Crosspost from careers: Switching Specialties to ER and Job offer-- please help!

Specialties Emergency


  1. Should I take the psych job?

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

So, I graduated from nursing school 5 years ago with my ADN. I *really* didn't like my experience w/ med/surg nursing during school and was discouraged by the high patient loads, constant running around giving meds and barely talking to patients, high number of tasks, and (I perceived at the time) lack of autonomy. Immediately after school I transferred to a 4 year college, obtained my BA in psych, and have been working as a psych nurse ever since.

I have worked at my current job in community mental health for 3 years; I do a lot of education and case management and supervise a wellness program and 2 nutritionists. Around February of this year I realized I was becoming bored with the job, not feeling challenged, and wanted a change. Since then, I have been looking at outpatient psych and case manager positions; I have been offered and turned down 6 jobs so far due to pay or feeling like it wasn't a good fit.

Over the past 2-3 weeks I have started to think about pursuing emergency nursing. I know it sounds random, but I loved my ER rotation in school-- I was just put off by the idea of having to do med-surg first. I have been reading a lot of posts about the ED setting, done some emergency nursing CEU's and bought books on emergency and critical nursing. I feel like I won't be able to find a position in the ER, as I have absolutely no medical nursing experience. So, I have been considering the idea of trying to get a med/surg position (which I think will still be difficult with my background) and trying to move on from there-- however, this seems like a long road-- first I would have to find a M/S position, then work there for 1-2 years, then find an ER willing to hire and train me. Most of the ER positions I have seen posted require previous ED experience.

So, in the midst of this, I was just offered a position as an inpatient psych case manager for a well known teaching hospital. The position is exactly what I was initially looking for-- However, I have been feeling really burnt out of psych in general this past few weeks, and more excited by the idea of going into medical nursing and ideally working in the ER. I am not sure what to do about this job!!! My gut is telling me to take it, as I am really fed up and burnt out at my current position, but I really want to try to find an ER job and am worried about starting something, feeling restless, and feeling compelled to stay at least a year (so as to not burn bridges or gain a reputation as a job-hopper).

If I didn't take it, I would apply to jobs in ER's and med surg positions, but I'm not sure how long it would take to find something-- I'm basically like a new grad when it comes to anything besides giving meds (I haven't done IVs or anything besides basic dressings since nursing school), and I don't know who would want to train a psych nurse with the skill level of a new grad, esp. in the ER!!

If I did take this job, it would be a good opportunity to be back in the hospital environment, meet the nurses on the different floors, and assess if I really did want to try medical nursing. Once I work for a hospital, I am assuming it would be easier to try to transfer to a different position than finding one as an external applicant. I am also trying to get a per diem job in the psych ER and considering trying to get a PD job in the geri med psych unit of a local hospital to get some more medical experience.

Any thoughts?? I feel so crazy, as I have been looking for a job since February and I am so ready to move on, but I don't want to end up starting something new and then wanting to leave!!

Any advice would be SO much appreciated!!

Take the job. When you have been there for a bit, perhaps ask if you could either cross train to the ED, or per diem in the ED a couple of evenings here and there. When ACLS or PALS come up, take them. A large teaching hospital is more than likely a place where this could be feasible. Or, hedge your bets and see if you can be per diem at a small community hospital in their ED every other weekend. I would take the job if you feel it is a good fit for this point in your life. It is a steady income, and what you know. ED can be for your off time, and that way, if you hate it, you won't be going back to square 1 again. Psych experience is a vital part of the ED, too. Good luck!

I don't know what area of the country you are in. Some areas hire new grads into the ER.

If you truly feel ER is your passion, go for it. Parlay your psych experience( very impressive) towards an ER position on you resume.

Good luck.

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