ER Experience

I would always recommend experience outside of emergency, for two main reasons. It gives you a greater appreciation of how the organisation works in its entirity, without the blinkered perception, that your department is the only one that exists or matters.

Secondly, the skills attained from working in other areas is irreplacable. Emergency being so diverse, it makes it difficult to attain specific knowledge of any one area of clinical practice. I have known nurses with several years (emergency) experience, not knowing how to accurately assess someones neurovascular status when they have a fracture.

If you want to know how to be an expert at ECG's, work in cardiology for a while. If you want to be an expert an chest xrays and non invasive ventilation, work in respiratory. Secondments to other areas whilst working in emergency are also beneficial, especially as you realise your deficits. A stint in paediatrics (unles you work in a paed specific ER) can greatly improve your kid handling skills. A stint in Psych always goes a long way.

Remember. Nothing is ever permanent and the opportunities are vast. Even if you don't particularly like an area, there is always something to learn. (if you have the right frame of mind).

I appreciate that the systems are different between Australia and the US are different, but I am sure that you can extrapolate some of the principles.