Switching to the ER after 20 yrs of floor nursing.

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Specializes in ER.

I've been a floor nurse for almost 20 years now, both cardiac and maternity. I tend to stay in a place for a long time, and I like the level of comfort of being where I know what is going on. Over the lasy year or so, I've become fairly burned out. I hate going into work, and a lot of what we do on the floors seems like such a waste of time. So many of the patients need incredibly extensive care, care that I have come to believe in my heart is cruel. We see so many people being kept alive who have no quality of life, and it rips my heart out to see the pain we cause them. I don't want to post about that topic here though...what I would like to talk about is the pros/cons of moving to the ER. Our ER has a pretty poor reputation in our hospital. They have gone through several periods of being "re-vamped", had new managers brought in to "fix" everything. They had to have multiple travelers in for staff coverage because a lot of the "old-timers" got fed up and left. But over the last year, it seems to have calmed down a bit. There was only one position posted as open, so I filled out the paperwork and got called for a meeting with the director. I met him, and I wasn't impressed at all. He seemed disinterested in what he was doing. He actually asked me "Why would you want to come and work in the ER?" It was NOT a positive question, it was posed in the vein of "Why in the world would anyone CHOOSE to come work down here?" And this is the MANAGER! Not a good sign. SO could I please have some (good I hope) feedback about your experiences. I have to do something different, I really can't take it anymore.I'm losing my compassion And I don't want to lose my love of nursing.

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Specializes in ED, OR, SAF, Corrections.

You know, this is one the best things about nursing - the lateral mobility. I've made the change several times and while it has been daunting on occasion, I've never yet regretted any of the changes I made.

If you feel you're losing your compassion, the it's defintely time for a change. Don't wait until you do because that'll mean you've burnt out. I was 10 years in the ED/Trauma Resus and I loved it, until I didn't. I remember the exact moment when I KNEW it was time to go. It took a few months more, but I ended up in the OR and regained my love of nursing.

Are you going into the ER because you feel 'pulled' there or just because it's the only thing open? If it's for the second reason I would caution you to hang on just a little longer to see if something else opens up. Only because you'd be jumping from one area of unhappiness to another AND things tend to be a LOT more intense (and critical) in the ED which only adds to the pressure if you find you don't really like it.

But ultimately, it's up to you and you may thrive there, but just the fact that you're aware of the bad reputation or your ER and its history makes me caution you to proceed slowly. Talk to the nurses that are working there now, see what they say. Talk to the travelers as well. A lot of times you'll hear things from them you wouldn't find out from the staff - like how the resident staff treats 'outsiders' because that's what you'll be AT FIRST. Good luck to you!

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Specializes in Med/Surg, Ortho, ASC.

I think no matter what anyone else can tell you of their ER experience, it seems clear that the ER that you've applied to is filled with issues.

Unless there is a new effort at revitalization underway (and I didn't understand your post to state that), it seems to me that you'd just be trading an old unhappy situation for a new unhappy situation.

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Specializes in ER.

Thanks for your input, I appreciate it. I have always wanted to work in the ER, and there are several other jobs posted (One for maternity that I could have in a second, but I don't want to take a step back), so I guess I'm doing it for the right reasons. I'm also in the middle of an accelerated BSN program right now- I'm doing well, but it is stressful, and takes a lot of time. I'm just worried I'll be taking on too much "new stuff." The other issue is that I can pretty much adjust my work schedule as I want, and I might not be able to do that in the ER- Sounds minor I know, but there are several events that I go to that I live for, that sustain me for the rest of the year- Not sure I want to start out as low man on the pole, so to speak.

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" "Why would you want to come and work in the ER?" It was NOT a positive question, it was posed in the vein of "Why in the world would anyone CHOOSE to come work down here?" And this is the MANAGER! Not a good sign. "

If you can't answer this, you may find it hard to respond to some of the other things ED Nurses are asked by patients and families such as...

"What the f is taking so long!??" (screaming in my face...pt's waited all of 10 minutes)

"When is the doctor going to see my mom, we've been waiting in this room for 2 hours and 4 hours out in the lobby!!!???? (Meanwhile the ED is locked down due to multiple GSWs, gang related...the lobby's packed and there's only one doc on duty.)

"CAN YOU HELP ME!!?? The FBI is watching me..." (as I observe q15, and reassess the need for restraints)

"Please..please please, can you fix my baby, please, please please, fix him, fix him?? (Ped Trauma, full arrrest, downtime was extended)

My interview consisted of the same types of questions, then enactments of stressful situations. I totally agree, it's not very positive, but I can't blame management. Sometimes the ED is not a positive place and wanna-be ED RNs have quit (after investing 3 months of precepting) because they got their feelings hurt or felt it was too hard. I'm not saying we should accept any sort of abuse, I certainly don't. But when it happens an ED Nurse can't be paralyzed, your team needs you. So...Maybe he just wanted to see if you had enough nerve to call him out on his negative attitude or stand up for what you want. Those qualities are essential in the ED.

Don't believe everything you hear. My ED has a TERRIBLE reputation in the hospital, looks like a mess to any outsider, but I'm happy there, and I know most of my coworkers are too. Talk to the staff

I came from the floors. And haven't looked back. Good Luck.

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Is there any way you can float down there for a few shifts, or volunteer to pick up a few extra, in the ED, just to get a feel for it? That may be the way to go. Lots of ERs are short on staff and willing to take nurses from outside the department on an "as needed" basis, even without experience-just be sure they are made aware that it is not your normal department. Then you can see how helpful the staff are there, too!

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Specializes in CVICU, Obs/Gyn, Derm, NICU.

Oh that sounds like an awful ED .... could you consider another one?

ED's are highly variable ...can be well-staffed great places to work or a complete nightmare.

I work in a wonderful ED with great coworkers and good management. We hardly ever have anyone float to us and never use agency. What we do have is a large PRN pool, which consists of nurses who used to work fulltime with us, but now work casually because they are involved in other stuff

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Specializes in ER, Trauma.

ER's usually have bad reputations. People die there. People forget the ER didn't make them sick in the first place. People expect miracles from ER's, and they want them immediately! Ignore loud obnoxious patients because it's the quiet one that will sit there and peacefully die on you. ER nursing is somewhat backwards from what you're used to. On the floor you'd look at the diagnosis of your assignment. In the ER a diagnosis is the last thing a patient gets before discharge or admission. The purpose of the ER is to take chaos and get it under control. If you're a "control freak" the chaos may discourage you. Priorities constantly change in the ER, too. Float there. You can survive an ER only as long as it's exciting to you. If it is or becomes stressful, move on. I love ER nursing and could never do what you do. I hope you find a place you're happy. May all your patients be compliant and orders legible.

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Specializes in Trauma, Teaching.

I went to the ED after 15 or so years on the floors, and I've been ED for 14. I loved the change, it is a completely different mind set. I like my comfort zone too, it took quite a while to get back to being "senior", instead of the least experienced member of the team; but my coworkers took an active interest in helping me past the "novice" stages (good ol' Benner).

I think the biggest mental adjustment was the multiple patients I'd have through the shift, and having to switch from diagnosis to diagnosis to diagnosis. New assessments every time I turned around, whereas on the floor I'd have my baseline assessment, and really be watching for changes through the shift, as well as the admits of course. ED is a new patient an hour or less, treat and hopefully send out again. The really sick ones getting admitted need a lot of tending as well, the drawback is when the hosp. is full and you end being an ICU or M/S nurse for the night for several patients.

And the adrenaline rush with the traumas and cardiacs and crazies is rather addicting too.:yeah:

As for whether this particular ED is right for you, well, mine has had ups and downs, frequent changes of management, etc. You can be a force for change, or find that it really isn't that bad. My personal opinion is that the docs and other nurses are more significant to your daily life than one manager. Do the ED nurses like/respect the ED docs? That's a question I'd try to get answers to before deciding.

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Run and don't look back.

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afraid to go to ER after reading all the comments.

Pasha

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Specializes in LTC.

Why would you be afraid?

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