I am an ICU RN with just under 2 years experience. I am considering transferring from ICU to ER. I have my ACLS, PALS, and TNCC. As an ICU RN in my hospital, we respond to all incoming traumas, so I have experiencing with triage there. My IV skills are decent, but considering I work with mostly central lines in the ICU my concern would be that I could use some work there...
I was just curious how you would think the transition would be? Any advice or helpful hints about the possible move?
Your slight concern is understandable, but trust me you'll adjust well. ED staff are always prepared for all kinds of medical emergencies, and your critical care skills will come in handy. You'll find that you eventually get accustomed to caring for patients with a wide range of injuries and acute ailments from the newborn right through to senior citizens.
Oh and don't forget - no more "two patients and I'm done."
Your assigned rooms are full? Hey presto! Say hello to your new hallway patient...
(This will really hit home when you're cardioverting in the hallway on a portable monitor because you've no place to put the patient!)
ED on total divert? Walk in patients don't know (and don't care). EMS will still bring you patients. And if every ED in the county is on divert, don't matter no how!
You're 'holding' patients because the hospital is full and no 'hold nurses' are assigned to the ED? Guess what - now you're both an ER nurse AND taking care of inpatients as well. You'll have to do both routine 'inpatient' orders, assessments and med passes - while also dealing with constant ER patients (assessments, EKGs, labs, IVs, etc.) admit/discharge/transfer. NEXT!
Honestly, IMO - this is the most infuriating part of being an ER nurse. I can do inpatient, I can do ED - doing both at the same time is just; I have not the words frankly!
you'll be fine. You'll get plenty of time to work on your IV skills. You will learn the ropes of an ER. You already know what a sick person looks like, so the rest is gravy. You'll learn the protocols, the regulars, the turkey sandwich and gingerale routines, when to talk to a doc (all of the time) and when to move it along and tell them what you need. Just listen and learn. Good luck.
I'd like to know more about time management too. I'm a floor nurse (tele/ cardiac step-down) who will start next week in the ED. I think the lack of routine might be a little tough for me too, I mean a routine is usually how I've managed my time in the past. I'm excited though and ready for the challenge! Any insights are always greatly appreciated. Thank you.
don't get ticked off at interruptions, because that is all that we work with day in and day out. Interruptions from a call light, give meds in that room first, no, give meds in that room before the pt goes to CT, give that person a blanket. Help! This patient is about to fall! There's an endless stream of interruptions and you just have to keep your priorities straight, keep shuffling the deck, don't get mad at the petty stuff (and coworkers) and keep moving. You may have been working on one thing and just HAVE to get it done, when another new patient rolls in the door (chest pain) and you have no choice but to address that patient. I always provide my patients with the plan and write it on our white board. When the plans change, I tell them that and write down the new plan. When I'm called away, I tell my patients and their visitors I have 3 other patients and I have some things to do and I'll be back in a "few minutes" - don't give specific times because patients and their families will hang onto that with their last breath. Be open, observant, willing to accept criticism, offer to help your drowning coworker and you'll be fine. Just go with the flow.
Nurse-Arnold
5 Posts
Your slight concern is understandable, but trust me you'll adjust well. ED staff are always prepared for all kinds of medical emergencies, and your critical care skills will come in handy. You'll find that you eventually get accustomed to caring for patients with a wide range of injuries and acute ailments from the newborn right through to senior citizens.