Rural ER Nursing

[MuayThaiGuy]

I'm brand new to to this forum, but I've scanned it many times during nursing school. I'm looking for some input from some of my fellow nurses.

I'm currently working at a Level 1 trauma center on the Trauma ICU as a new grad ADN RN (graduated in Dec. '19). I have prior experience as an EMT/ER Tech, so critical care is really where I find my interest lies with nursing. My orientation at my current job has been great, preceptors are fantastic and I'm getting a lot of great experience, however the ER is truly where I want to be.

I was recently offered a position for a rural critical access hospital that is right up the street from my house, and I'm wondering if working in a critical access hospital in the ER is too much for someone who is a new grad? The hospital is a 25 bed critical access, 7 ER beds, 3 ICU and 15 med/surg beds. I normally would not feel AS concerned as I do, but I'll be on 12 hour nights and as of right now I will be the only RN working alongside one provider. The DON has full intentions of having two nurses on every shift. Now I'm not entirely confident in that last statement, as we all know with a large shortage in nursing and considering it's a 2 hour drive from the closest large city, chances are probably pretty low that I'll have a partner RN on night shift (sorry, my cynicism is showing). The plus side is that the ER and ICU shares nurses, so when I need help I'm able to call on my resources and vice-versa.

There are more nerves thinking about this job than there were when I took my current ICU job. Working as a rural ER NP is in my 10 year plan, but is it too soon to work as an ER nurse in a rural hospital? Am I doing myself a disservice by quitting the ICU so soon after starting to work in the ER? Any input, advice, past experiences, etc. is very much appreciated! Thanks!

[Guest219794]

Well, did your current job but a bucket load of resources into your training? If so, what kind of obligation do you feel you have?

[EDNURSE20, BSN]

Your current job seems great, which is the most important thing as a new grad. I would stick where you are. You will get more support, learning opportunities there.

Going from ICU to er shouldn’t be hard either. When you have more experience, if you decide you still want to move to er, you will get a job.

[CharleeFoxtrot, BSN, RN]

...and for the sake of variety I offer another solution I would ask you to consider that the rural ED job will more than likely "be there" in future-I know, I've worked one and employee retention can be a problem. I'd say stay where you are for at least year, suck up all the knowledge and experience you can and then apply at the ED. That way, you're setting yourself up for success. IMO, you need some more seasoning before you take on all the responsibility expected of a nurse in a small rural hospital.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I think if you keep the ICU position, you’ll be setting yourself up to someday manage an ER.? Can you offer to pick up a PRN shift at the rural ER? With your EMT background and continued training in a Trauma ICU, that should be a workable option for you, in my opinion.

[MuayThaiGuy]

10 hours ago, BSNbeDONE said:

I think if you keep the ICU position, you’ll be setting yourself up to someday manage an ER.? Can you offer to pick up a PRN shift at the rural ER? With your EMT background and continued training in a Trauma ICU, that should be a workable option for you, in my opinion.

That’s a good idea, I think I’ll run it past them. I can’t imagine they have a ton of people applying for positions there so maybe they can make that happen. I appreciate your input ??

[MuayThaiGuy]

13 hours ago, nznurse93 said:

Your current job seems great, which is the most important thing as a new grad. I would stick where you are. You will get more support, learning opportunities there.

Going from ICU to er shouldn’t be hard either. When you have more experience, if you decide you still want to move to er, you will get a job.

ER is definitley where I would like to be, truly where my heart is. The training at my current job has been subpar at best, but I recognize that’s partially due to our current “situation” with Covid. I think you’re right though, the learning opportunities where I’m at will make me a better RN when I move to the ER. Thanks for your input!

[schroeders_piano, RN]

I’ve been a nurse for 17 years with a large portion of it ICU and ER. I have worked in Level 1 trauma centers to community hospitals to rural, critical access ERs where I was the only nurse. For the most part, the rural ER was like working in a clinic with simple stuff like sprained ankles,lacerations, and med refills. However, I also had nights where I had very critically injured patients that I had to rely on my years of ER experience to care for them. I had nights where I had 2 STEMI patients at the same time. I had nights where I had every bed full and a waiting room full of people who needed to be triaged.

One nurse in an ER is never safe. Being a newer nurse with limited or no ER experience is very stressful to start with and then add to it being by yourself. You cannot count on the ICU nurses being able to come and help you out each time you need it. They may be just as busy as you are.