length of orientation for ER

  1. Im having a problem with my length of orientation to the ER. Ive been a RN for 2.5 years working in burn/icu for 1.5 years and in SDS last year and have forgotten many skills in sds (except for IVs). I wanted a change and went to ER. I was told 3 week orientation for full/part timers. I decided to go prn to "test the waters" and was told orientation was 2 days! which makes no sense to me- Im still doing the same work. I did my two days(24 hours) which were okay but very busy. I asked NM for more orientation and she said take or leave it. the problem is I reallly like Er with the fast pace and actively using my brain but am getting overwhelmed. I worked last Friday 3-11 as one of 2 nurses for 10 patients-luckily most were routine clinic type but I think I was just lucky that night- still was drowning. Staff are very supportive but that will only last so long which I can understand. I cant begin to possibly pull my own weight and am starting to get resentful. I know NM screwed me but what can I do? Bottom line is I like Er and think I can be good at this but am seeing the beginnings of burnout. Any ideas, please!
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  2. 6 Comments

  3. by   MollyJ
    I don't think 2 days (PRN) or 3 weeks (FT) sounds like a very good deal. I'm a old nurse who hasn't worked the ED for 6 years and I would not accept that deal. Do you have other hospital options in your area, so you can at least find out what the norm is? ER is a different critter and this just gives you little room for answering questions or being helped through new experiences. I think this is medicolegal jeopardy...

    ...but. If you are determined to stick it out, I'd read voraciously, attend all pertinent inservices and ask questions constantly of my colleagues during any slow times and read policy books also during slow times. I'd ask for the new hire orient check list and study everything on the list and use my colleagues to check myself off on procedures.

    Since the area has a burn ICU, I'm assuming you have a sufficient pop density to support pretty specialized ED services.

    I'd also ask the NM if she would agree to give me more orientation IF I AGREED TO STAY A YEAR and then I would do all in my power to honor that committment.
  4. by   JillR
    I agree that this does not sound like much of an orientation, especially since it's your first position in an ER. I work 4 days a week and had two weeks orientation, which I felt was fine, but I had been floated there before and had at least some experience in our ER before.

    I guess it depends on how comfortable you are, there are times that I have questions, but I have great supervisors that are willing to answer questions and come and help if needed. 10 patients for a 3-11 shift does not sound bad, or is it 10 at a time, that would be a bit harder but do-able. Do you have tech's? if so then delagate what they are capable of doing.

    Good luck and I hope everything works out okay.
  5. by   debbyed
    In our ER our orientation is flexible depending on experience.

    An Experienced ER nurse would have 2-4 weeks out of staffing and another 2-4weeks with a preceptor in staffing.

    An Experienced Critical Care Nurse would have 3 week out of staffing and another 3-5 weeks with a preceptor.

    For Med/Surg you are looking a 4 weeks orientation and 4-6 weeks with a preceptor.

    We have recently taken on several new grads that did interships that lasted 6 months. They have become excellent ER nurses.

    Our facility has also grouped with other facilities in the area (there are a lot) and several times a year they have an Emergency Nursing consortium that lasts for several week with indepth Emergency Nursing Topics from Trauma to Peds to Birthing babys in the ambo bay. (we don't have a OB department so when those mothers show up in active labor we are it.) This is mandatory for new grads and Med/Surg nurses with limited backround and optional for the others. And yes the hospital pays for the courses as well as ACLS, Pals, TNCC, ENPC and the senior Clinical Nurses (there are 8 of us) are being trained to teach these courses.

    And incase you are wondering, we are not a teaching hospital, We were a small community hosital that is getting swallowed by the Metropolitin sprawl. We currently have a 26 bed ER and see between 140 and 160 patients a day. We are also currently building a new ER with will be quite a bit bigger. Our aim is to start hiring in January to be ready for opening in April.

    Even though I have >20 years Experience I would not go to work somewhere without a couple weeks orientation, every hospital is very different in their policies and protocals. Of Course this is also why I could never be an agency nurse. I need to be confortable in my surroundings before I am sure I can give the best care possible to my patients. My hat goes off to those who can work agency, Lord knows they have helped use out of many tight places.

    Sorry, Guess I got carried away.
  6. by   Dognutrn
    I am an ER nurse in a small Hospital We just started a Hospital based Ambulance service and have had to orient Emt-P's to our unit . We also made it mandatory for the nurses to orient to the ambulance (walk a mile in each others shoes) Our orientation is based upon previous experience and individual comfort level. It has been very interesting on both sides and has created a better understanding of each others job. We are very fortunate to have a Great Director that started as an EMT and worked her way up. Good luck and remember every case can be used as a learning tool.
  7. by   Tiiki
    Hi, I finished my ER orientation a bit back. Regardless of your past history (skills, education) we all orientated together. The first day was a brutal exam, covering all sorts of things like hemodynamics, MI, CVA, etc. From their the nurse educators knew your strong and week points. From there we had 4-6 weeks of classes. If you weren't in class, you were doing a buddy shift. After all the classes have finished you start 6 weeks of buddy shifts, with the flexibility of extending it, depending on your success, your feelings of comfort. I felt pretty secure after going thru this.

    I cannot imagine a 2 day orientation. Far too much to know, to learn. That seems awfully dangerous!!

    JO-ANNE
  8. by   teeituptom
    Howdy Yall
    From deep in the heart of texas

    Orientation here lasts from 6 weeks to 12 weeks depending on what is being oriented

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length of orientation for ER