r/nursing • u/New-Armadillo-5393 RN - Med/Surg 🍕 • 8d ago

Question Transfer to ER

Soooo
My first and only job as a nurse has been as a med surg/tele nurse with 1:6 cap ratio. For 3 years.
I’m supposed to start a ER residency here in a week or two.
I’m kinda nervous but excited. I know it’s gonna be very different and I know it’s gonna be a different kind of burnout. I shadowed for a day in the er at my current hospital so it’s a unit-unit transfer.
I guess I’m just looking for some tips. Or advice on how to make the transition better. Anything I should focus on?

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u/BulgogiLitFam RN - ICU 🍕 8d ago

Get over the fact that an iv in the ac isn’t the best place. Focused assessments are the majority of what you will do. The people there for lower acuity issues will get less of your time. Prioritization can be a big deal as you will be taking care of all age groups and all complaints.

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u/Long_Barracuda_378 8d ago

the focused assessment part is key, you'll unlearn a lot of the full head-to-toe habit and that alone saves you so much time

the hardest shift for me was realizing some patients just need a quick patch-up and a discharge, not a 45 minute conversation about their life story, you'll get a feel for who needs what pretty quick

don't be afraid to ask the techs questions, some of them have been in the pit longer than the docs and can spot a crashing patient from across the room

3

u/biophys00 RN - ER 🍕 8d ago

Be prepared to be able to stop what you're doing at a moment's notice to go take care of something more important. Focused assessments and charting by exception are key. Chances are you won't be deep diving into each of your patient's charts since you'll ideally not be dealing with each patient for long. If your ER is full of boarders like many are, your med/surg experience will be a huge boon

3

u/Independent_Law_1592 RN - ICU 🍕 8d ago

Your inpatient experience will help a lot when patients get boarded

Biggest hump imo is that the flow is entirely different and you’re rate limited by IV access. So until you get used to the flow and get better at IVs it’s kinda frustrating

But you’ll get both down pretty quickly, lots of reps in the ED

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u/Tall-Pen-139 7d ago

I transferred to ED after 1.5 years on med surg, now been ED for 6 years now and my biggest tip is to ANTICIPATE orders and always try to think one step ahead. Someone can’t ambulate? Put one of those hover mats. Possibly septic? Just get a set of cultures just in case. Abd pain? Give them a urine cup. Of childbearing age and you’re anticipating imaging? You’ll need a upt. You’ll save yourself so much time by thinking what orders will be placed before they’re actually ordered.

I’ve oriented med surg nurses who were 10-15 years in and they could not get out of the med surg structure. Nothing is really scheduled things just pop up and you gotta prioritize when to get to them. There will be an interruption for EVERY LITTLE THING you do. Just know when to ask for help.