ER Nursing vs Floor Nursing - page 2

by RN_survivor

8,268 Views | 16 Comments

Hi, ALL! I've been a Med-Surg/Tele nurse for about 5 years now, and I am planning to advance my knowledge and skills by stepping up to the next level, which is ER. --What qualities do I need to be an ER nurse? --What are... Read More


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    --good job! u convert that stress to some form of adrenaline rush and save people's lives!! but ER gets paid more right compared to floor nursing?

    I'm not sure how it works in the US...where I work in Canada our pay scale is based on years of experience, not necessarily the area you work in! So all 1st year nurses will be paid the same...all 2nd year paid the same...etc.
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    I am an ER nurse as well as SANE, so I will try to answer some of your questions for you.

    --What qualities do I need to be an ER nurse?

    You need to be assertive. You need to be able to think fast on your feet, and anticipate for the doctor will do. This is where it differs from the floor. You will not have a diganosis on your patient, you need to know your protocols like the back of your hand, and you need to be take initative. By the time the doctor gets in to see your pt, you should already have your pt worked up. Try to stay one step ahead. Also, you need to keep a level head in a REAL emergency (trauma, code, STEMI) and have a sense of urgency. You can't get flustered during critical times.

    --What are the certifications that I need to complete (aside from BLS/ACLS/PALS) to be more marketable in applying in the ER and the skills (and attitude) that I need to master to survive being in the ER?

    You will need all those and TNCC if your hospital is a trauma center. Even if your hospital is not trauma, it's still good to have TNCC. Also go for CEN about a year or so after being in the ER.

    --Aside from saving lives (which is the most important part), does the level of stress EQUALS the pay?

    In all honesty, I think I handle the stress very well. The be honest, I work well under pressure and I love the choas, the trauma and all the drama that comes with working in the ER. I work weekend nights and look forward to going to work every weekend. I know I'm going to be well entertained and it's worth the pay for me.

    --Are the doctors nicer in the ER?

    I work in a Level I trauma teaching hospital and I deal with residents and attendings. We work together as a team. The residents sometimes look to the nurses for advice. They will come to trust you, as well as the attendings.


    --How do u deal with (multiple) nasty family members in a professional way on top of being busy with other patients?

    Security.

    --Is it worth it if i leave floor nursing and be an ER nurse?

    Yes! I don't think I could go back to floor nursing, even if I wanted to. I sometimes work Stepdown and I count the minutes to the end of the shift.


    YES, i need your help. Doesnt matter if you're a new grad, experienced or retired Your advices, opinions and suggestions will be greatly appreciated!!

    THANKS!:heartbeat[/quote]
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    Quote from RN_survivor
    THANKS, 8mpg! Great advice of a real picture in the ER! so.. where would u suggest that i get internships / formal education from? do hospitals offer that? or is there like a training center for it?
    Your larger hospitals (say 300+ bed) will often have larger education departments and have internships once or twice a year. Look for any teaching hospital.

    And as far as salary....where I work in Texas, its based of years experience, not department. I got no raise going from MedSurg to ICU
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    I am a Med/Surg nurse and I currently work at an agency. They called me to ask if I could work in ED if they kept me in my scope of practice (which obviously to them that was taking vitals all night). It was really over rated. I was disappointed but happy I got the experience because the only patients that came through where children who cut their finger in the middle of the night, kid w/ snake bite, pain med seeker, stomach aches and it was BORING! Easy money but over rated. I kinda felt offended that they gave me triage but thanks for the free cash!! I will take it any time. ER on the other hand is not for me!
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    After a year experience as a tele RN, I got bored and transferred to the ER and have loved it ever since. As an ER nurse, you definitely need good communication skills, as you'll constantly communicate to MD's regarding anything from a patient needing more pn meds to communicating that 6th sense that there's something wrong with a patient purely based on experience. So yes, you'll need to be comfortable talking to MD's, assertive, critical thinking, etc.

    Qualifications: Besides what you've already stated....if you're going to a trauma hospital, they like TNCC certification or CEN.

    Are doctors nice?: Well, that depends on the doctor, and no, they're not nicer in the ER.

    How to deal with multi family members: Advice them that you're busy/ have sick patients that are higher acuity than their loved ones-- notify a charge nurse/float nurse to help you address their needs, and if all else fails and the family is still rude, then by all means call security (most ER's have them on stand-by) to escort them out. :smoking:

    Worth it?: It was worth it for me, but that's a decision you'll have to make by yourself.

    Good luck.
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    I've been an ER nurse for 4 months and have an eclectic background including psych, med-surg, pediatric/neonatal intensive care stepdown. The ER is everything I ever hoped it would be.

    --What qualities do I need to be an ER nurse? : you need organization, prioritization, strong instinct, team player attitude, and ability to stand your ground.

    --What are the certifications that I need to complete (aside from BLS/ACLS/PALS) to be more marketable in applying in the ER and the skills (and attitude) that I need to master to survive being in the ER? : TNCC and NRP will help you. I'm not sure personality wise exactly what to tell you. You just have to show you're hungry for it.

    --Aside from saving lives (which is the most important part), does the level of stress EQUALS the pay? : No, I am underpaid but my coworkers are what makes it worth it.

    --Are the doctors nicer in the ER? : It's 6:1, half a dozen to the other. Some are fantastic and some make you feel like you'd risk your life in an emergency to go to a hospital further away if you knew they were the doctor on....that's why being able to stand your ground in the ER is important and know the policies/protocols...because some will push the boundaries.

    --How do u deal with (multiple) nasty family members in a professional way on top of being busy with other patients? : This is easy. If you are emergent you have my undivided attention until you're through the crisis. It's about the patient not about the family, if they're in the way in the middle of the crisis then they will be escorted out until their family member is stable. If a non emergent patient or their family member is making a fuss while I'm in the middle of my crisis then they can continue to have a tantrum until I'm done or we have fabulous nursing supervisors who will be happy to reiterate this.

    --Is it worth it if i leave floor nursing and be an ER nurse? : only you can decide this.
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    I am a "float" nurse, so I work everywhere, but I consider ER my "home" so to speak. ER is not all excitement and trauma - lots of people use it as a free clinic and come for the STUPIDEST reasons. Because of that, I like working the floor (as I became a nurse to work with sick and injured people, not deal with BS). Having said that, I love the adrenaline rushes when they occur, and ER nurses seem to have a sharper sense of humor, which I enjoy. I also like having the doc right there instead of having to page them, and it does feel like more of a "team". But remember, even in a Level 1 trauma center, it is usually "feast or famine" in the ER: either all BS patients, or all really sick folks all at once. You have to be ready to deal with that, AND be able to take report (from EMS) and pitch in to help/be a team at a moment's notice - those things don't seem to happen as much or as well on the floor. Best of luck to you!


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