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Hate med/surg is ED any different?

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by RNKX RNKX Member

I've come to the conclusion that I really dislike Med/surg! The workload is extremely heavy and feel overworked! I've always had good work ethics and love fast paced situations... But med/surg is just stressful! I've always wanted to work in ED but wondering if I should even apply knowing how crazy/stressful inpatient med/surg is! Is the ED any different? Thanks in advance for your insight!

Sassy5d

Has 11 years experience.

It's a different kind of crazy.. Like three patients family members irate on the telephone, your pt about to do a back flip off their bed while the labs on the other line to give you a critical result and to tell you all your other labs hemolyzed.. All at the same time.

SquishyRN, BSN, RN

Specializes in ER, Trauma, Med-Surg/Tele, LTC. Has 11 years experience.

It's a different kind of crazy.. Like three patients family members irate on the telephone, your pt about to do a back flip off their bed while the labs on the other line to give you a critical result and to tell you all your other labs hemolyzed.. All at the same time.

While I'm pretty sure ER certainly is a different kind of crazy, the crazy you just described sounds a lot like the crazy that can happen on a Med-Surg floor too ;)

brownbook

Has 36 years experience.

I understand your point and frustration with med/surg but why limit yourself to ED!

There are at least 8 (off the top of my head) different areas of nursing in most acute care hospitals. If your hospital has a float pool it would be a great chance for you to be exposed to different nursing units. You might find yourself happily working somewhere you swore you would never want to work!

tarotale

Has 1 years experience.

I was a medsurg nurse and I absolutely detested floor nursing out of my guts. I moved to ER about 2 months ago. I am loving it compared to floor nursing; actually picked up OT at old floor just for extra cash, decided not to do it again because I was reminded how much I hated MS.

If you think floor is heavy-load and you're overworked, I will tell you that the workload is NOT EVEN COMPARABLE. ER load and pace is heavy and here you ARE overworked; There are definitely pros: simpler charting, in&out pts, interaction with Drs, amazing teamwork (or hopefully), autonomy, respect. At floor you have a pace. They won't transfer pts back to back, if so seldomly for example. That happens all the time at ER. Just got chest pain pt? Your charge can put seizure or code stroke to your room literally back to back, and this is where beauty of teamwork and priority comes in.

I felt like floor was restricting my talent and potentials. It doesn't take a genius to learn to titrate cardene or insulin, but they don't let you have that on the floor. I love those kinds of things and I am loving the ER compared to floor. Also they say work is what you make of it, and that's definitely true in ER.

If you don't got things to do and you don't actively seek out to help someone who is drowning in your zone, or assist fellow nurse with EMS arrivals, they won't help you either and that can be hell; but if you are hardworker, enthusiastic learner, actively seeks to help others, nice mix of humor, sarcasm, and ballbusting, good personality, you will fit right in! I still regret choosing nursing as career, but I am much much happier as ER nurse than floor nurse. I say go for it!

Workload wise, it depends on the place. My co-workers would disagree, but I think many GOOD floor nurses work harder than me. And my peers wold tell you I carry more than my share in the ER.

But, on many floors, nurses have to prioritize:

Must do

Really should do

Do, if time allows.

Often, floor nurses don't even get through the "must do" portion, and are busy all shift.

While some ERs crank all the time and nurses run for 12 hours, that is not everywhere.

I get down time. And often, when busy, my priorities are very clear. I am never overdue on my hourly repositoning of mr Smith. And, the other shift is never ticked off that I didn't do a bed bath.

Shadow a shift or 2.

A lot of the nurses who transfer down from our medical and surgical floors say that they love the variety the ER gets to see, you get to stabilize the sickest patient and if you have a patient or family that you cannot stand you don't have to worry about being with them for a full 12 hour shift. We have awesome team work, the doctor is there to clarify orders and help you understand rationales. Plus there is the thrill of never knowing what's on the next ambulance or what will walk in the door.

Now in trying to recruit some of floor nurses there are things they don't want to deal with. Such as the people who aren't really sick. Yes, we get deal with trauma patients, but more often we're bogged down with sore throats, kids with fevers and nonspecific abdominal pains. We don't have a set nurse to pt ratio. If a nurse has to go 1 to 1 with a pt the rest of the nurses flex to pick up the load.

There are similarities. You aren't going to get away from running your tail end off, that's just nursing. You're going to be interrupted mid-task for silly things and you'll have to prioritize. However, the ER has no routine. Everyday has it's own flow to it and every patient is a bit of a mystery. You take a patient from the very beginning and get the pieces of the puzzle to see if you can find out what's wrong and how to make them better. That's the fun in the ER.

Sassy5d

Has 11 years experience.

While I'm pretty sure ER certainly is a different kind of crazy, the crazy you just described sounds a lot like the crazy that can happen on a Med-Surg floor too ;)

But wait, here's EMS bringing your stroke and the triage nurse just pulled your abd pain out into the hallway with your acute MI. The floor can't take report, your ICU hold is tanking. I think your seizure pt in bed 1 just went endo over the seizure pads.. Did I just see a bed bug?

LakeEmerald

Specializes in Emergency/ICU. Has 4 years experience.

I find the fast pace and constant demand of the ED invigorating. However, the ICU gives a great challenge without the constant push/pressure of the ED to move-move-move! And, patient ratios in the ICU are typically much lower than ED or Med-Surg.

tarotale

Has 1 years experience.

But wait, here's EMS bringing your stroke and the triage nurse just pulled your abd pain out into the hallway with your acute MI. The floor can't take report, your ICU hold is tanking. I think your seizure pt in bed 1 just went endo over the seizure pads.. Did I just see a bed bug?

You forgot the pcp overdose yelling on his way down the hallway tied to the gurney lol

PacoUSA, BSN, RN

Specializes in PCU / Telemetry. Has 9 years experience.

I felt like floor was restricting my talent and potentials. It doesn't take a genius to learn to titrate cardene or insulin, but they don't let you have that on the floor. I love those kinds of things and I am loving the ER compared to floor. Also they say work is what you make of it, and that's definitely true in ER

This! I hate how a med-surg floor limits the things a nurse can do and learn. ER nurses seem to be able to do much more with their patients. There are skills I want to learn but cant because of where I am. Nurse education on my unit is a joke. Excited to go to the ED, as I know it will open up another world.

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tarotale

Has 1 years experience.

This! I hate how a med-surg floor limits the things a nurse can do and learn. ER nurses seem to be able to do much more with their patients. There are skills I want to learn but cant because of where I am. Nurse education on my unit is a joke. Excited to go to the ED, as I know it will open up another world.

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come play in the big league!

This! I hate how a med-surg floor limits the things a nurse can do and learn. ER nurses seem to be able to do much more with their patients. There are skills I want to learn but cant because of where I am. Nurse education on my unit is a joke. Excited to go to the ED, as I know it will open up another world.

That the floor nurses are restricted in their practice is an acknowledgement of the nature of the floor... the patients are too spread out, both physically and temporally, to have the bandwidth required to attend to tasks like titratable drips. It's the same reason that we prioritize moving the sickest ICU players out of the ED as soon as we can... they need a level of nursing care that's hard for us to provide.

It's true, though, that the ED provides ample opportunity for skill and knowledge development simply due to the throughput and because we're the first contact.

I've come to the conclusion that I really dislike Med/surg! The workload is extremely heavy and feel overworked! I've always had good work ethics and love fast paced situations... But med/surg is just stressful! I've always wanted to work in ED but wondering if I should even apply knowing how crazy/stressful inpatient med/surg is! Is the ED any different? Thanks in advance for your insight!

I dislike med-surg (and would thoroughly detest LTC) because it gets monotonous and tiresome. I am often much more overworked in the ED than I was on the floor but that's precisely why I prefer the ED. It tends to be very diagnostic and problem focused rather than recuperative. The medical model dominates the ED and I find it much more satisfying.

For the most part, I care not to know much about the lives of the patients. Rather, I simply want to treat their current acute issues and leave the remainder to other parts of the system.

My favorite times at work are when things are crashing down upon us. I enjoy the pace of trauma and medical codes, and I even derive some satisfaction by successfully working with acutely psychotic and/or intoxicated patients. When I'm saddled with floor patients waiting for beds, I struggle to keep my energy level up.

My experience is that the ED is far more crazy/stressful than is inpatient med/surg. You might prefer an ICU gig (which would generally bore me) or even an OR gig.

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency. Has 21 years experience.

But wait, here's EMS bringing your stroke and the triage nurse just pulled your abd pain out into the hallway with your acute MI. The floor can't take report, your ICU hold is tanking. I think your seizure pt in bed 1 just went endo over the seizure pads.. Did I just see a bed bug?

That was yesterdays shift. "Hey emtb2rn, i know you're in with that septic icu hold but your seizure guy is seizing again. And you've got a new one in the hallway".

ZooMommyRN, ADN, RN

Specializes in Med/Surg, ICU, ER, Peds ER-CPEN. Has 13 years experience.

You forgot the pcp overdose yelling on his way down the hallway tied to the gurney lol
And this is why I made the leap to a Peds ER lol every now and then I think I miss the adult side, peek at their census and realize NOPE! overdoses are few and far between, the occassional ETOH is a teen that quickly realizes they are not in Kansas anymore and will play by the rules, once in a while family members try to run the show and are quickly reminded of the rules by security, yep love the land of little people :dummy1:

tarotale

Has 1 years experience.

And this is why I made the leap to a Peds ER lol every now and then I think I miss the adult side, peek at their census and realize NOPE! overdoses are few and far between, the occassional ETOH is a teen that quickly realizes they are not in Kansas anymore and will play by the rules, once in a while family members try to run the show and are quickly reminded of the rules by security, yep love the land of little people :dummy1:

i admire ped nurses. psych and kids, would like to avoid them at all cost! i hear they get better pay though... but then, them kids are too different than big people, i hit my forehead when i get peds in my room

NurseOnAMotorcycle, ASN, RN

Specializes in Med-Surg, Emergency, CEN. Has 10 years experience.

Also as Altra said in another thread, by the time we discover that someone has c. Diff, TB, bedbugs/scabies, etc, we've already been taking care of them for some time.