Is ER nursing Floor nursing???

CoolhandHutch, MSN, RN · Jun 21, 2006

By "unpleasant codes", I am assuming you are talking about body fluids and such... and no, you can't go to the ER to get away from them. And if bringing a dinner tray to a family member that hasn't eaten all day because they've been at the bedside of a sick relative, then the ER isn't for you. I don't compare my ER to what the floor does. It's a different acuity and set of interventions but much of it's the same. To totally get away from the "unpleasant codes" and taking care of the patient and their families, it sounds like you are best suited as an office nurse somewhere.

RN007 · Jun 21, 2006

This may be a dumb question but is ER nursing considered to be floor nursing? Do you do as much of the not so pleasant codes, bringing food and other things I really don't like so much about floor nursing? What other areas are considered to be non floor nursing positions? Cath lab? Thanks for any input.

Can you be specific about the "other things I really don't like so much about floor nursing"?

nursejennie76 · Jun 21, 2006

I Would Make A Horrible "floor Nurse". There Is Limited Food Getting And Not As Much Butt Cleaning, But There Is Your Fair Share Of Unpleasant Things, Like A Foley In A Nursing Home Patient That Weighs 400 Pounds And Has Not Had A Good Bath In Who Knows How Long. But If You Like Variety Then Its The Place To Be, There Is No Other Place That I Can Be A Ob, Gyn, Cardiac, Renal, Critical Care, And Peds Nurse All In One Day. Oh And The Storys I Could Tell, People Never Cease To Amaze Me. But There Is That One Thing, The Er Is Like The Red Headed Step Child Of The Hospital, The Floors Don't Like Us, And It's Just That They Don't Understand What We Do, I Think That Is Something That Will Never Change. Good Luck!!!

rjflyn, ASN, RN · Jun 21, 2006

Um NO.

It is not floor nursing, it is not even close.

Rj

Katnip, RN · Jun 21, 2006

It isn't like floor nursing because of the turn over and the huge variety of acuity.

As for "codes" you name it, ER gets it. You haven't lived until you see someone vomiting feces from mouth, ears, and nose.

And yes, you have to give meal trays sometimes.

Maybe office nursing where most people are relatively healthy or an insurance office would be more to your liking.

welnet66 · Jun 21, 2006

I was a floor nurse for 18 years and now I'm in the ER. It's true that you see everything and the work is hard but as far as floor nursing is concerned, I would never go back to it. Try shadowing an ER nurse for a shift or two and see what you think. There is also ICU, OR, OB..shadow them all and then choose what you'd like to do. Now...about alternative careers for nurses..drop me a PM and I'll fill you in. Good luck!!

zaga21 · Jun 21, 2006

I think some of you took my question in the wrong light, I am well aware of what comes with the territory. I did my clinical hours in a hospital where the R.Ns spent a great deal of time messing with lunch trays, I know that is part of it, but not like this they must have been understaffed. I was just saying that I would prefer to be in a setting where the kitchen helped out more with this (like the other hospital I have worked at) I don't recall saying anything about not wanting to get a try for a starving family member who has not eaten a parcel of food in days, give me a break and don't be so quick to assume and attack "you may be best suited as an office nurse" Do you like code browns????? I didn't say I was trying to get out of them completely, but I would be willing to guess all of you ER adrenalin junkies wouldn't trade for an area where it is an every 15 min event. ??? I just wanted to know if it occurred less often, I am more than ready to help a person out in their time of need, they don't like it as much as we don't and its nice to help, I just would like to in an area where this is a part of the job but not the "main duty" sorry I must be human. Thanks to all of those who understood what I was saying and responded to my question and did not make snap judgments about me.

Jen2 · Jun 21, 2006

E.R. nursing is a totally different focus than on the floor. The poster who said that the ER is the red headed step child of the hospital is correct. Yes, we have code browns on a daily basis, we clean it up and then move on. It is a part of nursing anywhere. I cannot even begin to tell you how different the ER is as opposed to the floors, because no one can truly understand it unless they have worked in the ER for a period of time. We will often have people come shadow from like 7am-11am, which is usually are down time during the day and form an opinion on that. You truly need to spend a little while in the ER before you can truly understand it. If you do shadow I would recommend a minimum of 12 hours on all three shifts to get a better picture.

It's not just an adreneline thing in the ER either. You must be proficient in all areas of nursing to be a able to do it. There are days where I may take care of nothing but ingrown toenails and back pain and then other days that I go home so sore because I have done chest compressions on 4 different patients all of whom did not make it. There are days that babies die and children are abused. There are days that every bed has a patient in it, 20 people are sitting out in the waiting room, the ambulances won't stop comming, the helicoptor is on there way and you are trying so hard to get one of your patients upstairs so that you don't have to work a trauma in the hall and you call to give report and you cannot get the nurse because she is doing a sterile dressing change or whatever. All things are dealt with on an almost daily basis. Code browns are one thing, but have you ever been around a homeless person, alcoholic, or elderly patient after they have laid in there own feces, urine and vomit for three days before anyone called 911? Belive me the paramedics don't give a full bed bath before they bring the patient in. I've seen maggots coming out of orrifices that I never even knew existed. I'd take a code brown on the floor any day compared to all of that. Good luck in what ever you decide.

ERRNJunkie · Jun 21, 2006

Jen2 Said it well.

ER can be like floor nursing when you have patient holds. I was on "code brown" with a patient who had diarrhea Q 10-15 minutes. Or you have a methadone OD, who is given narcan and they have a huge BM. Or they are vomiting feces. We get the worst of the worst, stabilize them and send them up. The only difference is you usually don't leave and come back the next day to the same patient. Also not as many ER patients use the call light as they are too sick to use it. But not to say it isn't hard work. I sometimes don't get to use the restroom till 430am. I work nights. Sometimes I don't get a lunch, and we also get hallway patients. Also, codes don't care if it is change of shift, in fact most codes happen at 5am, and you get the patient at 0530-0600. Right at change of shift. The floor nurses hate you, because they don't want to get patients at the end of their shift, or even 3-4 hrs before the end of their shift. I really don't understand why they care if they get a patient 30 minutes before the end of their shift, they only have to take vitals and tuck them in.

I think all nurses should be required to float down to the ER to see what it is we really have to endure. Don't get me wrong, I love ER nursing, and wouldn't want to be a floor nurse, but some things need to be appreciated.

Jennifer, RN · Jun 22, 2006

I worked on a busy tele floor for 5 years, and transferred to the er 1 year ago because I wanted a change. Floor nursing and er nursing are two completely different kinds of nursing. Floor nursing entails complete assessments on all pts. er nursing is more focused. We take care of very minor complaints to life threatening illnesses on a daily basis. I am expected to assess pts, order labs/xrays, collect body fluids for those lab tests, insert iv's, hang fluids, do ekgs, transport pts, and, yes, all the other "gross" stuff of nursing like code browns, cleaning up vomit (often!), cleaning rooms, cleaning pt's of urine, etc..., which we never have time for, but end up making the time. Many of our pts come in nasty, smelling of urine, feces, puke, alcohol, sometimes covered in blood. I usually do not get a lunch or dinner break. I have gone 14 hrs without eating a meal too many times to count. I get home from work and binge like I am bulimic. Getting to pee on my shift is a luxery.

And yes, other floors treat us nurses like dirt, like we are intentionally trying to ruin their day by calling report. Well, trust me, I try to call report on my intubated, obtunded, fixed and dilated pt as soon as possible, because while he is my pt, I have to provide intensive 1 on 1 care to him, while still providing care to my SOB pt, chest pain pt and actively seizing pt. So, yes, I will get an attitude if the ICU charge nurse says that the nurse is too busy to take report, or that the ICU is understaffed and they can not take another pt, while another medic is rolling in with another pt for my hallway bed.

And you may wonder why we er nurses stay. We work as a team in my er. We are like a family. I get to use all of my skills as a nurse. I am treated with respect from the docs. ER nursing is the most challenging job I have ever had, and I would never go back to floor nursing. I think I would be totally bored. Floor nursing is monotonous and brain shrinking. I knew I was ready for a change when I kept wishing someone would code on my shift when I worked on the floor. Very morbid. Now I get to participate in codes or intubations all the time. Fun, fun, fun.

JMBM · Jun 22, 2006

Is ER nursing floor nursing? Actually, I find it interesting that allnurses doesn't list ER nursing as Critical Care, since the rest of the nursing world regards it as such. Anyway, Jen2 and Jennifer said it better than I could. I would only add that if you are looking at ER nursing as a way to get AWAY from anything, you probably won't like it there. Code browns, meal trays, paperwork, whatever you don't like, its all in the ER, too. Having worked on floors, I agree that floor nurses work just as hard, and sometimes harder, than we do in the ER. The difference is the "chaos factor". Blood, urine, feces, emesis, trauma, cardiac, overdose, seizures, sepsis, lacerations, flu, UTI's, babies, kids, seniors, drunks, addicts, chronically ill, snotty surgeons, distraught families, and everything else all coming at you in differing combinations all shift long. If there is anything you don't like to do, it will surely come up on your shift repeatedly. Now, if you are coming to an ER because you LIKE it there - the teamwork, the endless variety, the autonomy, and, yes, even alittle adrenaline - then you might find a home in the ER. I mean, what other nursing job can you have where you find at the end of shift that your shoes have blood on them and you have no idea where it came from?