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Differences in Working Emergency Department & Regular Floor



The hospital emergency room is the 24-hour body repair shop.  It never shuts down, and you never know exactly what you will see, or how busy you may be.  The emergency room is the specialty in nursing that encompasses care for patients of all ages, and all conditions.  From delivering babies and providing resuscitation to trauma patients, the pace of working in the emergency room can often change minute to minute. 

Is Working in the Emergency Department Right for You?

If you enjoy complexity, there is no question, emergency nursing has it.  Some determining factors to decide if the emergency room is the right choice for you:
  • Ability to shift gears and accelerate your pace as needed 
  • Good observation, assessment, and prioritization skills 
  • Multi-tasking ability 
  • Good interpersonal and customer service skills 
  • Stamina 
  • Good personal coping skills 
  • Assertive patient advocate 
  • Ability to maintain calm amidst chaos 
  • Good sense of humor 
  • Ability to think fast and on your feet

Where do Emergency Nurses practice?

  • Hospital emergency departments 
  • Administration 
  • Schools of nursing/universities/colleges 
  • Research/research institutes 
  • Emergent care centers 
  • EMS/Prehospital transport 
  • Flight nursing in helicopters/airplanes 
  • Poison control centers 
  • Telephone triage 
  • Military 
  • Corporations/businesses 
  • Crisis intervention centers 
  • Prisons/correctional facilities 
  • Federal and state governmental agencies

Can New Graduates work in the Emergency Department?

The short answer is yes.  It is not the easiest job for a recent graduate, however on a positive side; you would get a world of experience.  If you decide to select emergency room work right out of school, be sure to select a hospital that has a formal orientation or internship program.  Ideally the facility would be more of an on the job training, rather than having you work from day one.  Some of the benefits you would gain from working in the emergency department are:
  • Critical care experience.  You will gain the knowledge and skills necessary for life and death resuscitation scenarios.
  • Experience in a medical and surgical environment.  This will help you learn to prioritize activities and manage multiple patients simultaneously. 
  • Experience in a step-down or intermediate care unit will give you an opportunity to firmly ground your nursing knowledge and skills and help you when you do get an emergency nursing position.

Steps to prepare you for your first Emergency Nursing Position

  • Join the ENA, Emergency Nurses Association, and be sure to study all information on the website.
  • Attend any emergency nursing conferences that are available to you.
  • Take special classes in Advanced Cardiac Life Support & Pediatric Life Support

Working a Regular Floor in a Hospital

Working on a regular hospital floor varies, depending on what floor you are working on.  If it is a floor other than ICU, the night shift in particular can be less demanding at times.  A regular floor does not generally work at the super fast pace of the emergency department, however, that too can vary depending on patient load.  Your day is more planned out on a regular floor, and you can usually stick to more of a schedule.  You may have the same patient for more than one day, unlike in the emergency department.  Working on a regular floor is much more routine than working in the emergency department. 

Choice of Work Areas

If you are afforded the right to select where you can work, consider the following:
  • Emergency Room Advantages 
  • Fast Paced - makes the shift go by quickly 
  • Variety - different patients daily, sometimes hourly 
  • Never routine - Each day and often each hour brings on a new condition or situation 
  • You will encounter some unusual situations that you may never be exposed to working in another area. 
  • You will learn to work in a critical environment, and improve your skills to react quickly.

Emergency Room Disadvantages

  • Very demanding - you are often working in an extremely stressful situation 
  • Must make critical judgment calls, with no time to second guess or research your decision 
  • No routine - you will encounter a very different working scenario on a daily basis 
  • No quiet time - unlike other less busy floors, the night shift is often the busiest in the emergency room, and it's difficult to complete paperwork.

Regular Floor Advantages

  • More often than not, you have time to spend with your patients, and get to know them; many are there for more than a day or two. 
  • You have more time to prepare the paperwork 
  • Routine, if you like a more predictable environment, you may want to choose working on a regular floor over an emergency department 
  • Less hectic, a regular floor is less fast paced, and far less hectic than the emergency department, most of the time. 

Regular Floor Disadvantages

  • If you enjoy variety, you may feel that a regular floor is a little too routine for your preference 
  • Slower paced environment may make for time to appear to move slower.  A 12 hour shift can seem like it lasts for 24 hours. 
  • Routine, most regular hospital floors are fairly routine, and if you prefer variety, the routine may seem boring.
Regardless of what area you work in, nursing is a demanding job that entails the responsibility of saving lives on a daily basis.  Your personality, and work style preference should help determine what area you are best suited for.  It may be beneficial to work as a PRN nurse in the beginning to allow yourself time to work in different areas.  You can then determine which area seems the better fit for you.  Working in the Emergency Department at least a few shifts would be a good idea, as you will get some valuable experience in critical situations.  Some hospital Human Resource departments offer assessments to help you decide which area you may do better working in, however, there are online assessments as well that can help you decide for yourself. 
When selecting your area of choice to practice your nursing skills, consider where you will do the most good, and where you feel you will be more comfortable.  It’s important that you feel at ease with your job, so give yourself time to make the best decision.  In the event it does not work out, most of the time nurses are allowed to transfer positions after a certain period of time.  

 
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