ER or ICU (or another specialty)?

[amzyRN]

I am approaching my 2 year mark on a tele unit and I am so sick of it. I changed jobs and am now working strictly tele. My last job was on a step-down/ tele floor where I got to titrate drips and stuff, much more thinking involved. I'm now on a strictly tele/obs unit and I feel it's so task based where I'm running around like a chicken with my head cut off. Plus my current facility doesn't have to convenience of transport teams, so I'm having to do a lot of the "leg work", transporting patients myself, taking them out for discharge, going to pharmacy for supplies. It's understaffed, in my opinion. Nevertheless, even if the staffing was better, I might still be sick of the specialty. At my last job, I started to feel like I was maxing out on what I was learning and it would be time for a change.

I've always thought I would love ER, and I do like to be involved in codes and stuff (haven't had the opportunity too many times), but I don't want to go into it and hate it. ICU seemed cool when I would float there, but there are no nursing assistants and the interactions with the families seemed too intense. I don't want to be that emotionally entangled with my patients. I like to keep a sense of detachment and it seems like it would be hard in ICU. The drips, vents, and other things seem to pique my interest however. I do also like trauma, the adrenaline rush of emergencies.

I want to have a clear goal in mind before I make a move to move on from telemetry. Any ideas?

[That Guy, BSN, RN, EMT-B]

Hate to burst your bubble but the ER is not all codes and death and trauma. Its 95% boring clinic and 5% terror.

[nurseprnRN, BSN, RN]

Try to get into PACU or Endoscopy/special procedures. You need critical care aptitudes-- tele would probably get you in the door-- but you'll come in to a whole new bunch of patients every day, and even if it's intense, they're all asleep and their families are in the waiting room waiting to take them home, or waiting to see them when they go up to the floor. :)

[dah doh, BSN, RN]

I am approaching my 2 year mark on a tele unit and I am so sick of it...

I've always thought I would love ER, and I do like to be involved in codes and stuff (haven't had the opportunity too many times), but I don't want to go into it and hate it. ICU seemed cool when I would float there, but there are no nursing assistants and the interactions with the families seemed too intense. I don't want to be that emotionally entangled with my patients. I like to keep a sense of detachment and it seems like it would be hard in ICU. The drips, vents, and other things seem to pique my interest however. I do also like trauma, the adrenaline rush of emergencies.

I want to have a clear goal in mind before I make a move to move on from telemetry. Any ideas?

No place in the hospital is all codes, traumas, and emergency situations. Also those areas tend to have "stressed" patients, families, doctors, and other staff & can tend to end up with them "in your face" or confrontational and emotional. It doesn't sound like you are interested in that. Btw, I push my own beds even though we have a transport dept.

If you want less family interaction, but still want clinical hospital work, you might want to consider a procedural area, or PACU, or surgery.

It all depends on your ultimate goal. If you don't know, it doesn't hurt to try a new area every few years until you find your niche. Good Luck!

[_firefly, BSN, RN, EMT-B]

I believe nursing should and needs to be about wanting to care for people. If you just want new challenges and opportunities without patients you might want to consider software engineering. I just came from that world and the money, opportunities, and challenges are at least on par with nursing. I'm now in nursing because I am addicted to people. I want to be involved in the struggle, the attachment, and the relationships. I need that if only with staff and family. Honestly though if you have a fire for challenges and money without patient involvement, you should consider computer science.

[schnookimz]

What about surgery? Has some of the excitement in a totally different scene with very little family interaction and almost no transporting around because everything you need is right there.

[AZQuik]

Hate to burst your bubble but the ER is not all codes and death and trauma. Its 95% boring clinic and 5% terror.

This. Most of what I've seen are abd pain, etoh, si, nonspecific pain, non mi chest pain, and od. That said in new, and our ed does see it's fair share of legit emergencies. Rarely 12 hours worth but they are there. I don't get many as I'm new, but I keep an eye out what's going on around me as well.

Personally I love it. But have zero other experience as a nurse to compare it to.

Gluck

Sent from my iPhone using allnurses

[amzyRN]

I believe nursing should and needs to be about wanting to care for people. If you just want new challenges and opportunities without patients you might want to consider software engineering. I just came from that world and the money, opportunities, and challenges are at least on par with nursing. I'm now in nursing because I am addicted to people. I want to be involved in the struggle, the attachment, and the relationships. I need that if only with staff and family. Honestly though if you have a fire for challenges and money without patient involvement, you should consider computer science.

I didn't say anything about now wanting to care for people. I said I was bored by the specialty and the task based nature of my job. The stress and strain and demands placed on me are starting to burn me out. Nursing isn't just about "caring" either. It can be intellectually stimulating also. And to be an effective nurse, I believe a degree of detachment is necessary and healthy. I have experience in another field as well and if I wanted to pursue another field entirely I wouldn't have posted my question on this forum.

[Racer15, BSN, RN]

I'm an ER nurse and that is all I know. It can be fun and exciting, it can be overwhelming, and sometimes it is awful. I recently had to care for a pediatric pt that came in for a vague complaint. It ended up being a sexual abuse case and I very well may have to go to court over it. I've also had a few cases of truly awful elder abuse. The same day I had the pedi sexual abuse case, we had to do a rape kit on an elderly pt. And then there are more days than I can count that consist of minor complaints and petty things. And days where I feel like I'm running a peds clinic. Another fabulous perk of the ER is pediatric codes. Not trying to be a downer, just realistic. You deal with all ages in the ER for good and bad. You deal with drunks, homeless people, folks having psychotic breaks...it isn't for everyone.

[HouTx, BSN, MSN, EdD]

There's another factor to consider these days.... one that we really never had to deal with before. ICU & ED nurses are the ones who will have to deal Ebola - or any other dreadful new malady - that pops up. This means working in 'Class C' (biohazard) isolation- full haz mat gear & high likelihood of being quarantined for 3 weeks if you are potentially exposed. IMO, this is a game-changer.

Like most others, my organization is still developing all the infrastructure that is needed for highly contagious diseases. Today it's Ebola, but others will surely follow. I know that no matter what processes and procedures they come up with, it will still come down to 'hands on' nursing care. Trust me - trying to perform even minor patient care tasks in full Class C PPE is like trying to walk a tightrope in a suit of armor.

I wonder if this will have an effect on the impression that that ICU & ED are the 'glamour' specialties??