I don't normally iron my own clothes, but if I'm doing my husband's or tablecloths or something I'll iron with my right hand and the ironing board pointing left until my arm gets tired then swap it around to point the other way and iron left handed.
I have the smaller end pointed to my left, I'm right-handed. I don't really think it matters which way it is positioned, so long as it's comfortable for the way you work. I don't often use my conventional board, except for quick finishing touches. I have a padded bolster, a sleeve board, a table-top (smaller than a conventional one) board, a large bench-sized board (1m x 1.8m) that I made for when I'm sewing drapes or other big jobs, and I also have a garment steamer. I tend to use the sleeve board and my bench board the most.