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Discussion

ER Nursing

Even before I got into Nursing School, I had a dream of being an Emergency Room nurse. There is just something about an ER skill set that excites me. The idea of being able to use my every day nursing skill in day to day life is very appealing to me. So Fast forward a bit, I graduated in March of 2009, and since have spent a year in inpatient psychiatric services, in a lock down unit treating patients mostly on 5150's. I took that job with an open mind, thinking I would really learn so many valuable skills that I could take with me when I finally got that ER job that I have always wanted.

I was able to make the move from my job in psych to a telemetry unit. I always heard that every nurse should "do their time" on the floor. Pretty much all across the board, every experienced nurse would say that you should do your time in either telemetry, or med surg. "It really rounds your experiences out, and gives you the foundation you need" I would be told. I was strongly advised not to go straight into ER nursing, because I wouldn't be "as good of a nurse." Or at least that's what I was told.

So I have spent a year in psych, and coming up to a year and a half in telemetry. So now I feel I am a little bit older, and a little bit wiser, so here is my predicament. I feel I have greatly benefitted from my experiences in both psych, and cardiac, but I haven't had any ICU experience. I have been told, "ICU nurses can handle anything, any ICU nurse could float down to ER, but you couldn't float an ER nurse up into the ICU." Am I ready to go into the Emergency Room with the experience I have, or should I be actively trying to spend time in an intensive care unit? I feel while I'm sure I could learn a ton in the ICU, I feel like I would still have so much to learn, even after 1, 2, even 5 years in the ICU. I do really want to be an excellent Emergency Room nurse, but also want to give myself the best advantages to be the best nurse that I can be. I am currently working at El Camino Hospital, in Mountain View CA. The online job postings have just listed 4 ER RN postitions, and they cater to Internal hires first. Should I apply, and try to start "living the dream." Or would it be more wise to stay where I am in telemetry, and try to move to critical care before I take that step towards my dream job in the ER.

I have a couple friends who have pretty much gone straight into the ER without having worked in any other role as a nurse, will I really have a leg up on them having so many other experiences, or does it even really matter?

Thank you for your input and constructive feedback, I am looking forward to reading your responses.

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    I went straight from nursing school to the ER (at a trauma center, no less! :eek:) and don't regret it a bit. There was an intense internship - 6 months with didactic and clinical components-which helped me get up to speed. I think if ER nursing is what you want, what are you waiting for? Why keep letting other people tell you what you need to do - follow your own gut.

    I had no interest in working "the floor" as you put it, although I got the same advice you did. I didn't listen to it, and it's been a good decision for me.

    Best of luck!

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    JettRNurse:

    I graduated a year ago and have been working at a psychiatric facility for the past 9 months. I also want to work my way to ER nursing. I have been trying to get a job on a telemetry or cardiac unit for a couple months now. I was wondering if you have any advice for me?

    I think you should apply for the ER nurse position. I think you have the foundation you need! Good luck!

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    apRN, I found that the psych hospital I was working at had another hospital nearby that had a tele unit. This allowed me to be an "internal transfer" even though it was some 45 miles away. I'm not sure if there is a similar situation for you. I have found in any situation where you are seeking a job, you must try to score face time. Get some face to face time with a manager, make an impression.

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    I went straight from nursing school into ER and I definitely wasn't "ready," but I sure learned my stuff and now I can handle my own without a problem... and my facility has taken several nurses off of tele and brought them to the ER full time as tele nurses are "easier to replace" than ER nurses in terms of training, etc. I would say just go for it; you'll never really be "ready" anyway until you do it. We have had some ICU nurses come down and are absolutely at a loss when their patients can actually talk to them...

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    I've been an ER nurse in a small rural hospital for 9 years. Being an ER nurse is northing like being a floor nurse (I mean, yes, you need to know how to start IVs and put in foley's and clean up s***). I was a peds floor nurse for two years and loved that, but the way that things go in the ER...it just doesn't work like the floor. You can have periods of NO PATIENTS. Wow. Like right now. Or you can have times when they JUST WON"T STOP COMING IN THE DOOR. And unlike the lovely ICU nurses who can smile and say..."Yeah, I'm not ready for that patient yet. It's shift change." If they come in the door, you treat them. And you have to know who to bring back and who can sit. THere's more responsibilty on you...if you want to do ER...go do ER.

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    I'm a new grad and looking into going straight onto the floor as an ER nurse, at first I thought I needed med/surge experience first, but many people say its possible to go straight to ER. So i'm up for the challenge

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    I wanted to get floor experience first as well but they needed someone in the ER when I started so I immediately went there and I don't regret it! And while ICU would teach you many skills (only did one month there myself) it's a whole other ballgame working in the ER.

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