Advice for transitioning to ER?

[K1,RN]

I really want to work in ER.

Not a new grad, not a passing interest. ER is what I want.

I graduated in an economy (hiring) slump so ended up settling for primary care family practice where I have been for 3yrs.

Two options readily available to enhance my acute care experience are to pick up hours at an affiliated urgent care, and/or take an EMT class and volunteer as medical-only at my local fire station.

Which would you advise? Or both? And anything else I can or should do?

I have certificates for ACLS, PALS, PEARS and NIHS (stroke assessment).

My developed/trained skills include triage of adults and pediatrics, time management, interdisciplinary communication, care coordination, facilitating staff and patient education, and task-y nursing interventions such as IV starts, blood draws, wound care (acute and chronic), injectable medications, immunizations, ear washes, and assist with I&D. The triage I referred to near the top is over the phone to determine disposition of hospital, clinic, or home care advice as well as in-person walk-ins for acute symptoms including shortness of breath, chest pain, and altered mentation.

Solid advice for better shaping my career trajectory would be greatly appreciated.

Thank you!

[Emergent, RN]

It sounds like you already have tons of pertinent experience. That clinic type stuff was all new to me when I made the switch from various acute care units that I had worked in. If I were you, I'd pick up Urgent Care hours, there is a ton of overlap between that and ER. EMT is more of a first responder setting that I don't think would be as useful.

[liberated847]

EMT would give you the opportunity to network and meet many people at many different ERs, that's how I got my first RN job as a new grad in the ER. It truly is who you know!

[K1,RN]

I should clarify, the EMT part would be as a paramedic assistant in a rural area that has EMT-IV techs

[guest474423]

To the OP: I am involved in hiring at my facility and would echo the poster who suggested getting in at an Urgent Care.

Frankly, when I have applicants whose only experience is out-patient I am a bit weary and sometimes, if they interview poorly, it is reason enough to decline an offer. On the flip side, if you're a good public speaker and can really sell your skills in an interview then I might be inclined to take a shot. Our facility is so high pace that we regularly burn out our senior nurses (myself included) and really burn through new hires. I'd say we keep 50% beyond 1 year.

As far as EMS goes: I was a paramedic for many years before becoming a nurse. And when I took my first ER job they lauded my 1 year of ICU experience and said nothing about my 7 years in EMS. Nurses who haven't worked in EMS don't appreciate what EMS is. I do but I am the exception. Which is why I would stick with the Urgent Care option. There is a lot of cross-over and you can work on IV skills at Urgent Care!

Hope this helps.

[Maggie RN, MSN]

Absolutely!!! APPLY what are you waiting for. The ER is an awesome place to work. Start in a small ER to get your feet wet. You really have to learn how to manage your time management skills and have the ability to recognize unstable patient's and to triage appropriately. Learn from the experienced nurses around you! Every nurse who you work with will be an asset either to teach you things that are beneficial or things you will NEVER do. Listen to the MD when he talks. ER medicine is like cook book medicine. You know when say a patient comes in with CP you will get an EKG within 5 minutes, establish and IV, O2, labs, monitor, bp cuff, sat probe Nitro x 3 if the MD orders it, morphine ect, ect. It will be the same with similiar complaints. If you want it do it!!!!! NEVER LET ANYONE TELL YOU, YOU CAN'T!!!! Do not doubt yourself! Give 110%! Read! Educate yourself and pay attention to what's happening.... the little sutle things. You have to be able to take in everything. When you look at the patient you should be able to do a couple assessments just talking to them.

DO IT!!!!

[K1,RN]

Great pep talk :)

Problem so far is, I have applied (many, many times) and not been accepted. So I'm looking for additional experience, certifications, etc to make my resume more full/appealing to HR/ER managers.

[Loo17]

Great pep talk :)

Problem so far is, I have applied (many, many times) and not been accepted. So I'm looking for additional experience, certifications, etc to make my resume more full/appealing to HR/ER managers.

I don't mean to offend you so I hope I don't but have you thought about having someone look over your resume? In my experience, HR and managers look for keywords and traits within the resume when deciding who to call for an interview more than they look for certifications. Maybe your resume just isn't conveying how perfect you would be for the job. A good resume goes a long way and might be all you need to get a call.

Also see if you can schedule to shadow a nurse in the department. Even though that isn't an interview it gets you a foot in the door to make a good impression. Plus afterwards its the perfect excuse to send an email (with resume attached) to the manager thanking them for allowing you to shadow, how great the department was and how excited the experience made you about emergency nursing. And of course how interested you are in working in the department.

My honest opinion is that most managers don't care about certifications aside from CPR and ACLS. They care about hiring people they think will be a good fit for their department and adapt easily. They care about hiring people that are eager and willing to learn. Good luck!

[K1,RN]

Thanks! No offense taken :)

I have had several people (including nurses) take a look at and edit my resume, but a few more wouldn't hurt.

So far though, it seems the problem mostly is what I can't put on it (without lying lol); actual ER experience. Hence my question as to which additional experience is likely to help more.

The idea to shadow a nurse is good too.

I've always been told that shadows, clinicals, etc are like working interviews--even if they aren't hiring.

Thank you!

[Loo17]

Thanks! No offense taken :)

I have had several people (including nurses) take a look at and edit my resume, but a few more wouldn't hurt.

So far though, it seems the problem mostly is what I can't put on it (without lying lol); actual ER experience. Hence my question as to which additional experience is likely to help more.

The idea to shadow a nurse is good too.

I've always been told that shadows, clinicals, etc are like working interviews--even if they aren't hiring.

Thank you!

Good luck!

[DavidDudley]

Makes me happy to see your passion for ER. Its a great nursing career path. Getting in there all comes down to stepping stones and being at the right place at the right time. I agree with the other posters, go the urgent care route and build from there

[NP2BeNY]

I appreciate that you are not a new grad, but are ED Nursing fellowships (the ones that usually take new grads) an option near you? You'd have a leg up over the new grads with your outpatient experience.

Also, I disagree that UC is the way to go - you have outpatient experience, you've already proven yourself in that arena. What about working in a 23 hour observation unit of an ED, or an admitted patient holding unit attached to an ED? This would offer you the opportunity to network with ED staff and administration so they "know you" when an ED spot opens up.

I think the EMS training and experience can only help. I enjoy EMS, and that training and though process has only helped me as an ED RN.