med surge floor more stressful than ER?

[ffliper27]

HI:

I just started working on a med surge floor at a hospital where i live. I just came off orientation and now am on my own.. I find it extremely difficult handling 5 or 6 patients, even if I get help from the other more experienced nurses. Before I was hired to work on the floor, I had been toying with the idea of going into the ER. I know that working in the ER has to be stressful too. However, I keep thinking that it might have been less stressful if i had been hired in the ER as opposed to med surge. Can some of you experienced nurses share some feedback on this scenario? Is the ER relatively less hectic / more manageable than a medsurge floor? I'm thinking about asking for a transfer to the ER if I feel that I'm not going to make it on my own on the floor.

thanks

[Sun0408, ASN, RN]

For a new grad, it will all be very stressful no matter where you go.. ED manages just as many pts as med-surg but its not the same 5-6 all night.. They move one out, just to get another in its place with orders, vitals, assessments etc on each..They deal with codes constantly, critical pts that need to get to the ICU, MVA's, CVA's, MI's and many more all in a matter of a shift. It is very fast paced.

Med-surg is its own beast, yes it is also stressful and as a new grad overwhelming. Please give your self time to adjust, hone your assessment skills, delegation, learn your meds, etc.. If after 6 months to a year, you still feel the same, try for a transfer but transferring now will not be any easier.

Sounds as tho you have a supportive staff around you and trust me, that is a gift.. You will get better, faster, more well everything. Ask for help, ask questions, read on your down time but also give yourself that much needed break :)

Wishing you the best

[amarilla, RN]

OP, are you a brand-new nurse or new in acute care? If so, jumping from frying pan into the fire isn't going to be any less stressful. I'm a newer nurse - only a couple years now - and I spent those first two years in med-surg and float pool before leaving for the ED. When I oriented on my first-ever floor, I wanted to quit...I was overwhelmed, scattered, exhausted and totally defeated in ways no other job had ever asked of me. I would have loved to have 5-6 patients; we often had 7+ and later, 10. A good day with a few small successes would be followed by a never-ending shift where I couldn't seem to do anything right. The growing process was fairly painful over the first year, as it is for most of us. If you haven't visited the 'First Year After Licensure' Forum, wander over there - you're going to find out that we all felt as you do, and it passes with time and skill development.

Managing patients on the floor teaches you how to prioritize your time, develops your assessment and technical skills, and give you a knowledge base to work from if you choose to move on to another specialty. My time in med-surg was difficult also, but it gave me something to build on to transition to different forms of practice. In the ED, you will also have 4,5,6 (or more) patients, but there isn't a report, a chart to look through or assessments to go from. Some patients are poor historians, are found down or are otherwise unable to even give you a history or information to work from as you try to assess them and discover what's wrong. You won't be waiting for orders; you should be thinking and working ahead based on order sets, physician preference and protocol. Patients can come in at a trickle or flood; you might get three at once who all need lines, labs and workups *now* while one waits for discharge and the charge is yelling at you to give report to the floor to move another. When your rooms are full, you get patients in the hallway or others still in the waiting room. You are expected to be able to quickly assess and prioritize those patients as orders roll in fast and furious; this is total turn and burn on your own, while families are glaring at you from around the curtain, docs are questioning why you haven't gone with so-and-so to CT yet, someone's yelling at the desk and your (supposedly stable) patient with a rash is suddenly on the floor, flushed and sweaty and clutching his chest. This isn't easier, it's a different set of skills and much more demanding of everything you don't know yet.

Give it at least six months, if not a solid year after orientation, IMO. If you can't wait, try a shadow day...it might not be what you're expecting. Had I started here, I wouldn't have made it through orientation. Good luck :)

[hodgieRN]

ER is freaking insane. If your hospital is a level 1, 2, or 3 trauma center, it's crazy. If this was posted in the Emergency Nursing section...oh man...be prepared for the replies!

[Ernurse2012]

Leaving Med Surge for the ED it will be crazy believe me I know first hand. I did it and now I'm back in Med surge it's crazy in the ED I cried more than I did as a new nurse on med surge!! Hectic environment I sometimes had 10 pts to care for and asking for help from other nurses was hard cause everyone was busy. You hit the ground runni g and never stop! I didn't like it at all.

[angelia.price]

I work on a very busy med/surg unit we usually have 6-7patients. I rarely get lunch and breaks are nonexistent. As busy as I am I don’t think it could ever compare to how hectic and busy the ER is on a daily basis.The hospital I work in is small but we serve several of the surrounding countieswhich keeps the ER hopping. I have never worked in the ER but I have passed through that department several times. If you ask me I sure don’t want to workin that department. I think if you are a new grad med/surg is defiantly very hectic but the knowledge and skills you gain are priceless. Med/surg is not for everyone but if you can stick it out for a while it does get easier and your time management skills will become better.