Re: Bellevue ER, NYC
ok, just a few important things to clarify. There is no "ER" at Bellevue. It is the "Emergency Dept" because huge and it is divided into Pediatric Emergency Services, Adult Emergency Services, Urgent Care, Emergency ICU, and the TRU (Trauma Resuscitation unit).
Unlike many EDs, there is no rotation of nurses through the units-- only during orientation to familiarize you with the whole dept. So, what this means is...are you going to just do adult emergency, peds emergency, urgent care, icu/tru?
With a large dept it is easy to feel like there is no support. BUT if you are truly interested in emergency medicine and like the emergency environment, there is no reason why you shouldn't give it a try. A LOT is expected of new grads going into this area simply because it isn't for everyone. But if you are the type to pick things up quickly and like to learn it may be for you.
Granted, just one day in the ER to observe is not realistic in determining you want to be an emergency nurse.
Also, if you want the trauma pts, you would need to apply to work in the "emergency icu" because that is the only unit where the nurses are trained and oriented to trauma resuscitation unit or as we call it, "the trauma slot".
So to answer your question, at Bellevue the Adult emergency, urgent care and peds nurses do NOT get the real adult trauma pts or rotate into the trauma unit. What they would get is the isolated limb injuries or pts who are walkie- talkie. However, if you work in peds emergency there is a special pediatric trauma slot within the unit.
The way the emergency icu is set up is such: it is a 10 bedded unit (9 + 1 crash bed). It is inpatient-- so this means you do the admissions-- these are usually unstable, critical and/or acute pts who may need an ICU bed but there aren't any or need immediate intensive care--all types of serious traumas, septic shock, resp failure, acute renal failure, GI bleeds, drug ODs, CHF exacerbation, neurosurgery cases, acute strokes.... to give you an idea. Pts usually stay on the unit until they are stable to be transferred-- give or take a few days to a week. Trauma pts get priority in terms of bed availability. there is no fixed scehedule on who in the icu gets to go into the trauma slot... it is basically who ever is up for one or has more stable pts. The nurse to pt ratio on a good day can be from 1:1, 2:1 and on a bad day, 3:1. Orientation is about 6mos... but i;ve heard they are playing around with the orientation and i do not know if this changes the length.
I've never rotated into the Adult emergency side, so i can't speak for them, but the Emergency icu is an awesome place to work because the ppl are cool, VERY supportive, knowledgeable, and autonomous. It is an extremely tough unit to start your nursing career in, but do-able (i did). You have to like trauma and critical care. Working in the emergency ICU gives you many more opportunities than just working in emergency or ICU alone--- it truly is a combination of both which keeps you on your toes.
With all this said is, if you truly want to do it, it will show. This particular unit thrives on the enthuasism to learn and most importantly, to DO.
good luck in your search.
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