From MS/Tele floor to ER nurse

That Guy, BSN, RN, EMT-B · May 5, 2015

Welcome to the ER. All the things you are saying are normal. It was a weird transition for me too, but over time it became my life and I love it now. Ride it out the best you can and just accept that you don't know everything, and thats ok.

p.s. my iv skills sucked something fierce when I went down. Practice practice practice.

telenurse1963 · May 5, 2015

Thank you. I'm just tough on myself. I do love it and enjoy the rush at times. Thanks again.

ScrappytheCoco · May 6, 2015

I started in the ED as a new grad. I could barely get a line in a healthy young person with huge veins. Practice! Focused

assessments with occasional extras depending on the ESI and vital signs are a huge component of time management. Ask questions and get involved with patient populations you're unfamiliar with. Go with the flow and it will all come with time.:)

Guest219794 · May 6, 2015

Hi everyone,

Just wanted some input. I just transferred from MS/Tele floor to ER and I am on my 4th week of orientation. I have been a floor nurse for 5 years, but moving to ER just feels like I don't know anything. My IV skills aren't up to par. My assessments out the window and charting is just not there. Please give some pointers. Most days are not great. I enjoy what I am learning, etc. but am so stressed and just feel all thumbs and stupid. Need advice please

"My IV skills aren't up to par"

Of course they aren't. Why should they be in this short time? Let your peers know you want to work on this skill, and you would like to start all their easy IVs to build confidence and get you used to the sequence, etc. When you get the chance, observe others, especially on difficult sticks.

"My assessments out the window"

Observe how the experienced nurses do it. Chances are your assesments are good, you are just haven't adapted them to ER, Floor assesments are looking for change in conditions, and are based on the PT not being seen by a doc for hours, or even a whole day. Your ER PTs will be seen by a doc shortly. Assess the main complaint. Assess anything you will be dealing with. Listen to breath sounds before and after a neb. Don't listen to breath sounds on a sprained ankle.

"charting is just not there"

Read what and how other nurses chart. Then do that.

"Please give some pointers"

Read. Read up to date and medscape. Sift through this site, and look for actual discussion of nursing practice. Sitting around at home? Read a few pages of the ESI manual, version 4.

Last but not least, be realistic. Presumably in 5 years, you gained some expertise. You are probably used to working at a high level of competence. It will take for you to get good at ER.

OTOH, as afloor nurse, you probably have some applicable skills that are much better than most ER nurses. Look for areas in which you can help others with these strengths.