Maintaining patho knowledge base in the ER

Published

Hi everyone,

I accepted a position as a new graduate in a ED. It

is an adult trauma center but has pediatrics which is extremely appealing to me, as I love being able to work with both populations (especially the children!).

I'm currently completing my practicum here to prepare me for my impending orientation. I'm one of those students who truly enjoys pathophysiology and pharmacology, and teaching. One of my favorite parts of nursing is teaching, as my first degree is in public health and I eventually want to be a community health nurse or provider. I like when I can explain something to patients and see that they understand it better than they did before. The emergency department is great for teaching, which is another draw.

However, over the past several weeks I realized​ that there something that I am concerned about, and was wondering if I could get advice. Because the atmosphere is so quick, I'm realizing that everything is so reactive and very task-oriented... Of course nurses have to use quick critical thinking/assessment skills here, but I see I am not going to get the same ability to delve into patho as I would in the ICU setting.

I like the ER, I just wish there was a way I could figure out how to maintain and grow in my level of patho knowledge. I spoke with one of the ER nurses who used to be an ICU nurse, and she told me that even in the ICU, she still had to look things up.

So I began keeping a nursing journal where I write down the diagnoses that I encounter...& in in my free time I look them up, as well as common medical treatments. This is no substitute for the learning I would get on in an ICU or even a med surg / tele floor, but I'm just really worried that if I were to move to another specialty in the future I would have a hard time learning everything again. Plus I kind of just want this knowledge for myself so I can understand what's going on in the body.

Does anybody have any other suggestions as to how I can keep up with patho and critical thinking skills? I know that I'm going to have a hard enough time adjusting to the emergency department, and that this will not be a priority for a long time...but when I'm ready to return to it after I start finding my way around my new job, I'd like to have some ideas.

Thanks so much.

Up Vote Up Vote ×
Specializes in Emergency, Trauma, Critical Care.

Honestly you will learn a ton and maintain more than you think. Yes there isn't the level of detail with one or 2 critically ill patients in the icu. But in the icu you may have those same 2 patients for weeks. Every day in the ER is different patients with different problems. Dissections, STEMIs, traumas, cardiac anomalies, LVADs, etc. typically trauma facilities have a great supportive environment with opportunities to learn a lot. Embrace it and learn all you can.

Im much more satisfied than I was in ICU, but everyone is different. Good luck!

Up Vote Up Vote ×
Specializes in ED, Cardiac-step down, tele, med surg.

you should still be able to learn a lot of detail. I agree with NickiLaughs, you can learn more than in ICU because you will see way more. There are things you might not learn in depth but you can talk to one of the intensivists or another MD who can educate you. You can also request to cross train. You can take an ICU class later. You will get exposed to ICU knowledge in the ED. Maybe at first you might be a little overwhelmed with the tasks, but you will be able to see the larger picture later. I have almost a year now and am now able to stand back and see more how everything works together.

Up Vote Up Vote ×

Read emergency medicine and critical care journals.

Up Vote Up Vote ×
Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

EM podcasts!

Up Vote Up Vote ×
Honestly you will learn a ton and maintain more than you think. Yes there isn't the level of detail with one or 2 critically ill patients in the icu. But in the icu you may have those same 2 patients for weeks. Every day in the ER is different patients with different problems. Dissections, STEMIs, traumas, cardiac anomalies, LVADs, etc. typically trauma facilities have a great supportive environment with opportunities to learn a lot. Embrace it and learn all you can.

Im much more satisfied than I was in ICU, but everyone is different. Good luck!

Thanks for the response! How long did you do ICU before moving to ER, and what specific things make you more satisfied?

Up Vote Up Vote ×
you should still be able to learn a lot of detail. I agree with NickiLaughs, you can learn more than in ICU because you will see way more. There are things you might not learn in depth but you can talk to one of the intensivists or another MD who can educate you. You can also request to cross train. You can take an ICU class later. You will get exposed to ICU knowledge in the ED. Maybe at first you might be a little overwhelmed with the tasks, but you will be able to see the larger picture later. I have almost a year now and am now able to stand back and see more how everything works together.

Thank you so much. Once I'm further along I'll see if I can do this cross training...I would love that. And definitely good point about taking advantage of our proximity to the providers.

Up Vote Up Vote ×
Read emergency medicine and critical care journals.

Thanks! Any particular ones you like?

Up Vote Up Vote ×
EM podcasts!

Thanks for the tip! Are there any ones in particular you suggest ?

Up Vote Up Vote ×
Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Thanks for the tip! Are there any ones in particular you suggest ?

Podcast Page

Up Vote Up Vote ×
Specializes in Med-Tele; ED; ICU.

What makes you think you won't have an opportunity to delve into patho in the ED?

It definitely makes a difference as to what size hospital you're in but I've learned a ton from the super-sickies I've seen in the ED, though admittedly not quite as in-depth as in the ICU.

I'm with NickiLaughs: The ED suits me much more than does the ICU.

Up Vote Up Vote ×

I think you are on the right path looking stuff up on your own! I love that stuff too and I don't get to really delve into on my crazy med-surg unit so I go to youtube and Periscope a lot. I also just found VuMedi but haven't signed up yet and thank you pixie.RN for the EMCrit link!!

As a former teacher I LOVE teaching and wish there was more time to teach in regular hospital nursing but there just isn't- for the most part. I would love to find a position with more or ALL teaching! I have a strong interest in Health Literacy and you probably do too. Check out Helen Osborne and also if your area has anything going on with Health Literacy.

Up Vote Up Vote ×
+ Join the Discussion