Census has been low in the ICU again so I spent my last three shifts in the ED. Not that I am complaining, I have always been fascinated with the ED. It has always seemed like controlled chaos to me. Tons of people running around, doctors always available and lots and lots of patients coming and going.
Well after three nights working there I have come to a number of conclusions. First, there is no illusion the ED really is carefully run chaos. Nurses have a lot more independence there and ability to make judgement calls, and they work much more closely with the doctors. Second it is a fabulous place to brush up on skills that you may not have had a chance to practice while in clinicals. I think I put in about three times the number of IV's in three nights than I did in all of my two years of school. Never got a chance to do much in pediatrics? You'll get a chance to straight cath a baby PLUS give an injection all in one fell swoop. I did!
My suggestion to any students reading this, is that if you have an opportunity to hang out in an ED during clinicals do it. Do it even if you have no intention of being an ED nurse, it gives you a great chance to brush up on skills you maybe lacking and you will get plenty of chances to practice you assessment skills. To all you new nurses out there, if you can talk someone at work into allowing it, go float for a shift in the ED. It gives you a whole new appreciation for what goes on down there when you have been part of it. Not to mention you will always have a few patients who came through the ED and ultimately end up with you. It is smart to know what your patient has gone through before they came to your unit.
The last conclusion that I came to is that the ED is not for everybody. It really does take a particular type of personality to work there, and I think I may have it. At the end of my three nights I had a number of the nurses there asking me if I was going to transfer to the ED and leave the unit behind. When I told them I was just helping out they asked me to come back and play with them soon. I'll take that as a huge compliment.