Looking for a change

Specialties Emergency

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I recieved my nursing license one year ago, and since then I have worked on a step-down telemetry unit. I have taken a Critical Care course, and have floated to ICU on occaision. I enjoy the work, but I feel like I am ready to move on to something more hands on. I really want to try the ED, but am having some reservations about it. I feel like I handle stressful situations well, and I love performing skills, and that I would enjoy the ED, with two exceptions. I am having some major reservations about having to work with kids, and I am still intimidated by doctors. I like kids, but I don't know if I could handle their crying and being unsure of myself talking to them on their level. And the doctors...I work nights and mainly deal with them on the phone. I am able to convey to them what is needed, but I am not comfortable enough with them to make small talk when they are on the floor. I know small talk is not in my job description, but I think it helps when you can have the level of ease with them. So...I guess I am looking for some advice, insight, anything. I wish I could just try it out for a few days to see if I like it, but the small hospital I work in is very selective about who they let in to the ED. Thanks!

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Specializes in Nephrology, Cardiology, ER, ICU.

Hi - what about job shadowing? Even 4-6 hours would give you a general idea of what to expect. You become more comfortable with peds patients as you become more skilled. Many peds things are more parent-related..ie the parents are new, young and may need education.

I have loved the past 10 years spent in a big ER - is there a chance you could get into a level one facility? They are usually big enough to provide an adequate (12-16 weeks for level one) orientation.

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Specializes in Emergency.

I thoroughly agree with TraumaRUs. It is not unusual at all to have RN's, students, or folks from other facilities shadowing in the ED. If you aren't sure about what you want to do, you should absolutely, positively get some time in a real ED before you leap. ED nursing takes a personality that is comfortable in, and thrives on, chaos. You have to simultaneously be able to work with belligerent addicts, frightened kids, people in severe pain and not-sick whiners. Your patient mix changes every 15 minutes or so and the status of your current patients might change more rapidly than that. Your mental "to do" list of priorities needs to be reassessed and changed constantly. Believe me, by the time you have finished dealing with the angry drunk who is insisting on urinating in the sink, a diminished senior who keeps trying to tear out his/her IV and the frightened parents of an asthmatic kid, any feeling of intimidation by doctors will be long gone. .... Anyway, get some time in an ED to see if its a place you'd like to be.

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Thanks for the suggestions, guys. This is a great website for advice.

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Specializes in Trauma/ED.

About the doctor thing...In our ED our docs go by their first names and are very very approachable with even minor requests. I came from a surgical floor where I dealt mostly with surgeons who seem to be the other end of the spectrum (cardiologists are probably similar to surgeons). If you can wake up an on-call doc in the middle of the night and feel confident then I believe you will do great with the docs in the ED. Docs are people just like the rest of us, very few in my experience actually believe they are Gods...lol.

The peds issue was my biggest concern as a new hire in the ED. Funny how I can not be scared at all by a 300lb psych patient (worked on psych for 5 years), but a sick 20month old scares me to death :) It does get better with a little time and if you can float to the ICU in your first year as a nurse you will probably do great in the ED, just be prepared to be on your feet literally for 12 hrs (or 8 if you work 8's).

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Specializes in ER, telemetry.

I wanted to work in the ER for a long time before I actually transferred. Peds scared me the most. Now that I have worked there a year, cathing and sticking an infant are routine. I still don't like taking care of sick children. I have 3 kids of my own and I still tear up when I have to take care of or participate in the care of a very sick child. But that makes me human.

And the doctors in the ER are HUMAN. They all have attitudes and bad days like the rest of us, but you get used to them, since you work with the same docs day in and day out.

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Specializes in ER.

Echo what others have said about the docs. They are your allies, not the enemy. You work with the same ones routinely, and you get to know them and they know you. It is a very comfortable relationship, and I have worked in a lot of ER's over the years. You take care of them and they take care of you. Most are very approachable and I don't have a problem coming to them for advice or offering mine!

I had a patient the other night who needed a large access for CT with contrast to rule out dissecting aneurysm. She only has a #22 in her forearm, couldn't use the left arm because of dialysis, and had no other veins we could find. Doc wanted us to use her dialysis catheter. This patient was not crashing so I was not about to mess with the dialysis catheter and told him I did not feel comfortable doing it. He put in an #18 EJ and we were off to CT.

Now kids are another story. I don't mind the kids so much as the parents! There are hospitals with kids ER's and cities with large childrens hospitals, but no matter what, you are gonna see kids from time to time. You just have to think differently, treat the parents the way you want to be treated, and remember kids are quite resiliant. They may be near death one day and running up and down the hall the next.

Good luck, ER is the most challanging place I have every worked, but I do love it. Maybe I am just a bit cracked! OK, OK, I am a little bit cracked.

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