Experience...How much is enough?

guest655229 · Feb 10, 2014

You'll be able to travel in ICU but not ER...you'll need atleast 2 years in your specialty. I've done both and have 13 years in...and 10 of that is ER, including flight and they want 2 years "recent" experience....I haven't done straight ER in almost 4 years and they won't even touch you...even with all the alphabet soup. Good luck...you should just head out to CA on you ICU...ratios...only 2 pts! It's awesome, I've loved it!!!

AppleRN4 · Feb 10, 2014

I wouldn't advise you to travel as an ER nurse with only 5 months experience, even if a travel company/hospital hires you in that position. Just remember, you're expected to be competent and independent in the area you're traveling in and this is not the time to experiment with any new specialities where you'd constantly need help from the hospital staff. In my experience, the ER can be brutal and they have no patience at all with incompetent travel nurses. Stick with what you know which is ICU and you should never have a problem securing an assignment. ICU is always in demand. Good luck! :)

vinstafa · Feb 10, 2014

I see what you mean about being independent and competent, but there isn't any circumstance that I could see in which I couldn't be competent in an area after 5 months. Looking at it from the hospitals POV, I understand the concern they would have.

I guess it would make more sense staying with what I know, especially since the likelihood would be good getting an ER position with that little time in that speciality.

AppleRN4 · Feb 10, 2014

I see what you mean about being independent and competent, but there isn't any circumstance that I could see in which I couldn't be competent in an area after 5 months.

After 9+ years an an ER RN and having worked in a few trauma 1 & 2 hospitals, I know for a fact that I wouldn't be competent/independent in these trauma ED's without YEARS of experience. It's a little scary to think that you'd feel competent working the ED with only 5 months experience-- even with 5 years ICU experience. The ER is a much different beast vs the ICU and I can't pretend that I'd be comfortable working in ICU after only 5 months in your department, but to each their own. If you think you'd be ready, then so be it. Experience is often the best teacher. Good luck. :)

ERnurz · Feb 10, 2014

I see what you mean about being independent and competent, but there isn't any circumstance that I could see in which I couldn't be competent in an area after 5 months. Looking at it from the hospitals POV, I understand the concern they would have.
I guess it would make more sense staying with what I know, especially since the likelihood would be good getting an ER position with that little time in that speciality.

I've been in an ED for two years and I'm not ready to travel to any other hospital's ED to work! I cannot image someone thinking 5 months will cover "all you need to know about an ER" and I hope that I never have to work with someone who thinks they have all the experience they need in 5 months. I have to work with someone who spent one year in an ICU and "learned all they could" so they came to the ED to learn some more. Guess what? They aren't that good at what they learned.

vinstafa · Feb 10, 2014

Like apple said, to each their own. There is a difference between "all you need to know about an ER" and one being competent in his/her skills and knowledge, which is what I said. Thanks for your input:up:. And when I first asked this question, it was in relation to how long the hospital would look for time in an area in addition to overall experience as a RN, not when someone feels comfortable in an area, and I'm sorry this got off topic.

wanderlust99 · Feb 10, 2014

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NedRN · Feb 10, 2014

It is easy to misspeak online, but I'd like to continue to add to that conversation nevertheless. I have no doubt that you have an excellent knowledge base after 5 years in the ICU (hopefully in shock/trauma Baltimore which should be advantageous in ED) and organizational skills suitable for that position. That said, did you feel comfortable/competent after 5 months in the ICU? Are you able to look back and realize that where you are now is far different than where you were after one year?

Organizational skills are completely different in the ED. You might have 10 patients, and 10 minutes later have 10 completely different patients. A med surg nurse from a very busy unit who goes through one complete change of patients per shift might be able to transition better than an ICU nurse to ED. You also have to diagnose (yes, I said diagnose) quickly and accurately, and determine which patients are an absolute priority, and which are not. That is very different than watching trends on one patient.

Hopefully ED RNs will forgive me and/or correct me if I'm wrong about their specialty. They might also weigh in on exactly how much a year or five of experience makes on their ability to not get diagnoses and treatments wrong. It certainly does sound presumptuous for an ICU RN with zero experience in the ED to think they will be good to go after five months in the ED.

The other side of the story is marketability. Even if an agency agrees to submit you to an ED assignment, think about the nurse manager. Will they pick the 6 year nurse with 5 months ED experience, or virtually every other candidate with more ED experience. If you were manager, what would you do? If you were an ICU manager, would you be willing to hire for three months (and you cannot afford to orient for a month) a traveler with 5 years ED experience and five months ICU experience.

Finally, I'd be surprised if your hospital does not demand one or two years commitment to working in the ED in exchange for the training they will do.

I think you owe it to yourself, management, and patients to do at least a year in a new specialty.

vinstafa · Feb 11, 2014

Ned, thanks for very informative, unbiased and enlightening post; I was hoping that you would respond. When you put things into that perspective, I can see what you mean from the hospitals POV. My forte is ICU, and I planned on traveling ICU, but was just looking to make sure I was covering all my angles since it is such a huge decision to make for my wife and I. I was more or less looking at the additional locations that where offered if I would have been available to travel either of the two.

NedRN · Feb 11, 2014

I tend to think of ED RNs as more of a commodity, above med surg, but still common. There are tons of assignments yes, but tons of available ED RNs you are competing with. ICU is also a commodity, but with super specialties like open heart recovery that when a hospital needs one, there is a smaller pool of good candidates. I know some travelers that do both (super nurses!), but it gets a bit tricky as many nurses and managers really believe your skills have to be very current. Personally, I think that is a belief with little real evidence but you have to play the game of keeping both specialties current with recent experience to stay marketable in both. Hard to do.

The idea of going more bread and butter to get more location choices is a good one, but tricky if you want to keep ICU current as well. If you are interested in chasing money and putting your knowledge base to good work, I might suggest cath lab. As one former CVICU nurse aptly put it to me, cath lab is ICU nursing on steroids. Travel cath lab has been red hot for a number of years and demands top bill rates. Not as many location choices as ED, but more than ICU only, and better hours (other than call requirements). Kind of like OR, just one patient (they can't slam you with extra like on the floor or ICU or ED), and you are valuable to the hospital because you are creating profit - not an expense item like most of nursing. It is so red hot that 5 months of experience will get you into travel assignments, if only diagnostic. If you don't like wearing lead and a mask, maybe not for you.

trackhead, APRN · Feb 13, 2014

I worked ICU for four years, then 10 of ER. I'm doing ER travel now, but just took a staff ICU job to get current ICU experience to start traveling in ICU again. ER travel can be good, or it can really suck. At least ICU you pretty much know your staffing ratio, ER can be highly variable, and you never really know until your first day.

I used to travel as a per diem ICU and ED RN, and I much preferred ICU because it was more predictable.