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New ED job 2:30p-3a! Advice..

Specializes in Emergency - CEN.

Hi Everyone! I just accepted an offer to work evening shift (2:30p-3a) at a very busy, huge ED. I will be orienting on days (because that's when preceptors are available). I heard (from reading around on allnurses) that 3p-3a is the busiest shift and you literally do not have time to sit down and you may be dumped on. Is this all true?! (I know i'm asking the same people who probably answered before). I am very excited for this opportunity and I will learn a ton and their ED nurses get to drop central lines which is great experience! Any advice for a med-surg nurse transitioning to ED? I've taken ACLS already. I won't have to deal with the peds patients (who I am scared of) until I get comfortable as an ED nurse.

PacoUSA, BSN, RN

Specializes in PCU / Telemetry.

Never worked ED (would like to in the future tho) ... but I do know that the shift you are referring to is truly a dumping ground because it trancends shift change between traditional day and night (@ 7pm). In my experience, 11a to 11p is more common -- they get floated more and they end up picking up slack from shift changers. No one who has worked 11a-11p that I know has liked it.

I work 7p to 7a in a busy ED. We start slowing down around 2:30-3:00 in the morning so my guess is you will be very busy. Makes the shift go fast though! 11a to 11p is the most popular shift at our hospital. Waiting list for that shift is several months long.

Lev, BSN, RN

Specializes in Emergency - CEN.

I work 7p to 7a in a busy ED. We start slowing down around 2:30-3:00 in the morning so my guess is you will be very busy. Makes the shift go fast though! 11a to 11p is the most popular shift at our hospital. Waiting list for that shift is several months long.

11a to 11p is the shift I'd like to be on. I made this known to the manager and she said I would be put on the wait-list right away and hopefully something will open up when I'm done orientation. I know that I will never be bored and it will be a change in pace from Med-surg which is very busy too, but a lot of that business is related to documentation, passing oodles of meds, getting people drinks, and doing secretarial work. In the ED, patients aren't fed much. I think in the ED I will be doing more skills stuff.

I work in a level one trauma ED in Sydney, Australia and our busiest period is 4pm-2am so I'm sure you'll be busy as well!

I bought Sheey's manual of emergency care when I first started in Emergency (I was a surgical background as well) and I have found it a good summary of common conditions and scenarios I work with. It's also written in the USA.

good luck!

Lev, BSN, RN

Specializes in Emergency - CEN.

Thanks to everyone for your advice!

went from floor to ER. I felt like most of my floor experience didn't do jack to make me a better ER nurse. it's just different pace; you will see :)

i think the best thing that helped me was just drop the floor mentality. really, there's no possible way to be present in 4 rooms all at the same time because you will have orders and works ups to do on all 4 people, and you just got to pick the priorities and work on them. honestly, imo, most of people who come to ER aren't critical people like you see on TV, and even the sick ones, they aren't going to die if you attend to other higher priority stuff. It's code strokes, stemis, intubation, traumas, critical vs, active bleeds with critical h&h, etc... you know those kinds of things will make you run but most of them, they'll do fine :)

first 3 months really sucked big for me, but i'm pretty comfortable with all but really critical stuff. but you will have coworkers buzzing in there to help you, hope you do well!

I work in a level one trauma ED in Sydney, Australia and our busiest period is 4pm-2am so I'm sure you'll be busy as well!

I bought Sheey's manual of emergency care when I first started in Emergency (I was a surgical background as well) and I have found it a good summary of common conditions and scenarios I work with. It's also written in the USA.

good luck!

hey aussie girl, quick question. have you worked in US by any chance?

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency.

3-3's a weird shift. I did it for a couple of years before moving to 11-11. I found that things generally (but not always) settled down around 1am.

I didn't like the sleeping pattern on 3-3. Not days, not evenings, not nights. Was more exhausted then when i worked nights.

Racer15, BSN, RN

Specializes in ED.

I work it all. 3p-3a, 11a-11p, 1p-1a, and verrry rarely I work 9a-9p. In the ED. It just depends. On the 3-3, I may take over rooms for someone going home or I may float and get stuck in triage the rest of the night. 11-11 may find me in the fast track or I may spend my shift giving lunches with the last 4 hours taking a block. 1-1 is usually a crapshoot depending in how wild the day is. I don't really hate 3-3 but I'd prefer the other shifts. Most people balk at my shifts but I kind of like mixing it up.

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

I love 3p-3a, it is my ideal shift! Be prepared to run. You sound so excited, just remember that feeling if you start feeling like you're never going to get the hang of things during orientation. It's tough to transition to the ED, but it can be done and that is precisely why people orient! :)

Lev, BSN, RN

Specializes in Emergency - CEN.

I love 3p-3a, it is my ideal shift! Be prepared to run. You sound so excited, just remember that feeling if you start feeling like you're never going to get the hang of things during orientation. It's tough to transition to the ED, but it can be done and that is precisely why people orient! :)

I am really excited. I know it will be a big learning curve but I think with a good orientation I will do fine.

That Guy, BSN, RN, EMT-B

Specializes in Emergency/Cath Lab.

3p-3a is a great shift. So is 11a-11p. As is 9a-9p. Im doing 5p-5a now and it is fun too. We stay busy till about that time so It never really stops.

Lev, BSN, RN

Specializes in Emergency - CEN.

Thanks you guys! I'm getting more and more excited. It was kind of a surprised that I ended up here because I never thought I would do ED full time and here I am. I got an email from a hospital recruiter that the hospital was hiring for a variety of specialties. I sent her my resume. I had a panel interview and I liked the ED manager the most and she seemed very interested in me. I had indicated that I really wanted to work days or maybe evenings (11-11). I got two job offers one days, one nights, but no ED. There was a lot of back and forth and then I was invited for a share day and then the manager called me with an offer! She is everything a good manager should be: experienced, flexible, open minded, able to discipline staff (I've had a managers who were afraid to be confrontational to a fault), and OK with me trying out ED and then moving on to a different specialty if I find it isn't for me. Also she said I will be waitlisted right away and as soon as an 11-11 shift opens I can get that shift, it may happen as soon as I'm off orientation. Which I'm not counting on but it would be a nice surprise. Who knows? I may end up wanting to stay on 230p-3a.

Edited by Lev <3

I have worked ER 1-1 and sorry to say that yup all your fears are true. At least in my experience our ER started really picking up between noon and 3pm and didn't stop! I actually left late with some regularity (with supervisor approval) because it was tough to walk out of the mess.

eta

I did like it though. It was exhausting but exciting. Great learning and shifts usually went by very quickly. Eventually I went to 7a-7 but I valued the experience I gained on my swing shift.

Edited by Nienna Celebrindal

I've worked that shift as a newbie. My biggest complaint was that driving home afterward is more dangerous. It's at an hour when all the drunks and crazies are out. If I needed to pull over for a snooze on the way home, I felt unsafe. And a lot of people on the road are impaired with drugs, alcohol or sleepiness.

So, if I were sleepy after shift, I'd pick an empty room and nap in the ER. Now I'm on straight nights with a good rotation of my favorites peeps, but I had to earn that right by seniority.

Good luck Lev!

Lev, BSN, RN

Specializes in Emergency - CEN.

I've worked that shift as a newbie. My biggest complaint was that driving home afterward is more dangerous. It's at an hour when all the drunks and crazies are out. If I needed to pull over for a snooze on the way home, I felt unsafe. And a lot of people on the road are impaired with drugs, alcohol or sleepiness.

So, if I were sleepy after shift, I'd pick an empty room and nap in the ER. Now I'm on straight nights with a good rotation of my favorites peeps, but I had to earn that right by seniority.

Good luck Lev!

Good to know! I was kind of happy about the avoiding traffic bit...On the way there shouldn't be bad if I leave at 1:30 to get there 2:30.

Thanks for all your advice everyone. I've been reading the ED specialties forum and all the humor threads...such as "You know you're and ED nurse IF..." I know there's a lot of cr*p in the ED, just like on the floor, but I'm hoping there's less of it and more patient care.

I have been working 4p to 2a for the 6 years. I love it. For me the wrIters shift I'd 11 to 11p. The eves are very busy but time goes by fast. We have great teamwork. You will learn a huge amount every day and wont be bored. What could be better?

I like the 3p-3a shift. We bounce around more than anybody else and that's precisely what I like about it. It's uncommon for me to do the same thing for 12 straight hours.

I prefer the ambiance of night shift and that's 2/3 of my day. I also get most of the shift differential.

It is the busiest shift but that's a bonus to me because it makes the shift go by more quickly and I don't like sitting around.

Lev, BSN, RN

Specializes in Emergency - CEN.

Thanks!

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