Question for managers who do the hiring

  1. I am a fairly new nurse working in the ER. This is not my dream position. Far from it actually. I have only ever worked in the ER. I am thinking about switching to a rehab floor. I am concerned if I transition to rehab I will be closing the door for any future jobs in critical care. Would you look down on a applicant for leaving the ER to go to a less acute area? Please be brutally honest with me. I'm worried I will always be stuck in less acute areas if I leave the ER now. Thanks.
  2. 4 Comments

  3. by   Wise Woman RN
    I work in acute rehab, hospital based, and I will tell you that you will need all of your skills. A fine-tuned assessment ability is key, as many of our patients are in our unit a little bit early. We have runs of PEs, cardiac crises, DVTs, brain swelling, etc, etc, etc.

    It kind of makes me a little bit disgruntled to know that some nurses think that we don't have skills and knowledge. I have been asked if we do blood sugars, blood pressures, or even assessments, let alone know how to deal with IV's. We are REAL NURSES, and our chosen field lets us be just that.

    I chose rehab 18 years ago and still love it. True, we don't do the monitors or other "cool things," but we are able to recognize when a patient is circling the drain, or acting like he or she has a ticket for that "angel bus."

    We send then to the acute floor because we don't want them to lose their days allowed by the insurance companies. We also bill differently than the acute units, and every test, every procedure, every new problem they may have to have dealt with comes out of our budget. Our payment for the patient is for the diagnosis and the amount of days allowed for the patient to be in rehab. When I have to send a patient back to the medical unit, it is amazing to me how many nurses will say, "the patient doesn't look that bad." Well, no, maybe not, but he certainly can't tolerate 3 hours of intensive therapy in the condition he is in...

    Too many times I have received a condescending look from a nurse, and a hint that we just don't have what it takes to be a "real nurse," or that we just want to get rid of the patient to make our job easier. We don't like sending our patients out, it actually is more paperwork for us, and we build relationships with them, so it's sometimes an emotional thing for us to have to let them go.

    So if you want to go work in rehab, come right ahead... It is a wonderful, rewarding area of nursing, and you get to work with patients, assessing, teaching, supporting them and their families, and and assisting them to regain their function and independence. We don't have all the bells and whistles of Critical Care or Med-Surg, but I will tell you, it's real nitty-gritty nursing, and all the skills and knowledge that you have will be utilized with rehab nursing.
    (off my soapbox, now)
    And I wish you well, whatever you decide... Follow your heart, and you will be happy in your career.
  4. by   PAERRN20
    Wise Woman RN- you truly are wise! My heart is not in ER nursing. I don't enjoy it, but I go to work and tolerate day after day. I am afraid if I stay longer I will become numb and I don't want that to happen. I want to see my patients improve, I want to really help them. The ER mentality of treat em and street em doesn't appeal to me. That's not why I became a nurse.

    I have never thought of rehab nurses as not being "real nurses". I admire the nurses who can help restore a patient from a total assist to an independent person. I only hope I can do that someday!
  5. by   Vito Andolini
    I don't think you have to worry about being forever branded. If you explain to anyone hiring who asks why you made a move from ER to Rehab, just tell them what you told us. I thik it shows good self-insight.

    How soon could you get into critical care if you waited for an opening while working ER?
  6. by   PAERRN20
    Quote from Vito Andolini
    How soon could you get into critical care if you waited for an opening while working ER?
    I could get an ICU now if I wanted it, but that's really not what I want at all. The reason I am concerned about critical care/ER is that everyone keeps telling me I shouldn't go into rehab. I have been a nurse for a little over a year and I'm young. I keep hearing from nurses as well as non-nurses I should stay in the ER for at least 2 years or go into critical care. But that's not where my heart is. I am interested in rehab, hospice, wound care, and nursery/post-partum. I know my ER skills will serve me well in any of those positions. I think I just need to follow my heart and not look back. Thanks for your input!