Emergency Nursing -- What's it like?

RN1982 · Apr 27, 2008

Hi all,
I would please like to hear some feedback as to what you like most about being an ER nurse. I originally applied in the ER but they put me on an oncology floor instead. I'm a new grad and really trying to find my place in nursing. I like working at a fast paced environment and can multi task. I'm worried about staying depressed on a floor like I'm currently working on.....I like stay busy and working night shift on this floor is making me wonder if I'm going to get bored, or not challenged enough.

Stay there for a year, get your skills down then transfer to ER. Some ERs won't hire new grads. Don't be upset. Think of all the things you will be learning on the floor. It will better prepare you before making that move to the ER.

TazziRN, RN · Apr 27, 2008

I loved it. I went into it as a new grad, but in retrospect I wish I'd gotten floor experience first. The ER has its own assessment skills but having assessment skills from inpt floors is an invaluable tool I lacked.

To answer your question, I loved making a difference. I loved the traumas and the acute medicals, and making a difference that could be seen immediately. I loved working as a team.

RN1982 · Apr 27, 2008

Maybe after six months on the floor, they'll let you transfer. It wouldn't hurt to ask if that would be possible.

RedhairedNurse, BSN, RN · Apr 27, 2008

I appreciate any advice you guys give me. BUT.....Will it really benefit me that much to have floor assessment skills in the ER? I really want to make a good nurse, but I've also been told that most nurses that are transfered from a floor to the ER generally don't last....they find the ER too overwhelming. I love trauma shows, ER shows....but I want good assess skills, so I'll do whatever I need to do.

mom2michael, MSN, RN, NP · Apr 27, 2008

I started out pretty new to the ER (I worked 12 or so weeks on a Tele floor as a GN/RN). Looking back, I have to say, I probably would've been a bit more comfortable in my role as an RN had I transitioned from another area before diving into ER.

I lacked a lot of basic nursing skills and assessment skills when I went to the ER and while the team concept exists in the ER, the harsh cold reality is a lot of time your team has their own fires to put out and you are left on your own. That's a HUGE scary deal when you are doing things you have never done before in your life.

If you really want the ER, it will still be there 6-12 months from now and in the mean time you can gain some seriously valuable experience where you are.

RedhairedNurse, BSN, RN · Apr 27, 2008

I started out pretty new to the ER (I worked 12 or so weeks on a Tele floor as a GN/RN). Looking back, I have to say, I probably would've been a bit more comfortable in my role as an RN had I transitioned from another area before diving into ER.
I lacked a lot of basic nursing skills and assessment skills when I went to the ER and while the team concept exists in the ER, the harsh cold reality is a lot of time your team has their own fires to put out and you are left on your own. That's a HUGE scary deal when you are doing things you have never done before in your life.
If you really want the ER, it will still be there 6-12 months from now and in the mean time you can gain some seriously valuable experience where you are.

thank you so much. that really makes a lot of sense to me and is kind of what i was wanting to hear. I really like the ER, but in clinicals it does seem to be a very busy place. And I do worry about having the necessary assessment skills and the necessary experience with meds. I just don't want to get too comfy on a floor and then go to an overhwelmingly busy place. You know?

mom2michael, MSN, RN, NP · Apr 27, 2008

I appreciate any advice you guys give me. BUT.....Will it really benefit me that much to have floor assessment skills in the ER? I really want to make a good nurse, but I've also been told that most nurses that are transfered from a floor to the ER generally don't last....they find the ER too overwhelming. I love trauma shows, ER shows....but I want good assess skills, so I'll do whatever I need to do.

You will use basic assessment skills anywhere in nursing you go. You will learn to trust your judgement because you learned such good basic assessment skills.

You'll also learn a lot of basic nursing skills, IV insertion, etc...

Let me tell you, I can start an AC IV on anyone, but I struggle HUGE with hands, forearms or any other place. That's because all my IV experience is the ER where ACs are the place to go for IV's.

Assessments are one thing I am NOT good at. In the ER you rarely to a head to toe assessment on anyone and that is a shame. We do more focused assessments and focused care while they are there. I work with many RN's that can not hear lung sounds or heart sounds because honestly, they don't listen to them very often and so it's hard to hear what is abnormal. And to chart a person with pitting edema....it's hard to do when you don't see it often. I'm good at charting a broken arm or a lac to the head but honestly, this is a huge fault of mine, other assessments are very hard for me to do and I do think it's because I came as a pretty new nurse to the ER.

Where you are now, you learn to care for the entire patient, their entire problems and you see a lot of co-morbities that will only help enhance you as an RN where ever you end up in life.

jaasea · Apr 27, 2008

You really need that basic floor nursing skill before going to the ED.

Telemetry experience, starting IV's, interpreting Dr.'s orders and responding to emergency situations on the floor are important skills before hitting the ED. It is a whole different world, but the basics are still your foundation. Not every patient who comes in is really an "emergency" and you wind up using the same skills you are developing on the acute units. Oncology may not be your favorite but you will have these same patients coming in to the ED. Every experience is a learning experience. Good luck!

TazziRN, RN · Apr 27, 2008

There are people who believe that you can go straight into a specialty area, and many moons ago I listened to someone to told me that. I went straight into the ER. I loved it and I did well, but I think I could have gotten to that point faster and maybe even would have done better had I obtained floor skills first. Med Surg is its own specialty, but the skills you learn there, you can take ANYWHERE. It's a lot easier to learn how to take care of a crashing pt in the ER when you know what the stable/norm of that pt's condition is.

wildmountainchild · Apr 27, 2008

My plan, if everything works out, is to a get a new grad position in an ED right out of nursing school. I live in the Bay Area and these types of positions are very competitive. I had a five month preceptorship at a busy Oakland, CA ED. I loved it. I've taken ACLS and PALS and read ER texts in my free time. I've taught myself how to read EKG's.

The program I want to get into has a four month new grad internship w/ classes. I'm sure getting a job elsewhere first would be nothing but beneficial.....I just know what I want so I feel I should go for it. I was a firefighter/EMT before nursing school so I'm familiar w/ EMS.

When I was precepting I felt that I did full assesments....of course if someone is coming in w/ a stab wound that assesment was more foucsed. But if the patient wasn't actively bleeding to death or experiencing crushing chest pain I did my best to fully assess.

However...I totoally agree that the BEST thing to do would be to get experinece in med/surg 1st. I just can't wait!

Altra, BSN, RN · Apr 27, 2008

Assessments are one thing I am NOT good at. In the ER you rarely to a head to toe assessment on anyone and that is a shame. We do more focused assessments and focused care while they are there. I work with many RN's that can not hear lung sounds or heart sounds because honestly, they don't listen to them very often and so it's hard to hear what is abnormal. And to chart a person with pitting edema....it's hard to do when you don't see it often.

I'm perplexed by this statement because a large proportion of ER patients come in with cardiac and/or respiratory complaints. Are you saying that nurses in your ER don't listen to the lung sounds of the patient w/a chief complaint of wheezing? I really hope that I've misunderstood you.

OP, one of the reasons I was strongly drawn to emergency nursing was because I love assessing patients. In the ER I'm assessing a new patient at least hourly. I also get to see fairly rapid responses to meds and other interventions.

You will likely learn as much or more during your first 6-12 months as a nurse as you did throughout your nursing education, regardless of the specialty area in which you practice. You're working in a challenging area now. If you continue to have a strong interest in the ER, based on a realistic assessment of that environment and your ability to function well in it, then I would encourage you to pursue it after 6 or 12 months.

Good luck to you. :)