Is the ER for me?

Specialties Emergency

Published

I have been a nurse for 2 years now. I started on a women's and children inpatient unit (PP, Special Care Nursery, Gynecological Services and Pediatrics). We also had med surg overflow from time to time and floated to med surg occasionally. I was there for a year and a half and now current on a NICU for the past 6 months.

In my short time on the NICU, I have found it is not for me. I thought the pace would be much faster but I'm finding it to be boring.

I found this with my first job too, I get tired of the redundancy of the floor routine. I did however, like the range of patients I had on the women's & children's unit which I would get in ED.

I love fast paced. I think I would like the aspect of treating the patient and then admitting or sending them out the door, the shuffle. I also like it when I have a more critical or questionable patient because it pushes me to be on my toes and makes for a interesting night. I also feel the strong need to be in a learning environment which I think ER would provide for me with the range of medical conditions and age ranges. I also feel like as a nurse working in the ER I would have more autonomy and be in a better place to help various different people in many different ways. I feel like I would be better able to contribute to my profession in this environment.

The more time spent working on the floor the more I think ER would be a better fit. The only thing is I am somewhat of an introvert and I know ER can have hard personalities. I also don't know if it would be in my best interest to get med surg experience first or if my experience is enough. I am a fast learner and learn best when I am in the moment. I also take time outside of scheduled work to study and learn more information.

Looking for advice and people who who have had similar experiences.

Thanks.

JKL33

6,777 Posts

Try it! See if you can arrange a shadow day or two. It has its many challenges but overall is great for exposure to many different people and medical/surgical/psych problems. I have no doubt it will challenge you in the way you seek to be challenged.

As far as the personalities - - They run the gamut anywhere you go. My experience has been that the ED is full of awesome people and the jerks are outliers by far. You develop good relationships with the docs/providers, too, if you are on the ball.

You can be an introvert and do just fine in the ED as long as you can be a team-player and help others. Some introverts find it way less draining than other areas of nursing because patient relationships are shorter-term and purpose-driven. You get in there and develop a good rapport that is centered around what you're there to do (get to the bottom of the problem and get them out of there). As far as staff relationships, there's no time to sit around sharing your life story; you can get by just fine with regular pleasantries and a collegial attitude.

OldDude

1 Article; 4,787 Posts

Specializes in Pediatrics Retired.

JKL nailed it. The best things I got from the ER was witnessing and participating in a team of nurses and staff whose only agenda was patient care and working together to get the job done, regardless of individual personalities. The other thing is the confidence I gained and critical thinking skills I developed from working nights when there is no one to call and you have to "figure it out" on your own; stuff that can't be taught in a classroom. Give it a try!

Truthfully, there is only one way to find out. Go for it.

Specializes in ED.

As far as the personalities - - They run the gamut anywhere you go. My experience has been that the ED is full of awesome people and the jerks are outliers by far. You develop good relationships with the docs/providers, too, if you are on the ball.

You can be an introvert and do just fine in the ED as long as you can be a team-player and help others. Some introverts find it way less draining than other areas of nursing because patient relationships are shorter-term and purpose-driven. You get in there and develop a good rapport that is centered around what you're there to do (get to the bottom of the problem and get them out of there). As far as staff relationships, there's no time to sit around sharing your life story; you can get by just fine with regular pleasantries and a collegial attitude.

100% this.

I'm actually an introverted extrovert or maybe an extroverted introvert. I dunno.

I find that I love the quick pt turnover, the autonomy, and the team work. I have good work friends that know my story but only because we've worked together for 8+ years together. There are others that I barely know their last name. Staff turnover can be rather high in the ED so it is often difficult to have personal relationships with co-workers. I compare it to a military brat that often makes fast friends but doesn't get too close too quickly.

I would pick up incentive shifts on the floor some last year and hated that work. Loved the people I worked with but the work and patients were too mundane for me. I also hated having the same patients day after day.

With the ER, you might work with a totally different set of nurses from shift to shift. It is never the same day twice, that's for sure!

I always tell folks to shadow for a day or two and make sure you see the morning and evening routine at shift change. That can tell you a lot about the department and the people within it.

katenicuRN

7 Posts

Hey!

I'm in a similar situation as you are. I have been a NICU nurse for 2 years. It was my first nursing job and while I love the kiddos, the pace is too slow for me. I also get frustrated with feeling like I have less autonomy than I would in an ER. I just accepted a position in the ER and I'm pumped but also kind of a nervous wreck. How has your experience been transitioning NICU to ER? I haven't touched an adult since nursing school and I'm a little nervous that they have hired me on as an "experienced nurse" rather than doing a residency. Is orientating for 8-12 weeks enough?

Specializes in Emergency Medicine.

Hey

Well I can't answer your question fully because I just completed hospital orientation this week. I start on the floor next Wednesday. It will be a big learning curve for you as it will be for me. I was a CNA for 6 years in various nursing homes and they liked that experience. They didn't ask much about my NICU experience. I know ER usually likes nurses experienced in pediatrics because that's a big hurdle for a lot of ER nurses who've only ever worked ER.

Here's what I am doing and my best advice to you

1. Read your Saunders NCLEX book and take notes

2. Order ER nursing books off amazon. I got a ER pocket guide, TNCC manual, ENPC as well as fast facts for ER nurse. Bring them with you to work. Keep them in your locker but study them outside as well

3. Take as many extra courses as you can that your hospitals offers

4. Last, and most importantly. KNOW YOUR BOUNDARIES. Know what you do know and don't ever be afraid or ashamed to admit what you don't. Even if you think it's stupid. This helps put the safety of your patient first. Never stop asking questions and show them that you want to be there!

I'm really intimidated by the ER and hope I have what it takes. I am going to throw myself in 100%. I feel like it's somewhere I can really grow as a nurse. Like you, I need to feel more autonomous as a nurse. NICU was slow and painful death by boredom.

Good luck to you! Post an update in a few months and let me know how things are going for you!

JKL33

6,777 Posts

Kate and nurse-please:

Consider Sheehy's

Specializes in Emergency Medicine.

Oh and 8-12 weeks orientation is what I'm going to get too. I'm on the schedule for 6 weeks of orientation and then they are going to reevaluate if I need more time. I think it will be enough if you really utilize your time on orientation and try to learn as much as possible. That being said, it's also hard to see everything (you never will) on orientation because ER is so varied. Everyday will be a learning experience, even after you're off orientation. Utilize your time well and I think you will do just fine!

amzyRN

1,142 Posts

Specializes in ED, Cardiac-step down, tele, med surg.

I think ER can have "hard" personalities but also has a lot of "soft" personalities too. I was surprised by that, that there is a huge diversity of types of people who work in the ER. I think you should go for it, give it a try and find out for yourself what it's like.

gemmi999

163 Posts

ER is full of different personalities. There are definitely the loud/brash personalities but introverts can thrive there too! Biggest thing is team work. Offer to help others because it creates good karma and there will definitely be shifts where you need the help!

One thing to note--you won't always have critical patient's. It's maybe an 80/20 ratio. 80% of people that come in don't get admitted. Of that 80%, maybe 10 - 15 % really even needed to come in. Most treat the ER as a PCP, coming in for routine things like med refills, UTIs, coughs, injures from two - four years ago that they want to check out, etc. You do get critical patient's and you do need to stay on your toes to catch them, but the majority of the time it is more common things.

The single biggest thing I will say about surviving in the ER? ASK QUESTIONS/BE HONEST. If it is a disease process you don't know, a medication you've never given, a rhythm that just looks funky--ASK someone. Every ER doc I've ever worked with will take the time to educate (if it's not mid code or whatever). Just the other day I had a bad asthma patient and the doc wanted to give terbutaline. We don't give that routinely. I'd never given it. You step up and ask the doc/ask the charge. Everyone in the ER that day had never given it, we called pharmacy. We all learned because I stopped and asked.

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