What experience would be better, higher acuity or a pediatric ER?

[ladybug95]

Hi Friends,

Question for you: I work in a large, relatively high acuity ER (45 beds, level III trauma center w/cath lab and certified stroke center). However, my hours were recently reduced (budget cuts) so I've been searching for a casual job to supplement my income. I have two offers right now: a level II trauma center at the University Hospital, or an ER job at the local Children's Hospital (level III trauma). I'm currently working on my FNP and have a few years left on that. I love pediatrics, and my current job has some (but not a ton) of peds. However the doctors I work with have been encouraging a higher level trauma center saying that experience will be more valuable to me/make me more marketable when I graduate. Any advice/comments?

Thanks,

Nickie

[OldDude]

Go with the pedi ER...you'll develop a completely different set of critical thinking skills and confidence that'll carry through and enhance your FNP future greatly.

[Lunah, MSN, RN]

You might not get a lot of the trauma action as a casual person unless you already have trauma experience. I think the peds ER would be a better fit for you.

[JKL33]

However the doctors I work with have been encouraging a higher level trauma center saying that experience will be more valuable to me/make me more marketable when I graduate. Any advice/comments?

Thanks,

Nickie

I'm sure higher level trauma experience wouldn't hurt you, but it might not help you as much as additional peds work for someone who wishes to work as an FNP in the future - my educated guess. Also, my observation has been that a lot of physicians are pretty ignorant about NPs and their educational tracks and career options, so personally I'd take their comments as speculation or perhaps they're thinking of marketability in the trauma/ED world rather than FNP marketability...might be interesting to ask them why they say that in order to get a better idea of whether or not to consider their advice.

[PeakRN]

A high trauma rating doesn't necessarily mean you will see sicker patients nor a whole lot of trauma. I work more trauma cases in my current level IV trauma center than when I used to work in a level I, and most of our cases were transfers from other EDs and already had their stabilization initiated.

The reality is that if even if you were a full time staff nurse if you are one of forty plus nurses on shift there is a good chance that you won't be seeing a whole lot of that trauma. The other thing is that the more resources that come down for a trauma the less ED nurses do. If you get anesthesia, RT, a trauma surgeon and a trauma PA, ED Doc, OR nurse, trauma ICU nurse, lab, house supervisor... et cetera the smaller the piece of the trauma pie that is left for you.

There are definitely conditions and skills to be learned in a pediatric ED that are not in general EDs, and this would be beneficial in your future as an FNP. I doubt that working in a higher level trauma center will make you more marketable anyway, even if you worked in the ED in a smaller hospital the PAs and NPs tend to see other patients in the department during traumas and codes.

[ivyleaf]

WHat's your end goal with the FNP? IF it's family medicine/primary care, peds would probably make the most sense. However, if you want to do ED as an FNP, the docs might be right.

[AnnieOaklyRN, BSN, RN, EMT-P]

Pediatric ER, you have lots of adult ER experience by the sounds of it!

Annie

[ILUVERNSG, MSN, RN]

I hope you take the Peds ER. That would give you lots of valued experience and plenty of marketability.