ED Nursing

Wuzzie · Mar 5, 2021

2 hours ago, Kbelle said:

Any advice for a new ED nurse switching from an ICU environment?

Yes, be ready to do a complete 180 when it comes to how your nursing care is delivered. The whole point of an ED visit is to rapidly diagnose and/or treat life threatening medical conditions, rule out and/or treat acute conditions, get some semblance of control over chronic conditions and then move the patient out so you can get the next patient in. Your assessments will no longer be full head-to-toe but will now be focused related to the presenting complaint. If you try to do the same assessments you did in the ICU you will slow things down and annoy your colleagues. You will learn why the AC is so often used for IVs and it will suddenly make sense and you will regret if you ever sniped at an ED nurse for placing one. You will learn that patients poop in elevators. If your ED sees pediatric patients it would be a good idea to take the ENPC course. BTW, a quiet baby in the ED is very likely a sick baby, watch them like a hawk! Don't be disappointed if the ED isn't exciting all the time. You will have long stretches of busy boredom followed by bursts of swamp-donkey butt moments. Oh, I have sooo many more but always remember that your ED nursing peers will aggravate the heck out of you and will also be your biggest supporters. It's the only way to survive!

JKL33 · Mar 5, 2021

This is a general ED tip not necessarily related to transitioning from somewhere else: You can treat people with basic human dignity no matter what their problem or presentation is. Don't get bogged down in choosing to "cope" by disparaging them, arguing with them, treating them poorly or gossiping about them. This represents a maladjustment in my opinion, not healthy coping--but you will see it a lot. You are going to be incredulous about some of the things you see and hear, just plan now to take it in stride, focus on what you need to do to get them safely to their next destination (which is what the ED is ALL about in a nutshell) and move on to the next.

Good luck! ?

Wuzzie · Mar 5, 2021

8 minutes ago, JKL33 said:

You are going to be incredulous about some of the things you see and hear

Oh yeah...this. Practice your poker face. It will save you from so many situations.

akulahawkRN, ADN, RN, EMT-P · Mar 6, 2021

21 hours ago, Kbelle said:

Any advice for a new ED nurse switching from an ICU environment?

Yes. Just to reinforce what was said above: you'll have to learn NOT to do full assessments. You'll have to learn to do focused assessments. I try to get my initial assessment and initial tasks done within that first 5 minutes. After that, I'm on to someone else. Somewhere along the way I'll get my charting done.

It's a lot like being a squirrel - never in one place for long, always moving, and always reevaluating and acting on the priority items as they pop up and change. I'm also big on jumping in and helping my fellow nurses with their tasks because many hands do make for light (and speedy) work. I accept help sometimes because I know this. Sometimes I refuse the extra help because I'm not too swamped and the offered help can be best used elsewhere.

Your knowledge and experience to date WILL be valuable. You just have to be able to refine it for the ED. That's a whole different beast but once you get the flow, it gets to be really fun.

Emergent, RN · Mar 6, 2021

I'll never forget the loveliest ICU nurse on the planet, Maria, came to work in our ED. The first week she gave a full bed bath to a little old lady, getting one of our scarce techs to help.

Eventually she got a better grasp of the work flow, and succeeded!