with greater competition for those positions (i.e. you may need to apply with a BSN and experience within your specialty), but there are always RN positions to be found. Have you checked that hospital's HR website to see what's available? I'm guessing there are RN jobs posted right now.

Some of the things you've described occur at the hospital level (like benefits and salary), but others are very much dependent on the unit. It's possible to be on a great unit at a crappy hospital, and it's possible to be on a crappy unit at a great hospital. Things like staffing, turnover, scheduling, and ability to use your PTO are often much more dependent on the unit itself than the hospital system (although hospital admin may put pressure on unit managers regarding some of those topics). Personally, I'd rather work on a unit I love in a hospital that isn't great (even if it means having worse salary/benefits) than work for a 'great' hospital on a unit I can't stand, and I've known coworkers who changed jobs for that precise reason.

One final thought: a drawback to working at a hospital or on a unit with exceedingly low turnover is that it takes forever to build seniority. We see this very often in NICU since the specialty has such low turnover. I've worked in NICUs where it takes 5+ years to go from night shift to days. Any time there's such little turnover, it means that you could spend years working a schedule you don't like (including nights/weekends/holidays) while building up seniority.

Some hospitals definitely treat their staff better than others, but there's no perfect hospital and no perfect unit; no matter where you go, the grass is always greener somewhere. Every job will have parts that are great, parts that aren't so great, and parts that stink, but you tolerate the bad parts because the good parts are worth it.

[choksantos, BSN, RN]

I realized that sometimes you make up a job far better in your mind than it actually is, then when you actually work, you realize it's not as good as you thought it would be cause of the standards you set in your mind.

[beekee]

I see these posts from the new grads about their “dream hospital.” Maybe I’m just old and jaded, but it’s not like one hospital is going to be so much better than another. Are certain units better? Sure. The whole hospital? Unlikely. It’s a job. It’s nursing. Chances are it’s going to kinda suck no matter where you are, it’s just a matter of degrees of suckiness.

[HelloWish, ADN, BSN]

I work at a good hospital and in a good unit too. They have a 94% employee retention rate at my hospital. You can ask the hospital about employee retention when you are looking for a position. They do exist!

[myoglobin, ASN, BSN, MSN]

Not sure about good hospitals, but there are definitely better states (like California) and worse hospitals/states (like Florida where I live). Almost every travel and agency nurse that I work with tells me that we are the worst (or second worst if they have been to Sanford) hospital they have ever experienced. A solid 50% fail to show up for even their second shift. I always tell them "just imagine that you are in a third world country, after a military coup during a natural disaster and that is us on a good day". Of course I'm exaggerating, but it does capture the spirit of our facility. I do find that the nurses tend to be nicer at worse facilities (perhaps because they have learned to live with lower expectation?). Some of the "best" facilities and most elite units where I've worked have also had some of the most difficult nurses to work with.

[Seeing Myself Out]

While some hospitals are better than others, I don't think there will be a place where I like everything. If I am having a good time I probably won't get paid for it.

[myoglobin, ASN, BSN, MSN]

6 minutes ago, Seeing Myself Out said:

While some hospitals are better than others, I don't think there will be a place where I like everything. If I am having a good time I probably won't get paid for it.

That's a really good point. There is a reason that Walt Disney World doesn't pay that great (for entry level positions) and have so many "barely" paid interns. Because it is a great place (at least perceived) to work. Back in the day in Indianapolis I had several friends who worked at the zoo and often complained that I made double what they did waiting tables. They could not understand that there is a reason that the zoo paid less, specifically because it was a relatively "more fun" place to work that the Pizza Hut or Max &Erma's where I waited tables.

[NurseBlaq]

20 hours ago, myoglobin said:

I always tell them "just imagine that you are in a third world country, after a military coup during a natural disaster and that is us on a good day".

? ??

Paging @Davey Do Gett'r done!

[OUxPhys, BSN, RN]

On 7/14/2019 at 10:11 PM, adventure_rn said:

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[OUxPhys, BSN, RN]

I haven't actually worked for a good hospital that you describe in your post but Id imagine it means having a high retention rate, good pay and benefits, safe staffing ratios, no mandating, etc. There are not a lot of them but they are out there.

[Hoosier_RN, MSN]

1 hour ago, OUxPhys said:

I haven't actually worked for a good hospital that you describe in your post but Id imagine it means having a high retention rate, good pay and benefits, safe staffing ratios, no mandating, etc. There are not a lot of them but they are out there.

Sadly, all it takes is a greedy bean counter or board of directors, or a bad manager to make it go south very quick