Emergency Room Nursing vs Floor Nursing

I recently finished my first week at the Emergency Department as a RN student. As some of you may know my hospital has sponsored me to become an ED nurse. Through this program we have clinical and courses we must pass in order to become a specialized ER nurse. Throughout the past year I have been working as a ward nurse on different medical and cardiac floors. I wanted to make this video to explain some of the main differences I have noticed on a specialized unit versus a non-specialized unit.

The first thing is that there is a lot more support. Staff are generally better at showing up on time when needed. You often have staff that are walking around helping other nurses. Because the workload is unpredictable you never know if you are going to be understaffed or overstaffed; therefore they try to staff it as much as possible to meet the demands. This is an ongoing challenge.

There is a lot more work to do. You’re always doing something critical for a patient. A lot more skills. You see it all from neuro to cardiac to behavioral issues.

A lot of unknowns, you don’t know ANY medical history about the patient. You have to assess using an Emergency nursing assessment framework to derive information from the patient. Make sure they don’t have any symptoms that could be critical for their health that the MD doesn’t know about. With that being said, there is A LOT more critical thinking. It is less about doing the tasks more about thinking about the tasks you should be doing. You have to identify any abnormalities and implement interventions that you see fit. That means you need to make sure you know the pathology of many conditions and symptoms a person may face. Example) everyone is on a monitor with v/s being automatically done and generated. However it is up to you to pick up on abnormalities and identify where things may go wrong. A LOT of teamwork involved. The physicians are ALWAYS there; if you need something you just page them overhead and they are there. It is more collaborative and many disciplines are there right away to help you out. Overall, the emergency department seems very intimidating at first. There is a lot to know and a lot to do constantly. You have to be sharp with your skills and think quickly and effectively. It is definitely a stressful place to work but I enjoy the chaos and I enjoy having to critically think about my patients. In that way you have more autonomy; you know what to do for the patient what tests they need and what needs to be done to medically stabilize them for the ward if needed of course. Even though my first week I didn’t get to do much, I thought it was interesting and I am glad to have chosen this specialty.