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Sunday, November 25, 2012

Large versus small hospital

When I first started out as a respiratory therapist one of the senior male RTs pulled me aside and said, "If you really want to harness your skills, I highly recommend you work for a large hospital, like Butterworth in Grand Rapids.

"If you work here you're going to lose your skills over time," he continued.  "And you're going to become complacent.  You need to work for a teaching hospital, a place where they have traumas, really sick people, RT Driven Protocols and lots of ventilators," he said.

"I think this small-town hospital is a great place to work, but it's nowhere to hone in your skills," he said. 

I kind of figured he was right, although being of a phlegmatic personality I wasn't motivated to hunt for a new job.  Plus all my friends were in shoreline, and I didn't want to have to make new ones.  Funny thing is, I met my wife while working, and when that happens you sort of give up your friends to raise a family.

So, in retrospect, and from discussing this topic with other bloggers and coworkers who work for large hospitals, I'd like to list some of the advantages of small town verses large town hospitals.


  • Forced to learn quick because you have to do it all for all age groups, and often you work alone.  
  • Lower patient load, so you may be asked to do things below your educational level, like EKGs
  • You'll also have to do breathing treatments on people who don't need them so the hospital can justify your existence. 
  • There's a greater risk for apathy
  • Low times allow time to do other things, like blog
  • Ability to spend more time getting to know, and taking care of, your patients due to lower patient loads. 


  • More intense due to more critical patients and higher patient loads
  • Can specialize in one area:  neuro unit, critial care unit, peds unit, neonatal intensive care unit,   adult general care
  • More protocols that can result in better patient care, and better morale
  • Patient overload, that can lead to burnout
  • Doctors available at all times
  • More risk for burnout. 
I could go on.  I'm still looking for a person who works for a large hospital to write me a post on life at a large hospital.  You can take any angle you like.  Let me know if you're interested. Or what you think.  

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