Advice for a New Grad in the ER!

Specialties Emergency

Published

About a month ago, I accepted a position in our local ER (Illinois) and then thankfully passed my NCLEX last week. I'm just waiting to get my official license before I can really get started.

I understand that there are a lot of people who feel like new grads should have experience on a med/surg floor first, but I loved my experiences in the ER as a student and the staff is extremely welcoming. It is a level II but they still see a little less than some of the other ERs in our area, so as far as EDs go, I feel it will be a good place to begin. My mom also encouraged me to take the position because she feels I'll be a good match for that environment (she's a med/tele RN).

I'm excited for this opportunity, but still extremely nervous because I understand it's going to be more fast-paced and intense than a typical floor and it's definitely going to be a challenge.

That being said, I was wondering if you seasoned nurses out there (ER or not) have some advice for this newbie! It would be much appreciated! :)

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Specializes in PACU, ICU.

Get a book on emergency medicine and start reading to give yourself a head start. Also start looking at material for CEN or CPEN certification. Finally, ask around on the floor for what types of cases your ED sees the most of and brush up on those first.

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When in doubt - just ask. If you're working with a great group of seasoned ER nurses, they'll help a newbie out! I went directly into the ER after graduating RN school and I absolutely love it! I work with a great group who have been (and continue to be) great mentors! There's ALWAYS going to be things you don't know how to deal with - that's why teamwork is of upmost importance! Each nurse has their own nitch and as you work with your group, you learn who is best to ask about each situation you're faced with. Do your best and show your co-workers that you are ready to learn and you'll do great! Good luck! :)

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Thank you for your input, guys! :)

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Don't be afraid to ask questions, that's the only way you will learn

How long of an orientation phase do you get?

I was a new grad that started in the busiest ER in my state and I survived/am surviving.

Only been there for about 7 months now, but I've learned a lot and continue to learn a lot.

You have to be willing to get involved and help others. In my ED we all work really well as a team to help others and learn from others.

When I started working there I had a couple people that helped orient me, and most of them kept telling me it's a steep learning curve being brand new and starting in the ER, but if you have the drive for it, you will do great. They all thought I should come off orientation early, you just gotta strive to be the best you can be!

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Specializes in ER - trauma/cardiac/burns. IV start spec.

I too went straight to the ER from school. I had 1 week of "class room" orientation then went to the ER. My orientation lasted less than 1 week once I was there. I was taught by a very interesting method - watch one, do one, teach one. Yes it was a bit daunting but I loved the commotion and the fast pace of the ER. If you love doing something every minute you will do great. I have only one rule that I shared with all the new graduates that came to the ER - the only stupid question is the one you do NOT ask. Each time you wonder why or how ask someone and you will do just fine.

As a new grad to the ER do not try to jump into CEN or TNCC too fast. Do not try to cram your mind with theoretical information. As you encounter new things, i.e. burn patients, cardiac arrest, gunshots or stabbings, just get in there and watch and LISTEN to everything. Listen to the Doc's orders and see what the more seasoned nurses are doing in response. If you find yourself with patients that need suturing a lot learn the limits on lidocaine with and without epi. Learn what sutures each Doc prefers for sewing. If you spend a lot of time with cardiac patients learn the drips and the strips.

Remember your ABC's and all the rest will fall into place. The ER can be scary, daunting and intimidating but it can be a great place to work.

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Specializes in Emergency Room.

Learn your protocols.

Learn to anticipate needs - suture cart, ENT, Eye cart/lamps, OBGYN cart

All chest pains are cardiac until ruled otherwise

Unless hysterectomy - all females 12-60 need to be eval for pregnancy

Always check your rooms for AT least suction, wall 02, ped/adult ambu bags, portable O2 tanks, cardiac leads/pulse ox/bp cuffs, nc's and NRB - everything else can be fetched if needed. More applies to trauma rooms.

ESI levels are determined by resources required and can change thru out the visit.

hmmm, can't think of any more at this time

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Draggonnurse1: Our orientation is at least 3 months or so, depending on how we do. The staff I've met so far has been very welcoming. When I did a rotation there during clinicals I worked with the nurse who will likely be my preceptor and I absolutely loved her. I feel like the ER worked better as a team than any other unit I've seen. The fact that they are all so open and friendly makes me feel very good about working with them because I know I'm going to have to have good communication & speak up when I need help.

Thank you for sharing your experience with me!

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