Med/Surg nurse to ED - what to expect?

time4meRN · Jan 10, 2008

Each are has it's share of woe's. I was just dicussing with ICU nurses I used to work with before I transf. to ER, that It's different when you see both sides. ER nurses say the ICU never want's to take pt's, that they hold off till the last min. to take them. I am quick to tell the ER nurses that is not the case, ICU can also be very busy, but on the other hand the ICU nurses were complaining about ER brining one pt up after another. Even having most of my expericene in ICU, I have to side on the ER nurses view. ICU nurses are just that critical care. ER doesn't have gate outside that won't let people in no matter how busy we are (we do not divert)., So ICU just needs to suck it up. I can say that with confidence because I know what is involved from both ends. I think however, once you are a full ER staff member, taking a full load. You will be more stressed than you can imagine. You will be yelled at , abused more than you can ever imagine , be over worked and less appriciated by the pt population than ever before. So , enjoy the pink cloud while you can, it won't last long.

raindrop · Jan 10, 2008

Hmmm. Getting yelled at by doctors, family, and patients happens everywhere, all the time. That part doesn't stress me out, it's just a nursing thing in my book.

nursemoons14 · Jan 10, 2008

Each are has it's share of woe's. I was just dicussing with ICU nurses I used to work with before I transf. to ER, that It's different when you see both sides. ER nurses say the ICU never want's to take pt's, that they hold off till the last min. to take them. I am quick to tell the ER nurses that is not the case, ICU can also be very busy, but on the other hand the ICU nurses were complaining about ER brining one pt up after another. Even having most of my expericene in ICU, I have to side on the ER nurses view. ICU nurses are just that critical care. ER doesn't have gate outside that won't let people in no matter how busy we are (we do not divert)., So ICU just needs to suck it up. I can say that with confidence because I know what is involved from both ends. I think however, once you are a full ER staff member, taking a full load. You will be more stressed than you can imagine. You will be yelled at , abused more than you can ever imagine , be over worked and less appriciated by the pt population than ever before. So , enjoy the pink cloud while you can, it won't last long.

Thats a great point, time and time again we have RN's from ICU or medicine come and float in the ER and are blown away at the pace and amount of work we do for 12 hours straight. Often enough they can't take the pace in emerg since they are used to their order, and scheduled meds/orders etc. We get a lot of slack in emerg but these pt's come to us with "generalized" complaints and have to dx their issues , decide who is more sick then the next guy. is it indigestion or a massive heart attack? A lot of the time, most of the work is done for the floor nurses and its a matter of processing orders. I can count 6 times in my last shift where i had to be in a confrontation with a pt. or pt's family member about wait times, not doing enough, not giving out ms contin 80mg to a guy with back pain. Just wait until you have 5 emergent, or resussitative pts sitting in a 3 bed resuss room. I don't think the ICU or medicine floors have pts' in their hallways? lol. if so they aren't telling us

MAISY, RN-ER, BSN, RN · Jan 10, 2008

Without making it and us vs them debate. It's true the ED never closes. Even with divert, medics and ambulances, as well as, walkins...they just keep coming.

It would be nice if every critical care admit or even medical admit was given the full package treatment prior to being sent by the floor...but it can't always happen.

If you are in ER....get ready to do the full work up every time....be ready for the inevitable code during your shift....be ready to call for intubation with respiratory distress...be ready for anything. You never stop....charting is the same as on the floor with holds, critical care charting and orders are intense and require extreme attention to detail. Meanwhile, that critical care patient requires hands on....but you have several patients--unlike icu or ccu who have 1:2. You do have to give daily meds, order tests, receive orders, follow up with doctors and anything else you would do as a floor nurse.

Oh, and I forgot about the barking families, difficult patients who come and then don't want to be treated, parents of sick children, drug addicts, and on and on. NO CNA-no personal bathrooms...no ancillary help. No phlebotomy, no respiratory(unless intubated), lots of calling to other departments for tests, testing times, and results. It's very rare that in 13 hours I take a seat, most of my charting is done standing. Not a job for the faint of heart. Of course I would imagine it would depend on your ER, shift, staffing levels, ancillary help,and types of patients you see.

Oh almost forgot, no one wants to take report...everyone wants all of their patients orders done for them prior to receiving them. All tests, meds, tx, whatever done....oh and all wounds, marks, rashes-documented in detail, complete history, family contact numbers, measurements, all paperwork initiated....And whatever else. Basically, they want to do their admission paperwork, put them in bed and walk away with a current set of vitals.

It can't always happen, therefore, ED is not a loved entity....unfortunately, those cardiac arrests, strokes, and respiratory arrests get in the way. :devil:

Hope this helps give a better picture.

Maisy;) Love my job, I really do!

johnnrachel · Jan 10, 2008

10 months ago I transitioned from Telemetry to ER. I can tel you to expect mostly utter insanity most of the time... You will quickly adjust to any situation and just take things as they happen, Just do your best and hold on and enjoy the ride!!!!!:dncgbby::nclr:

Good luck