Thinking about switching to ED

Koalified · Jun 6, 2017

Surprisingly, sounds like your typical shift is like dealing with: Demented patients, bladder/bowel issues, and decubs w/dressing changes on a "tele floor". I know how tiring and frustrating it can be.
But based on what you wrote: It sounds like tele floor does not include someone who's going in and out of VTACHs or uncontrolled Afib and to top it off you have a GI Bleed pt. requiring blood transfusion. Right?
Tell us the the number of years you have been working as a "Registered Nurse" and I'm sure a "well experienced" nurse will chime in.

We have vtachs, afibs, nstemis, cardizem, amio, milrinone, lasix, heparin drips but those tend to be my "good" pts. We cannot titrate cardiac drips. If they have a titration order, md has to either fix the order or we need to send them to ICU. Almost all the pts have hx of CHF, COPD, PNA, and some type of cardiac hx. That's why they all end up in my unit with an order for tele. Our med surg floors can't push iv hydrazine so anyone with that med order end up in my unit too. So, a mixed bag of med surg tele pts which is pretty typical of most hospitals. I have been in various type of nursing units for 7 years. Never have I worked in ED except in one of my previous jobs in a tiny 100 bed hospital when I got floated. They were atypically chill shifts though - just drug seekers and ppl that got lonely when they woke up at 5am and decided to come to ED with c/o and pain, toothache, etc....

marwidog · Jun 6, 2017

I was in your situation recently and then got a job in the ED of another hospital. So far, I really love it. I've found the teamwork is much better than the floor I worked on at my last job. I do a lot more primary care in the ED, but as others have said, I only deal with each patient for a short time, and the stellar teamwork helps a lot. I'm always busy, and often overwhelmed, but I think that will be true of any new job. I can see myself being much more comfortable where I'm at in a few months time.

My favorite part is how much I get to see in any given shift, and I never have to come back to the same set of patients. The Dr's have been great to work with, too. I still really struggle with the pediatric cases, but hopefully that will get better with time.

I don't think you'd regret making the change unless you somehow end up in a really crappy work environment. Best of luck!

Koalified · Jun 6, 2017

Pediatric population sort of worries me too. Not sure if I can place ivs in tiny veins or do other uncomfortable procedures on a baby/child that don't understand what is going on

OlivetheRN, ADN, BSN, RN · Jun 6, 2017

Pediatric population sort of worries me too. Not sure if I can place ivs in tiny veins or do other uncomfortable procedures on a baby/child that don't understand what is going on

Fortunately the number of IVs I have to do on kids is limited, because we don't have a peds ED associated with our ED. With that being said, I have had a run lately of about one shift a week I have to stick a kid and/or in and out them and then sometimes transfer them out to one of the other hospitals to be admitted. It's not easy, but you get better and you get help from your team. On days I knew who the kid IV masters were, and I know who they are on nights. Great teamwork is what makes or breaks an ED job for me.

~Mi Vida Loca~RN, ASN, RN · Jun 8, 2017

Pediatric population sort of worries me too. Not sure if I can place ivs in tiny veins or do other uncomfortable procedures on a baby/child that don't understand what is going on

Of course you can, you will learn and practice and get better. Like every other skill. More often than not, it's the parents that will be your bigger challenge when working with pediatrics, more than your patients.

Koalified · Jun 8, 2017

Of course you can, you will learn and practice and get better. Like every other skill. More often than not, it's the parents that will be your bigger challenge when working with pediatrics, more than your patients.

I just realized that the hospital I'm looking at has a separate pediatric ED. Crisis averted.

I'm attending an open house type of thing today. I'll see what happens. Time to update my resume. Ugh, I'd rather clean poop.

Ben_Dover · Jun 12, 2017

With 7 years of experience, now I can professionally say, try the ED. I just have a feeling that you'll love it!

Good luck! :up:

SapphireKitten, CNA · Jun 27, 2017

Do you guys do a lot of heavy lifting in the ED? Do you deal with a lot of incontinence?
I go to work, I pick up my assignment sheet and hope that I won't get that demented, sundowning, 90 y.o. grandma who pees every 10 min. Another least favorite pt is that 350lb person from a nursing home who is incontinent of stool and urine with complicated sacral/coccyx dressing changes. Take 5 pts like these times 3 12h shifts in a row and that's my nursing life. I need to escape! Is ED the right answer?

Hey there! I'm sort of late in my reply, so you might have already made your decision. I wanted to add my input though, just in case! I work as a tech in the ED since I'm still in school, but I work a lot more closely alongside our ED's nurses than I've seen techs in other units. :)

I feel like we do the same amount of heavy lifting as most other units. My hospital says to never lift a patient by yourself, so you always have help. No big deal.

YES, we all deal with lots of incontinence everyday! I assist multiple nurses a day with cleaning up different patients who urinated or defecated on themselves. The vast majority of these patients are elderly or morbidly obese.

I feel like the variety of other things we do on a daily basis overshadows the "lots of incontinence." We see a pretty wide variety of cases and complaints each day, and of course, not all of them are bed-bound!

Gary Mendoza · Jul 10, 2017

Depending on the facility you could have lots of heavy lifting or just the occasional (Trauma? Bariatric center? Stroke center? Etc...), but you'll also have drunk patients that want to fight, patients under the influence of drugs that want to fight, psychotic patients that want to fight. Keep in mind that many times when you get an ED patient in bad shape, they are not all pretty packaged and clean like you get them on the floors. It's a whole different world. I would also suggest (as someone already has) that you shadow for a few days. Mondays and Friday are usually busy days, but ask your ED manager what days are their busiest and then shadow on those days.