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Canada, two groups of acute care nurses were compared on the work satisfaction variables of autonomy and nurse-physician interaction based on whether their workplace community population was rural (10,000 or less) or small urban (>10,000 but <100,000). For this analysis, the variable “size of community” served as a proxy indicator for hospital size. Kanter’s (1993) theory on the structure of power in organizations was the basis of the hypotheses. As predicted, the rural RNs (n=811) working in the smaller hospital organizations had significantly higher levels of autonomy [F(1, 1229)= 5.602, p<0.05] and higher levels of nurse-physician interaction [F(1, 1229)=27.78, p<0.001] than the small urban RNs (n=427). The findings suggest that the size of an organization or hospital setting does have an influence on the level of autonomous practice and interaction between nurses and physicians.