Being an ER Nurse, is it worth it?

[Levitas, BSN, RN]

Some back round info - I'm graduating from a Diploma based R.N. program this Sunday, and I had my eyes aimed towards Med-Surg. I'm even in the midst of interview processes for SSM Futures, in which I planned on asking for a M-S position. I'm definitely continuing education, and I am already registered to take BSN courses this next Fall (might even start with some of those additional classes in the Spring, granted I have the time). All online.

Well, recently I've come to find out that I've been requested by the Nurse Manager in the ER of our sister hospital to come fill out an application, and talk to him about becoming an ER Nurse.

I plan on applying, one way or the other, but I do not know if I'll be able to handle the expectations of an ER Nurse? Especially with no prior experience. I've read through some threads in this sub-section to read some of your experiences, et cetera, and I'll say it definitely sounds interesting.

I suppose I fear that it may be entirely too stressful? Would this be a poor choice in career while going to school simultaneously? Is the stress worth it?

Forgive me for asking, but I am curious: Do ER Nurses get paid more than Med-Surg, as far as starting salaries?

As I had previously mentioned, my first aim was towards Med-Surg. This was because I felt it would be good to get a solid foundation before attempting any specialty field. But I fear that if I pass up on the ER position that I will later come to resent it.

Aside of the above questions, can anyone share with me their career choices, how they feel about them now, when you started them? Any other graduate nurses that went straight into the ER? Your experience(s)?

[DavidDudley]

I plan on applying, one way or the other, but I do not know if I'll be able to handle the expectations of an ER Nurse? Especially with no prior experience. I've read through some threads in this sub-section to read some of your experiences, et cetera, and I'll say it definitely sounds interesting.

I suppose I fear that it may be entirely too stressful? Would this be a poor choice in career while going to school simultaneously? Is the stress worth it?

With no prior experience then a smooth journey is contingent upon how long your orientation is, the quality of your preceptor, and how cool the other nurses are with teaching and helping you after your orientation is over.

As I had previously mentioned, my first aim was towards Med-Surg. This was because I felt it would be good to get a solid foundation before attempting any specialty field. But I fear that if I pass up on the ER position that I will later come to resent it.

Aside of the above questions, can anyone share with me their career choices, how they feel about them now, when you started them? Any other graduate nurses that went straight into the ER? Your experience(s)?

I made the mistake of passing up on ER in attempt to go to med-surg and I ended up losing out on both opportunities in the beginning of my nursing career. From that point it took me 2.5 years to get into the ED. So if you have a guaranteed ER position on the table and the med-surg is not as guaranteed then the answer is simple: go with what's guaranteed.

I'm not a believer in the med-surg being a required foundation for other specialities. It helps, but not essential. The foundation is essentially determined by the quality of your orientation and work environment.

Now, as far as which route is the best option for you, I think you need to reflect on your personality type. People who get bored easily, have short attention spans, kinda ADD like, and always wanting something fresh and brand new with different challenges then ER is probably a good fit.

If however you like sitting on the same patients all day and dealing with their same problems all day and being in a structured routine then med-surg is probably more ideal for such a person. I take joy in the fact that if a have a crappy annoying patient that it is only for a short period of time and that I'm going to get them transferred upstairs asap.

I didn't go into the ER as a new grad but I didn't have any prior ER or hospital experience either. For me, it has been a liberating experience because I am finally working in an environment that best suits my personality.

[Anna Flaxis, BSN, RN]

Nobody can possibly tell you whether or not you can/should be an ED nurse. You're going to have to make this decision based upon what feels right to YOU.

I will share my own personal experience, as it may assist you in thinking about your own situation.

I started out on a high acuity cardiac/PCU/tele unit with little orientation, and I loved it and thrived there, up to a point. There were a lot of problems with culture, namely uncooperative CNAs and a Nurse Manager who consistently failed to address it in any meaningful way. Additionally, although I love cardiac, I felt limited and like I wanted to broaden my experience, so I transferred to the ED.

My experience was definitely broadened; I went from working with primarily older adults with cardiorespiratory disease processes to everything from pregnant women and newborns to elderly people on hospice with DNR orders who had been shipped to the ED despite a written order not to transport, and everything in-between. I learned so much and was challenged, to my delight. However, the culture in this particular ED was terrible. Nurses were unhappy, had very negative attitudes, the teamwork was lacking, staffing was inadequate, education practically nonexistent despite having a full time unit educator, and management ineffective at holding staff accountable.

So, I got out and did an infusion gig for a while. I loved that at first, learned a lot, started working toward CRNI certification, wanted to learn to place PICCs, but eventually bumped up against feeling really bored and unchallenged in the job that I held at the time. Plus, I wanted to relocate to a different part of the state due to my personal life drawing me in another direction geographically.

I applied for work in infusion, on a med/oncology unit, and in 2 different EDs, and in the end I chose the 7 bed community ED, and let me tell you, the culture is a complete 180 to my previous experience (the reason I chose this job). We have all the same problems with staffing and trying to cover holes in the schedule, but everyone is friendly and supportive and the teamwork is awesome. Everyone is held accountable for how they perform their job duties and how they treat others around them. It's making me love ED nursing all over again.

So I think, in essence, based on my experience, while the type of nursing you're doing will either be something you enjoy or not, the culture in the unit you're working in makes a big difference. And unfortunately, you won't really know what the culture is like until you are there, working as a nurse. The type/specialty is only half the picture, at least for me.

[Larry77, RN]

I'm curious why the ED Manager is looking for you to apply, do you know him/her or someone from that dept? If so, what do you know about the department, are people happy there? I ask because the good department's I have been involved in don't really need to recruit new grads...new grads and experienced RN's were applying in droves.

I agree with the other advice above. It used to be that I recommended a year on Med/Surg but lately it has become so difficult to break into the ED that I would never advise turning down an opportunity if you believe the ED is for you.

I do believe you should do anything you can to get into a hospital because that can be another very difficult hurdle, but once you are in the hospital world you can more easily move to different, more acute departments. It's very uncommon to come from subacute care and land a job in the ED or ICU.

Good luck!

[Esme12, ASN, BSN, RN]

If the ED nurse manager wants you....go for it...it will be challenging. Can't hurt to apply and interview.

[Footballnut]

I agree with Esme, nothing is lost by applying and interviewing. Go in with your good questions and find out what you want to know about working there. Especially check on what the ED will do to prepare you to work with them. We train new grads with a program especially designed to meet their needs.

As far as pay, every system is different. I am pretty sure you won't be paid less in the ED if that helps.

[hella_RN]

I started in the ED as a new grad and I absolutely loved it. Everyone I worked with was so nice and helpful and they trained me the "ER way." I was the same as you, I was actually anxious of starting in the ED right away because I wanted to do Med-Surg first to get some experience. Starting in the ED was a great move for me! I personally think it's easier to start in the ED than to start Med-Surg then switch. Also people won't expect you to know everything, I still ask a whole lot of questions to this day! Good luck with whatever decision you make!

[JB-RN]

I had the opportunity to either do telemetry or ED and am so happy I chose ED as a new grad. I immediately learned the mindset, assessment, and prioritization skills specific to ED. I didn't have to unlearn anything. However, I will say this. You need to really want to do emergency nursing to make it. You will be tested to your limits time and time again. I learned so much as a new grad in ED. 2 years later I continue to learn more every shift. If variety, chaos, and continued learning for the rest of your career appeal to you, go for it!

[Levitas, BSN, RN]

I really appreciate all of the advice, guys

I'm going to apply, and go for it. If I get hired, I might just take it. I've come to realize that I am a lot like what many of you describe as what it takes to survive in the ER. My Adv. Med-Surg professor used to always say that I would do good there as well. I just always felt like Med-Surg was the way to have a solid start. But if I can get in, I'm leaning towards taking it!

Thank you all, again. I will keep y'all posted on my decision coming soon!