Is 1-year ED experience enough to apply elsewhere?

[RunawayN]

Hello! So I'm a new grad and I'm working at a rural Emergency Department. It's a nice little small place and we see a lot of different cases and I think ER are classified as a level 3 or 4 trauma center.

As much as I love working here, rural nursing isn't really for me. I have a couple of months until my one year anniversary so I'm wondering, do you think I have enough experience to work in another emergency room?

Of course i want to stay as long as I can buy moving someplace with more people would be nice.

Thoughts? Opinions?

[exit96]

A difference of $20/hr!?!?!!!!...Can I ask where this facility is? That's good info also about the difference in Levels, thanks!

I saw more in 3 months in my new job than I did in 3 years at my old one. Location: Rural northern California to urban northern California...

[RunawayN]

IMO it depends on your skill/critical thinking level and the diverse experience you have. I too work in a Rural ER, but I feel it has been advantageous because of the "interesting" demographics of the area. I mean, I have seen a lot of different diagnoses and traumas. I "think" and have also been told that in Larger ER's you might be on certain teams, and that may limit what I can "get it on." Correct me if I'm wrong, just going by what I was told, and it does make sense. In the small ER I am in on everything; gunshot, RSI, mental health, cardiac syndromes, sepsis etc.....BUT the larger ER is paying $5-7 per hour more, so I may gravitate that way when necessary.

Wow, it sounds like your rural ER sees a lot more types of patients then my rural ER. Our easy days can be 0 (zero) patients per shift and there have been times where I've gone days without having a patient walk in. Other days can vary of course but its never anything we can't handle (and we do send out severe patients to bigger hospitals once we get them "stable").

Wow, it sounds like your rural ER sees a lot more types of patients then my rural ER. Our easy days can be 0 (zero) patients per shift and there have been times where I've gone days without having a patient walk in. Other days can vary of course but its never anything we can't handle (and we do send out severe patients to bigger hospitals once we get them "stable").

To be blunt, then... your 'almost-1-year' of experience is less than 1 year in terms of patient contacts.

Mine was not as slow as you describe... I think my record low was three patients in a shift and I never went days without patients (I get part of why you want so much to move on).

Of course you want to leave but do realize that simply getting another job up the line is only part of the challenge... being successful and making it through orientation and probation is another part.

Honestly, you may not yet be ready to make a big move up the line... though it depends partly on you and partly how far up the chain you're looking to go.

You may be better off chilling for another year or two... and perhaps trying to land a per diem gig.

[RunawayN]

To be blunt, then... your 'almost-1-year' of experience is less than 1 year in terms of patient contacts.

Mine was not as slow as you describe... I think my record low was three patients in a shift and I never went days without patients (I get part of why you want so much to move on).

Of course you want to leave but do realize that simply getting another job up the line is only part of the challenge... being successful and making it through orientation and probation is another part.

Honestly, you may not yet be ready to make a big move up the line... though it depends partly on you and partly how far up the chain you're looking to go.

You may be better off chilling for another year or two... and perhaps trying to land a per diem gig.

Oh no, don't get me wrong. I love working at my ED and my population. For me, I don't know that many nurses that can treat a patient for chest pain and then, 30 minutes later, assist in a child birth all in one unit. One day, there can be a flood of patients with such different acuities and then, other days, it's one patient coming in with tumbleweed in their hair but we are it when it comes to health and the closet other hospital is miles upon miles upon miles upon miles of vast nothingness.

However, with that in mind, one reason why I want to relocate is because I live in such a rural area that there is nothing for me to do aside from work and home. And when working three 12 hour shifts per week, the remaining four days of free time are spent just waiting for my next shift. In my area, it's rural: there are no fast food restaurants, there are movie theaters, there isn't even a coffee shop. By 5pm, the town is quiet (not to say there was much going on earlier).

Yes, I would like to work at a hospital with more patients day to day but overall, as selfish as it sounds, I want to relocate to look forward to something that isn't my next shift.

[Lunah, MSN, RN]

I have to agree with ♪♫ in my ♥ -- your "one year" is limited by a very low census. Have you thought about studying for the CEN and kind of getting a feel for how versed you are in the gamut of ED patients? It might be a bit soon.

Lunah makes a good point about CEN.

The knowledge will be helpful for interviewing and the cert will help you get noticed.

Having come from a limited background was definitely an issue in my interview, which was mostly knowledge and scenario based (about 45 minutes of the 1 hour). It was challenging because it addressed patients and treatments that we didn't deal with out in the forest.

I recommend patience and preparation.

I also recommend keeping a contact log book, just for your own edification... include c/c, dx, tx and personal pearls.

Rural ED nurses rock... and learn to be independent and self-sufficient, and how to cope when the stool hits the rotary ventilator. Being from *** is a real asset, but it does take time to get enough experience.

Good luck to you.

[RunawayN]

Lunah makes a good point about CEN.

The knowledge will be helpful for interviewing and the cert will help you get noticed.

Having come from a limited background was definitely an issue in my interview, which was mostly knowledge and scenario based (about 45 minutes of the 1 hour). It was challenging because it addressed patients and treatments that we didn't deal with out in the forest.

I recommend patience and preparation.

I also recommend keeping a contact log book, just for your own edification... include c/c, dx, tx and personal pearls.

Rural ED nurses rock... and learn to be independent and self-sufficient, and how to cope when the stool hits the rotary ventilator. Being from *** is a real asset, but it does take time to get enough experience.

Good luck to you.

Very good ideas. I've been looking into the CEN (and even the TNCC). I should actually look into it more aggressively since I do have free time.

Interesting enough, I did a couple of "feeler" phone calls just to get an idea of how HR and nurse managers would feel about hiring somebody with my skills. The reaction has been positive (as opposed to when I used to call as new grad) but I will still be considered to be a new RN I nurse due to my inexperience in a large variety of cases. Not a bad thing because that would mean more training and I want to build a stronger foundation.

Hmmm, at least I have experience. Honestly, I'm just looking to relocate out of my rural area. If I don't find an ED job, I'll look for other acute/med-surg units.

Thanks for the honesty!

Honestly, I'm just looking to relocate out of my rural area. If I don't find an ED job, I'll look for other acute/med-surg units.

If you want to stay in ED, I'd suggest you bide your time out in the sticks until you've hit the 2-3 year mark and then look to get into the ED directly. I think it will be harder for you to go to the floor and then try to get back into the ED. Flip side is that ED is a high turnover job. Just concerned that cutting after only 1-year in a rural ED might not get you noticed over the competition for high-end ED jobs.

Thanks for the honesty!

Thanks for listening.

[Anna Flaxis, BSN, RN]

If you want to stay in ED I'd suggest you bide your time out in the sticks until you've hit the 2-3 year mark and then look to get into the ED directly. I think it will be harder for you to go to the floor and then try to get back into the ED.[/quote']

I don't necessarily agree with this. ED positions are highly desirable, and many facilities transfer from within, so a job on an inpatient unit might be a good way to get your foot in the door at a particular facility, as you might find it more difficult to be hired for an ED position from outside the organization. On the other hand, I've had the experience where recruiters have pigeonholed me as an ED nurse and not a "bedside" nurse (even though I do have past inpatient experience). Your mileage may vary.

I did pretty much the opposite from you. I went from a large urban Level 2 regional medical center to a smaller 7 bed Level 3 community hospital. The challenge for me is that sometimes I am the only RN in the ED, and we have no techs or CNAs. It's just me, the doc, and the unit secretary. This is a huge contrast from my previous experience in a large, busy ED.

I think coming from this background looks good on your resume, but I also agree that the very low census doesn't speak well to your ability to handle the high volume of most larger EDs. I agree that getting your CEN is a good idea, and maybe sticking it out for a little longer, like the 2 year mark. That's probably what I would do, although I also understand that feeling of not being able to stand it for even one more minute, and wanting to make the change sooner.

Sorry to be so unhelpful.

Good luck in your decision!

[RunawayN]

I don't necessarily agree with this. ED positions are highly desirable, and many facilities transfer from within, so a job on an inpatient unit might be a good way to get your foot in the door at a particular facility, as you might find it more difficult to be hired for an ED position from outside the organization. On the other hand, I've had the experience where recruiters have pigeonholed me as an ED nurse and not a "bedside" nurse (even though I do have past inpatient experience). Your mileage may vary.

I did pretty much the opposite from you. I went from a large urban Level 2 regional medical center to a smaller 7 bed Level 3 community hospital. The challenge for me is that sometimes I am the only RN in the ED, and we have no techs or CNAs. It's just me, the doc, and the unit secretary. This is a huge contrast from my previous experience in a large, busy ED.

I think coming from this background looks good on your resume, but I also agree that the very low census doesn't speak well to your ability to handle the high volume of most larger EDs. I agree that getting your CEN is a good idea, and maybe sticking it out for a little longer, like the 2 year mark. That's probably what I would do, although I also understand that feeling of not being able to stand it for even one more minute, and wanting to make the change sooner.

Sorry to be so unhelpful.

Good luck in your decision!

No no no, you were helpful! And I appreciate your input.

I'm guess what I could take from your comment is that each facility is different. I actually didn't think about if I get a job at a hospital and it's not the ED, I could transfer to the ED from within or I could also take a couple of per diem shifts at a ED.

I always wonder if the low census is hurting my nursing ability - "if I don't use it, I lose it" type deal...

le sigh...

[harrird]

Honest answer? Master your skills. You have some leeway at your first position, the people there still see you as a new grad. When you take the next position, you're going to be expected to just come in and perform. Maybe some light orientation concerning the new places specific computer software, admission procedures, etc. I noticed you started a thread 2 months ago about being new to the ED and having difficulty with IV insertions. Make sure you're ready. Best of luck.