Want to go to stand alone ER : Opinions?

[rn-n- 2005]

Hi all! I have been wrestling with this for awhile and thought I'd try to get some opinions. A little background on me; I have been an RN for almost 2 years and I've been on an Oncology/Hematology floor. We see the worst of the worst in Oncology and we also get overflow medical pts. We're shortstaffed but even before we were I was tired and depressed about working there. A lot of our pts die. After awhile it's getting to me. I feel that I'm giving futile care when I stop to think about it. I really don't like floor nursing so I thought that I'd try something diferent!

Our hospital has a Level 1 Trauma ED but I'd like to try the ER that's a stand alone that's close to my home. It's owned by the same healthcare system that I work for now so it would be considered a transfer.

Does anyone have any experience with these places? I know that no one can tell me if I'll like it or not because it's something I need to experience myself but any opinions would be appreciated!

Thanks,

Ann

[justme1972]

I'm not a nurse, so I don't have any advice on your job move...but God bless anyone that works Oncology...that has to be an emotionally trying job, and even though someone, somewhere has to work it, I can totally understand if it's too much for someone.

Good luck with your job change, and I really hope it works out for you.

[HealthyRN]

I've worked in a free-standing ER. What questions do you have?

[anne74]

What's a "free-standing" ER? Is that like an urgent care or clinic?

[rn-n- 2005]

I guess some my questions are; Is my almost 2 years Oncology experience worth much going to any ED? Is the learning curve really steep? Since I've learned good prioritization skills on the floor is that helpful going to an ED?

I guess I'm nervous about taking the leap!!

Thanks for the replies,

Ann

[HealthyRN]

A free-standing ER is not the same as an urgent care. It is associated with a major hospital system and usually located in an urban area. The one that I worked at is about 10 minutes from the main hospital. It is a fully functioning ER, but it does not have a hospital at the same site. Instead, we transfered admissions to the main hospital. This is not a new concept. This ER has been there for more than 20 years.

RN-2005, I think that your oncology nursing experience will serve you well in your transition to the ER. I started out in the ER right after graduation and I was just fine. I say go for it!

[rn-n- 2005]

Thanks for the encouragment! I worked the last 3 nights and I had 2 codes. 1 was for an unresponsive pt who we found on the bedside commode and had to start compressions on the floor and she was shocked at the bedside. The 2nd was a pt who went into resp distress and had to be intubated at the bedside. I feel terrible for those pts and don't want anything bad to happen to them but it was a great learning experience for me!! I'm applying for an ED job and hope I get it!!

Ann

[JoshuaAdamsRN]

I'm really fascinated by this concept as it's something we don't have in my area. When a patient is admitted, how long does it take to get them to the "main" hospital? If the patient has to be seen by a consultant while in emergency, how long does it typically take to get that person there? Certainly the hospital must utilize its own ground transport crew or have a subcontract - how much does this add to a patient's overall bill if they present to the standalone department?

[KsEDRN]

I have recently started working at a new stand alone ER. We are all required to have a minimum of two years ER experience.

We are a full service emergency room and can handle anything that walks through the doors (and have). Ambulances only bring us "noncritical" patients. They do make errors at times and have brought us up to level 1 traumas. We have onsite lab, x-ray, CT scan, RT, and on-call sono.

We have seen gun shot wounds, stabbings, cardiac & resp arrests that walked in or drove up. We start the stabilization process and call EMS to transport to our main facility across town.

Our admits are transported at hospital expense to our main facility by EMS, and if necessary a nurse rides along. If the patient wishes to go to another facility the get the ambulance bill.

It is a great place to work and we see a similar variety to the main facility. We were expected to see only about 30 patients a day by the end of the first year, we met that by the end of the first week and continue to see more patients every month.

[inova]

:smilecoffeecup: So, yes, there is a lot to say about the stand alone ED. They can be very important to a community. It is good work. People might think that it will be confused with an urgent care type facility, but you have fast-track patients in any hospital ED. These patients will be seen in a stand-alone, but you will still get the critical patients. I would highly recommend that you transfer to a stand-alone that is part of a health-care system.

Good luck

[rn-n- 2005]

The stand alone that I would like to go to is in the same health system that I currently work in now. The job, if I get it, would mean a transfer.

Apparently, anything too critical goes by ambulance to the hospital via ambulance. We have a Level 1 within 5 miles and a Level 2 or 3 close to 5 miles away in the other direction. These hospitals are owned by the same health system. There seems to be a monoply starting around here!!