Transitioning from ICU/PCU to ED

Larry77, RN · Jul 6, 2013

This has been discussed a lot but the biggest challenge ICU/PCU nurses have in the ED is the lack of diagnosis and the problem focused assessments that we do. The pace can also get to some nurses who are used to having only 2 patients (yes sick but still 2). Most ED's are going with 4/1 ratios depending on acuity and this requires really being efficient with your time at the bedside. As far as skills, the frequent challenge I've seen has been pediatric care...peds tend to scare a nurse who has only taken care of adults their whole career. Just a few things to think about, I've seen some recovering ICU nurses become some of the best nurses I have ever worked with...the transition can be done very well.

Good luck!

BellionRN · Jul 9, 2013

I recently transitioned from ICU (med-surg ICU) to Emerge in April! Congrats on the new job!

Luckily, I had worked on a general surgery floor for a few months before I went to the ICU as a new grad, so I did have experience juggling multiple patients. I found the hardest part was not knowing everything about your patients... in ICU I knew everything, right down to their aunt's sister-in-law's birthday (a little stretch, but seriously, you know everything about them!). Going back to taking care of multiple patients (up to 6 in my department but mostly 5 in the acute care, the non-acute area is more of a clinic setting and was the biggest learning curve, and trauma depends on acuity, and amount of pts presently in there) was... rough, and very different. I like to write everything down; things the patients I'm taking over for need that day or night, med times, vital times, etc., and when someone new comes in, it's all about prioritizing what to do first. At times it can be very overwhelming, like getting in 2 ambulances and a kidney stone from triage at the same time... breathe, once thing a time, prioritize! I always set eyes and chat to my new patients a little in order to get an idea of who I should be seeing first, and eases my mind to know I have at least looked at them!

And as Larry77 mentioned, pediatrics absolutely terrified me. We have no children's hospital where I am, so while the more serious things go to the next province, I see a lot of children. I'm not going to lie, I still get nervous about everything to do with children, but practice makes perfect and I've been getting (a little) more comfortable. The first thing I tried to do was get into an Emerge Peds nursing course but of course, the department funds weren't there so I wasn't able to go.

During my orientation, I listened closely to what the Emerge nurses had to say, asked lots of questions, and always offered a helping hand to my co-workers. The group I work with is wonderful. I was always told the new-to-the-unit nurse who doesn't ask many questions is much scarier then the one who does. And I find if they know you're willing to help out (even with the dirty jobs), they are much more willing to help you when you need it!

I don't know if that helped, but those were/are my main challenges. I really like it there, though!