Med surg experience v. ER/Trauma

nilepoc · Nov 15, 2001

As a charge nurse in a Level 1 trauma center, I say go for the gusto. I would suggest trying to get into the ICU end of things first and then going to the ER.

After four years as a nurse, I finally feel comfortable in ER.

If you have anymore specific questions, let me know.

Craig

essarge · Nov 16, 2001

Thanks Craig! An instructor and I were just talking about doing triage and having enough experience to to it correctly. The hospital that I am NOT going to puts anyone up there. My mother-in-law could have lost her life because they put a new nurse up there if I wasn't the "mouthy" one of the bunch! Anyway, thanks allot for the advice, it's greatly appreciated!

janine3&5 · Nov 16, 2001

Do what you love- you have to like what you do, if med-surg isn't your interest, then don't go there. I just got my RN in July, and went right to ER. I love my job and can't imagine doing anything else.

Yeah, it's stressful-but you learn so much. I can't believe how much I've grown in the past few months. You have to have a lot of confidence in your assessment skills and be quick thinking in the ER. But you have to know how much you don't know either, and feel comfortable asking questions when you need to. You will learn something new every single day- go for it!

essarge · Nov 16, 2001

When you first started in the ER out of school how was the training? Was it adaquate, did they nibble, bite , or teach you?

**canoehead, BSN, RN** · Nov 16, 2001

I vote for going straight to the ER. You'll get loads of experience and you can gradually move up from the colds and runny noses to the big traumas. A good spot for an enthusiastic new grad in my opinion.

debbyed · Nov 16, 2001

find an er that has a great preceptorship for new grads and go for it!!!!!!

essarge · Nov 16, 2001

Wow! I kind of expected everyone to tell me that I should get experience in med surg first. This is great!! That is what I wanted to do, but I really didn't want to go into a situation where I was the "bait" and get eaten alive. I think that I would be very bored on med/surg. I need the adrenaline moving in order to really enjoy myself in any job and I have had jobs that absolutely bore me right to ......!

I hope that the hospital that I want to go to has a preceptor program in the ER (I'm sure that they do, they are very progressive). Thanks everyone!!

janine3&5 · Nov 17, 2001

Essarge,

My orientation was only 3-4 weeks (1/2 on the floor, 1/2 doing education) No, that's not very long, but I was lucky enough to have a wonderful preceptor.

We really have a great team of nurses, everyone helps each other and I know that I can ask anyone of them questions. I haven't experienced any of the "eating your young" deal.

And like canoehead said, you're not thrown into the most critical areas right away. I slowly bridged into the more critical rooms. At the hospital I work at, you need your TNCC to work the traumas, and your ACLS to work the two most critical rooms.

Trauma Columnist · Dec 17, 2001

Go for the ER, but find out about orientation - for level I trauma center, it should be at least 8-10 weeks. This will give you enough time to feel at least a little comfortable.

I have to add that I work at a 65K/visit/year level I and we do hire new grads. Unfortunately, with the nursing shortage, our second shift is all new nurses with less than one year of experience, which is horrid!! You can't count on not having a seriously ill patient these days. Make sure you're comfortable. Find someone to mentor you and keep asking questions!!

KKERRN · Feb 27, 2002

I agree with the others about going for the ER! Checking the preceptor/orientation and/or mentor type would be best. I've been at ER 1 1/2 years with no ICU/CCU background. They promised preceptor/internship BUT all I got was the usual 8 days of orientation with a different nurse each day! It was over whelming to say the least. I went there with a friend co-worker and we worked together to learn EKG's and ACLS. Many of our new co-workers were not receptive to new staff....didn't matter if you had experience or not. I learned after about 6 months that they treat you different once they feel secure that you are staying in the ER. Our turnover is high, esp. on nights. Be assertive with caution to always ask questions on what you're not sure of. Use resourses...when I couldn't get answers from my co-workers I would call units with that type patient/specialty for answers.

After about 6 months you begin to feel a little comfortable, but still new. After 1 year I am comfortable in most situations. Now, they want to train me for charge on nights and that is scary. If I end up in charge it means the most experienced nurses have been there 1 1/2 years...that scares me!!! Most of our docs are great and usually willing to teach as you go. I learn something every shift I work. You have to be knowledge thirsty and learn how to improvise constantly. You will love it!!

Karen/KKERRN

highasthesky · Mar 5, 2002

I'm so glad to have found this thread, ER/Trauma is mainly what I'm interested in going into, but I don't even have my LPN license yet, so it may be a while for me. But the inspiration I've found here lets me know that it will all be worth my time and effort. Sounds like you all really enjoy your jobs, and that excites me even more!