nonlegit

Don't define yourself with your job first. Ive been a tech in the ER for 10 years and cringe whenever I hear the "ER nurse" line like its some crowning achievement. I get it, we deal with all kinds of sh*t and we are a different breed. Really the same could be said of so many other branches of medicine, or indeed other professions. In the end, its just a job. Second, since I identify so strongly with emergency medicine myself, I have started to think about this same situation somewhat (in terms of planning my future). I personally don't enjoy any other units, but the days of seeking out the baddest busiest EDs I feel are over for me. I just don't need that patient volume. We all have a shelf life, no shame in admitting it. Perhaps you go to what I call a "retirement ER?" Its a play on what the FF/Medics say to someone that leaves the hardcore station to go to a slower "retirement station" in a nicer part of town. So maybe a slower ED than you are currently at? Thirdly, if its time to leave EM, then its time. Especially since you have a hand in other ventures, the transition should be easier for you. Think honestly - are you pulling your weight in the unit? Are you grumpy, or having quality of life issues due to your job? Look at this situation without the ego and make the best decision for your sanity, even if it means leaving the ED. I agree with others above, after 1/3 a career here, I wonder how anyone could do 30 years at my mega ER? I surely won't once I'm done with school. I'm headed for slower, hopefully greener pastures.

"somewhat" designated tech (medic - me). Its supposed to be an assignment....but you know. 100 bed ED with 100k visits. I'll take all calls including transfers, and assign rooms, charge has final authority and does approx 20% of the work anyhow, overstaffing RNs/hall beds/assigning RNs to pick up traumas and medical resus's etc.

Nice comment, and good on OP for doing research. Not every case is routine (obviously), so remember that the physician has the right to deviate from protocols if they are attempting to do right by the patient. Don't be that person in the corner losing it if ACLS isn't being followed to a T if you don't really really have a handle on the situation; you could very well not know whats going on and be wrong. New RNs and medics that work in my ED get burned on this sometimes. We are a mega center that gets all kind of cases with 24/7 residency-trained pharmacists on the floor etc etc, so this kind of stuff happens often enough.

Stay humble once you get your feet. I hate cocky people, and the ED breeds them. ED nursing is probably the worst for this, EMS contributes their part, and EM occasionally puts out some awfully arrogant physicians - although I find them to have some of the best personalities of all the specialties generally. All you have to remember about EM is that no, you (we) haven't seen everything yet, and no, you are not the best and you don't need to let everyone know it. We all started new at some point so beating up on an intern for their clunky orders doesn't make you cool. Don't be "that person." Other than that, its a great specialty. Its hard and fun, loses a lot of luster of time, but with that comes a very satisfying ability to calmly handle crises and unusual situations. Great teamwork, mostly down to earth normal people, patients generally suck but I deal with them more on my own terms than the floors, and I really look out for those that need it. Check it out, if you can work hard you will guarantee fit in - we'll make sure you don't sink.

108.4 core, I pulled her out of the car unresponsive and I will not forget how hot those armpits felt. Epidural abscess, likely from her IVDA. Arrested within 30 minutes but we managed to get her upstairs... where she died. We core cooled her (zoll cath), but prior to line insertion one of the ideas floated around was filling a bodybag with ice and getting her in it. Had a older guy in the 70's core temp from prolonged exposure (fall outside) once, he made it although he was very sick in our ED.

Being stuck in an office is not a death sentence to sit for hours on end. Our managers use standing desks, "medicine ball" chairs, and other things to promote posture/health. A couple of them are very physically fit. I highly suggest doing more research into overall health/fitness in the working world. Clearly you had some level of fitness as a FF/Medic/Tech, but all too often we rely on youth or brute force as opposed to overall health. I suggest checking out reddit/fitness for ways to maintain fitness throughout your life (thats where I go). A big demographic of theirs is desk/office workers, so no matter what you pursue past bedside nursing (which options you definitely need to consider) you can retain your health and hopefully, a good amount of fitness!