It's interesting to see the difference between nursing in a big hospital and a small country one. Separate wards for each specialty, critical care units, doctors on the ward 24/7, specialists in abundance, all the major services nearby, on-site pharmacy, and access to plenty of staff, plus good education makes the city hospital a fine place. The country hospital looks like the poor cousin in comparison - no doctor (of any kind) on site, one ward which takes all comers, no pharmacy on site, very limited radiography services, and the list goes on. Most of the nurses tend to be locals who've worked there for 20 plus years, with a few younger/newer ones thrown in. Resources are stretched really thin.
But for this nurse, it's a great place to be. My fellow graduates in the big hospitals may have all the luxuries and expertise available to them, but they are limited to the specialty of their current rotation. If you're in orthopaedic, you do only orthopaedic. If you're in renal, you do only renal. If you have your heart set on a specialty, then that's fantastic for you. I, on the other hand, in only 3 weeks, have taken part in "general" nursing (including pre- and post-op), palliative care, high dependency, and paediatric nursing, as well as the odd assistance to the midwives with maternity patients. It's exciting, but boy can it be scary at times!
Nurses here are "jack of all trades" and they truly have to be. The scope of practice is so much broader, and the nurse is often the real decision maker. On the flipside though, is the greater accountability. With more responsibility in terms of scope of practice, comes more responsibility in terms of your own actions.
It's very interesting to note the differences. It's something I'm definitely still adjusting to! Sometimes, with the lack of resources, you have to be a bit creative in your thinking, since not everything is available immediately as it is in a big hospital. But that's all part of the challenge that is rural nursing.
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