Will ER nurses help me answer a few questions, please??

SillyStudent, ASN, RN · Jun 19, 2013

Our ER hires new grads that have gone through our nursing residency program.

I started in SICU, and when I was in the critical care float pool, I floated to ER a lot. I changed specialties because I enjoyed it so much. As for education, it might depend on your area but we have to get TNCC within 2 years and maintain ACLS, BLS and CPI. We hire diploma nurses, ADN, and BSN.

mcao11 · Jun 19, 2013

Thanks for the reply!! :) What did you like about the ER that made you switch?

SillyStudent, ASN, RN · Jun 19, 2013

Don't get me wrong, I loved the unit. However, ED nursing is pretty diverse. My patient load could consist of a finger laceration, a headache and an indigestion or a degloving, a head bleed and an MI. I love the puzzle. We have absolutely no idea what's wrong with a patient when they hit the door and have to figure it out. In the unit, I got patients that had already been 'figured out' for the most part. I love using my assessment skills like this. Stuff that you think is BS can turn out to be a huge medical problem and you can make such a difference if you just listen to the patients.

The whole time I was in the ICU I got a card and some flowers from a patient one time. In the last 18 months it has happened about 8 times. People really appreciate compassionate emergency care, and that is what I try to deliver.

mcao11 · Jun 20, 2013

What's your schedule like? Do you ever feel burnout? If so, how do you deal with that? I volunteered in the ED for a few months once, and saw a few nurses that were kind of apathetic and rude to patients. I didn't know if they were just having a bad day or had a hard time handling stress.

Georgia peach RN · Jun 21, 2013

I work in ER on PRN basis, I have not worked in a large trauma center but only small rural hospital ER, I have found that most of our ER nurses are cynical. They see people who will lie about anything just to get drugs. This is why they are that way but if you have a "true" emergency they are top notch and the most compassionate people I know.

DeBerham · Jun 21, 2013

I work 3 days a week, 12 hour shifts. Generally I'll pick up 2 or 3 extra shifts/month for extra $$$$. To handle it I compartmentalize. I keep my work stuff at work and home stuff at home. What results is you absolutely develop a work family, with all of the associated personality quirks and dysfunction.

The ER is an interesting area because you see A LOT of self diagnosis which I think certainly contributes to the "apathy" and "rude" impression that may be given. You're in the ER for N/V but demanding to have your chinese food.... let me get right on that. There is also the time management issue to deal with. We exist to get you stabilized and either up to the floor or out the door. We're not there to hang out with you. We need specific information and when that is not given in a direct manner I may begin to direct the conversation so I can find out what I need.

Belle2013 · Jun 21, 2013

I won't be too much help but I'm a recent new grad in a nurse residency program in a level 1 trauma center. I've just started but the new grads already am scheduled for ACLS (luckily I took it in NS), PALS, stroke care, and TNCC. I believe the right department will get you all the training they feel is necessary for you to be a competent ER nurse. Hope that helps a tad :)

mcao11 · Jun 21, 2013

Thanks for the reply, DeBerham! What's the most difficult thing you've experienced or had to do as an ER nurse?

mcao11 · Jun 21, 2013

Thanks for the reply, Belle2013! It does help :). How do you like the program so far?

floridaRN38 · Jun 21, 2013

I have been in the ER for 6 years. Started in a little ER when I was a new grad. Now I work in a level 1 trauma center. If I could do it over again I would go straight into a level 1 Truma center. You get everything there and learn so much more. It's great experience but I am starting to get tired of it. Best of luck to you

turnforthenurse, MSN, NP · Jun 21, 2013

I worked on a progressive care unit for 2 years before switching to the ER. By the last few months on my home floor, I got floated to the ER a lot and learned that I loved it down there, so I made the switch. I work full-time nights, which is 3 nights/week.

I love the variety. I had to brush up on peds and OB because in the ER, you can see ALL patient populations, from the very young (some just a few days or weeks old!) to the very old and everything in between. On my previous unit we saw adults and occasional peds, but I very rarely took care of the peds patients.

As a PP has mentioned, it's like a puzzle. A patient comes in and tells you their chief complaint and then you get to figure out what's wrong with them. There is a lot more autonomy here compared to floor nursing. I love these aspects. As for certifications, you will need to maintain BLS, ACLS and PALS. TNCC is to be obtained after 1-2 years and they highly recommend getting your CEN (certified emergency nurse) certification but it isn't required.

In the ER, you have the opportunity to keep your nursing skills in check. I have always been okay at IVs but now that I am working in the ER, I start them all of the time and I have gotten to be REALLY good. I get so many patients who are "hard sticks" and I am able to get them on the first try. Of course, there are still patients who I cannot get so I call for reinforcements. And I have my "bad IV days" but everyone has those. It is definitely something that I have gotten better at. On the floor I would have to start an IV but not nearly as often as I do in the ER. I also straight cath and place foleys and NGs a lot more often in the ER than I did on the floor. Those are just some examples.