Transfer from Stepdown to ED

[SoilderofLove]

I am a New graduate newly hired at a great teaching hospital in my area into the Stepdown unit. My original aspirations were to go into the ER and the Stepdown offer came first so I accepted the position. I had my senior preceptorship in a stepdown unit and it was a great challenge and I can't wait to get started. I still keep thinking about if I can ever still have a chance in the ER dept. down the road with Stepdown experience and a 9 month internship in the ED. I have heard from a classmate that the ED doesn't hire nurses from stepdown departments. How true is that? I have to stay for 2 years (contract) with this hospital which I dont mind at all because I think 2 years in a good timeline to see if a unit is a good fit or not.

Are there any experienced nurses or ED nurses that can shed some light on this for me? I dont want to ask the manager at this point since I am just starting and I think that will not reflect positively but during my interview I definately let the manager know my aspirations of higher learning and critical care/telemetry.

Thanks ahead of time.

[cjcsoon2bnp, MSN, RN, NP]

Its a little OT but I would think carefully before accepting a two year contract for a facility unless your getting some kind of huge benefit out of it (like them helping you repay student loans or something.) Two years doesn't seem like very much time now but it could be a REALLY REALLY long time if the unit isn't a good fit. I was on a Cardiac Med/Surg unit and it was HELL for me, I couldn't wait until 6 months so I could transfer. I transferred to the Pediatric ED and it has been a year now and I'm still as excited about it as I was that first day. Just make sure that your not settling, if you are really excited about this then go for it and learn all you can while your there. Hopefully the unit and the experience overall will be great for you and this won't be an issue but its just something to keep in mind.

!Chris

[SoilderofLove]

I definitely am concerned about the 2 year contract but I love the hospital and the people but my first love is ED. I had another offer in LA for 2.5 years same dept. but I want to stay in bay area. I will see in a few weeks in the contract what the fee is for a breach in contract but I'm not considering it at all.

I have always been someone who can see the glass half full so I think since I precepted there I kind of know what I am getting into but I will be reading the contract carefully. Thanks for your input.

[SummerGarden, BSN, MSN, RN]

i still keep thinking about if i can ever still have a chance in the er dept. down the road with stepdown experience and a 9 month internship in the ed. i have heard from a classmate that the ed doesn't hire nurses from stepdown departments. how true is that?

first of all, your extern experience will not mean a thing after you gain rn work experience. in order words, no one will care what you did as a nursing student/tech in future rn positions. your two years of rn work experience will be the key that will open more doors.

secondly, i do not understand why a classmate of yours responded that the ed does not hire nurses from step-down? is there an internal political struggle to keep nurses on that floor? if so, then it may be true in your hospital but it is not true of others! also, i would not take the advice of a former classmate even if you think of him/her as a friend because he/she may be jealous.

it makes very little sense for a nurse to discourage cardiac step-down experience prior to entering the icu or er because cardiac traumas is the hardest aspect of critical experience to master for new nurses. also there are nurses that i know of who have transfered to the ed with specialty experience that has very little to do with cardiac emergencies or recovery so i doubt your chances in two years will be slim comparatively. gl!

[SoilderofLove]

first of all, your extern experience will not mean a thing after you gain rn work experience. in order words, no one will care what you did as a nursing student/tech in future rn positions. your two years of rn work experience will be the key that will open more doors.

secondly, i do not understand why a classmate of yours responded that the ed does not hire nurses from step-down? is there an internal political struggle to keep nurses on that floor? if so, then it may be true in your hospital but it is not true of others! also, i would not take the advice of a former classmate even if you think of him/her as a friend because he/she may be jealous.

it makes very little sense for a nurse to discourage cardiac step-down experience prior to entering the icu or er because cardiac traumas is the hardest aspect of critical experience to master for new nurses. also there are nurses that i know of who have transfered to the ed with specialty experience that has very little to do with cardiac emergencies or recovery so i doubt your chances in two years will be slim comparatively. gl!

i agree and know that 9 months of being a nursing student was something to help me as a new grad but will be slim to nothing in two years. funny you picked up on the characteristic of my classmate. i just entertained the idea since he was a ed tech for 2 years but in an entirely different hospital. i will stick to my path and not cut ed out.:) if i truly still want it in two years ill still apply. thanks :)

[taz628, BSN, RN]

This move is pretty much EXACTLY what I did. we call it "special care" but it's essentially an ICU step-down. I was there for 10 months and then transferred to the ED - where I originally REEEEEEALLY wanted to be but couldn't for various reasons. My step-down experience has been a HUGE plus in the ED. There are certain things that I'm more comfortable with than other ED nurses (i.e. ventriculostomies) because I've had more 1:1 experience. The director of the ER when I *first* interviewed actually told me that starting out in the SCU was preferable to coming direct to the ER anyway. So, YES! They will hire you, and you'll get good experience. You have to very carefully monitor pt's in step-down because they can very easily and very quickly get either better, or worse, very fast. So that sort of experience does help quite a bit when transferring to the ER. Hope this helps a bit. :)

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

I've seen some new grads have emotionally traumatic experiences going right into ER's. I usually recomend a year of med surg first. Makes ER much easier. The 2 year contract makes me really suspicious, though. If they're treating staff right they don't need a 2 year contract, no matter how they dress it up as "the way we get the cost of training you" or some other way. I learned the hard way to be suspisious of sign on bonuses and timed contracts. But that's just me, your mileage may vary.

[SoilderofLove]

Last year this same program had a 1 year contract. The economy had gotten worse since then so I accredited the longer contract to ensuring less turn over and higher retention. Other employees say the unit is challenging with the higher accuity level but great experience. In the end its just money if things aren't working out.