When is it time to leave ER?

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So I have been an ER nurse now for 20 years, since graduating from nursing school. I have done many things also besides ER--treadmill lab, gyn/onc, teaching, etc. I love ER--the excitement, the use of skills, pt teaching, etc. But in the last year there has been changes in staff and environment. Bullying. I work in other departments as well. I have had personal stress lately and injury that has limited my ability to work in ER. Is life telling me it is time to leave ER? My concern is that if I left (even though I am only per diem) is would I ever be able to go back? I love all the different departments I work in. Trying to think if the opportunity arises if I should take a benefited position in one of them (get retirement benefits). But the status of "ER nurse" is one thing that is difficult to give up--tell someone you work ER and they treat you with such respect. Family friends come to me for advice because I am "ER nurse". So what am I if I don't work ER anymore? I know that I am and always be a nurse no matter what department I work.

Anyone else ever face this idea of feeling they are giving up their identity if they leave their department?

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

You know what? With all that time, you will ALWAYS be an ER nurse. Always!

Specializes in Urology.

For your personal sanity it's time to go. You can always go back, its like riding a bike. The problem is once you leave, you might NOT want to go back! You might find that your tastes have changed and you want to experience something else. I was in our ER for almost 5 years and I had enough. I moved to the PACU and haven't looked back. I took all my skills and knowledge with me and it has been invaluable. I loved the ER but the way things in healthcare are going and the increase in patients with decrease in staff, it was time for me to move on. I really dont know how anyone could do more than 2 years in an ER now days.

Specializes in Emergency Nursing.

I'm at my 2 year mark now and my job has seriously been causing some health concerns for me. I've recently started having panic attacks (severe) again. I haven't had any since graduating nursing school and now the panic attacks are scaring the crap out of me. I've never had any this severe. My husband and I are looking to relocate and I'm looking for a new job. I can't decide what specialty I'm going to do. I do love ER nursing. We've had some changes in management at my facility recently that haven't been for the best and I wonder if I would/could be happy in another ER or if there's something wrong with ME. I guess we'll find out!

Don't define yourself with your job first. Ive been a tech in the ER for 10 years and cringe whenever I hear the "ER nurse" line like its some crowning achievement. I get it, we deal with all kinds of sh*t and we are a different breed. Really the same could be said of so many other branches of medicine, or indeed other professions. In the end, its just a job.

Second, since I identify so strongly with emergency medicine myself, I have started to think about this same situation somewhat (in terms of planning my future). I personally don't enjoy any other units, but the days of seeking out the baddest busiest EDs I feel are over for me. I just don't need that patient volume. We all have a shelf life, no shame in admitting it. Perhaps you go to what I call a "retirement ER?" Its a play on what the FF/Medics say to someone that leaves the hardcore station to go to a slower "retirement station" in a nicer part of town. So maybe a slower ED than you are currently at?

Thirdly, if its time to leave EM, then its time. Especially since you have a hand in other ventures, the transition should be easier for you. Think honestly - are you pulling your weight in the unit? Are you grumpy, or having quality of life issues due to your job? Look at this situation without the ego and make the best decision for your sanity, even if it means leaving the ED. I agree with others above, after 1/3 a career here, I wonder how anyone could do 30 years at my mega ER? I surely won't once I'm done with school. I'm headed for slower, hopefully greener pastures.

Specializes in Emergency Department.

I would move on in your position. Heck, I have been an ER nurse for 7 months and already looking forward to when I can leave (mostly because of unit policies/politics). Your knowledge is invaluable and any unit would be lucky to have you. It is impressive that you have reflected on your situation and contemplated moving on.

Specializes in Pediatrics Retired.

Anyone who has worked for a substantial amount of time in an ER will always, first and foremost, be an ER nurse. I've been out of the pedi ER for about 15 years now and I still do rapid assessments in my mind when I see injuries or illnesses and I still check out people's veins for IV starts. My wife is constantly on me because I still don't "hear" crying babies since I blocked that out of my mind while in the ER. I left because we were so chronically short staffed my license was in jeopardy. So, hang it up and breathe easy is my advise.

Specializes in ER, Neuro, Trauma, Educator.

I work PRN in the ER and full time in education and I know what you mean! I feel like I get so much more respect and the people I am teaching actually take me serious when they realize I still currently work in the ER. I love both jobs and am struggling with the decision to leave education and go full time ED. However, your health and happiness MUST come first. just like some of the other posters I would like to re-iterate: you will ALWAYS be an ER nurse. you have a wealth of knowledge, experience (and probably some great stories ;) ) that will be beneficial in any teaching or patient care you do in the future.

On another note, it sounds like maybe more of the issue is your co-workers and the physical/emotional stress... have you every considered going PRN at another ED? Even the critical care access centers still see some cool stuff and get to utilize their skills.

Regardless, i wish you luck! Only you can decide what to do and it sounds like you already know... you just need to trust your judgement :)

Thank you all for your posts. They are along the lines I am thinking too. I know that I will need to still continue to keep up my ER critical thinking even if I leave the ER. We will see. If one of the other units offers me a benefited part-time job I think I will take it. I think I need to practice what I preach about leaving stressful situations that make you to be a grumpy unhappy person. I know wherever I work I would want to be there.

Thank you all for your support.

Just thought I would update. I had stayed with the ER. But again the bullying came around, had to get the union involved (I was having health issues and the ER bullies were making it their business to try to get me in trouble with excessive absences (even though MD notes), not being "up on skills", etc.). Union said I had case for harassment. Just not worth the fight anymore--why am I working so hard to try to stay in a place that I love the work and patients, but hate the people I work with--and that constant stress of working with people who are making life difficult for you. The stress of working with those people was affecting my work and my health. I have 2 other areas I work in with no problems and people happy to have me there. So I quit the ER. I am still coming to grips with that, mostly wondering how uncomfortable it will be running into those who made my life so miserable. But it is a major relief not having the stress of working with those nurses. There are others who have left recently also for similar reasons. I wish management would wise up and see they are loosing good people. I really hope those bully nurses will eventually get in trouble for what they are doing. They are not representing the spirit or values of a nurse.

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