Do you have to be an adrenaline junkie to work in the ER?

akulahawkRN, ADN, RN, EMT-P · Mar 30, 2015

ER = adrenaline junkie? Not as far as I can tell. It might be for the busy Paramedic... Like Med Surg, you just have to be willing to move quickly and adjust to situations fast. I've been an ER nurse for just over a month and I'm starting to get the hang of things, but I still have a ways to go before I'm ready to manage a full load. In a way, you almost need to have a distractable personality that you keep under control because you have to shift gears quickly. ICU nurse seems to be the kind that can hyperfocus on things because you're usually 1:1 or 1:2 with your patients and have to watch them closely and you get to know everything about them.

If you're working LTC with lots of patients, you have to develop a great sense of time management...

Everyone's personality is going to be a bit different, even within a given field. I work with people that are a bit wound up, some are quite laid-back, but they all can shift priorities quickly.

I suppose there's at least some truth buried in there to give rise to the generalization though.

Nola009 · Mar 30, 2015

Thanks for your answer. Maybe I am asking because one of my coworkers on med surg said she thought I'd be good in the ER. I couldn't believe it because I'm not great with IV starts, bad at tele, and don't see myself living for an adrenaline rush. I thought that's what the ED was about. I have no clue why she said that, but I can't stand med surg that's for sure.

KeepItRealRN, BSN, RN · Mar 30, 2015

To work in the ER you have to be a glutton for punishment. And in ICU you will see as much geriatrics as you see in the NH. Sometimes the only diff between a NH and the ICU is that the ICU is a NH with monitors, vents, and vasoactive drips.

flyersfan88 · Mar 30, 2015

I can't imagine you being happy in the ED if a med surg unit is "waaaaayyy too busy" for you.

RNperdiem, RN · Mar 30, 2015

See if you can get a chance to shadow in both departments and then decide for yourself.

ER needs a person who can "go with the flow" and deal with the unpredictable. In ICU, I know I will start my shift with 1 or 2 patients. They will have a diagnosis and a couple of working IVs. The ICU day has a structure of report, assessment, meds, doctors on rounds and making a plan for the day, assessment, etc. Now, the patients do get sicker, have to travel etc, but in ICU there is an underlying rhythm and structure to the day that I like.

In ER, you don't know what you will find: kids, adults, the actually sick, the people who don't need to be there and everything in between. ER nurses need to be able to change direction, re-prioritize and deal with many diagnoses.

akulahawkRN, ADN, RN, EMT-P · Apr 1, 2015

See if you can get a chance to shadow in both departments and then decide for yourself.
ER needs a person who can "go with the flow" and deal with the unpredictable. In ICU, I know I will start my shift with 1 or 2 patients. They will have a diagnosis and a couple of working IVs. The ICU day has a structure of report, assessment, meds, doctors on rounds and making a plan for the day, assessment, etc. Now, the patients do get sicker, have to travel etc, but in ICU there is an underlying rhythm and structure to the day that I like.
In ER, you don't know what you will find: kids, adults, the actually sick, the people who don't need to be there and everything in between. ER nurses need to be able to change direction, re-prioritize and deal with many diagnoses.

I've been an ED nurse for just over a month and I'm seeing this. You do have to be a glutton for punishment and you have to be able to kind of go with things a bit. What's "nice" about the ED is that I always have a physician close at hand so if my patient needs something, I have to just ask. You do have to be very flexible because so far, I've dealt with people from about 4 months old to right about 95. Many patients I've seen have very minor complaints and probably would do just as well going to an urgent care or even just staying home. Some have had relatively serious problems and we somehow manage to get them feeling better and back to their usual lives in a few hours. Sometimes we have to admit or send the patient to a more capable facility. Sometimes we're their last stop alive. Last week, I pretty much had all those in one day.

When I go to work, just like being a Paramedic, I really don't know what I'm going to see or do that day. I know that I show up at a certain time and I'm supposed to get off work at a certain time and that's about it.

I can certainly see (now) why the ED isn't considered "Intensive Care" because for the most part, it isn't. That doesn't mean that "Intensive Care" doesn't happen in the ED, it's just that doing that level of care is reasonably rare.

Looking back over that relatively short time since I started work, it's now obvious that my Paramedic experience was great training for having to mentally shift gears so quickly and deal with such a wide population.

I'm still very new to this... and I know where my performance will end up because I've worked at that level before, just not as a nurse. Very unique perspective. I'm still learning and I've got a ways to go before I'm ready to learn on my own.

Anna Flaxis, BSN, RN · Apr 1, 2015

Gosh, I hope not. I am a very detail oriented, love to know the "whys" of everything, and enjoy caring for the sickest of the sick, and I think I'd be good in the ICU, but I really love the ED. I'm usually flying by the seat of my pants, things are down and dirty, and there is no time for very many details. I've been doing it for five years now, and I always get good performance evaluations, so I guess I'm doing okay.

MatrixRn · Apr 1, 2015

What is real is defining what type of patient you would like to help.

Young vs old [you are going to see geris in all arenas unless you work peds or nicu]

Bed bound or a walkie talkie

Delivering a lot of education as in a surgical arena or not really talking to folks...as in a PACU

Do you like one and done [Think ER] or longer term

And define longer term....hospital or nursing home

Nonyvole, BSN, RN · Apr 2, 2015

If I want an adrenaline rush, I'll pay to go on a roller coaster. I hate roller coasters. No, I love the ER because it requires so many skills that I have , and I'm not talking about just the technical ones. Quick rapport with patients and their families. The ability to be flexible and quickly move from one thing top another. Critical thinking. The working relationships with the ER doctors, the hospitalists, and the residents. All the learning opportunities that the floor nurses may not get.

Okay, and because during school the ER was the only place I didn't get bored out of my skull. Me and planning a day don't mesh well at all even with a brain sheet; I happen to have ADHD that is only partially controlled so all that I can do is make a generic to-do list and hope that it all gets finished.

Bit yes, tyke stereotypes that ER nurses are trauma / adrenaline junkies and ICU nurses are brainiacs are just that. Stereotypes.

pugmom79 · Apr 13, 2015

I did floor nursing for 2 years and hated the monotonous routine of it. I'm in the ED and I finally feel like I am thriving as a nurse. It just depends on what you like. Others love the floor because of the routine. One is not better than the other. Just different.

RunnerRN2015, ASN, RN · Apr 13, 2015

I can't imagine you being happy in the ED if a med surg unit is "waaaaayyy too busy" for you.

This was my first thought as well. The ED would be "waaaaaaayyy too busy" x a million at times.