Advise Needed for new ER nurse

TampaCCRN · Aug 20, 2003

Hi! I too started in one of the busiest ER in the nation as a new grad two years ago. I work nights so I usually walk into chaos at shift change. Give yourself at least 6 months to feel comfortable. I usually do a quick eye-ball into every room to start, then I pull EVERY chart and go room by room starting with the most acute patient. You'll eventually learn your own pattern. I know you probably here that from everyone, but you will.

rollingstone · Aug 20, 2003

I too started out in the big city ER. They called me "SloMoJoe."

Best advice is remember the basics: ABC's- Airway, Breathing, Circulation. Are they all intact and secure.

Don't forget that the veterans were once rookies standing in your shoes. Don't be afraid to tap their knowledge. I would suggest earning your TNCC (Trauma Nurse Core Course) certification as well as ACLS (Advanced Cardiac Life Support) certification. Some employers pick up the tab for these certifications, mine did.

Lastly, give yourself a break and relax. It takes time to hone your skills and organize your priorities. Remember, in a couple years the new rookies will be looking to you for support and advice.

Congratulations on earning your license!

healingtouchRN · Aug 20, 2003

just a reminder, ACLS, BCLS, PALS, BTLS, TNCC are not certifications. They certify one to do nothing!!! They are courses to be completed. (I am an instructor so I really do know! ).

ainz · Aug 20, 2003

You made the statement that you do not think the doctors realize how long it takes to carry out orders, assess new patients, etc. I think they do realize it and so does everyone else. You are the new person . . so . . lighten up on yourself and keep plugging away. You WILL learn how to assess patients quicker and gain the knowledge of the experienced nurses. That is why they are experienced, they have had the time to learn and refine their skills, you can too!!

I think nearly all nurses go through some sort of reality shock when first out of school and out into actual practice. Nurses also frequently use the phrase "I am putting my license on the line," or something similar. Well reality is we all put our license on the line everyday and every time you interact with a patient. I would discourage using that line because it is old, tired, and every other licensed professional in the ER with you also has their license on the line, it is the nature of the beast.

So again, relax, learn, observe, gain the skill and knowledge you need and desire, and soon you will have a new nurse coming to you for help. Just be sure and remember what it feels like right now so that when you are the experienced nurse perhaps you will be patient and helpful rather than irritated and rude to new nurses. Good luck with it and congratulations!!!

rollingstone · Aug 21, 2003

Thanks for the clarification healingtouchRN.

purplemania, BSN, RN · Aug 21, 2003

Relax. It will come. After you have years of experience there will still be people expecting too much. You just have to learn to do your best and then hope for the best. Make use of ALL your resources, including other ER nurses. Good luck. I train new hires and you sound right on track to me.

VictoriaLeavitt · Aug 22, 2003

You sound very serious and dedicated to becoming an excellent ED nurse. These are great attributes. That being said, cut yourself some slack - you are at novice or advanced beginner level and achieving competence takes time, practice and curiousity. Be curious - about everything; read, learn from others. Learn from your patients. If you are spending a lot of time in the nurses' station there is something wrong. Spend lots of times with your patients.

You will screw up - everyone does. Make it work for you - learn from it, then it is not just an excercise in humility.

I an a nurse educator for 3 EDs and teach the residency. I can tell that you have "the right stuff".

Wehn I was an ED resident 14 years ago (awful residency, just sort of thrown together) I had only been a nurse a few years - and that was Psych! I was so nervous the first year - my goal for the first 3-6 months was to make it to work - then I was trapped there for 12 hours. The charge nurse on days walked up to all the residents and said, "None of you are going to make it." She had just met us! Being older and lippy I stepped forward and sai, "Thank you. Thank you for that - because no matter what happens, now I know that I will." And I did. You will too.

**canoehead, BSN, RN** · Aug 22, 2003

In the ER there is always someone who can go faster- deliver your care safely and you will be fine.

petiteflower · Aug 23, 2003

Your assessments will become quicker with practice, and it is a good practice to do a quick head to toe, especially with injuries.

veetach · Sep 4, 2003

>>just a reminder, ACLS, BCLS, PALS, BTLS, TNCC are not certifications. They certify one to do nothing!!! They are courses to be completed. (I am an instructor so I really do know! ).

we may not receive "certifications" anymore, but these classes do give us the advanced training to perform in the ED in a manner that those without this training can not... (I remember when ACLS was a pass/fail certification)

nialloh, RN · Sep 4, 2003

In 1 year, when you see the next new grad and the questions they ask, is when you will really see what you know. You will realize exactly how much you know now and think "I was like that". It's a great boost, but remember, be nice to them. They will be fealing what you are now.