Tell me about your ED

elizabethrn · May 16, 2011

Don't know much about the ER's there, but just wanted to say good luck to you. I used to live in the Pocono's and now live in Atlanta. Sort of backwards from you. Someday I hope to go back. Hope you have an easy time finding a job!

jetsh, ASN, BSN, MSN, RN, NP · May 16, 2011

Hi! I work in the ED so I'll tell you what I know:

1) Our nurse-patio ratio is generally 1:3.

2)How receptive is management to staff going back to school? -- in my experience, very receptive. We like for our nurses to be highly trained. A lot of staff RNs on my floor are pursuing MSNs, and several already have them -- and are remaining staff RNs.

3)What shifts do you guys work? (my ED does 12s 7a, 11a, 3p, and 7p) -- that I don't know, but we are hiring right now and I think we need more evening/night nurses more than anything else.

4) What are the requirements to work your traumas? -- no idea.

5) What certs are required and how soon? -- I think BLS is required before hire and PALS is required within a certain amount of time after, but I'm not sure. Don't know about trauma certs.

7) What do you wish someone told you about your ED before you started working there??....

? I know no one like to talk about $$, but what is your base pay rate.... $20-23/hr, $24-27/hr, $27-30/hr../ >$30/hr??? Are weekends required, any shift diff? -- I THINK it's in the $27-30 range. Definitely shift differential, and I'm pretty sure around every 3rd weekend is required. There is a differential for nights, for weekends, and you do pretty well for yourself if you work night shifts on a weekend...

9) How long have you been an RN?? Two years.

nfdfiremedic, BSN, RN · May 16, 2011

Greetings. I work at a large hospital in the area you mentioned you plan on moving into. You listed Lehigh Valley in your OP, they are not terribly far from here.

We see around 55k a year. We have a 32 bed ED, of which 7 are "fast track" beds. We have every conceivable specialty.

1) Our assignments are either 3 or 4 rooms depending on which rooms they are. In a crunch, nurses may take 5. Under my watch, that's as high as it goes barring a true emergency or disaster situation. If you have a really critical patient you will obviously not have 4 other ones to take care of on top of it. If we have a really sick, unstable ICU level patient, the nurse generally only takes care of that one and the other nurses in neighboring rooms absorb the rest of his or her assignment until the patient goes to the unit.

2) We're supportive of it. We pay a tuition reimbursement stipend, I think around $2000 per semester.

3) We have every shift, pretty much. Some work 5 8hr shifts, some work 3 12hr shifts, some work two 8's and two 12's, and so on. Shifts we have are:

7a-3p

7a-7p

11a-11p

12n-12m

3p-11p

3p-3a

7p-7a

11p-7a

4) Pennsylvania requires nurses to take a trauma nurse course to work traumas. We hold the course a few times a year. In addition, you should have at least a year of experience with unstable patients in some form or other. Unlike many places that give the trauma assignment to the "favorites" our assignments are done my ED leaders. We rotate everything and we're fair about it. Will you be in trauma the first week? No, of course not. If you come in and consistently show that you have a good head on your shoulders for a few months and you have the right credentials will you? Sure. We like to give everybody a turn doing it if they're qualified. Same goes for triage.

5) BLS (CPR) is required to start and must be maintained. ACLS is required as soon as you can get it. PALS is strongly encouraged but doesn't have a rigid timeline requirement. If you don't have PALS you can't do conscious sedation on peds patients or pediatric traumas. CEN is not yet a requirement, but I'm pushing to make it one within two years of hire. Trauma nurse class is not required, but if you want to do traumas you need it. Critical care and basic arrhythmia courses can be waived on the basis of experience but are available. Anything else you decide to take is up to you but we teach pretty much everything.

6) We have a midlevel on duty 24 hours a day. We have lots of docs during the day and evening. We drop down to one doc and one midlevel from 2am to 7am.

7) I'm not sure... maybe how busy we are! If you come into it expecting to be extremely busy every shift you might not be shell shocked when you get here.

8) This is a union shop so there's no real haggling with wages. It's just in the contract. Base rate is $25.xx I believe. There is a diff on top of that for evenings and a bigger one for nights. OT is available like you wouldn't believe (you could do 100 hours a week if you wanted to.) OT is time and a half. In addition to that, you get a $150 bonus for every 8 hour shift you sign up for above and beyond your 40 hours. Staff nurses work every other weekend and every other holiday.

mandababy0326 · May 16, 2011

Hi there! I'm at an EC that sees 70-80,000/year at this point, becoming increasingly more busy! We are not a trauma center yet, however our sister hospital is a Level I trauma. We are in a large suburban area that sees Level I traumas and all fairly often, we stabilize and send to the sister hospital as needed. We typically rotate throughout the teams so just about everyone works peds at times, high acuity beds, occasionally minor care, and all of the acute care beds.

1) What is your standard nurse to patient ratio? Depending on how busy we are and acuity of patients, we range from 3 to 6 normally.

2)How receptive is management to staff going back to school? They seem to be indifferent. Small amount of money given by the hospital as tuition reimbursement.

3)What shifts do you guys work? 7a-7p, 11a-11p, 3p-3a, 7p-7a

4) What are the requirements to work ur traumas? We all work the resus room which includes resuscitations and traumas, and anyone that needs to be seen right away. Everyone is oriented in there and assigned in 4 hour blocks to respond if one is called, you are placed in there shortly after you're off orientation, at least at the secondary scribe nurse.

5) What certs are required and how soon? BLS- upon hire, ACLS- within 6 mos, ENPC- within 12 years, TNCC- 15 months

6) Do you have midlevels (NPs and PAs ) in your ED? Our PA's run minor care and our NP's see the pediatric pts.

7) What do you wish someone told you about ur ED before you started working there??Actually, nothing that I can think of!

8) I know no one like to talk about $$, but what is ur base pay rate.... $20-23/hr, $24-27/hr, $27-30/hr../ >$30/hr??? Are weekends required, any shift diff? Starts at $25, top of pay scale is about 10 or so $ more. Shift diff for afternoons is like $1.50 and for midnights is $2.50. We work every 3rd weekend, you also get weekend shift diff :)

9) How long have you been an RN?? 1 year! Still a baby;)

godbless-yute · Sep 25, 2011

Thank you guys for you responses. very in depth, just what I was looking for!

ReWritten · Sep 26, 2011

I work in a hospital in rural Texas, just a preface to my replies. 15 bed ER, 3 bed fast track. We probably see around 200 patients a day.

1) What is your standard nurse to patient ratio? 1:4

2)How receptive is management to staff going back to school? Some of my coworkers are working on their MSNs. I think the hospital is reimbursing them if they go part time. But honestly, I'm not sure.

3)What shifts do you guys work? This has been kind of an ongoing battle in my ER recently. Everyone works 12's. The manager wants 7a, 10a, 3p, 7p... but finding people to work the 10's and 3's is pretty difficult so he rotates people through them (only dayshift nurses will do 10's, and only nightshift nurses will do 3's).

4) What are the requirements to work ur traumas? We're not a trauma center, but we do have 2 trauma rooms. Everyone takes turns rotating through these room assignments.

5) What certs are required and how soon? ACLS, PALS or ENPC (you can have 1 or the other, or both, but required to have at least 1 of the 2), and TNCC. I believe all of them have to be obtained within 6mo of hire.

6) Do you have midlevels (NPs and PAs ) in your ED? Yes, but they only work midday shifts. The latest they'll possibly stay is 1am. (they typically only work 11a-11p, 10a-8p, 3p-1a)

7) What do you wish someone told you about ur ED before you started working there?? I worked on the floor and lived with some ER nurses. They're the ones that convinced me to transfer, so I know what I was getting into beforehand.

8) I know no one like to talk about $$, but what is ur base pay rate.... $20-23/hr, $24-27/hr, $27-30/hr../ >$30/hr??? I'm in the $20-$23 range. Most of my ER coworkers started out as travel nurses to my hospital and received very nice sign-on bonuses. Also, they have many years of experience compared to me so their pay scale is much higher than mine.

9) How long have you been an RN?? 1 year and a few month's worth. I worked Med-Surg for 9 months before transferring to my ER in June. I'm very thankful for my amazing coworkers who all of them have years of experience compared to me and have taught me ALOT since coming. Also, my manager didn't want new nurses in the ER, but they argued for me to come stating it'll be easy to train me brand new than someone "stuck in their ways".

turnforthenurse, MSN, NP · Sep 26, 2011

Hi, I'm moving from Atlanta, GA to PA (somewhere between Philly/Quakertown/ Lehigh Valley) next year. I'm in an ER at a Level2 trauma center right now. By the time I move I will have exactly two full yrs nursing/ER experience under my belt. I know things are done differently from hospital to hospital, and I can only imagine things being even more different from state to state. So here's some things I'd like for you to tell me about your ER:
1) What is your standard nurse to patient ratio? (In GA, there's no official ratio, but at my current ED, we don't do more than 4pts.
2)How receptive is management to staff going back to school?
3)What shifts do you guys work? (my ED does 12s 7a, 11a, 3p, and 7p)
4) What are the requirements to work ur traumas? ( at my ED, you had to have taken a TNS course, which you have to apply for, very selective/ clique oriented)
5) What certs are required and how soon? (We need BLS to be hired and then ACLS or PALS within a year (our peds is separate from our adults so u only need PALS if you work over there regularly). TNCC and TNS are not required but liked.
6) Do you have midlevels (NPs and PAs ) in your ED?
7) What do you wish someone told you about ur ED before you started working there??
8) I know no one like to talk about $$, but what is ur base pay rate.... $20-23/hr, $24-27/hr, $27-30/hr../ >$30/hr??? Are weekends required, any shift diff?
9) How long have you been an RN??
Any info you're willing to share would be greatly appreciated....Thanks!!!

I do not work permanently in the ER at my hospital, but I do get floated there on occasion.

1. No more than 6.

2. They seem to be very receptive about going back to school and further education (obtaining certifications, etc)

3. The ER here has a lot of off-shifts - 2-2, 3-3, 11-11, etc. Since I am a floor nurse I always work 7-7 and when I get floated to the ER, that is what I work. Sometimes I will get sent home early if the ER is slow, or my unit will have me come back up if they need me.

4. not sure about this one...

5. BLS, ACLS and PALS are a must. TNCC and TNS are strongly encouraged.

6. Our midlevels work primarily in the fast track ER while the MDs and DOs work primarily in the main ER.

7. -

8. I work in progressive care and am a new grad. My base pay is $23.50/hr + shift differentials, which change based on the time. From 1900-2359 I get an additional $3/hr, then from 0000-0659 I get an additional $5/hr. Weekends I get more. Starting at 0700 I will go back to my base pay. For any classes/meetings that I attend, I will get my base pay because it is before 1900. At least 4 weekend shifts are required. For day shift, that includes Saturdays & Sundays. For night shift, that includes Fridays & Saturdays.

9. I have been a nurse for a little over 3 months!