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Hi, Moriah. Glad my previous posting was helpful.
In terms of hospital closings/combinings, etc., my guess is that nurses wouldn't find it too hard to find a new job. I don't know the stats specifically, but I know that even in Western New York, the medical field jobs, nursing included, are still in demand. Certainly you could find a good job somewhere from Central New York state westward, since there are many prospering towns from Syracuse westward. And the drive from any of these to your lakeside area in Ontario is very lovely, if you choose the older, more scenic highways rather than the boring (though conveniently quickl) Thruway. I'm sure that Googling around will find you more solid stats on nursing jobs in the region.
Regarding the commute: as others have said, unless there's an accident or a real intense snow storm, the commutes into and out of Buffalo are quite easy. Certainly nothing like the D.C./northern Virginia/southern Maryland madness. (My wife lived in Arlington, VA, and my brother lived in Towson and then Lutherville, Maryland, and I've driven into D.C. often, so I know how crazy and exhausting this can be. Buffalo does not have the equivalent.)
In terms of property taxes, it does help somewhat, of course, that you can deduct these from your taxable income. And I myself do think the quality of life and gov't. services & good schools you get for these taxes is worth it.
Buffalo is a hockey-crazy town itself, especially with the Sabres doing well these days. Very loyal to the Bills, too. (Anybody here remember the Buffalo Braves in the Ernie D days, by the way??)
Though some areas do sprawl--Amherst is pushing into Clarence, the last I was up there--there is an upside to the area's less than hot economy. Things change pretty slowly and on a sane scale, at a sane pace. You'll rarely see a lot of farmland disappearing into McMansions up there, partly 'cause the area is very traditionally minded, very loyal to what has been and should continue. And pretty farmland and some real wilderness are always just a 15, 25 minute drive away. And a drive or walk along Lake Erie (south of Buffalo--Buffalo's waterfront is a work in progress after decades of industrialization) can unclutter and uncrowd you very nicely. You won't feel crowded!
Twingirls2boys is right--some fine suburban hospitals around Buffalo (some of which rescued me from my boyhood bad judgments, like falling through the ice and also shooting a big nail through my own foot!).
And yes, you may want to think about an area between Buffalo and Rochester. There are a lot of towns and choices through there, many of them quite nice. The 30 or 40 minute commute you mentioned you could live with would give you a ton of choices in just about any direction. Some of the small towns up on Lake Ontario within this radius are really exquisite--very peaceful. On a clear day, your husband can wave a hockey stick at Toronto!
If you're set on Buffalo itself, do look over the many postings about it on different threads on this website. It's very a much a depends-on-the-neighborhood kind of city, and if you have kids, you really do want to be careful about where you settle (and for that matter, travel/explore) in Buffalo itself. It's my old home town, and I get teary-eyed thinking of it, so I don't say this glibly. Still a great town--true character--but dicey these days.
Best of luck!
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