Hospice to ER... Tips??

[Emm_RN, ASN, BSN, MSN]

Hi all, thank you in advance for any advice/tips. I worked med surg for one year then ICU for 2. I have been in home health and hospice for the last 4 years and am now transitioning back to the hospital setting, but this time in the ER. I am VERY excited, because this is always something I wanted to do, but never had the courage to try. Now that I am 7 years into my nursing career, I finally feel confident enough to dive in and learn anything I possibly can.

Has anyone transitioned from hospice to ER? Or any general tips for someone going back into the hospital setting in the ER? Any advice is appreciated. I am nervous but very much looking forward to this adventure! I love a good adrenaline rush and I get bored easily, so I'm hoping ER will be the right fit for me. I already have a few books on emergency care and tips for new ER nurses. Thank you! 

[gere7404, BSN, RN]

Pay attention in your orientation period, don't be afraid to ask questions or tell someone you don't know something; ER nursing is a lot more skills based than other nursing fields, so you might be doing things you haven't even thought about since nursing school, so its OK to let people know when you need a demonstration or instruction. You're ahead of the game in some regards with your experience in the unit, you'll be able to run drips and titrate meds a lot more comfortably than a new grad. 

Your hospital should pay for ACLS, PALS, and TNCC, so don't fit the bill for those certs. 

Don't ever let good pee go to waste. If a pt has to urinate, make sure they have wipes and a specimen cup in case the provider wants a UA (this will always be the case in anybody with abdominal complaints and women of childbearing age)

Sheehy's is a good book, it lays out the workups we do for different ddx's. Mark Boswell has a free Youtube series on CEN subjects -- even if you don't intend on testing the CEN anytime soon its good to brush up on the s/s, diagnostics and interventions for the common things we see like cardio, GI, respiratory and neuro stuff.  

[masscane, MSN, RN]

On 6/1/2022 at 5:35 AM, gere7404 said:

Don't ever let good pee go to waste.

Truer words were never said.

I went from ER to oncology/hospice, exact opposite of you, and can tell you that it is a HUGE transition. Floor nursing could not be more different from what you do in the ER. You already have a big head start because you'll be needing all the skills you've mastered.

My best advice for you is to try and stick it out for a few months. Starting out can be miserable in the ER, but once you get over the learning curve ER nursing can be enjoyable. Just remember that if you help someone out when they're drowning, they're more likely to be there for you when it's your turn to drown. The teamwork and camaraderie are what I miss the most.

Good luck to you!

[gere7404, BSN, RN]

On 6/4/2022 at 5:03 PM, masscane said:

Just remember that if you help someone out when they're drowning, they're more likely to be there for you when it's your turn to drown. The teamwork and camaraderie are what I miss the most.

This is huge, especially coming from a kind of nursing where you work alone a lot. ER nurses need to just jump in when they see something has to be done. We aren’t possessive about our patients like they get on the floor, all of us could use a hand pretty much all the time, so when someone offers it, take it! Goes both ways, if you see a coworker who has a bunch of critical patients, ask them what you can do to help. You see an ambulance coming in and the nurse for that room is busy in another one? Jump in and start the triage and getting the patient worked up.

[Emm_RN, ASN, BSN, MSN]

Thank you all SO much for your replies! I'm definitely a team player so I'm sure I won't have any trouble jumping in once I'm feeling comfortable. I just got Sheehy's and will be cramming just like I did for the NCLEX. Memories!