Which route?

[MomtaRN2B2020, ASN, CNA, LPN, RN]

Hello fellow nurses! I need lots of opinions. I have been a lpn on a medsurg floor for 9.5 years. I recently graduated and obtained my RN and am currently working in an ambulatory clinic. I want to leave the clinic because I don’t feel any job satisfaction since we use zero nursing skills. We triage like at a MD office and send them home. I have been offered a medsurg position and an ER position. I applied for medsurg because thats all I know as a LPN but not RN and I find its my comfort zone. I want to try ER but am terrified of the unknown! However, I want to challenge myself to do critical care nursing. In the future I would either like to teach nursing or become a NP. Any advice on which way to go? I have to give them a response by Friday?

[OUxPhys, BSN, RN]

You could go back to MS since you have stated it's your comfort zone. If you feel like you would enjoy ER then go for it. It will be an adjustment because it's a completely different world but if you have a good manager and good co-workers you should be fine. How large is the hospital for the ER position? That too will also help.  

Either one will allow you to become a teacher or a NP.

[MomtaRN2B2020, ASN, CNA, LPN, RN]

Our ER is a 22 bed unit that can manage any level of trauma! 

[Wuzzie]

You need to clarify your end-game. What kind of NP are you looking at becoming? If you want to be in the ED then you need your FNP. If you want to be a hospitalist then your AG-ACNP. I think the best way to figure this out would be to take the ED position since you’ve already done Med-Surg and see how you like it.  It’s very different than the type of nursing to which you are accustomed. You may love it or it may be the worst experience you’ve had but you’ll never know until you try and you aren’t married to the position. Do it for a year and if you hate it move on. 

[MomtaRN2B2020, ASN, CNA, LPN, RN]

I would like to do FNP if I’m not teaching somewhere later in life. I think I must mention I get bored easily and was the reason I left medsurg 2 years ago and went to the family clinic. Our clinic has a variety of patients from newborn to geriatric with OB included but the only skills we use is vitals and every now and then we will have an IUD or implant. Otherwise nothing else. I was promised I would see more before going to the clinic which is why I took the position there. Now I feel as if I don’t use my skills I will lose it.

[JKL33]

This is a personal decision but I will say that your situation seems to be at least as well-positioned to succeed in the ED as any random new grad RN. You don't have acute care RN experience but you have a significant amount of acute care LPN experience. Those 9.5 years have been spent learning things that are way underrated in the world of nursing: The flow of things, how to communicate with patients, problem-solving, prioritizing, etc., etc. These things are imperative and are indeed additional hurdles for the typical new grad. Some of them take quite a bit of time to develop, too.

So, overall I would say you're in a good position if you want to try the ED--with the understanding that you will still have a million more things to learn, of course. And some of them will be difficult.

??

[Jedrnurse, BSN, RN]

How good is the orientation at the ER facility supposed to be? If you think it's good and you want the experience, go for it. You can certainly always go back to med-surg from there if you want to down the line.

[MomtaRN2B2020, ASN, CNA, LPN, RN]

From what I understand it’s a four month orientation. the only thing that would stop me is the hours. The hours is 10 AM to 10 PM with the option of 7 days on and 7 off or 5 off and 5 on, or a weekend special of 7a-7p. The MedSurg position is  7 AM to 7 PM with a 3 day on 2 day off schedule and vice versa . The Clinic where I work the hours are 8 to 430 Monday through Friday but I feel like I’m not learning anything as a new RN. I want the experience but I am not comfortable with change. My heart says ER because I crave something new but my mind says go where you know you will succeed which is medsurg.

[Wuzzie]

1 minute ago, MomtaRN2B2020 said:

My heart says ER because I crave something new but my mind says go where you know you will succeed which is medsurg.

Why pigeonhole yourself? You have no idea what you can accomplish and you will never know if you don’t try. Like I said if you try it and it isn’t your cup of tea you can always got back to MS. 

[MomtaRN2B2020, ASN, CNA, LPN, RN]

Great point!

[JKL33]

7 minutes ago, MomtaRN2B2020 said:

The hours is 10 AM to 10 PM with the option of 7 days on and 7 off or 5 off and 5 on

I gotta say that working multiple days in a row on midshift is going to be brutal. Maybe some people like working the stretch in order to get the stretch off but be aware that midshift in the ED is no joke.

[Corey Narry, MSN, RN, NP]

OP, you may actually fit well in an ED environment. With your background in adult Med-Surg and out-patient primary care of all ages, you will find that some of your skills may translate.  ED is not all trauma and critical care.  There are ED patients who actually present with primary care issues including OB. 

I worked in a large inner city level I ED and because the ER is so large and there are many nurses on staff, we were rotated to various parts of the ER.  You will a acquire a certain skillset in each one area (I.e., prioritizing who you want to see first vs focusing on a patient that worries you, getting IV's on tiny babies, etc. you will have a favorite area).  If you think you can take a challenge in this point of your career, don't settle.  

That ED schedule, however, is a busy one though not as bad as 2 PM  to 2 AM which exists in some ED's. I could never do a six-day stretch. Four was my max.