I made the transition to full-time Ed about 18 months ago, after 24 years of Critical Care. It was the best move I ever made.
The transition? The most challenging (for me) was developing the Mental Map of the Ed Flow, and the priorities as they relate to ED. This is not to say that the Critical thinking and prioritizing is any different for the Ed, but coming from a background of being totally responsible for every
aspect of a patients care, to an atmosphere of shared responsibilities and trust in your team mates in constantly shifting priorities. (I did trust my co-workers in the units, this was just a "mind-shift" thing for me...
order in the chaos...embrace it!
I am taking every class I can to improve and/or enhance my ED skills.
The usual ACLS, Pals, NRP.
But also PHTLS. I would highly recommend PHTLS to anyone working the ED. I feel it would really help all of us to better understand the Pre Hospital thinking skills, expectations based on those thinking skills and priorities, and improve the continuum of care based on those expectations. EMS is a great resource, BTW.
I take my first TNCC Class this week. I think, like ACLS, it'll improve expectations and communication. Knowledge is never wasted.
Late 40's? I'm in my 50's. We have better than 30 beds and run 160 patients/day. Only a Level 3, but run a high acuity. I'm tired when I finish a 12 or 16 hours shift, ibuprofen is my friend, but I look forward to each and every day as a positive learning experience. It's a challenge, but a commitment I wish I'd made years ago.
You bring a lot to the table with your background and experience.
Being positive, open to learning, and ready for a challenge will serve you well.
Just my $.02 worth.
Best of luck to you.