Psych nurse interested in ED....

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Background: So I graduated about 5 years ago with my ADN. For various reasons, I didn't enjoy school or most of clinicals - mainly med surg- and went back to school to get a bachelors in some thing else, which ended up being psychology. I ended up working per diem/part time in a community crisis unit (pts medically stable, mostly just po meds and VS) on my breaks, and throughh a connction also picked up per diem shifts at a local locked inpt psych unit in a hospital-- there, i was mainly the med nurse and mostly transcribed orders and gave po meds. When I graduated, I took a full time position in outpatient community psych with clients with severe mental illness, mostly doing counseling and health education. I've continued to work per diem at a psych crisis unit, and after about 3 yrs of the community job, took a psych case management position in a teaching hospital.Currently: The CM job has a lot of perks, but I've been longing for more autonomy and considering Going back to school for NP (or med school, but that's another story). However, I'm not 100% sure I want to go into psych. *And* I've always wanted to work in the ED. What deterred me in the first place was the idea of having to do med surg first. My mom was an ED nurse, and I did some shadowing during nursing school as well as volunteering in an ED in HS, which I really enjoyed. I want to try working in the ED so I don't always regret never giving it a shot. And who knows, I might want to go for my ACNP.So, my main problem/reason for posting is the difficulty of actually *getting* an ED job. I have worked in psych for 5 yrs since graduAting and the vast majority in non acute settings. I never completed a hospital orientation. I have not touched an IV since school and have done nothing but the simplest dressings. My nursing assessment skills are near nil. I feel like im in a worse place than a new grad, as it's been so long since school. Calculating IV drip rates? I have no clue. Priming an IV? It's been over 5 yrs. Positioning post op patients, dosing of non psych meds, classes of antiHTN meds, rules for mixing insulins, caring for pressure ulcers--- I have no clue how to do this stuff. This morning I was even wondering if I'd get on trouble for not doing 3 checks before giving meds..So I guess I'm just looking for suggestions...I've only been in my latest job less than 6mo and want to give it at least a year out of respect to my boss, who is great. My plan is to start reviewing this stuff and talk to an ED CNS I met through a psych NP I've known and shadowed when I started. I already talked to her briefly and it sounds like doing med surg is the only option, to get my skills down. The idea of leaving my comfortable 9-5 desk job with my own office and minimal supervision for an entry level med surg position seems crazy in a way, as I really didn't like med surg in school. Am I nuts???

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well,

are you eligible for any state return to practice courses/refresher courses? They do those for nurses going back to the bedside after not having been there for a while.

I would also call and speak to nurse recruitement at the hosp you want to apply to to see if you could be considered a new grad since you have been away from the bedside for so long. Then you would have a longer orientation.

I don't feel that you need to do med surg to do ER...they are two completely separate beasts.

good luck

if you can't get in to ER, you might try urgent care first.?

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Are you an ED nurse? I currently work at a large teaching hospital so I'd be hoping for an internal transfer (from the case management dept)--I'm told they don't take new grads into the ED

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Yes I do ED and critical care both.

If that is the policy at your hosp then you might have to do the floor first. I know you were going to talk to the ED nurse educator to see what her take on it was. You could always try to go into tele instead, where at least you might have fewer pt's to concentrate on. I never did med-surg, thank goodness...I don't know how those nurses do it!

good luck!

I would start with an nclex review book to help see what current practices are, as well as looking at the policy and procedures for any of the floors-I assume they are all on the intranet for you.

good luck.

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Missnurse- Thanks for all of your responses. I would love to do tele vs regular med surg if I could get in. NCLEX review book and policy/procedures are great ideas.

Before I took my current job I applied to a handful of medsurg and ED positions (even dropped off my resume/cover letter in person a couple times) but no luck. I live in an urban area surrounded by lots of schools and the market is pretty saturated here. On the upside, I got 6 psych nurse job offers before I accepted my current job!

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Any time ivy and good luck!

You might have to travel more rural for first ed job. Thats how I got mine as an lpn, I applied for an rn opening and convinced them to let me have the job!

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Rural jobs are a good place to look, but if you have been out of practice for some time I would recommend looking for a tele job-- even better if you get one as a 'new grad'. "My nursing assessment skills are near nil. I feel like im in a worse place than a new grad, as it's been so long since school", might want to brush up on that a bit before the ED.. heh

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.
Rural jobs are a good place to look, but if you have been out of practice for some time I would recommend looking for a tele job-- even better if you get one as a 'new grad'. "My nursing assessment skills are near nil. I feel like im in a worse place than a new grad, as it's been so long since school", might want to brush up on that a bit before the ED.. heh

Haha I see what you're saying. Yeah, I live in the city and there isn't a rural area for a long way out around here... further then I'd want to commute-- although I may consider this in the future. Ideally, I would love to have a thorough "new grad-esque" orientation to the ED (like, one designed for new grads) but they don't have one at my hospital. A tele job would be great if I could swing it-- next to the ED observation/short stay unit, that would be my first choice. Last night I got out my med surg review book and started plugging through it-- finished fluid/electrolytes and got partway through neuro... I also made a bunch of index cards as that helps me with remembering. I also printed out a bunch of stuff from our intranet's policy/procedure manual and even some stuff from the RN orientation here that was available online.

Thanks for your support everyone!!!

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good luck!

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