After spending almost the equivalent time in the big city as I had in the smaller rural hospital, I can honestly say that I miss the rural hospital.
In the big city hospital, you have backup. Which is fabulous when you're a new nurse and still need mentoring, but since the backup is there you forget things like how to hook up an ecg, or where the syringes are (because you don't stock them), or what it's like to take a patient to xray.
There's something to be said about doing things ON YOUR OWN, and having the outcome be the same. Also, there's a smaller bunch of nurses, and since you are it, you get to do skills/procedures that there would be support staff (or more senior nurses) to do. For example, in the big hospital as a new nurse I probably wouldn't be a primary nurse in a trauma. However, in the small hospital, any nurse that is available is "a primary nurse" just because they need all the help they can get.
I also like having a mixture of cases throughout the day. In the big hospital, you're assigned to 3-5 beds and that's where you stay. In the little hospital, you take patients as they come in, usually getting about 3-4 each, depending on their acuity. Typically you get 1 high acuity and some lower acuity.
Most people assume that the periphery hospitals have lower quality care, and that the nurses may not be as good. I think the opposite: you have to know so much more to work rural, because you can't rely on anyone else.
One day, I'll feel ready to go back.
Friday, July 25, 2008
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