To ER or not to ER?

Posted

I am thinking about taking the plunge into ER nursing. I have a chance to get in at the hospital group where I currently work. (The ER is non-trauma, by the way.)

I've been a Med/Onc nurse (in Nevada) for 2 1/2 years. I switched to infusion (in California) about 3 months ago and am bored out of my mind. (I still work per diem in med/onc, so my bedside skills are current.)

Here is my dilemma. I am extremely intimidated by ER. I know it's hectic and sometimes controlled chaos at best, I am concerned that I don't know enough. I'm scared of hurting, or worse, killing someone. I like the floor, but it's next to impossible to even get an interview. I like to idea of ER, but again, I am really nervous about going to ER.

Any advice?

MattyIrie

MattyIrie

23 Posts

If you are looking for a change then ER is a great direction. Do not go into it thinking it will be any type of chaos. This will cause you to panic and freak out with largely stable patients and make emergencies out nothing. Acting this way will cause you to rush, make mistakes, fumble more and ultimately be slower in your response to the real "emergencies" as people call them. You will have a semi steep learning curve in the beginning but you also have your team of (hopefully) stronger ED nurses to check in with.

I personally love ED nursing and will be involved with it for the rest of my career. But if there is ANYTHING I can say, its this: "There are no emergencies in the ER." I'll use an example to explain:

25 y/o male comes in post stab to the chest in PEA arrest CPR in progress. Many staff will begin running around, yelling bogus orders and a general air of panic will begin to descend...almost inevitably to some degree in most ED's (especially teaching centers). This WILL create a slower response to management than slowing down..acting purposefully and realizing you DO have time to treat this patient, discuss a plan of action, preassemble needed supplies like blood or a thoracotomy tray and internal paddles, chest tube and airway kit.... Etc. So DONT act emergently but rather purposefully.

You should do ED! :) you won't regret it!

Racer15, BSN, RN

Specializes in ED. Has 5 years experience. 707 Posts

I started in the ER as a brand spankin new grad. I was excited but scared for the reasons you are. If you really think it is an area you would like, go for it! Some days I want to take a long walk off a short pier but I love my coworkers and you really can't make up the stuff you see, lol. Makes work interesting!

Guest219794

Guest219794

2,453 Posts

Once you decide if you are ready for the ER, you need to figure out whether the ER is ready for you.

Do the have a good mentoring/training program?

Are classes available?

Do they have a tack record of training inexperienced ER nurses?

With the right environment, new grads can flourish in the ER. If they are well set up, and you are hard working and motivated, you should do fine.

whygeeRN

whygeeRN

13 Posts

I'm in the same predicament I was offered a position in the ED in a level 1 trauma center and I have about 5 months of medsurg experience but idk if I should take it I'm scared but so excited lol

rearviewmirror

rearviewmirror, BSN, RN

Specializes in ER. 231 Posts

before I start my statement, I would like to use this quote: If someone has done it, so can you". I came from medsurg background and then went to ER because I thought that's what I wanted; I learned exactly what to do for intubation, STEMI, sepsis, code stroke, level 1 and 2 traumas, and etc in the ER. It is truly a place along with ICU where a RN becomes "bad-a" (I had no idea what to do with code blue as "floor nurse"). I highly recommend it because I know how much growth it can provide. Unfortunately I worked for a level I ER department where the admin thought it was okay for RNs to transfer all their patients at night, so after a year, I said "to hell with this!" so now I am CM of hospice. I don't know if your admin supports nurses with enough medics/PCTs, but regardless, ER is THE place to learn.

wojoRN

wojoRN

4 Posts

Here's the thing....I had 6 months of float exp...after nsg School then straight to my major metro city's busiest downtown ER.......LOVED IT..... 3. Yrs later I left due to personal administration reasons and that hospital getting bought out etc, now I moved on to the busiest level 1 trauma ER here and love it even more. Can it be chaos. ..yes, but you will never learn more about yourself and just being on a great bonding team than u will working in a good ER.

I was just about to post asking for advice regarding an ER position that I wanted to apply for. I am happy I found this. I second guess myself a lot and can be so hard on myself but I think I want to take a leap of faith. Good luck to you!

Edited by forever_faithful
auto corrected

mago8388

mago8388

163 Posts

Same here, I've been thinking of applying to an ER open position at my local hospital but I'm intimidated by it. I have a friend who is an NP and he loves it there. I just feel like im not experienced enough. I've done a year at a med surg telemetry unit and that was hectic. After that I went into Visiting Nursing and that was too boring. Then I got a job at a Behavioral unit and this is not my thing at all and I'm missing working at my telemetry unit but would like to try something different. I just fear that being away from a high pace floor made me lose some of my skills and I fear looking dumb and making mistakes. I wish i could give it a no commitment try and switch if I dont like it :barf02:

GCom24, ASN, RN

Specializes in Medical-Surgical, Emergency. Has 2 years experience. 39 Posts

I think this might be a good place to pop this question... I'm a Med-Surg/Nephrology RN with a little over a year's experience. I've accepted a position in our ED to start in about a month. I've been pulled to the ED numerous times, worked there as a tech in my last year of nursing school. So, I feel pretty comfortable with the pace, the environment, etc. My question is, what are some things I can do/read now to get my head in the Emergency Nursing mode vs. floor nursing mode? Maybe refresh myself on things? MONA and such?

I'll also be transitioning from day shift to night shift, which is honestly more terrifying than moving to the ED.. >_

AZQuik

AZQuik

224 Posts

If you know "sick" vs "not sick" and you can nail that down quickly, and understand that this is an ongoing assessment of all pts around you (not just your assigned pts) the rest is details you can learn.

You already have nursing experience. Ed is fast paced, chief complaint focused, sick/not sick prioritized. If you can do that you can learn the rest. The "details" of the Ed aren't any more difficult than waiting tables. It's knowing who is crumping before they crump. Most eds will train you how to deal with a pt you have identified as "sick" the key is to be able to tell the difference between them and "not sick".

Team players go further in the Ed imo. If you are out for you, and only you, people will sniff that out and let you hang. And you will hang. No single nurse can get by without assistance from others in the Ed. Now that we are pushing flu season, teamwork is a must IMO.

Gluck!

BSN GCU 2014.

Sent from my iPhone using allnurses

RescueNinjaKy

RescueNinjaKy

Specializes in Cath/EP lab, CCU, Cardiac stepdown. Has 3 years experience. 593 Posts

I have to say I have always been interested in Ed. I'm just not sure if it's something I would want to do eventually. I'm still pretty brand new, only been working 5 months as a nurse so I'm not see a move anytime soon but I still like to think about it. My dilemma is that while I am interested in the Ed, I am worried about the population that I will see there.

Personally I do not like seeing sick kids which is why I've vowed to never work peds(at least that's what I say now) and I do not enjoy seeing drunk/detox patients on a regular basis. I feel like there will be a lot of drunk patients in Ed and sometimes some pediatrics there as well.

I currently work on a cardiac floor but I still get the occasional detox overflow. So I don't see them often and I like it that way. Anyone ever have that same sort of preferences and still worked in the Ed?