Bellevue ER, NYC - page 2

I originally posted this message at N.Y. Nurses -- maybe somebody here can put light on this: Does anybody here have experience at/with Bellevue? As a level one trauma center - is that one of the... Read More

  1. by   MagsRN2008
    Dear ZuZu Trauma,

    I have just been reading this post and have a few more questions. I recently graduated and passed my nclex. Most of my clinicals took place at bellevue including one day in the ER. The charge nurse gave me her details if I was interested to work in the ER after graduation.
    In a way it would be a fantastic opportunity to get the experience, but I also feel that I need a good, supportive environment to learn. The moeny is not an issue for me. The most important for me is to work and learn in a friendly supporting environment. I was told that the orientation was about 5-6 months - is this correct. Also if you work in the ER do you get to deal with any major trauma or do they go straight to the trauma ICU?

    Many thanks for any input.
  2. by   ZuZuTrauma
    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.
  3. by   MagsRN2008
    Thks so much for the great post!
  4. by   truejewel82
    I just went through bellevue and submitted my resume a few days ago and just sent it through email...I have been out of school for a year passed the boards in the fall and am learning that I need to be a little annoying and aggresive to find a job as a nurse....I hope I get an interview.
    crossing fingers
  5. by   doudou
    ZuzuTrauma -

    Do you know if in the Peds ED area, the nurese rotate through all areas or are there specific peds trauma nurses there as well?

    Thanks!
  6. by   ZuZuTrauma
    only peds ED nurses go into the peds trauma room.
  7. by   doudou
    oh, thanks. I actually meant with in the peds ed, do the nurses float to all of the peds areas? as in only peds ever but between peds trauma and the other peds areas, or are they too restricted to the peds trauma area only, like the adults? sorry for the confusion! thanks!
  8. by   ZuZuTrauma
    The peds ED is not that big, actually. Whoever gets hired as staff in the peds ED is trained to go into the trauma room when a trauma arrives (so whoever is up for a trauma based on your pt load, other nurses cover while you are in there). Assignments to different areas of the peds ED exists and I'm sure they assign nurses accordingly and staff get to work in all the areas of their ED. i hope this answers your question.
  9. by   dkurland
    OK, so I have four years med-surg experience at a county hospital in California with the exact same patient population as Bellevue and I am bilingual but can't even get an interview because I don't have a BSN. I do have a BA and MA in other fields and an ADN. How is this right?

    And if I have to get a BSN who can recommend a program, please. I now live in NYC. Do managers really look at on-line RN to BSN as as good as going to school? Thanks.
  10. by   krztysu
    med surg is hectic..u get 10pts at times and preceptorship is 6weeks, but dont worry u wont need more than that.

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