I posted this same thing on the ICU page and would love to heare from the ED RNs too.
I'm feeling very discouraged with nursing after only two weeks of clinical. I'm in my 2nd semester of my BSN program. My clinical instructor thinks that I am way better suited for ICU (I'm thinking ED may be better for me) so I'd love to hear what your day is like (in general) in the ED. So far I've been on rehab, which I hear is the least acute it gets, and I'm SOOO bored. I NEED to use my brain more or I'm sure to go mad. I precepted last week and had three patients, was able to do all but pass meds myself (acuchecks, i&o cath, showers, vitals, all the charting, changed the beds) and was still craving more action. I'm thinking that's a bad sign as I'm "supposed" to be overwhelmed and nervous my first real week with multiple patients. We go back to only one patient this week. I'm not sure what I'll be doing the whole time if I was bored with three....
So that got long! =) Please tell me it gets crazy busy in a more cerebral way. So far they act like critical thinking is holding insulin if the bs is 40. The thought of never knowing what is going to happen and needing to "turn it on" in a moments notice sounds like heaven! My passion and interest lies in wanting to figure out what is wrong and then fixing it. Do you think the ED is a good place for that? I've worried lately that I may need to go the M.D. route to fulfill this need of mine but I'm thinking and hoping the ED (if not the ICU) may do the trick.
I work 7p-7a in an 8 bed rural ER that averages 60-70 patients per day. We don't have assigned rooms. It's 2 RN's, a tech, a medic and a house super that floats thru out the facility.
I clock in at 1850, go potty, get my goodies together and head out to see what's up. If I can I try and get a diet coke before the waiting room explodes with angry waiting people.
I'm usually greeted by day shift screaming....THANK GOD YOU ARE HERE and they I look at the board to usually find 3-4 waiting to be triaged and more often than not, every room full and who knows how many actually still in the waiting room. So, I head up there to see what's up and if I need to help out whoever has been suckered into triage at the moment.
If all is good there, I start on the orders and/or discharges or I start fielding the barrage of phone calls that always take place right at 7 p.m. because what a better time to call than shift change.
I make sure to read all the charts to ensure all the orders are done and are cooking. Here is where I get to use lots of critical thinking skills - if it looks like we can complete something before the doc sees the patient, I try and get labs started, IV's started, X-rays ordered, etc.....Anything to speed up the process.
I might get a report if day shift hasn't ran out the door screaming by then - if not we have computerized charting so I read each one to make sure I know at least why everyone is there.
Sometimes I feel like traffic control for about the first 2-3 hours I'm at work.
We alternate who takes triage so that one person doesn't want to cut their wrists by the end of the night (joke). We also don't keep assigned rooms unless we have a complex patient and one person has primarly been in the room. That helps promote more teamwork.
We usually transfer a few out, send a few up to our M/S floor.
We have a whole list of chores that have to be done on our shift because we are not busy according to the powers that be, so we try and hurry and finish those up in between patients.
We usually get a good amount of downtime around 3 or 4 a.m. and by then I usually need a break. It starts up again between 5-6.
By 7:10 a.m. I give report on my patients and head home for sleepy time all day.
thank you rlgiv and alkaleidi, so much! that sounds like the perfect atmosphere for me! we don't ever rotate to ed for school but i'm going to have to find someone to let me come check it out! my clinicals are at a level i trauma center so i'm sure it would be an action packed visit.
does anyone have any recommendations for getting an ed job as close to graduation as possible? from what i've read it seems that they don't often take new grads. is that accurate?
thanks much!
you're welcome. it totally depends on the facility. i know some hospitals that pretty much require you to have 2-3 years ed experience for hire, but then the hospital that i work at, which is a magnet (yeah yeah) level 2 trauma with a really good reputation with the community, gladly welcomes new grads (in fact, 3 new grads are in orientation now and they were offered jobs prior to graduating -- they interviewed, and were guaranteed jobs providing they graduated and passed boards, and are allowed to work license-pending or whatever they call it now). i would apply at all the places you could see yourself working closer to graduation, ask to shadow a mentor/preceptor from the department... see what a shift in that facility is really like and get a real perspective of what the role entails -- if you spend an 8 or 12 hour shift with someone you'll also get a feel for the morale that the department's staff has in general and see how well (or poorly) their teamwork is. that, to me, is very important in choosing an ed to work at.
It still seems odd for a nurse on a hospital unit to have only 3 patients. Do the nurses do total care? (no aids?). What is the acuity level of the patients? How long are patient stays? Is this a unique facility/unit with better staffing than average? You say the nurse had just 3 patients. Did all of the unit nurses have the same load? What was your patients' nurse doing while you were there since you were doing much of the basic care? Just curious!!
Yes, total care. I guess I'm the aid! I'm not sure what my classmates at other hospitals do since all I do is aid stuff.
The patients stay from one to six or so weeks normally. All the nurses had this kind of load. It seemed more like they were life managers (helped the pts. get to therapy, made sure they were dressed in time and all, etc).
After having done 16 yrs ICU and 5 yrs ER I can say that they are both "cerebral", as is any part of nursing. You may be bored now but I really believe that you have to start with basics, and as a pp mentioned basic care and procedures are very important. as your training goes on you will be exposed to more "good stuff".
I went to ICU from the ER, and oh, was I in for a rude awakening. I thought we were busy in the ICU, I had no clue!!
I work 3-11pm and have a different assignment every night, it may be triage, working the front aka "sicker" pt rooms or working in fast track. I start(a lot) of IVs, draw bloods, foley or I/O caths, give meds iv, po, pr or any other way you can think of giving them!! I work with pts on vents, different critical care drips, trauma pts, old people, pregnant women, kids etc.
I deal with people who are sick, people who think they are sick, hear every story that you can imagine, or not imagine and basically run my butt off every shift. It is amazing the 101 uses for a TV remote!!!
Sometimes it is very crazy but generally I love it. When I want a "calmer" night I go up to the ICU and remind them why their pts coming up from the ER have not been bathed, fluffed, puffed etc!!! :)
mom2michael, MSN, RN, NP
1,168 Posts
I work 7p-7a in an 8 bed rural ER that averages 60-70 patients per day. We don't have assigned rooms. It's 2 RN's, a tech, a medic and a house super that floats thru out the facility.
I clock in at 1850, go potty, get my goodies together and head out to see what's up. If I can I try and get a diet coke before the waiting room explodes with angry waiting people.
I'm usually greeted by day shift screaming....THANK GOD YOU ARE HERE and they I look at the board to usually find 3-4 waiting to be triaged and more often than not, every room full and who knows how many actually still in the waiting room. So, I head up there to see what's up and if I need to help out whoever has been suckered into triage at the moment.
If all is good there, I start on the orders and/or discharges or I start fielding the barrage of phone calls that always take place right at 7 p.m. because what a better time to call than shift change.
I make sure to read all the charts to ensure all the orders are done and are cooking. Here is where I get to use lots of critical thinking skills - if it looks like we can complete something before the doc sees the patient, I try and get labs started, IV's started, X-rays ordered, etc.....Anything to speed up the process.
I might get a report if day shift hasn't ran out the door screaming by then - if not we have computerized charting so I read each one to make sure I know at least why everyone is there.
Sometimes I feel like traffic control for about the first 2-3 hours I'm at work.
We alternate who takes triage so that one person doesn't want to cut their wrists by the end of the night (joke). We also don't keep assigned rooms unless we have a complex patient and one person has primarly been in the room. That helps promote more teamwork.
We usually transfer a few out, send a few up to our M/S floor.
We have a whole list of chores that have to be done on our shift because we are not busy according to the powers that be, so we try and hurry and finish those up in between patients.
We usually get a good amount of downtime around 3 or 4 a.m. and by then I usually need a break. It starts up again between 5-6.
By 7:10 a.m. I give report on my patients and head home for sleepy time all day.