ER RN moving to Trauma 1 Center

Specialties Emergency

Published

Hi all! So I am an ER RN with 4 years of experience at a remote, island hospital (not in the US, although I went to school and am licensed in the US). I'll be moving to a Trauma 1 Center in the states soon and am wondering what to expect in terms of the transition. Has anyone else moved from a smaller, community hospital to a large Trauma 1? Any advice/recommendations/suggestions?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

In going to a Level 1 trauma center as an experienced ED RN, I found that the biggest challenge was just learning where the supplies were and how to move my patients toward dispo (i.e., making sure that all ordered labs/studies were completed, results back, etc.). My biggest frustration was patients holding for beds — some days it was super exciting to get a fresh workup!

I have learned that wherever you go, the ER is the ER. You'll see the common complaints — chest pain, pulmonary issues, stroke, abdominal pain, addiction, psych, surgical patients, OB/GYN, renal patients, ortho, and the usual cast of characters. But at a Level 1 you'll get far more trauma, plus transfers from your outlying areas. For you, I would encourage you to attend the TNCC course if you haven't done that. And remember — you already know how to be a nurse. How long is your orientation?

Good luck!

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Specializes in Med-Surg, Emergency, CEN.

I'm actually going through exactly the same thing right now and I agree with PixieRN.

I just moved to a level 1 from the level 2 hospital. I went from being a student nurse to an experienced nurse with deep established friendships. But at the new place I don't know anyone, can't find anything, struggle with their different computer charting or some of their different equipment, or know any of their policies. It's awful!... at first.

However, I am slowly getting acclimated and apart from the one jerk saying "Why didn't you YYY, I thought you were already a nurse somewhere else," it's taken me a third of the time to adjust as when I first started at the ED in 2012. Mostly it's just FINDING stuff.

As a side bonus, while you are orienting you get guaranteed lunch breaks! And bathroom breaks!! Whee! You better believe I'm taking advantage of that.

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Specializes in Med-Tele; ED; ICU.

I went from a level none to level one and it was an abrupt change.

I saw more in a week at the urban teaching hospital than I did in a month at the rural facility.

In addition to the things mentioned above, it took a while to figure out how the medical staff worked: attendings vs. fellows vs. chiefs vs. residents at every level and the various consulting services... even what a "house officer" was.

It just takes time to figure it all out. It took a year or so before I started to feel fairly comfortable.

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