Float Pool RN looking to transition to ED

[Gooseontheloose, ADN]

Hi there.

I've been a med-surg/tele float nurse for a year and a half. I was one of those people who started my career not knowing what I really wanted to do. I thought maybe I'd be a med-surg nurse forever. Let me start by saying I do love my job and where I work. I'm very grateful for everything. However, lately, I have been floating to the ED quite a bit. I mostly go there for overflow patients or to work as an admissions nurse, but I have fallen in love with the energy and chaos of the ER. Even though I haven't seen it all on the floors, I find that on the units, it's often the same old thing, same routine. It's extremely rare to see a code on the floors and I work NOC shift, so I don't use a whole lot of skills. Sure I put in an occasional foley, or an IV, maybe see a short run of Vtach, but that's about it. Most of the patients are trying to sleep in the middle of the night and there isn't much going on when that's the goal of their care. Not that the occasional crazy doesn't present itself, because it does, but it's rare. I feel like I'm not growing as much as I would like and I'm ready for a new challenge. I crave action. The last time I floated to the ED and someone went into unstable SVT and they were getting ready to cardiovert, I was all over that like white on rice. I wanted to watch, learn, help... whatever they would let me do. (The patient ended up converting without intervention and I was a bit bummed).To be honest, I've never had to pull out the crash cart on the floors, so I thought it was a glorious shift that night. Lol. Perhaps I have discovered I really am an adrenaline junkie? Anyway.... I've been thinking a lot about transitioning to the ER. I'm a bit intimidated by it, but I feel that I need to challenge myself and grow. I want to see everything, learn everything. I want to be one of those nurses who jumps in on a code and works it like a boss. I'm not there right now because I never see that stuff, but that's where I want to be. Several of the nurses in the ER have encouraged me to come work with them. I've come to realize that I need more than what I am seeing and doing right now and that's why I feel like the ED is probably going to be a good fit/move for me, even if I'm scared of making a change. So here's where I could really use some advice... the hospital where I work WILL NOT take a med-surg nurse and let them train for ER. It doesn't matter how many certs I have, or if all the charge nurses know me and like me, they are very rule-based. You must serve a year in their observation unit before being eligible for the Emergency Nurse Orientation program where they will train you. Clinically, the observation unit is a step backwards skill-wise for me, but I have reached out to the director and right now, there aren't any openings. My option is to stay float pool and hope I float to the ER while I wait for the observation unit to open up, OR go to admissions nursing full time. That would have me working in the ED, but not as an ED nurse. The advantage to that would be I would get the opportunity to learn and help, but it wouldn't count when it comes to trying to get hired on as an ED RN. My current boss advised me to remain in the float pool and try for a per-diem ER job at another hospital that might be willing to train me. My hospital will hire someone for ER IF they have previous experience only. I feel like I am in a dilemma at the moment because I don't know what direction would be the best for me. I want to reach my goals and do it in a way that will help me to be prepared for the stress and acuity of the ER. If anyone has any advice or thoughts, I would very much appreciate it ? Thanks!

[JKL33]

20 hours ago, Gooseontheloose said:

the hospital where I work WILL NOT take a med-surg nurse and let them train for ER.

20 hours ago, Gooseontheloose said:

I have reached out to the director and right now, there aren't any openings.

20 hours ago, Gooseontheloose said:

The advantage to that would be I would get the opportunity to learn and help, but it wouldn't count when it comes to trying to get hired on as an ED RN.

20 hours ago, Gooseontheloose said:

My current boss advised me to remain in the float pool and try for a per-diem ER job at another hospital that might be willing to train me.

I think your boss is right. Or else just look for a FT ED position where they are willing to train you, and leave your current employer who doesn't see the wisdom in doing so.

I do think it would be wise to temper your adrenaline-related dreams just a little. ?? A very decent portion of what we do is not that, and when we are involved in critical scenarios, quick but calm works well. I've seen places where those who fancy themselves adrenaline junkies are banging stuff around and yelling at everyone and the whole scene is way more "uncontrolled chaos" than appropriate response to an emergency.

If you get the chance to interview for any ED-related opportunities, you will want to convey how you have become interested and what appeals to you about the ED, but also your potential for becoming solid (vs. boss). Hope that makes sense.

Best of luck!

[Gooseontheloose, ADN]

Thanks for your reply and advice. I realize that majority of the time, there isn’t necessarily lots of action. I think what appeals to me more is the opportunity to learn and grow from situations like that though. Perhaps I didn’t convey myself the right way. Many floor nurses pray they never see anything during their shifts, I’m not that way. It’s not total adrenaline I crave, but it definitely excites me when something is going on. Hope that makes sense. I think working in the ED on occasion has made me see a different side of Nursing that appeals to me for various reasons. But I totally get your point too.

["nursy", RN]

I would try to find a position anywhere where they are able to train you in the ED. If you stay where you are, waiting and hoping something will happen, you may end up being unhappy, or burned out. It seems like you've been in nursing long enough to know what you want, so go for it!