Is ER nursing Floor nursing???

elthia · Jun 22, 2006

I totally disagree that "Floor nursing is monotonous and brain shrinking"...I do think that floor nursing is totally different than ER nursing.

The only thing I ask is that if I say, "I can't take report, I have a pt in VTach and I need this phone for the rapid response team". Please believe me. The only time I have refused to take report from the ER nurse is in a situation like that, and the reason I was answering the phone was that it was a CORDLESS phone I put in my pocket so that I could stay at the pt's bedside. However I wasn't believed, and the admit arrived while I was coding the vtach pt.

JMBM · Jun 22, 2006

Elthia, I totally agree that floor nursing is not monotonous or brain shrinking. I'm pretty sure what Jennifer meant is that floor nursing would be monotonous and brainshrinking to her. Just like ER nursing can seem frustrating and overly stressful to another nurse. If we all liked the same type of nursing, it'd get pretty crowded in that department. A good floor nurse is a gem beyond value. As to the nurse who sent a patient up to you while you were working a code, that was the wrong thing to do - for both patients. Still, we all need to keep talking and trying to work together. I've have plenty of floor nurses ask me to "drag my feet" on an admission until they could get something done. Fine, I'll try my best every time. I've had plenty of floor nurses suck it up and take multiple admits right before shift change because they knew we were getting slammed in the ER. Unfortunately, we've all had other floor nurses promise to "call you right back" for report and then drop off the map until after shift change. In the meantime, we have folks puking and bleeding in the halls. I think the point of this line is that a new nurse shouldn't look at the ER as a way to avoid cleaning up feces or any other nursing task. It is, as you say, an entirely different type of nursing altogether.

Jennifer, RN · Jun 25, 2006

I totally did not mean to offend anyone by stating that floor nursing was brain shrinking and monotonous. As JMBM pointed out, it was to ME. When I first started as a nurse working on a tele floor, it was very exciting and new. After 5 years of the same type of pts day after day, a change was completely necessary. Sorry to offend.

teeituptom, BSN, RN · Jul 1, 2006

well there are code browns

there are code yellows

there are code barfs

you name it

there is a code for it

Granted Fal · Jul 3, 2006

Let's put it this way, In a year I've wiped about 4 butts, occasional bed changes when you space out that the 80 yr old hip fracture has to pee every 5 minutes. I now automatically ask for a foley so I don't have to deal, it really eats up time doing this type of care, uh bed baths? never. "housekeeping with a mop to 1414 please...." ER is nothing like the floor.

TinyNurse, RN · Jul 3, 2006

ER nursing can quickly turn into floor nursing when your ER is holding 25 patients waiting on rooms...................( and discharging an admitted patient from the ER because they have been there 2 or 3 days)

In my 60 bed ER this usually happens during the week. Weekends seem to be fine though.

nuangel1, BSN, RN · Jul 4, 2006

jen2 and rn junkie said it well. i agree.er nursing is not floor nursing .i am not knocking floor nurses when i say that its just a fact .i have down tele floor nursing x2 icu/ccu pacu hometherapry and er nursing in 4 er's i know.

gonzo1, ASN, RN · Jul 4, 2006

ER is absolutelly floor nursing. You are nursing and you are doing it standing on the floor. Therefore, floor nursing. There are some departments who don't stand on the floor when they are nursing. I wipe butts, help with barfing, and bedpans and it is unethical to put a foley in a person when it is not medically called for just to make our job easier. Foleys increase the risk of infection and they are not there for our convenience.

The beauty of nursing is that there is a niche for everyone, but if you are looking for easy don't go to the ER.:trout:

carlarn, BSN, RN · Jul 8, 2006

ER nursing, aaaaaahhh, I miss those days. Is it like floor nursing? To a degree but then again, not at all. I agree that Jennifer and Jen2 have said it best. I have had varied and wide experiences working in the ER, some good and some not so good. I also agree with shadowing an ER, or other area, nurse for that matter. It would benefit you beyond belief.

As for placing a foley when it isn't needed just as a convenience, think of how fragile that 80 year old hip fracture's skin is. Now is it a necessity or a convenience? I think it is necessary to prevent skin breakdown and it is convenient for the patient because he/she no longer needs to worry about PAIN when he/she needs to urinate. Not all hip fractures are surgically repaired. It is up to the surgeon and the patient or the patient's family regarding the treatment. So foley or no foley? I vote foley everytime because the patient will eventually get one in the OR if he/she makes it there or from the Ortho-Surgical floor nurse.

auzzieneuronurse · Jul 8, 2006

Hmmm, very interesting, I'm "just" a ward nurse intruding to add my two cents. The wards and ED are vastly different worlds and it takes different nursing skills and strengths to do both but why is that a bad thing and why do we need to demean what the others do????

I can't stand this us versus them mentality!!! This ridiculous attitude that in my department we work harder and under more stress that anywhere else in the hospital and all the other are working against us to make our life more unbearable!!!! Come off it been up to a ward lately?! The patient acuity is higher than ever, it's not all about simple tasks like making cups of tea and "tucking people in" (did u really say that??).

It takes all kinds of nurses!!!! I do believe that you should get a grounding in an area of general nursing first before moving into ED (I may now get lynched) otherwise you can become a jack of all trades and master of none. Sorry to offend.

I fully appreciate how stressful and busy ED can be and trust me I try and get patients up ASAP and understand why things get missed or simply not done but it goes both ways how about a bit of understanding for the stressors I am under (we have codes/arrests on the wards too). Believe it or not the goal of my day is NOT to make yours hell!!!!

Please don't demean ward nursing and what I love to do. I wouldn't work in ED for quids but don't trash what you do!!! Step out of your emergency world once in a while and come for a walk in mine maybe then you might all cut us some slack!

Sodie, BSN, RN · Jul 8, 2006

This may be a dumb question but is ER nursing considered to be floor nursing? Do you do as much of the not so pleasant codes, bringing food and other things I really don't like so much about floor nursing? What other areas are considered to be non floor nursing positions? Cath lab? Thanks for any input.

My ER is considered Critical Care because we get a major amount of MI's coming in. I haven't exactly worked in the ER at my hospital, but I have many friends who have. They love it. They thrive on the busy moments. As with any nursing, there are the occassional need to deliver food or those little "accidents".

I think it depends on what type of patient you want to work with. I know that I am not cut out to be a nurse that works in OB, pediatrics or cancer. Why? Because I had an experience in nursing school with a fetal demise and I decided I didn't want to deal with that if I could avoid it. With cancer, I found it depressing and I didn't handle that very well. I started in med-surg-urology and ended up in cardiac 2 years later. After 10 years of telemetry, I went to the cath lab. The difference between cath lab and the telemetry unit?

The patients that are in for diagnostic purposes like heart caths are generally "walkie talkies" that are scared of what the results are going to be. They do not come to us with infections or the flu. They have to be well to have a catheter stuck in the heart (no fevers, no active infection, etc). The emeregency MI's, are fast and furious as we work to save their lives. The patients are sedated, but awake. They communicate. I love working with one patient at a time and being able to hold their hand and get them through the procedure. We do occassionally have to hold patients so long due to high census, so we do have the occassional trays and other things to deal with. It's not that I don't like working with patients on a nursing unit, I really did enjoy that, but after working on a unit for many years, I needed a change. The stress got to me. The cath lab is stressful at times, but I do only have to worry about one patient at a time. I really like giving one person all the attention.

One person suggested shadowing other areas. That is an excellent idea. I think this could work for you. I always encourage shadowing somewhere if you are not sure where you want to be. This can heko clear up any questions about different units.

steelydanfan · Jul 9, 2006

To ZAGA21:

I am not trying to belittle you, but I am only responding to your own words.

If you feel demeaned by passing out meal trays and wiping up stool, then get out of hospital nursing NOW.

ER nurses are the first to see the patient; and they WILL be the ones to remove the encrusted dirt and maggots from a homeless patients wounds. There is NO clean area in nursing. There is only seeing what is, and intervening to to try to ensure a better outcome.

Maybe you would be better off in a management position; I cannot say.

But from your posts, I would think that maybe nursing is not the right fit for you at all.