ER vs Med/surg- someone wanna clue me in?

Specialties Emergency

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Specializes in ER.

Hi guys. ER nurse of almost 2 years here. Never have worked anywhere else, thinking of picking up some shifts in med-surg. Wondering if I can do it? Obviously it is different on the floor, but how much different? Can anyone enlighten me? Any ER nurses actually enjoy med-surg? Thanks!

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Specializes in M/S, Travel Nursing, Pulmonary.

I'm a M/S nurse looking to get out.

I can't really say what the differences are since I am not so familiar with ER.

I can say, the experience will be.............enlightening. I LOVE getting with other departments and seeing things from their angle. I have a lot of ER nurses in here who I go to and get ER perspectives from. And, you might have some opportunity to show the M/S nurses that everything we think about ER nurses isn't true.

I think you'd fit right in. M/S is very.......general, never know what you will see. ER is the same though so..........you could really excel.

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Specializes in M/S, Tele, Peds, ER.

You'll be fine. Totally do-able. Especially if your ER is anything like mine and backed up with inpatients waiting on beds and you BECOME an inpatient nurse in the ER setting.

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Specializes in M/S, Tele, Peds, ER.

Oh, and one thing thats annoying about working the floors after working ER...

You know all that little stuff that you're allowed to blow off cuz...well... its the ER and your prioritization skills tell you ''that can wait'' because...it can? Well it all gets to be addressed and attended to up on the floors cuz...well.. you have that pt for the next 12 freakin hours...and its not the ER anymore. They're admitted, time to iron out those wrinkles. It drove...me....CRAZY!

I picked up a M/S travel assignment after working ER and all I could keep thinking was ''this doesn't matter! this doesn't matter! doing this affects your health/recovery in NO WAY! why am i wasting my time with this?!''

All those little things pt's love to have you do for them to make them more comfortable, their stay better, etc are all wonderful and, yes, important (in the pt's eyes...and Press Ganey's). And the nurse that does them is a saint.... I admire them truly. It takes a great deal of patience, and a whole new kind of prioritization. You'll be busy, but a different kind of busy. Some love it, some hate it.

Good luck!

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Specializes in M/S, Travel Nursing, Pulmonary.
Oh, and one thing thats annoying about working the floors after working ER...

You know all that little stuff that you're allowed to blow off cuz...well... its the ER and your prioritization skills tell you ''that can wait'' because...it can? Well it all gets to be addressed and attended to up on the floors cuz...well.. you have that pt for the next 12 freakin hours...and its not the ER anymore. They're admitted, time to iron out those wrinkles. It drove...me....CRAZY!

I picked up a M/S travel assignment after working ER and all I could keep thinking was ''this doesn't matter! this doesn't matter! doing this affects your health/recovery in NO WAY! why am i wasting my time with this?!''

All those little things pt's love to have you do for them to make them more comfortable, their stay better, etc are all wonderful and, yes, important (in the pt's eyes...and Press Ganey's). And the nurse that does them is a saint.... I admire them truly. It takes a great deal of patience, and a whole new kind of prioritization. You'll be busy, but a different kind of busy. Some love it, some hate it.

Good luck!

So exactly why I need OUTTA M/S. I walk around all day thinking "Who cares..........".

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Specializes in Trauma/ED.

Will be tough to not have the docs right there to change orders, I would hate to chart full head-to-toe assessments again, working with a ton of green nurses would drive me nuts, working with only "profiled" meds would be hard (all orders on the floors at my hosp have to be scanned to pharmacy, then profiled in Pyxis), and having to deal with difficult patients for days, maybe weeks...needless to say, if I need extra money I work agency in other ED's...not Med/Surg.

Things I would like would be a little less chaos, getting closer to nice patients and not having the docs so close :-)

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Specializes in Orthopedics.

I agree with what everyone else has said, though I've never worked ED, just observed and taken lots of reports on trauma patients. In the hospital I work in the floor nurses have to do the whole admission, so that's a pain. Then you have to figure out what they forgot to order (e.g. diabetes order sets on diabetics), call the docs or page them and wait for them to call you and be mad at you for interrupting them, meanwhile 2 or 3 of your patients are usually calling you. You are always busy, because they staff for the census. If the census is low you are cancelled, and if its high, you're extra busy. All that said, I love it. I get the same patients for 2 or 3 shifts in a row so I get to know them well and I learn quickly what they need and how to take care of them. I like doing all the personal care stuff and baths too so m/s is better for me in that way. Oh the charting is really extensive though...I probably spend 2 hours of my 12 hr shift charting.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

the difference between med surg and er is simple... as the others have already stated in med surg you are responsible for all aspects of patient care not just the chief complaint. i want to add a few more things.

first ed nurses do not spend much time with the same patient or much time with any patient!!!! on the m/s floors the best way to survive is to work 3-4 days in a row and to have the same team of patients give or take a two. also you have to get to know them well, which mean spending time with them in their rooms and talking to family.

not to mention that you may have more patients then you are accustom depending on your state or facility. i had 6-8 patients on nights and 5-6 on days without regard to acuity level. keep in mind that some of my former patients belonged in an icu and i had no way to give them one-on-one care that they needed..... in stark contrast, within the ed acuity matters to all (charge nurses and your peers) so that they can keep an eye on you to make sure you get assistance if you need help. on med surg floors there is very little help because all of the nurses are overwhelmed and no one pays attention to the pain of others (they have no time).

speaking of little help you receive on med surg... med surg is hard on your back!!! many of your patients are obese and immobile! you have no one to help you turn them at times. on the other hand, in the ed have yet to turn a patient on my own. not once!

last but definitely not least, the amount of wound care you must do the correct way and the amount of paper work you must complete is ridiculous!!! being a specialty nurse has its stressors but nothing compares to the trash you have to deal with in med surg. nothing!

in general med surg floors are poorly run. the good ones have no need for prn nurses. thus, if i need a second job (something i am considering in a few months) i refuse to work a med surg floor. i rather pick up extra hours outpatient if i cannot land another ed. gl!

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After working ER and medsurg, I would say ER is where you want to be. Every day you see different pt's and you get instant gratification helping people with acute problems. While on med surg i felt like all i did was run around pushing meds and answering call lights.

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Specializes in ER, progressive care.

I worked progressive care which has a different ratio compared to med-surg (1:4 as opposed to 1:6-7) but some days it feels like a med-surg floor. A lot of sick patients, a lot of total cares, a lot of patients who are immobile and cannot do anything for themselves. Now being in the ER, I agree...ER is probably where you want to be.

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Specializes in ED.

ED is the jam compared to the floor. I went to ICU/PCU and hated it. Not only do you deal with the patient for 12 hours, but sometimes the family as well.

Most people have this self-defeatism complex, 'Woe is me, I can't do anything.' Not a problem for the post CABG, hip fx or septic patient, not cool for the 26 year old with pyleo or abscess. Man up!

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10 years nursing, 8 in er, 2 in icu. In that time, I have done 2 floor shifts. Got floated.

Absolutely positively not for me. Not something I think I would ever adapt to, just like some people wouldn't adapt to er. 6 pt's, all have call bells, and 3 of them are actually sick. And some genius figured out that all patients should get meds at the same time- 2100, for example. As far as I can tell, this is physically impossible. The exception to this is when the same patient has meds ordered an hour apart. What moron thought that one up?

The funny thing is the assumption that as an ICU nurse, I would have no problem.

"How are making out?"

"Just ducky. About the same as you would be with a fresh crani and a vent."

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