ER Newbie

rn-n- 2005 · Sep 10, 2008

Congrats for making the change!! :yeah: I love that about nursing!! I think that you will do great! I have less experience than you and made the change about 8 months ago and I am so happy that I did it. I came from Hem/Onc so it's different from ICU. You have the critical care aspect down so you'll just be concentrating on the different flow of the ED versus ICU. It is a different mindset but you're lucky because you will not be as task oriented as new grads.

Good luck to you.

Larry77, RN · Sep 10, 2008

You are going to have different challenges than a lot of others who start out more green in the ED. In my experience ICU nurses have the biggest challenge in time management we in the ED cannot plan out our shift and have to juggle many tasks at once but you will know how to do most of these tasks giving you a huge advantage.

Also time at the bedside is an adjustment...we just don't have it. You get a critical patient (same as you might have in ICU) and you still have 2-3 other patients to worry about.

Anyway the nice thing for you is you probably will not have to do much studying you only need to adjust your style in patient care (and get some comfortable shoes :)).

I'm sure you will do great and you will have so much more FUN than in ICU...trust me

Larry

rjflyn, ASN, RN · Sep 10, 2008

Don't know how much advice I can give you because the USA is different than there. Nursing is nursing however. ER pts are ER pts. I can only hope there you dont have to be primary care like we do here.

Rj

Dixielee, BSN, RN · Sep 10, 2008

I have done ER and ICU and they are different, and you do have to manage your time differently.

In the ICU, you are concerned about I&O...in the ER you just want to know if they are urinating or not.

In ICU, you are concerned about quality of respirations, in ER you are just happy if your patient has respirations.

In ICU, you make sure your dressing are nice an neat. In ER, you are just happy if they are not bleeding all over the floor.

In ICU, you hate having antecubital IV's because it makes the pumps beep everytime the patient bends their arm. IN ER, you are just looking for the largest, most easily accessible vein at the time, because you don't know if your patient will need CT's with contrast, large volumes of fluid or blood. IV sites can be changed any time, but in an emergency, you go with what you can.

In ICU, you are concerned about family education and understanding of the disease processes. In ER, you are just hoping Security will keep the visitors in the waiting room long enough for you to get your job done.

In ICU, you are concerned about proper diet, caloric intake, etc. In the ER, you say, "What do you mean you are hungry, you should have eaten before you came in!" (not really but we want to!).

In ICU, you are interested in making sure the body temperature is stable. In ER, we just want to keep it between 93-102 F. Anything in that range probably won't kill them today.

OBVIOUSLY, this is tongue in cheek, but the idea is a change in mindset. As another poster stated, you may be working with your One on One critical patient in ER, while several others are filling your rooms expecting to see you on a regular basis as well. So, manage your time well, decide what is going to kill someone versus what can wait, and 99% of things can wait, while you take care of the 1% that won't.

Good luck, and welcome to our brave new world! :yeah:

minifish · Sep 23, 2008

Thanks guys, had my first week under my belt and what you all said si true. Its VERY different to ICU but in a good way. The main thing I'm struggling with is the more junior nurses trying to tell me what to do, grrr had one girl today tell me that when a patient comes back from x-ray I have to reconnect them to the monitor :banghead: Felt like hiting her for stating the obvious lol. This girl was still in high school when I was finishing my training for crying out loud.

Ah well two days off then bk to it friday! I like the fact you dont know whats happening next.

Thanks again guys

Jill

tina_the_nurse · Sep 23, 2008

Please dont assume that just because some "junior nurses" are present in the ER that they dont know what they are doing or talking about. We need these "young faces" in the ER since many of the seasoned nurses are taking jobs elsewhere ...perhaps to a less hectic environment. Maybe, just maybe, you can learn something from the younger RNs just as the younger RNs can learn from you.

Glad to hear you like the ER...it is a totally different breed of nursing

TraumaNurseRN · Sep 24, 2008

Jill,

ER nursing is a different bird for sure. I have been in the ER since I graduated from school. (was an RRT for 14 years prior)...So, although I was green out of school, I did have the acuity issues in my pocket. Even so, nursing was sooo different than resp. My comment being....every specialty is sooo different from the rest. Your preceptorship will be wonderful to get you on the road to ER medicine....Goodluck and welcome!