Finally Got the Job I've always wanted and now i'm nervous

Specialties Emergency

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  • by MMDEC
    Specializes in NICU, ER.

I have always love emergency medicine and first responding. I took EMT classes while in college, I did my school internship for nursing in the ED and planned to get an ER job after graduating with my BSN. Unfortunately there were no open positions when I was applying (all required 3 years of experience), so I sent to my second choice, ICU nursing.

By a twist of fate I ended up in a NICU but it was a very intensive unit and I learned so much! I moved out of state and was recruited by another NICU but I am very unhappy with my current postion (host of issues, lots of false promises, not as many critical patients) and I have been looking around for other positions in my area. I just accepted an ER position at another local hospital and I am very excited....and Extrememly nervous. I have only worked with infants for the past 2.5 years. I am out of practice with adult IVs, adult assessments, adult medications and doses. I know I haven't been out of school long and a lot of these things will come with practice but I am still ill at ease. I hope I sitll do well with the pace and environment ( I loved it while completeing my internship). Any words of advice/encouragement would be appreciated? Tips, tricks? Anyone else transfer from the NICU/Peds world and have some advice? Thanks!

Specializes in ER, progressive care.

What kind of ER is it? What levels of acuities do they see (if they utilize the 5 level ESI system)? Is it a trauma center? How long will your orientation be? Does the facility have a split adult ER and pedi ER? Anyone with peds experience going into the ER is a great asset. There are some books that I would recommend, tho:

Sheehy's Manual of Emergency Care (a wealth of information!)

ECG Workout - Jane Huff (goes over basic EKG stuff because you will be expected to recognize any life-threatening rhythms!)

12 Lead ECG for Acute and Critical Care Providers - Bob Page (this book is in depth and I would hold off on getting this one right away but still a great resource for 12-leads)

Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell - jennifer Buettner RN CEN (this basically provides all of the info that is short, sweet & to the point!

Bobjohnny

99 Posts

Specializes in ER.
Anyone with peds experience going into the ER is a great asset.

Massive understatement. Anyone with peds experience going to the ED isn't worth their weight in gold, they're worth their weight in platinum. The vast majority of ED nurses seem to have primarily adult pt. experience and are sometimes a little lost with kids.

As to the adult IVs, I find that as general rule of thumb they're easier than on kids. Obviously they aren't always, but generally. Most of the meds are the same, just as indicated different dosages.

MMDEC

16 Posts

Specializes in NICU, ER.
What kind of ER is it? What levels of acuities do they see (if they utilize the 5 level ESI system)? Is it a trauma center? How long will your orientation be? Does the facility have a split adult ER and pedi ER? Anyone with peds experience going into the ER is a great asset. There are some books that I would recommend, tho:

Sheehy's Manual of Emergency Care (a wealth of information!)

ECG Workout - Jane Huff (goes over basic EKG stuff because you will be expected to recognize any life-threatening rhythms!)

12 Lead ECG for Acute and Critical Care Providers - Bob Page (this book is in depth and I would hold off on getting this one right away but still a great resource for 12-leads)

Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell - jennifer Buettner RN CEN (this basically provides all of the info that is short, sweet & to the point!

It is not a trauma center (the other area hospital is) but there are a regional stroke center (which I find very interesting). They do not to alot of Peds because there is an area children's hospital, but they said they still get there fair share to stabilize and send out agan. Orientation will be 3-6 months depending on experience. Thanks for all the book reccomendations! I think I will be collecting and studying resources a lot!

AZQuik

224 Posts

Good peds nurses are at a premium where I work. I mean there are enough good ones, but not enough that can learn the dept flow instead of having to figure out how to get solid iv access "now" on a consistent basis. Our peds primary's are darn good. Our peds leaders are fabulous.

Almost to a T they all have great experience prior to the ED, and have the right "sas" for the Ed to deal with kids, RN's, MD's, charge, ems, parents, the list goes on.

Good luck, and enjoy the journey! At my hospital, the ED is kinda the "back door" to/of the hospital ;)

BSN GCU 2014. ED Residency ;)

Sent from my iPhone using allnurses

ScrappytheCoco

288 Posts

Specializes in Emergency/Trauma/LDRP/Ortho ASC.

Don't let it slip that you came from NICU or your co-workers will have you doing all their pedi IVs! :)

Specializes in ER.

True true. We are level 1 but rarely get peds and neonates. Recently had activation on little kid and gosh wish we had experienced critical nurse from nicu. I came from floor and did fine, lots of learning but can't do nothing but ER. Love it! Good luck!

Specializes in Emergency, Trauma, Critical Care.

Seriously you will be a huge asset to the department. I was adult ICU before and wish I had peds experience like you. Adults seriously are different and the same. You can look at an adult and just know when they are going to crump. Some will actually hold still when you start an IV. Most say they will and won't. My knee helps hold their arm in place usually and my left hand is on their forearm as well. With adults, you tend to have more time than a sick kid. They have more circulating volume. Kids are weight based, adults are standard one dose based.

most frequent meds I give:

zofran 4 mg

GI cocktails

pepcid

antibiotics

morphine 4 to 8 mg

beta blockers like metoprolol

cardiazem

the average ER patient is a clinic patient who couldn't get to a clinic now a days sadly. We do have emergencies, but many are not. They are just people who need some meds and advice on how do deal with a health condition. You may find yourself missing some acuity. I love it though.

MMDEC

16 Posts

Specializes in NICU, ER.

Thanks for all the great info Everyone! I start mid-next month and we'll see how it goes :)

Specializes in Pediatrics, Emergency, Trauma.

Congrats!!! :up:

medic9872

104 Posts

Specializes in ER/ICU.

I second the recommendation for the Bob Page book. It's a great book and very easy to understand. Good luck!

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