Small town healthcare is different.

My professional life has undergone huge changes recently. Working as a locum has been interesting to say the least. This is my first assignment, and to be honest, I am having a blast.

The most interesting part has been some of the things I have learned.

I take knowing the specialists in an area for granted. Trying to keep a sea of new names straight and remembering the process for dealing with them is interesting. I am lost most of the time. (Good thing the nurses know what is going on. I am so grateful they are so helpful. I really think I would be drowning without their assistance.) You do not just consult nephrology, endo, or GI. THEY DON’T EXSIST! So, I am looking up a lot of things I just don’t do often enough.

Small town medicine is different from medicine at home. The best way to compare it to my past experiences is to remember what it was like before I moved to the ICU as a nurse. I remember the mystery and confusion about how things worked after I transferred patients to ICU. Later, I moved to ICU so I could understand how critically ill patients were treated. I feel kinda like I am back on the telemetry floor, most things can be treated on the floor until they require more specialized care.

There is no dialysis. I miss dialysis. Dialysis is my friend. There is also no cath lab. I am not sure if there is interventional radiology or not. (I am pretty sure not.) This means that patients who need these services have to go.

I have a whole new respect for the hospitals that serve as major medical centers. I used to think it was dumb these little hospitals could not handle these issues. DUH! They don’t have the numbers to justify the expense of highly specialized services. That is why you have the larger hospital to receive the funneled patients from a large area. (It’s all becoming more clear!)

Living in a medical hub is quite different from living in a small town. I am not sure which I like better. The small town is interesting, and requires a broad knowledge base. I would think more importantly, it requires a certain sense of humility and practicality. You cannot be afraid to collaborate, and to admit when you are in over your head. It is very likely there are not four or five physicians following each patient, so you need to have a good grasp of basic standards of care for so many situations.

At some hospitals knowing hospital employees makes you a VIP, in these small towns everyone is a VIP. I love that. I think it is exactly how people need to be treated.

Mostly, I am thrilled to see so many competent healthcare providers in this small town. I suppose I always assumed people settled in these rural areas because they could not hack it in a larger hospital system. No… not so much. They are providing services for these communities and I am impressed. I am glad to be here. I cannot wait to see what other adventures are in store for me.


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