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Discussion

CVICU to ER

Hi all,

so I have worked in the CVICU at my hospital for almost 5 years and I started there as a new grad RN. I am currently in the process of trying to transfer to the ER at my facility or their sister hospital. Just wondering peoples opinions of making the switch from CVICU to ER. Also, I’m in a bit of a dilemma as I’m currently on day shift and really don’t want to have to go back to nights. My facility is a level 1 trauma center, but would be nights if I transferred to the ER. Our sister facility is a level 2 trauma center and I would be 11a-1130p which I think is like the perfect hours. I’m worried though that I’ll regret not staying at the level 1 trauma center. Just wanting to get some opinions. Thanks!! :)

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    Level 2 is typically the same level of clinical care, just without the residency programs; depends on your location and what kinds of traumas you'd receive. I actually prefer working in a Level 2 at the bedside (fewer cooks in the kitchen, I feel like dispo happens more quickly), but that is just me. I also love the 11a-11p shift, I did that for years. It's very busy, though — busy when you arrive and busy when you leave. It can be a challenge getting out on time because there is not typically an oncoming nurse at 11p to take your patients, so they have to get absorbed somehow (or a good charge nurse or flow person will stop giving you patients in advance to let you wrap up and get out).

    Can you shadow in each ER?

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    As for switching units, you will need to massivelly adjust your workflow. I tell new people, there is no later. You do it now, chart it now, because you will turn around and someone has discharged your patient or transported them upstairs. There is no later. You are are also not doing a deep dive into many patients. Healthy person with a fracture? I'm only going to rule out multitrauma, and I don't care when they last pooped or what their dog's name is. Typical time in a room with a patient ranges from 30 seconds to 5 minutes (for like starting an IV). You have to give up a lot and accept you won't get everything done, nor should you try to. You have to prioritize your workflow to what really matters. So have an open mind, and be prepared to exit your comfort zone! Good luck. Oh, and read Sheehey's book on ED nursing.

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    On 3/20/2019 at 7:31 PM, JessRNBSN said:

    Our sister facility is a level 2 trauma center and I would be 11a-1130p which I think is like the perfect hours

    Go for your sister facility! It can be hard to get days in a lot of ERs, but the more experience you have in the ER the better your chances will be of being day shift in the future. While I have not worked nights, I have many friends and coworkers who have told me the toll it took on them and the huge lifestyle changes it required.

    But if you're a night owl, have blackout curtains, and great insulation at your place, nights may be for you!

    Don't be discouraged by moving from level I to level II. I actually work in a level III, but let me tell you, that does NOT stop anyone from sending us level I worthy patients on a regular basis. Countless GSWs, brain bleeds, and full arrests have come through our doors. We usually stabilize and transfer out patients who require equipment or procedures we can't provide (when possible) but that means we still get hours of one on one with serious injuries. It's a great learning experience.

    Best of luck!

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    • Author

    Thank you all for your opinions and input. I really appreciate it! Unfortunately, I got neither job because they both went with someone with “ED experience” ? so I’m stuck where I’m at for now. Guess I’ll keep trying.

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    • Moderator
    On 4/19/2019 at 12:12 PM, JessRNBSN said:

    Thank you all for your opinions and input. I really appreciate it! Unfortunately, I got neither job because they both went with someone with “ED experience” ? so I’m stuck where I’m at for now. Guess I’ll keep trying.

    I'm sorry! Don't give up, someone will want your experience and see your potential. People are always coming and going when it comes to working in the ED. If you can, reach out to the managers and thank them for their consideration and ask that they keep you in mind for future positions.

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