ED a reasonable fit ? Or am I crazy?

[ivyleaf]

trying to decide if i should apply to ED positions. my experience is psych and outpatient (mostly primary care, some urgent care and specialty). i've shadowed in various eds and wanted to do ed pretty much since i graduated 10 yrs ago, but i (unfortunately) avoided doing med/surg first

I am mostly thinking about my temperment/likes/dislikes and whether or not it would be a good fit, at least for a couple of years

the main thing that draws me to the ed is the acuity (which i know is not the majority of the time.. lots of abdo pain, twisted ankles, URIs, etc), patient turnover, cardiac stuff, and the challenge/mystery of figuring out the presenting problem (although i know that's the provider's job), also the variety/not knowing what's next

Pro ED:

less monotony, i like the work day to pass by quickly

i kind of like chaos

i am calm in emergencies

i have a background in psych, detox, so im used to dealing with all sorts of people

focus on cc vs all body systems/head to toe assessment

teamwork

cons:

I am burnt out of working with personality disorders, malingerers, and substance abuse; i know i'll see a lot of all 3 in the ED

i have minimal tolerance for people for pain/med seekers after dealing with the above

i get frustrated easily at stupidity

i am kind of burnt out working with patients in general... i know that's horrible to say but i deal with it since i am not ready to leave the clinical arena quite yet -- just being honest here.

the last 2 are what worry me the most...

i want to gain more acute clinical skills and i dont like the idea of the more routine stuff on the floor and being stuck the same 5-6 pts for a whole 8-12 hrs

icu seems a bit out of my league since a) i have no med/surg background and b) im not a super perfectionist, im messy/not outwardly organized (my lines would not be neatly labelled), and c) more constant medical intensity than ED (depending on acuity of pts)

plus i am more of a big picture person than focusing on every little detail

although i really like the idea of my patients being sedated...

i know i likely won't stay in ed forever, but i want to get some acute care experience and try it out

thoughts? i am aware there is no perfect nursing job that matches what i am looking for, but i am trying to be realistic looking at the next steps in my career

[JKL33]

It looks like you have a decent pro/con list going! I have no problem encouraging someone with a 'pro' list like yours to check it out.

What I can't answer is this:

i know i likely won't stay in ed forever, but i want to get some acute care experience and try it out

I don't know how that would work (not questioning it necessarily, I just literally don't know...) I loved it my first day and never looked back and haven't left yet.

My first inclination would be that there's so much to learn...I don't know how the ED works as something to "try out" without having some kind of desire that you may want to do it for awhile. I hope our peers here with such a variety of experiences will comment on this for you.

Ask if you can shadow?

Good luck!

[ILUVERNSG, MSN, RN]

Maybe try and shadow an ER nurse during a 12 hour shift and see what you think...

My concerns here are that you say you have no tolerance for stupidity and malingering and 'drug seeking'.

You will encounter these IN SPADES along with a variety of other 'challenging behaviors' to put it nicely (staff included).

I have seen way too much lack of patience (and caring) already with burnt out, experienced ER nurses. I kind of feel like you might want to reconsider since you say you're already burnt out on patients. I feel like to be a good ER nurse, you must like people. ALL KINDS of people, LOL.

Also, consider the learning curve you will need to overcome- basic med surg, physical assesment, priority setting, time management, cardiac care, basic trauma, triage, ACLS, PALS, pediatrics, etc, etc, etc. It's an area where there is a lot to learn and you need to have grace under pressure.

I have been working ER 28+years and I still LOVE it. There is no place I'd rather work. It is fast paced, challenging and rewarding. It's also an area that you can get easily burnt out on since you see so much. It's easy to become hardened and lose empathy for all the nonsense. I've worked with lots of nurses like that. I've also worked with great and caring experienced ER nurses who still treat EVERY patient with kindness and respect. When I'm an ER patient, I hope I am taken care of by the latter.

Good luck in whatever you decide!

[SeaH20RN, BSN]

Of course you have to be a Little Crazy to Work in the ER.