ED as a new grad?

[Maverickm808]

so this is for all the pros out there. My local hospital offers a transition program for new grads to enter ER or ICU positions for a first job. What are your opinions and views about critical care for new grads? Yay or nay, and why?

[RNcali22]

I started as a new grad in a level II trauma center. Super crazy busy and I Iove every minute of it! I go to work everyday with a smile. I work my butt off I earn every cent I make for sure. I so agree that a supportive team environment is a must because without that support I wouldn't have felt safe. I'm learning everyday growing and becoming part of the well oiled machine that is ER. Good luck and follow your heart

[Scrubs_n_sirens, MSN, RN]

I had to chuckle as someone who worked both ICU and ED when people are like-- "oh no! ICU can be too hard for new nurses, but go ahead to ED!"

Managing four patients (sometimes up to five) who could all be ICU level, trying to do full work-ups, hang meds, fetch a damn drink for every family member in the room because your PCTs have better things to do than play waitress, all while monitoring patients and keeping your charting up to par, helping the next zone over settle their ambulance, and OH LOOK! an arrest is rolling in....

Yeah-- don't play down ED like it's not hard :-/

Basically: no matter where you go, it will be a challenge as a new nurse. But you're fresh out of school and still in the mode to learn so if you plan on going big-- do it now! You'll learn much faster than of you go to a slow floor and habitualize to slow floor ways.

[Señor V, ADN]

Basically: no matter where you go, it will be a challenge as a new nurse. But you're fresh out of school and still in the mode to learn so if you plan on going big-- do it now! You'll learn much faster than of you go to a slow floor and habitualize to slow floor ways.

I completely agree with this. For one you said they are offering a transition program - so you won't be left high-and-dry as you start off. The hospital I worked at did the same for new grads but only for the ER - both managers I worked under in the ICU required 1 year experience. So man, I feel that this would be a great opportunity to start off strong in an area that you are obviously interested in - Critical Care. Do what feels right, especially if you have a passion for it. Good luck!

[synaptic]

all these nurses that say you should work the floor first are silly. the floor only teaches you how to hand out pills and time manage and not much else. Jump in the ER you will be fine.

I had a nurse tell me nobody should work anywhere but the floor for 5 years. Dumbest thing I ever heard. Maybe it takes them that long to learn but most of us aren't that dull.

[PHNMike]

Re: ED nursing, if it's right for you, you might never want to do anything else. I see ER nurses go to PACU, less commonly to ICU. In some ways ICU and ER are polar opposites. ER nursing is about emergent conditions requiring emergent, fly by the seat of your pants, no time to dick around implementation. ICU nursing can certainly get scary, but it's much more about being really, really anal about every lab value, every change.

[bgxyrnf, MSN, RN]

The single biggest difference between the ED and the ICU that I have been experiencing is that while I'm in the ED, I have a doc immediately available. I don't need to call and report what I see and what I suggest, I simply grab 'em and we sort it out at the bedside.

In the ICU, the docs are often elsewhere. Sometimes they're on a different unit (for example, when I was recently in cardiothoracic but my patient was a trauma patient, the trauma docs were either in the trauma unit or in the ED) and separated by a pager. Even at that, the trauma docs are less engaged with the non-trauma aspects of the patient's care and it can sometimes be difficult to get orders from them in those cases.

In the ED, even for admitted patients with ICU orders, the ED docs will step in and actively manage a crumping patient from the bedside while we're waiting for the admitting team to show up.

As an experienced ED nurse who's also picking up shifts on the units I can say with surety: The ED and ICUs *are* polar opposites with completely different mindsets. Part of why I do both jobs is because it is so challenging to switch back and forth between the two mindsets.

[Susie2310]

all these nurses that say you should work the floor first are silly. the floor only teaches you how to hand out pills and time manage and not much else.

I take it you've never worked on med-surg? Because if you had, you would know that med-surg nurses do much more than you've described. It's ok to be ignorant, but not so good to give advice based on ignorance.