ICU nurse now in ED

[ParrotHeadRN]

Good morning all!

My background is Neuro ICU with some Med/Surg ICU thrown in. I started a new position in a small ED a short time ago. So far, I love all the people I work with and have been made to feel very welcome.

My problem is that I feel very disorganized and scattered. Right now there are no assigned rooms, we just all help with everything. Which is fine, I love that kind of atmosphere, but I am very afraid I am going to miss something. We will, at some point, be changing to assigned rooms, but I don't know when that will be and in the meantime it just leaves me feeling lost.

Another thing I'm having difficulty with is, well, I don't know how to phrase it. I'm used to knowing EVERYTHING about my patients. I know them inside out and upside down and I have them monitored at all times. I literally know when they pass gas. Of course, in the ED that is just not possible and I realize that but it is still hard to get used to that. I believe that is another reason I feel like I am wandering around lost.

Charting is also a challenge for me because I want to chart everything and it doesn't seem to be the way it's done. Geez, I guess I have more than just one issue here!

So, I guess what I am looking for is maybe some tidbits of advice or experience from both new and experienced ED nurses. I know I am not the only ICU nurse to go to the ED so I'm sure someone has been plagued with the same issues.

Thank you all so much for being here and I hope you all have a great day!

PH

[gonzo1, ASN, RN]

Welcome to the ER. It won't be long before you get the hang of it. One thing that ER nurses do is chart only on the system the pt is in the ER for. For example if pt comes in with a laceration on their knee you don't need to chart on lung sounds or bowel sounds. Charting is typically more system specific. Of course if you have a pt with CHF you are going to be doing a lot more charting than a laceration.

If a pt comes in with an eye injury try to put the eye equipment in the room right away. If pt comes in with laceration try to put suture kits in the room right away.

Perhaps I will think of more things later, but just got off 13 hour shift and very tired.

Good luck and enjoy

[AfloydRN, BSN, RN]

It an overwhelming difference between CCU and ER. In the ER you don't get time to read a chart, sometimes can't get any history- here he is and fix him. My CCU charting was long d/t 1 :1 time. ER patients, unless of a code situation, don't get any 1:1 time. ER is treat em and street em. CCU is longterm.