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I'm going to play devil's advocate. I've been at it for six years and I still hate nursing :) Thankfully, I've found a job away from the bedside for now. Healthcare in America is just FUBARed. RNs are set up to fail from the beginning. Your ratio sounds average to me, despite what others have said. The fact that you're getting admission after admission isn't fair. Nor is staying late to chart (make sure you ARE clocked in and ARE getting paid). Don't kill yourself over this job. If it's too much, quit and find something else. Most people regard nursing homes as the end of a nursing career but maybe you could enjoy it. RNs there get more personal time with staff and residents. LPNs do med passes, CNAs do ADLs. Or maybe home care. Again, more time to connect with patients. Chart at home AND get paid. Acute Care nursing (in hospital) is brutal for all of us. And it will be so until there is a revolution in American healthcare. I have lots more to say on the subject but I'll leave it there. It might not necessarily get better. It never did for me. My goal is to get out but I've got a lot of student loans to contend with first. Good luck. All of us here feel your pain and are rooting for you.

I work in Upstate NY and we receive no differentials for unit specialty. I've been in ED for several years, no extra money. RN is an RN is an RN (degree doesn't matter either).

In my experience they have called your "references" and not necessarily your "current supervisor."

Typically speaking, a four week lead time on your travel assignment is both ample and appropriate. But yes, start talking to agencies and weeding out the people you don't like. Be forewarned, it's a lot like buying a car. Don't let yourself get rolled over or pushed into an assignment you don't want to do. Some companies have "exclusive" contracts and will do all they can to force you into a certain hospital in a certain place, etc. Just know what you want and what you don't and stick to it.

To the OP: I am involved in hiring at my facility and would echo the poster who suggested getting in at an Urgent Care. Frankly, when I have applicants whose only experience is out-patient I am a bit weary and sometimes, if they interview poorly, it is reason enough to decline an offer. On the flip side, if you're a good public speaker and can really sell your skills in an interview then I might be inclined to take a shot. Our facility is so high pace that we regularly burn out our senior nurses (myself included) and really burn through new hires. I'd say we keep 50% beyond 1 year. As far as EMS goes: I was a paramedic for many years before becoming a nurse. And when I took my first ER job they lauded my 1 year of ICU experience and said nothing about my 7 years in EMS. Nurses who haven't worked in EMS don't appreciate what EMS is. I do but I am the exception. Which is why I would stick with the Urgent Care option. There is a lot of cross-over and you can work on IV skills at Urgent Care! Hope this helps.

From what I can ascertain, lignocaine and lidocaine are one in the same. I do not use it nor am I familiar with it being used in New York State. That doesn't mean it's not happening. Anecdotally, it sounds like a great idea and I'd be interested to learn more if anyone can point me in any additional directions.

Can anyone link me to a full-text study related to use in the adult population? I'm interested!

Cell biology? That's not very nice. Here you go: 1) benign belly pain 2) chronic belly pain 3) subacute belly pain 4) acute belly pain 5) dental pain 6) benign joint pain and 7) "dilaudid is the only thing that helps" pain. But seriously, in terms of what the CEN test deems as need-to-know material for the ER nurse: cardiac and respiratory pathologies and management of their emergencies; abdominal pathologies; psychiatric crisis; traumatic injury (aka: blood loss, shock, ABCs, etc.)

*BUMP*

Sassy5d - I know what you mean. I work so fast in the ED that often times I don't even think about what I'm doing. We see so many patients that we lose the ability to think about it or care about them. I used to feel like I knew a lot of the in's and out's of emergency medicine but volumes have crushed my soul and brain. Now I am a mindless worker drone who can sink 10 lines an hour and medicate all my boarders at the same time!

I'm not aware of any transport teams near me serving the adult population. Nor does my state have prehospital RNs except on flight crews (which aren't hiring right now). I do know of a pediatric ground team nearby but I wouldn't be qualified to apply for that having all of my experience in the adult population. I really enjoy the 3 12 schedule - that is one of the things that keeps me in the hospital working environment. I guess I'm leaning towards traveling for now...maybe I'll come up with something.

I'm at a crossroads. I was a paramedic for five years before deciding to go back to school for nursing. I thought it would be great to work in an ED and make extra money doing similar things (making a living as a medic is hard). I quickly found out that a) your pre-hospital experience counts for nothing in the world of nursing and b) ED nursing is nothing like pre-hospital care. Anyway, long story short I'm sick of nursing. I'm considered early to mid career. I've worked in high volume and low volume EDs. I've worked in ICUs. I'm just sick of it all. I miss the ambulance but now I am so into student loans, etc that I need the nurses wage. I've looked at flight nursing but the two services around here just did lay-offs. I'm contemplating traveling but am finding that you really don't make that much more money traveling once you go through the hassle of finding housing that is suitable for a family. What do I do? I feel really stuck.

I have recently been hired as a Nurse Manager of two small critical care units and am looking for some supportive words! I am coming most recently from a staff position in a very large, very fast-paced critical care specialty so am not worried about pace or acuity. Mostly I am worried about doing something completely different. I'm incredibly excited but incredibly worried all the same. Namely I am concerned I'll get burned out. I have worked 3 overnight 12s for the last three years and have found a system that works great for my work/home balance and for my own personal sanity and health. Now I'm looking at a potentially 50hr work week. Can anyone speak to the transition from shift work to the Mon-Fri atmosphere. It's more hours at work, less at home. I have no kids nor anything that really needs me to be home so that draw is out the window. Anyone? Someone calm my nerves! :)

I skimmed some of these responses so I apologize if I am echoing sentiments. I'm second career as well. Almost 30 now. I had a great job before but wanted more money and more mobility. Those are the only 2 factors I chose nursing for. I can take or leave caring about people...most of the time it is hard for me to hide my contempt. That's the Darwinist in me. So, if you want to enjoy your career I would echo what I know has been said...you need to make sure your heart is in it. Mine is not and I pretty much hate my job. I am now saddled with so much debt that I can not afford to do anything else. That sucks. A lot. Another piece of advice - don't overpay for second degree programs. They are spouting up everywhere because of all the people like you and I who want second careers. I paid 80k for mine. I know. They're like puppy mills, they don't care what they're churning out...just numbers, numbers, numbers. There are a number of state sponsored schools now offering these shortened programs which offer a better bang for your buck and if you decide to go third career later on you won't be so tied to nursing. Statistics are that most men leave nursing within the first 10 years. So while you are seeing all these guys going to nursing school the overall percentage in the profession isn't rising very fast. I will be one of those men if I can craft an escape plan. Good luck man.

I'm a male who has been a nurse for 3 years. My first job was in a small ICU with all women. I was the youngest by far. I think that being a male actually helped me. I could sit by and listen to them nit-picking each other or the other women on other floors but no one ever gave me crap. I kind of felt like a son to some of them - they were always bringing me food. I've moved on to a very large system now and we are hiring tons of men into my unit. We have none of those "eating their young" issues. The guys I work with are all great and we're all in this struggle together.