Med surg nurse x 28 yrs needs advice about taking job in er

CLAIRE'SCOWBOY · Apr 1, 2010

Why were you thinking of moving to such a different type of nursing, loved working in the er for over 25 years. And yes there are big pros and cons and alot of those can be the er you move to. I guess i would have gone the other way from the er which i did to icu, to try and give my mind and body a rest. But i left on complete disability not by choice.

pawsomepooch47 · Apr 1, 2010

I would like a change of scenery and a change of hours. I guess i think at this attained age I have the maturity and the knowledge to handle the ER better than i would have in the past. My kids are nearly grown (The youngest just got his drivers license so won't be needed for that anymore) so I will have more time to devote to a new job and the lengthy orientation that goes with it. What did you love about the ER?

Marshall1 · Apr 1, 2010

I went from floor nursing to ER and loved it. You will too - its different, challenging but not in a bad way. The good thing is if its not for you you can always go back to the floor. It's difficult - at least where I live - to get your foot in the door w/o ER experience. Better to try than not. Good luck!

RunningRNBSN · Apr 1, 2010

I do not have personal experience in this but I work with a nurse who did L&D for 20+ years and transferred to the PICU for a change of scenery. She has regretted the choice ever since and is having a really difficult time with essentially re-learning everything.

I think changing specialties is a great thing -- change is a good thing! I would just make sure you understand why you are changing specialties and will be ok essentially having to re-learn many things all over again.

snoopy29 · Apr 1, 2010

I went from surgical to the emergency department and would never go back to ward nursing, but nursing in the emergency department is like ICU nursing you either love it or hate it - there doesn't seem to be any in between.

Every emergency department is different but generally they are fast paced, constantly busy and there is rarely a dull moment. You have to want to nurse every age and every condition and be able to accept an alcohol induced puke on your shoe as part of the job description.

Your experience would be incredibly useful to the department but be prepared initially to feel completely de-skilled. ED nurses have codes every day so know their ALS and ATLS back to front, they routinely plaster and suture and undertake a wide variety of extended scopes. Little things like putting on a high arm sling as opposed to a broad arm sling can all be done in their sleep. With your experience you will quickly learn the ED nursing skills but only you know yourself how you will feel initially with nurses half your age initially running rings around you - it can be a huge confidence booster.

I would say to anyone considering ED nursing however long they have been in the profession that the only way that they will know if they like it is if they try it out safely. Can you do some bank shifts - money in the pocket and a chance to check it out, if not would they let you shadow an ED nurse for a few shifts.

I absolutely love ED nursing and my as my nan says that the only time you will ever find out if you can fly is when you jump. So go ahead and jump and all credit to you for thinking of a change :)

rn4ever? · Apr 1, 2010

I think it depends why you want to leave. If you're already comfortable and happy with what you do and you just want some fun and adventure that's why you want to make that move, I'd not be very at ease doing that especially with the economy right now. What if it ends up that the place where you transferred to is horrible or much more horrible than the former job? But then, if there is a heavy reason (like if you and your boss don't see eye to eye and you always get written up over petty things)that makes you look for another unit to work at, go ahead, it may be worth the try.

fungez · Apr 1, 2010

Well, I worked in the ER after 15 years of med/surg and onc and I'll do my best to give you my perspective.

It's very task oriented rather than goal orientated. That sounds simple when I say it but it took me a long time to wrap my mind around it. I enjoyed the comraderie between the physicians and nurses. I hated the work. Hated, hated, hated it. Gave it a year, didn't like it any better, and so I quit. Lots of drama, lots of screaming kids, lots of drunks. I was under the naive impression people went to the emergency room with, you know, emergencies. Nope! They go for mild n/v, glorified finger cuts, and unpleasant hangovers. And they get vocally rude and loud when they have to wait. And you can't tell them to sit their ass down and be patient because that's bad "customer service."

There's lots and lots of cardiac. At least in my hospital, all the chest pains went to the head of the line even if you knew there was no way in heck it was cardiac related, and they were all worked up for r/o MI. Well, except for the time I was triaging, and a patient came in with chest pain and a history of aortic aneurism, and my stupidvisor told me there were no beds. My response? Get this patient out of my waiting room, I don't care where you put him.

Anyway. I did like quick care, which is the ER lite for easy stuff, where you had, IIRC, 9 patients vs. the regular floor, which was 3 beds plus a trauma room. Unless they felt like putting beds in the hall, then you had 5. Also, you had to watch your own monitors as there was no monitor tech. And they usually scrimped on the other techs so you had to take vitals and transfer patients and all the other techie stuff. I HATED triage. They expected you to triage, and watch the patients in the waiting room, and visually assess all the walk ups. Triage is a high liability area and should have the most support, but it usually had the least. A hospital let a chest pain wait awhile before taking him back, where he promptly grabbed his chest, keeled over and died. And that triage nurse was named in the gazillion dollar suit and her name was all over the paper.

Some things were easier. I never had to think "hmm, should I call the doc?" because the doc was always right there. I use my critical thinking skills a lot more in m/s than I did in ER. And all the ER docs I worked with were topnotch, without exception. I felt lucky to have worked with them.

Good luck with whatever you decide. I don't regret my experience, even though I didn't like it.

Otessa, BSN, RN · Apr 2, 2010

I transferred from Med-Surg to Cardiac Care then ICU then ER then critical care float pool now education.

Your 28 years of seeing 'everything' in the Med-Surg world will suit you well!!

otessa

SassyRedhead · Apr 2, 2010

I think you should go for it if you want to do it.

One word of caution though. *If* your 28 years have been at the same facility, be forewarned. You are in that special group of nurses that gets targeted by administration for termination because it's considered a fiscally good move to terminate you and hire 2 new grads to take your place (their logic, not mine). They may not be able to touch you in Med Surg due to your skill, expertise and good reviews. But you may be exposing yourself somewhat by your learning curve, making inevitable mistakes, etc. in a new department. Just something to think about.