Medicine/ Step down to a New ER

  1. Hello all!
    The situation:
    I recently made the plunge into emergency nursing September 2017. After 5 years I left my medical/ step down floor in a rural hospital and moved to a larger city to join their emergency department. I felt like I had a decent base to facilitate a smooth transition, but I was very wrong. I was fortunate to receive a comprehensive in-class 6 week training/orientation: mostly on the major ED emergencies (Cardio and Respiratory mainly) prior to a 5 week buddy shift-style orientation to the floor and facility. I have been 'on my own' for 6 weeks now. I am usually a pretty quick study; I was 9 times out of 10 charge nurse on my previous floor and was a resource to many staff, old and new. I held positions on committees and was even offered a position as a support supervisor. These are not pretentious comments, just stating that I had a level of job satisfaction and self-worth.
    The problem:
    Here... I feel like I know nothing. My old facility was e-charting and my new one is still 90% paper (which isn't helping). I encounter new things every shift that leave me feeling almost incompetent. My training was excellent, but it cannot cover everything and I know this.

    The point:
    I just need to get back into some studies. Read more. Learn more. What are some online courses and resources that I can utilize to help this transition? My facility offers TNCC and various advanced courses but none for another 6 months +. I have been told a million times that I am too hard on myself and that I am doing 'fine'. True or not, I just need to feel comfortable in my own skin in this department. Any input would be greatly appreciated.
    Thanks in advance
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    Joined: Dec '17; Posts: 1


  3. by   Kuriin
  4. by   QCG33k
    ED is a different beast. And most the medical floor nurses that migrate to the ED quickly realize it's not the same work flow. Like any change where it sounds you went from knowing all the ins-and-outs to something you are unfamiliar with, is it common to feel unprepared; whereas your brain thought you were ready.

    Just stay tough, there will be good days and bad days, and take the punches as a team.
  5. by   ruby_jane
    You cannot underestimate the culture shock going from rural to urban - the pace, the expectations, subtle and not so subtle differences in culture...on top of the change in specialty. Be easy on yourself.