Is ER nursing out of my league?

[OkieDokieNurse]

I moved to a very rural area a couple of years ago for my husband's job and decided to stay home at the time with a new baby b/c we didn't really know anyone here to watch our children or even to receive trusted advice in regards to local childcare. I am now considering going back to the workforce, but choices are very limited.

My only nursing experience is as a Case Manager. It wasn't my initial interest in nursing, but the job kind of fell into my lap at the time and the hours and pay were awesome. This really limited my experience with skills, and paired with not working has left me a little less confident than I would like. The only openings I have seen in my town are the occasional ER position. The idea of ER nursing scares me, but I really would like to get back to work so I'm open to giving it a try. I have very limited experience with IVs and other skills I know will be an everyday necessity in the er. I'm not sure if I would even get hired if I applied, but has anyone had experience with transitioning from a desk job to an ER position? Is there normally a pretty good orientation when entering this line of work, or do they kind of just throw you to the wolves? Am I out of my league here? I will be going in completely blind. I didn't even do a clinical rotation in the ER during school bc I did pretty much all of my rotations in the ICU of a major burn center. None of the nursing students in any of the classes ever wanted the 1 rotation we had at that center and so they allowed me to do it for my ICU, ER, and even labor/delivery b/c one of the patients was pregnant during my time there. At the time I loved it, but now I'm wishing my experience had been a little diverse.

[LakeEmerald]

If you are tough, willing to learn (and they are willing to teach), and if you do not mind running your buns off, then it's not out of your league. Best wishes to you!

[knpurvis]

As long as you have the will and drive to do the work, it is not impossible. Go ahead and apply for the job. If you get it, be open with your preceptors. Let them know that you need help with basic nursing skills like starting PIVs, inserting OG/NG/foleys. It is your preceptors job to help you in any way they can, and if they are not willing to help, inquire about getting a new preceptor. Be willing to work hard and ask for assistance to help you critically think through the whys/hows/ and whatnots of the job. Good Luck!

[brownbook]

There is some good advice on Allnurse about new grads taking CEN, or TNCC, or joining ENA. You might look good at a job interview that you are studying this material.

[Roy Fokker, BSN, RN]

I've been an ER nurse for a while. I have precepted nurses to the ER. Here's what I think:

* Believe it or not, I prefer nurses straight out of school. ER Nursing, like any other branch of Nursing, is it's own special kind of beast. If you'll pardon my expression - I prefer nurses straight out of school because I can train them up the right way (there are no 'habits that need to be broken' if you understand :)) From what I understand, your only experience in Nursing has been Case Management - but nothing truly 'everyday bedside nursing' (please correct me if I'm wrong). To me, that qualifies as 'New Grad Nurse'.

* "The idea of ER nursing scares me, but I really would like to get back to work so I'm open to giving it a try."

You're already one step ahead of other candidates. Why? Because while you're daunted about working in an ER... you still aren't against giving it a try.

"I have very limited experience with IVs and other skills I know will be an everyday necessity in the er."

So is pretty much every candidate who applied to the ER! :-)

"I'm not sure if I would even get hired if I applied"

Well, there's only one way to find out ;-)

"but has anyone had experience with transitioning from a desk job to an ER position? Is there normally a pretty good orientation when entering this line of work, or do they kind of just throw you to the wolves?"

There's no real way to answer this question - Orientation programs differ from unit to unit. A Trauma Center has a different set of expectations as compared to a rural ER for example. ANY ER Orientation program that 'throws you to the wolves' is NOT worthy IMHO.

"Am I out of my league here? I will be going in completely blind. I didn't even do a clinical rotation in the ER during school bc I did pretty much all of my rotations in the ICU of a major burn center."

Only YOU can answer that question - however, your experience in the ICU of a major burn center should help you. You've seen critical patients. The prime focus of ER nursing is constant evaluation of critical status of your patients - the patient you saw 5 minutes ago and classified as stable can potentially become unstable over a period of 5 minutes or less. Never mind the true emergencies...

My advice - give it a shot. I wouldn't worry so much over the lack of 'skills' (IVs, NG tubes etc.); as with everything in nursing, you get better with practice. I'd rather you focus on honing your assessment skills to recognise the truly 'sick' from those who can wait...

cheers,