ER right for me? Not an adrenaline junkie

  1. I'm a soon to be new grad wanting some advice. I know this forum gets a lot of these so thanks for reading. In trying to decide whether or not to apply to a new grad ER position after school or stick with traditional med/ surg in my small town hospital. Both new grad jobs come with a residency program. I've worked in ERs before as a tech/ CNA and neither loved nor hated the environment, but had always assumed ER nursing wasn't for me because I'm not an "adrenaline junkie". I don't lose my cool in emergencies, but don't love it either. I can work hard and like a busy work environment with lots of random in my day. Also, I used to think I wouldn't like the fact that patients come and go and you don't make a 1:1 connection with them, but lately that seems much more desirable. My question is- am I way off base to consider ER nursing? What kind of personality works well in the ER? Will I learn to love the adrenaline rush? Does it matter? Thanks!
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    About gypsierose

    Joined: May '15; Posts: 82; Likes: 73


  3. by   JKL33
    Quote from gypsierose
    Also, I used to think I wouldn't like the fact that patients come and go and you don't make a 1:1 connection with them, but lately that seems much more desirable. My question is- am I way off base to consider ER nursing? What kind of personality works well in the ER? Will I learn to love the adrenaline rush? Does it matter? Thanks!
    Great questions.

    There are different types of people who enjoy ED nursing. I'm not sure so-called adrenaline junkies have a leg up on anyone - that's not to take anything away from them either, it's just that so much of ED nursing isn't that, and there are other motivators besides adrenaline rushes. Regardless, the ED is in no way comprised solely by the type of person to which you refer. It's kind of more of a stereotype that doesn't hold up as far as I can tell. I've assumed it is a common belief because of stories people hear (those stories being told by the type who likes to tell stories of their adventures)...

    The idea that ED nurses don't connect with patients is another misunderstanding that a lot of people have. In the same way good ED nurses learn to make quick and fairly accurate assessments of physical condition, we also learn how to assess other factors quickly (personalities, social and situational factors, body language, etc.) in order connect with people in the shorter time frames we work within. It may be a challenge, but given that so many of our patients don't have a host of other options when seeking care in the ED (due to either the urgent or emergent nature of their situations, or due to social or financial situations that limit their care options), I think it is a worthy challenge.

    I do prefer the shorter duration of our patient relationships. Maybe this is a common preference amongst nurses who enjoy the ED, I'm not sure about that. I wouldn't enjoy 12 hours with the same patients; it's emotionally draining, like hosting people who overstay their welcome while you endlessly try to maintain decorum.
  4. by   gypsierose
    Thank you so much for your reply! I'm sure it does take all types. Good to remember that the ones who tell stories are the ones who like those situations.
  5. by   bsnrngirl1
    Thank you for asking this question! The more I look into moving to the ER the more I want to but I'm in no way an adrenaline junkie either. I want to work with many different people with all kinds of ailments so I think ER is where I belong. Have you chosen to do the ER residency?
  6. by   gypsierose
    I'm going to apply to both med/surg and ER in two different hospitals. We'll see where I land, but I know that there are a least a few EMTs applying to the ER so that job is more competitive.
  7. by   bsnrngirl1
    I hope you get it if that's what you want to do! I'm going to try and shadow someone in the ER soon!
  8. by   nurse2033
    It takes all types. It sounds like you know what the ER is like so go for it.
  9. by   BassCatchingNurse
    To answer your do not have to be an adrenaline junkie in order to make it in the ER. You do need the desire to help people that are having an emergency and the ability to handle said emergency...that's it!

    Is med-surg or ER your only two options? I firmly believe that people should seek out their passion. Find a population or work environment that you are passionate about and apply there!!! You will be so much happier, IMHO!! That first year is rough, especially if you do not enjoy the area in which you work.
    I wish you all the best with your decision.
  10. by   gypsierose
    Thanks! Small town so yes- ER or Med/Surg are my best options. Good hospital, though, so I think I will learn at either position. Bracing myself for that hard first year, but also excited to spread my wings.
  11. by   akulahawkRN
    I would say for new nurses that are contemplating starting out in the ED, you will learn a LOT about there. That being said, you need to be certain that you're getting a longer orientation than other folks that are coming into the ED from another background because you'll be having to learn how to be an RN generally on top of learning to be an ED RN. I count myself lucky in that I started out in the ED (I was a Paramedic before this) and landed my first job in the ED and that place took the time to train me well. Unfortunately I was initially placed with someone that didn't believe that new grads should start in the ED so my first few weeks didn't go all that well but once I was placed with a nurse that was actually willing to help new grads do well, they reset the clock and I got 16 weeks of actual good training after that. If they're giving you anything less, they're doing you a disservice because ED nursing isn't much like anything else because we've got too much "squirrel!" going on.

    If they're committed to supporting you through your first year, then it might be OK to give you a slightly shorter orientation time. Now if you're picked up for the med/surg job, that's great too. You'll learn a LOT about time management and the like and that'll help you transition later to other floors or departments like the ED because you'll know what info is actually needed for report when you're transferring patients. The downside is that if you do transfer to the ED, you have to re-learn your assessment stuff because the focus is more on the "problem" system and not an entire head-to-toe assessment for all systems.
  12. by   OldDude
    I started as a GN in a busy Pedi ER. I never thought of the term adrenaline junkie until I heard it after I had moved on to other pediatric things. My biggest draw was it provided an environment that "wasn't" med/surg. Although, in my experience, you frequently have to get "in the zone" and sprint to the finish line, most of the shift was run of the mill bumps, bruises, coughs, fever, and general snotty noses. My years in the ER gave me a vast array of experience and problem solving skills and much nursing confidence to take forward with me.
  13. by   PeakRN
    As far as the adrenaline thing goes, you really don't want to get excited and worked up about any case in the ED. You should be equally calm whether your treating an ingrown toenail, restraining a psych patient, or working a code. Being amped up produces rash decision making, and subsequently poor outcomes. This is not to say that you shouldn't be excited to able to work in such a unique environment.

    Three quarters of our ED patients last year were discharged home, and the reality is that most of the ones who got admitted were things like bronchiolitis or pneumonia that were not critical. Most of the patients in the ED are low risk chest pain, coughs, colds, mild asthma, sprains, minor fractures, et cetera.

    The best personality for an ED nurse is to be a hard working team player. It's not an environment of "my patients" or where the nurses are afraid to talk to the physicians. It is everyone's goal to triage/assess, stabilize, and disposition.
  14. by   canoehead
    My own experience was that I was interested in the traumas until I knew I was competent in those situations. I wanted to be OK with all the ICU type monitoring, and the ABCD etc of trauma. So I went into every trauma, and at least recorded. Once I felt confident, there was a new crop of orientees coming along, and they are the ones that run into the traumas. I think I'm the opposite of an adrenaline junkie, a good ER story is fun, but I'm glad it didn't happen to me. You don't need to live for trauma to find ER work satisfying, and make a difference.