Small hospital nurse..... big insecurities

[mainelydad]

I'm hoping to find some advice and support here. My nursing experience so far has been at a very small critical access hospital. 5 years on "acute care" ( a mix of medical and SNF patients), and 1 year in the ED. I feel my career is at a standstill, and there's nothing holding me back except ....FEAR! Maybe some of you have made the move from small hospital to larger and can offer advice.

[bearprn54]

Even the big hospitals are just alot of small hospital in a big hospital. I went from a larger hospital that I had been at for 20+ yrs to a small hospital (less that 150) on my first travel assignment. Talk about scared, I was use to doing things one way and had to learn new ways. But it is like that at each assignment and thats okay. I have been traveling now for 5 yrs and I have enjoyed almost every minute of it. I have been able to to places I have only seen pictures of. GO FOR IT- you will not regret it. You will regret not doing it. Look at it this way- if you hate it, its only for thirteen weeks.

[lost in texas]

I'm hoping to find some advice and support here. My nursing experience so far has been at a very small critical access hospital. 5 years on "acute care" ( a mix of medical and SNF patients), and 1 year in the ED. I feel my career is at a standstill, and there's nothing holding me back except ....FEAR! Maybe some of you have made the move from small hospital to larger and can offer advice.

i have been a medical/tele nurse for 7 years but my first job was at a small hospital which i worked for three years. take my word for it you will find that in the larger hospitals it's actually easier and more convient. in the smaller hospitals often times you have to do everything because they are not big enough to justify things like lab techs so you end up doing things that larger hospitals take care of. but the best thing about larger hospitals is that you will increase your skills and become a better nurse for it. teaching hospitals are especially good for learning. so don't be scared of big hospitals you actually have more support................good luck, bonnie

[smbrn]

I just finished up a contract at a large teaching hospital in CT after working at a small community hospital for 12 years. Hands down I prefer a small hospital. I did not find it at all convenient to have to wait for interns and residents to figure out how to handle the most routine of problems, nor did I think it was a particularly good learning environment for a nurse. The "teaching" part of it seemed only to apply to the residents. I was accustomed to having actual attendings to ask questions of if something I didn't understand came up. When I would ask questions of the interns and residents, most of the time they didn't know the answers. I wouldn't be insecure about it at all. There is nothing so magical or special about a "teaching hospital". As to whether they have more resources, I have to disagree with the writer who said they have more resources available. I was accustomed to having an IV team available if I could not get access on my own. We had a phlebotomy team, all kinds of things unavailable at this large facility. I suppose it depends where you go. I'm headed to another teaching hospital and if I were to travel to an area where I did not know the local attendings I probably would prefer a teaching hospital to having to deal with quirky, local attendings. I just didn't find it to be all that it is cracked up to be and you shouldn't feel intimidated by that kind of environment.

[mainelydad]

I just wanted to share my horror story, and tie up the loose ends of this discussion that I started. I decided to take the "leap" and went with Onward Health Care. My recuiter was very sweet, but she placed me in an inappropriate and totally hostile environment at a CT hospital. The hospital had complete online documentation through Meditech and they refused to provide me with any manual or guide to help me learn it. If any of you use it, you can attest to its complexity. Every time I asked a question eyeballs rolled and another nail went into my coffin. My contract was terminated after 18 hours! Onward Healthcare did not find me another job, so I returned home and have spent the last month securing a new job. Will I ever travel again??????? Maybe. But I would be much more selective in choosing a company.

[smbrn]

Sorry to year about your experience. I work with both Cross Country and Preferred Healthcare. My first contract was with Cross Country and had no problems. I agree. Learning these individual computer things is rough. I haven't used Meditech and am stunned, (though why should I be?), that they would expect you to know how to use it without so much as a proper inservice to it. Interesting to me that you had problems at a Connecticut facility. My most recent contract was at a large teaching hospital here in CT and it was quite an unpleasant experience. I did float at that hospital a couple of times, though, and had good days on the other units, so I have to assume that there were issues specific to that floor as opposed to the hospital in general. Actually, the experience was so horrible that I nearly gave up on travel nursing altogether but am giving it another try in hopes that my recent experience was just an aberration and not the norm. I used to do staff relief locally through an agency at two area hospitals and that was an easy, part-time way to learn how to "hit the ground running", so that probably has helped me, too. Any way you could join a local agency and do some hospital shifts at another facility for a while and see how that goes? The money is good and you might get exposure to different places, computer systems, and that kind of stuff. What a drag. All that time spent getting all the paperwork in order for a travel spot and then having it all turn sour on you. I'm sure it's nothing you did. Some of these places, including places I've worked on staff that employ travelers, somehow expect a travel nurse to know all the little quirks of their individual facilities without having to be told. I know my nursing stuff, as I'm sure you do, but got quite a bit of flak over stupid, institutional stuff I couldn't possibly know and that many of their own staff didn't know. Still, I'm going to keep going. Good luck. Would be interested in hearing how things are going and what you decide.

[bobblehead1]

this is to mainelydad--I have been to a variety of hospitals and I can tell you from experience that MEDITECH computer charting is by far the best and easiest to learn. I am now in a facility using the most barbariac system ever, EMTEK. Give it a chance, you will love meditech charting.

[telenurse85]

Try not to get too discouraged. I've had a couple of really bad experiences with hospitals and agencies but more good experiences.
When you consider a new agency it is always best to check Utimatenurse and allnurses forums to see what other nurses have to say about their experiences with the same company. This is a real Godsend when you've got a recruiter promising you the sun, moon and stars. Remember, you are usually a sales commission for most recruiters.
Also make a list of what you want in compensation. Mine: weekly pay, day one benefits, free private apartment in a safe area, everything furnished in the apartment right on down to the linens, all utilities paid, 24 hour on-call person at agency if there is a problem at the hospital, etc.
Then make a list of what you want in an assignment:
Mine: location, night shift, 12 hour shifts, decent nurseatient ratio, and area where I want to work, etc.
The healthcare facility will call you for an interview. Make sure you ask about all things that you are concerned with including how much orientation that you will be given and what method of documentation you will be using.
I am currently working through RNDemand out of Irving, TX and they have really been good to me. Another agency which I had a good experience with was Supplemental Health Care. Good housing, benefits, etc.
RNDemand even calls if I've forgotten to fax my timeslip on time. And Lisa Thurman (RNDemand) has even called just to check and see how my assignment is going. Plus, RNDemand pays for your license in any new state. Not just a reimbursement, they pay for your license up front! Weekly pay, direct deposit or overnight check, day one bennies, great housing, etc
Well, I hope that I've been of some help.
Again, don't give up. Just iron out all the details next time.