Birdsofprey

Thanks - Yes I now have almost a year here. While on nights, by the time I was just 6 months off of orientation, I was already becoming one of the more experienced nurses here. I just switched to days where there are plenty of more experienced ER nurses to bounce questions off of an learn from. I know a super busy trauma ER is not where I am going to stay long term but I am trying as much as I can while I am here. I love the rush of it, but overall it is not very conducive to a balanced life. At least not for me. Day shift suits me better, I will hold on a little longer while I determine what I want next. It is great that you have such good ratios in the trauma area of the ER. Here, we do not hold onto med-surg admits there, they go back to the main ED. ICU and stepdown holds do stay in the trauma area of course. It's incredible your friend is in a unit with an average of 10 years in that unit. That's amazing!

Yes. Many times the patients are upgraded to the CC area of the ER from the team area (the 20-30 pt a piece areas I mentioned- which can be a combo of glorified med-surg with some patients who can go south fast). And yes the place can be more akin to a combat/war zone than a typical ER in other areas. I actually enjoy the Trauma Slot and would love to spend more time there, the good the bad and the ugly. I recently spoke with my manager about it. I came here because I wanted to train hard. And I am. Most people last a year here. With 2 years being an outlier. I am also working hard to discern what I like most about this environment and what this means about where I wanna go after this. The good thing is that I am now trained in triage, trauma, fast track and ER teams.

Thank you, I appreciate it. I know there's a better gig for me out there. I will find it. You are so right- no job is worth my sanity or my health.

Thank you for your suggestions and insight. I think I will try lasting until 1 year and then try for ICU or PACU, or at least ER in a private hospital. I'm just tired of juggling so many patients with so many needs, hence the areas you suggested will be more tolerable/I can keep leaning more. Even if I decide to go back to travel I'll try to wait til I get a year of ER in so at least I have that on my resume. In the grand scale of things, a year will be here soon enough. Very true.

I am 9 months into my career as an ER nurse and I am really thinking this is not the right job for me. Which is very sad because I really thought I would enjoy it. I started in Med-tele fresh out of school at a horrible Level 1 public hospital and then was a travel RN for 3 years. I always wanted to try ER but couldn't turn down the travel opportunities during the pandemic. I decided last July to stop travel nursing and go back to staff as ED to finally get some Emergency experience. I work in a major city in a Level 1 Trauma, a public hospital that does not turn anyone away. People say if "you work here, you can work anywhere". I often have over 20 or even 30 patients between myself and one other nurse, no tech and no phlebotomist. Despite asking, I barely get cycled into the Emergency ICU or the trauma slot. Since most patients are admitted and waiting for an inpatient bed upstairs, I feel like a glorified Med-Surg nurse, which is what I was trying to get away from. It is a large Level 1 with a separate ER for Peds, so I will not even be trained in peds ER until I am there for a year and a half or so. So I feel like this isn't as great of an experience as I thought. Especially since in my interview I was told I would be cross-trained in peds ER. If I wanted to stay here then this wouldn't be a problem. But the idea of staying almost 2 years just to get peds or more trauma experience makes me wanna vomit. To top it off, there is so much more liability here. Particularly in triage, I often can only go by what a patient tells me, once they change their story to the providers inside the ED I am asked why I did not catch certain things. Good thing I have thorough documentation. I feel like everything that annoyed me about med-surg is magnified here. Having 30 patients, many of which are intox/homeless/psychotic and having to babysit the nurse techs/other departments and make sure they do their jobs is too much. I understand this can happen in any ER, but the fact that we were not able to tend to certain patients more closely among the collective chaos makes me feel angry/helpless/anxious and want to leave this work situation as fast as possible. I dread going to work now. I promised myself if this ER job made me feel like how I felt at my first RN job then I would leave. Sadly it looks like that is where I am mentally now. I am very burned out. I am so stressed out that other areas of my life are very lacking. This is way more than I signed on for. I did not feel this way as a traveler in M/S Tele even though I was bored with it and wanted a challenge. I am trying to be grateful for what I have learned during my time in the ED- I am great at placing IV lines now, I enjoy triage, and I multitask and work faster than I did before. Many of my coworkers are great, too, I just can't justify being in this kind of situation despite that. MAYBE it is because many of them are newer nurses and did not work before Covid/did not start their careers until Covid was winding down- maybe they just aren't as burned out as I am. The turnover here is incredibly high and being here 2 years is a long time. My plan was to do ER at a Level 1 Trauma for year and then go back to travel as an ER nurse. But now I am about to get out of here ASAP and just do med-tele as a traveler until I pay off my student loans. Maybe someday I will go back to ER... but I am starting to think that I should go to a community hospital or a level III or IV where there is less of a hierarchy and I can see a lot of things every week instead of waiting in line to be placed in those areas. I don't know. Maybe I just don't want such stressful job anymore. I do not think it is sustainable to have this much acuity/volume of patients. Thanks for letting me share.

Hi! I heard that although Johns Hopkins is a level 1 Trauma center, it's ER doesn't get a lot of trauma cases because the University of Maryland Shock Trauma ER gets most of them. Is this true? Do you get ER trauma experience at JH? Does anyone have experience working in the ER at JH? I'm just checking whether I should apply at another level 1 if there's not much trauma at JH ER. I'm trying to work at a crazy Level 1 ER before I do travel ER gigs. Thanks in advance!

True!

Thank you for your input- and I agree- regardless of whether I go for ER or OR, I want a Level 1 Trauma center (I started my career at an inner city Level 1 and even though it was hell it paid off). If I go for OR, I must make sure I am in a location I really want to be in(since I will posted there for a few years).

Thank you!

I'm thinking of changing specialties to either ER or OR, but I love the travel nurse life. So many question here is for the OR nurses in the group- how long were you an OR nurse before traveling? And how much experience do you think is needed? Seeing as how it's a very specialized part of nursing it seems 2 years is the standard. Has anyone travelled after only 1 year? Thanks in advance for your feedback!

Anyone have experience first-hand, or heard about, what it's like working in the ER at Bellevue Hospital in NY? I am a Tele and MS nurse who wants to gain ER experience in a Level 1 Trauma Center. Any info is appreciated, thanks!

Hi NedRN, Yeah.... I think my co-worker was nice to suggest trying for per diem, but as you mentioned that option sounds a little too good to be true and would not allow the time or flexibility to thoroughly gain a full year of ER experience- which is obviously what I want- an value- if I going to continue as a travel nurse in a new specialization. So my best bet is that I will have to give in to being a staff nurse again at some point. I will probably have to suck it up and move somewhere high paying to do that (like northern California.....) haha. Thanks!

Hi All, I am currently a travel nurse (Tele, M/S) and loving it. I want to transition into ER nursing but I do not want to become a staff nurse for a full year. I know this might be a long shot but has anyone ever had any luck changing nursing specialties by going PRN in that specialty for a year? A colleague suggested I could keep travelling and try to get in with an ER that hired PRN nurses who may not have an ER background, and doing that for a year. This doesn't sound very common but I figured I would ask. I seem to come across a lot of ER PRN positions that of course want nurses with an ER background.

NedRN, good points. And also- OR sounds so unique and interesting to me- it is one of the specialties I would love to try (that and ER)- a friend of mine is training as a circulating nurse and loves it. The only reason I am not going back to staff right now is due to the high pay for Covid travel, which is what I have been doing for a year as Tele/PCU/Med-Surg nurse. I also have heard many times that OR takes up to 2 years to feel comfortable doing(minimum of 1 year), so if I go into that specialty I know I will not be a travel RN for a bit.

Hi! Is it true that if you are an ICU travel nurse you can travel as an ER nurse or most other specialties (aside from OR) for that matter?