How did you switch to ED nursing?

FancypantsRN · Aug 9, 2011

Hey, go for it! I made the switch with about 4 years of experience. I worked PCU and CV stepdown for a while. So I had tele experience, but ER is not like a tele floor really. If you can recognize that someone is not in NSR, the doc is right there. You can also take a class, like basic EKG interpretation. You will learn the protocols of the ER when you get there.

I also chose a move out of state to switch to ER, I was a traveler and decided I did not want to work on the floor anymore. I love working in the ER. The major difference is the assessments, they are focused on why the pt presents to the ER. You just have to train your mind to not think head to toe and every single pt anymore. It's something you get the hang of after a while.

The only thing I can say about you being a good fit is you just can't be the type to get flustered with multiple distractions, your assignment (unlike the floor) is constantly changing, and depending on what shift you work - you may end up with less or more of a pt load than you are used to. Good luck with your decision and keep us posted!

crb613, BSN, RN · Aug 10, 2011

I was a MS nurse for about 1.5 years...and I was always being floated around....Tele mostly. Then one day I was sent to the ER....the rest is history. I loved it, and moved from MS to ER. I would suggest that if you can get some Tele/ICU experience first that would be very helpful to you, and your patients.....not only would you have a good grasp on cardiac, but you will learn a lot about drips,critical care. If you don't want to wait you can as the above posted mentioned take some classes. I think I would have been much more at ease if I had been more experience with cardiac the drips ect.....I made it just fine but I had to work really hard, and I still am not what I would call a cardiac nurse. Your MS experience will be very helpful with time mgmt., and juggling a lot of things at once. Good luck on whatever you decide to do. :)

apocatastasis · Aug 10, 2011

I've been in a high-volume, pretty low-acuity ER for 10 months... Had over a year of ICU experience in a high acuity SICU, which I found to be invaluable for knowing the drips, being comfortable with ventilators, crashing patients. In the ICU and ER, when a patient goes downhill, the buck basically stops with you, there is no rapid response other than yelling "I NEED HELP IN HERE!" You will probably need a pretty long orientation to get used to the critical care aspect as well as the unique flavor of the ED. I thought I was pretty badass as an ICU nurse but I found the transition to the ED pretty stressful.

I had trouble going from the comprehensiveness of ICU to the quick and dirty of ER. A lot of ICU/Med-Surg nurses do not understand this, and on occasion you will get flack from them for it. Basically, ER nurses care only about what are you here for, and any medical problems that could complicate the chief complaint. The rest, you don't care about. If you are complaining about a heart attack, I don't care about and probably would not even notice a huge sacral decubitus... and even if I did, I wouldn't do anything about it anyway. It's a totally different mindset, but when you have 4-7 patients, you absolutely do not do head-to-toes... and you have to move FAST. As soon as you get one patient out the door, you have another one waiting for you, and everything you do is evaluated not only according to standards of care, but also how long it takes you to do everything.

I went into ER because I got burned out from watching patients rot to death in the ICU. I wanted something faster and less intimate. But the grass is not always greener... there are lots of frustrating things awaiting nurses new to the ER... people looking for handouts, people that want drugs, and the overall stupidity that is just beyond belief (you have not seen stupid until you've spent 8 or 12 hours in triage).

Basically, if you're interested, try it! You may love it, and/or it may be a good stepping stone to other critical care areas if you'd like to try ICU or Cath Lab in the future.

Nrsstudent09 · Aug 10, 2011

I was a new grad who went right into tele in June of 2010. I found I got bored. It seemed to be the same thing over and over. I was an EMT prior to an RN so I think I'm an adrenaline junkie, for lack of a better term :) I made the switch to the ER in Feb of 2011. We are basically the only ER for 30 ishmiles and see approx over 100,000 pts/yr. It is very busy. I am so glad I made the switch though. It is never the same thing every night. I had a very intensive training program that lasted from Feb to the end of June. With that being said the ED was a very big change. To me it was hard getting used to if you come in with a sprained foot an extensive assessment on the rest of your body isn't needed. We have a basic ratio of 4:1 with sometimes a 5:1 ratio. It is very quick paced, but I love it. You really learn to bond as a team. For example when one of us has a Code STEMI or Code CVA come in you are focused on that patient and your coworkers help pick up the rest of your patients.

That being said the ER is an awesome place :)

NeoPediRN · Aug 10, 2011

the overall stupidity that is just beyond belief (you have not seen stupid until you've spent 8 or 12 hours in triage).

I said these words VERBATIM today!! It was my 2nd day in triage and could NOT believe the complaints, the amount of self-pay, the groups of friends that came in drug-seeking, the sheer amount of level 5 patients!! Triage is burn out central, baby!

Anna Flaxis, BSN, RN · Aug 10, 2011

I appreciate any feedback on what ED nursing is like for you, how you chose it, and your advice for someone considering a change.

ED nursing is at times 8 hours of nonstop stress, and at other times, redundant and mind numbingly boring. Some days I feel like a great nurse, other days like an adequate nurse, and others, like a complete failure of a nurse.

I chose ED nursing after 2 years in a specialty unit where the focus was so narrow, that while I learned a lot about cardiac pathophysiology and pharmacology, I wanted a broader experience.

I sure got it!

OLDTRACKMEDIC · Aug 10, 2011

Simple..

I climbed out of my ambulance and walked into the ER. I was a 5-year Paramedic, and decided it was no job for an old man. I am proud of my ambulance heritage. I was difficult, because the nurses I worked with had an issue with paramedic-RN. I did find out that nurses eat their young, and ER nurses are among the worse....

jotond · Aug 10, 2011

I was an ICU RN for 10 years (CVICU and CCU mostly) who was ready for more variety. It took a solid year of looking and applying avidly to make the switch to ER. I'm in No. CA where the jobs are tight, and it is difficult to change specialties. But hang in there because someone will give you a chance eventually! Persistence will pay off. My husband and I always say that if you have a goal, you have to keep trying until you've exhausted everything, until every possible avenue has been explored. Don't give yourself the option to stop trying until you've done everything you can to make it happen!

ER nursing is great - some days the stress is too much but at the end of the day, I feel satisfied and challenged in ways I never did before. I think all kinds of personalities can thrive in the ER. The most important qualities are flexibility and resilience - you have to be able to let things roll off (ie - difficult family members, stressed out coworkers). It's fine to be sensitive, which is a great quality for a nurse, keeps you in touch with your patients, but you cannot take things personally, and you have to keep things in perspective. It's a dynamic place.

Overall I think it can be a great environment to grow professionally and personally. Now and again I'll help out in ICU but am happy to say that ER is definitely where I belong! Good luck to you!

SweetsRN522 · Apr 12, 2012

Any advice for a MS nurse with 2 years experience, ACLS and currently taking a Telemetry course. My applications never make it to the manager because they require ER or ICU experience, even at the hospital when I apply internally? Any suggestions? I have gone to HR and they tell me to obtain telemetry experience, but other nurses with the same experience in some cases less are able to obtain jobs in ICU and ER. Any advice would be beneficial. I plan on obtaining my FNP and working in an ER someday! :)

NurseOnAMotorcycle, ASN, RN · Apr 12, 2012

Any advice for a MS nurse with 2 years experience, ACLS and currently taking a Telemetry course. My applications never make it to the manager because they require ER or ICU experience, even at the hospital when I apply internally? Any suggestions? I have gone to HR and they tell me to obtain telemetry experience, but other nurses with the same experience in some cases less are able to obtain jobs in ICU and ER. Any advice would be beneficial. I plan on obtaining my FNP and working in an ER someday! :)

Take your resume directly to the nurse manager. Dress decently for it. Most NMs will mini-interview you when you hand it to them. Ask questions. Don't take more than 5 minutes, they're busy.

IZGO22 · Apr 12, 2012

Hello -

I have actually helped mentor / transition a few ICU - FLOAT RNs to be cross-trained in the ED... first we asked MY boss if they could shadow me for a day or two ( non paid and then paid ) to see if it was a good fit before we ended up officially cross-training and the boss saw they were a good fit, got to know them and it worked. Other classes / certifications you might look into are TNCC ( Trauma Nursing course ) to show them you are serious.

Good luck!