I moved from ward-based nursing to the Emergency Department!
A few months ago, I transferred from a ward to the emergency department. This was a big decision as I had only ever worked in one speciality since joining the NHS.
Some of the reasons for the move:
- I had an emergency department placement during my training and loved it – although I wasn’t sure if I was cut out for the fast paced nature of the ED.
- I wanted to gain additional clinical skills and experience other situations that I would not see in my previous clinical area.
- After five years in one area – I started to feel that I was just going through the motions much of the time.
- I wanted to push myself and try something new and challenging.
Day one walking towards the department was daunting. The ambulances were already lining up early in the morning. I could only imagine that this was a bad sign! Everything about the department was different to what I was used to: the main area was a hive of activity, the phones were ringing, doctors were everywhere, the door to the resus area was open and it looked crazy in there!
There were a couple of patients with mental health issues being escorted by mental health nurses, the police had someone else in handcuffs. What had I let myself into? I was starting my supernumerary period so assigned to work with a registered nurse. We took handover of some patients being cared for in cubicles – I honestly had no idea what was going on. This was the most terrifying thing I had done in my healthcare career.
It got better…
Three weeks of supernumerary time gave me the opportunity to work in each different area of the ED. I slowly began to understand how the department works, the patient flow, the duties and tasks expected of me and the differences between the ward I worked on and the ED.
Working in the cubicles has some similarities to working on a ward – especially if a patient is there for much of the shift. If the hospital is managing to discharge patients elsewhere and free up beds then the flow of patients through the cubicles can be very fast. Other areas such as ambulance unload and resuscitation also operate on a quick turnaround. Often there is just enough time for bloods to be taken, ECG and other assessments to made and the patient is moved on.
There is a constant flow of walk-in patients. Many of these patients are relatively easy to treat and discharge. Others are more complicated and social and mental health problems are very common.
There have been some low points…
The Emergency Department is an extremely challenging place to work. It is very busy, very noises and really chaotic at times. Sometimes it seems that the whole of society is represented in one way or another in the patients that present, their relatives and friends.
I have already experienced some very difficult situations. I do feel however that my resilience has improved greatly. I have had to learn to work quicker while still working safely for my patients. I have had to learn how to concentrate in the middle of noise and chaos. I feel that these things have improved my overall confidence.
Nursing Associates in the Emergency Department
As a nursing associate – I am providing and monitoring care. Changes to a patient’s plan of care always come from a member of the medical team, a registered nurse or allied health professional. In this way, working in the ED is the same as any other area for a nursing associate.
Working in the ambulance unload area requires a registered nurse to carry out the triage and initial assessments. In the same way, the walk in triage area is always staffed by a registered nurse as this is outside the nursing associate scope of practice.
Nursing Associates can play an important role in the resus area – however this area is always led by several registered nurses, advanced practitioners and of course the medical team and other specialists depending on the specific emergency. There is still a lot for nursing associates to do however, prepping for emergencies, providing and monitor care, taking bloods and ECG’s, etc.
Was it the right move?
I feel that making the move to the ED was the right thing to do. It has been a boost to my overall confidence and has shown that I can work in an intense area. It hasn’t been plain sailing but I do think I have fitted in well to the department and have developed a good understanding of my role and the department as a whole.
Beth
