Any advice to help me prepare for larger ER?

Hit the floor running you say...in a bigger ER?

Well then my suggestion:
A more comfortable pair of shoes. Soft, comfy...
Arch supports help. Perhaps some Spenco's or even some Rx- Orthotics.



Really, a bigger ER just means you have to run around more. Patient care IS and always WILL be the same. Protocols will vary from place to place but you just have to get use to the way the new place does things.
I know of NO WAY to prepare for something that just comes from on-the-job training. You just can't. You will learn the most from just familiarizing yourself with how THEY do it.

They should break you in with a preceptorship program for a week or two but don't expect to find your "comfort zone" for a few months. It's not you. It's the nature of things.

Stroke Protocol-NIH, STEMI Protocol, Chest Pain Protocol, Hyperglycemia (DKA)Protocol, Fever Protocol... You just have to do it. No one will expect you to know it all. Just ask questions and you'll be fine. You only get into trouble when you think you know more than you do and do something wrong.

(Oh, and I'm really not kidding about the shoes )


Good Luck and welcome to the show.

I agree about the shoes, just be sure to replace them often. YOu dont say how much bigger ER you are going to . ANd the best of intentions of not having your own patients for 5 weeks might last for 5 days. This is the real world be ready for it. I have been in the 5 bed ED, the 10 bed unit, the 20 bed unit, the 45+ ones. These numbers double when they start putting patients in every nook and cranny.

5 weeks orientation isn't enough IMHO. I worked level one trauma center (58 beds) and our current orientation is 6-8 weeks for experienced RNs (those that come from level I or II trauma centers) and 10-12 weeks for new grads.

I also work as an APN in a community ER (18 beds) and the orientation for RNs is still 6-8 weeks). Just don't sell yourself short when it comes to orientation.

Ride that orientation train as long as possible! My orientation was about 14 weeks, until I was unceremoniously dumped from orientation when another RN called out sick. LOL.

observe, ask lots of questions, and you'll be fine.