OK how do I get off the floor and into ER?

Nurses General Nursing

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I've been in med-surg for 8 or 10 years. I'm done with it, it's arguing with families and doctors and about every 3 weeks another mandatory form is added to the stack of forms and charting I already do. I want to get into ER but except for floating there years ago at a different hospital, I have no experience. Other than that, my clinical skills are great.

So what to do? Apply and ask for a trial by fire? Is that smart? Is that possible?

Specializes in ED, ICU, Education.

It is possible. Most places will offer a 90 day probation period, and if you absolutely despise it after that, then as you know, your options are endless. However, I have ED experience, and there is always going to be family, doctor, nurse, et.c disputes. Not to mention the intoxicated, homeless, and beligerant patients. But if you need a change of scenery, the ED will definitely offer you that, in comparison with what you're used to. Best of luck!

Specializes in ER, ICU.

How to get off the floor? Pick yourself up lol... sorry... Yes, possible. Show interest, attend a few ER CEs, make a friend there. Look at the requirements and start knocking them off, ACLS, PALS, TNCC, PHTLS, ENPC, CEN whatever... If you decide you will become an ER nurse, you will. Start taking the steps that will lead you there. If it doesn't work out at your hospital, apply elsewhere. ER needs people who are adaptable, can go with the flow, can multitask, prioritize, and work with what they're given. In my opinion these qualities are more important than actual experience, because anyone can learn the details if they have the ability. But I'm not your future boss. Find out what they want, then get it. They might be concerned that, from med-surg, you might not have the knowledge to rapidly identify problems. Most ER assessments are brief and single system focused. You have to be able to be comfortable with that. There usually just isn't time to follow the nursing "ideal" of a holistic assessment. Not everyone can adapt to a routine of no routine. If it's your passion, then go! ER medicine is see it treat it. Although not all patients are dying, you need to be able to see the dying patients right off and start intervening. If you can address these issues you will be able to get hired. Good luck!

Oh man, if you're tired of arguing families the ER will offer no relief from that.

Otherwise, ER is exhausting, frustrating, aggravating, and fun!

What the other posters have suggested is good advice. Network!

Specializes in ER, Trauma.

Nurse 2033 gives an excellent answer. I point out that ER nursing is back-wards in a sense. On the floor, the first thing you might look at in your assignment is a patient's diagnosis. In the ER a diagnosis is about the last thing a patient gets before discharge or admission. This provides opportunity for working much closer with the patient and the docs, and soon you know the treatment algorithm for most complaints and can initiate the process to expedite things. Above all else, remember that nobody is born knowing how to be an ER nurse. We all had to learn, and if you and fate so choose, soon it'll be your turn to learn. ER nursing isn't for everyone. You MUST either love it or leave it.

Specializes in ED, CTSurg, IVTeam, Oncology.
I've been in med-surg for 8 or 10 years. I'm done with it, it's arguing with families and doctors and about every 3 weeks another mandatory form is added to the stack of forms and charting I already do. I want to get into ER but except for floating there years ago at a different hospital, I have no experience. Other than that, my clinical skills are great.

So what to do? Apply and ask for a trial by fire? Is that smart? Is that possible?

You know the adage of being careful what you wish for (ie because you may get your wish and not be too happy with it)? I get the sense from your description that you're a bit fed up with certain stresses placed on your by your milieu. However, before you make your change, consider this; take your worst day, with your most nightmare family, and a full nursing district, and don't think you can take anymore... and get slammed by 3 more ambulances, with another 12 patients in the waiting room demanding to be seen next.

My point is (as I've always argued with my floor colleagues), that no matter how bad they get, once they filled their beds to capacity, their unit is effectively closed. If your floor was to function like the ED, imagine then, if you take your regular two bedded room and put four beds in it, line your hallway with extra patients with no cap on the number that you can be assigned, and visitors are there all day long. Sounds easy doesn't it? Further, we get new mandatory forms about every two days.

So I hope you don't take this as an insult, but rather as a dose of sobering advice; if you can't withstand the pressure in med surg any longer, you're sure as heck not going to enjoy the heat in the ED.

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