ER to ER transition

[mickeyrose912]

I am looking into taking my first Er travel assignment and would love some insight on what it is like to transition from ER to ER (as a traveler, or job change).

I have been a nurse for 3 years (1 cardiac and 2 in ER) in a 28 bed local Er. The facility i work at isn't a trauma center I am concerned about going to a level 2 or level 1 trauma center for travel. Is there a drastic difference in acuity and expectations? How is the transition? What was your experience like going from one ER to another? I worry that I'll get an assignment at a big Er and not be able to handle it.

Any advice is greatly appreciated!

Thanks

[amzyRN]

I had 6 months experience in the ED and changed jobs due to safety issues. Previous to that I had 4 years experience in cardiac/tele/med-surg. I found the transition a little challenging but was able to do it successfully. The system was totally different from my first ED job and it took about 2 months to really get used to it. The specialty is the same though, so the logic and order of operations are the same no matter where you work. Staffing ratios, acuity, support staff, and unit culture will vary along with the charting system, etc and you should consider those things when you interview. Try to ask questions that give you more information about the workings of their particular unit during the interview.

[mickeyrose912]

Thank you! I am really concerned about going from a local ER to a level 1 or 2 trauma center. I wonder if the acuity is higher or how things are different. I know a nurse that works at the Trauma Center up the street (as a 'regular' Er nurse) and he is always coming home with stories. He has patients die on him daily.

[Lev, MSN, RN, NP]

No two community ER's are the same. The ER I worked at for 2 years, while not a trauma center had high volumes and high accuity patients. There was at least 1 cardiac arrest, sometimes as many as 5-6 that came in each day. That being said, the ER I am transitioning to, is a much slower ER.The hospital doesn't have a fully functional cath lab. One way to gauge the acuity of patients at a particular hospital is to see how busy it's ICUs are, if there are many specialty ICUs, if the hospital does open heart surgery, if there is a PICU or NICU (for the kids), if the cath lab is open for emergent cases. For example, the hospital I worked at didn't have a PICU, so we didn't get as many very sick pediatric patients.