New ED Extern- advice

ED Nurse, RN · Dec 15, 2015

I have been an ED nurse for almost eight years so hopefully I can give you some insight-

ER nursing is a completely different aspect of nursing and we tend to do things differently than any other department in the hospital. With that being said, you may feel comfortable with the basics, as you stated, but you need to come in as a "blank slate" so to speak. In my busy level one trauma center, new nurses are on orientation for six months. In that time you will run the spectrum of diseases and disorders. You need to carry a notebook and take notes daily- you need to ask questions and write them down if it is not the appropriate time to ask. Be OPEN to constructive criticism because you will hear it if you have a good preceptor. Do not be defensive when it comes to that constructive criticism because when done correctly if will make you the nurse you will be for the rest of your career. Try not to be too overly excited, I know you are excited for this opportunity, and there is a time and place for it, but in the department is the time to get down to business and be professional. Make sure you are also writing down the experiences you have had so you know what you still need to experience. It's ok to not know things- a good preceptor understands that- I've been a nurse almost 8 years and there are still a lot of things I don't know. Don't expect to jump into the excitement in your first couple of weeks, you need to learn the basics and fundamentals of ED nursing before you take on the critical experiences. Although you work in the ED of a level one trauma center, don't expect to take care of trauma patients for some time. At my hospital you are required to work in the dept for at least one year and then it is decided on a case by case basis which nurses are allowed in the trauma bay.

Good luck! Please remember it is ok to be scared- if you don't walk into those doors scared everyday then you don't belong there- I still get nervous every time I step across that threshold. Again, good luck!!

turnforthenurse, MSN, NP · Dec 16, 2015

Great advice.

As for things to carry on you, I always have my stethoscope, 2 pairs of trauma shears (yes, 2 pairs. People always ask why - more to go around when trying to cut clothes off of someone or if someone needs to borrow a pair, you still have a pair), tape, hemostats (I've actually used those hemostats, too), some alcohol prep pads, pens, board marker and a sheet or two of paper. If I find I don't have paper on my pocket, any other writing surface works - a pack of gauze, a paper towel, a gloved hand, an alcohol prep pad - you'll learn soon enough! :) I also always keep my phone on me if I need to quickly look up a drug or if I'm doing a stroke scale on someone - I have an app that contains all of the appropriate materials.

And speaking of apps...if you have an iPhone, here are some of my favorites:

- Micromedex

- Lab Values

- 10 Second NIHSS (stroke scale)

- 10 Second EDM (more so for docs but there is still a lot of useful information on here)

- NurseGrid (for my schedule)

- Figure 1

- Fast Facts: Critical Care

- Fast Facts: Trauma

- DripsManager

KAS2689 · Dec 16, 2015

Thank you for taking the time to reply! I really appreciate all your words of wisdom. I totally agree with your point about constructive criticism, you can either take it the wrong way and let it bring you down or use it as a way to improve your skills and gain confidence. I've learned that staying grounded and humble is so important in nursing... I will definitely keep all that you said in mind when I start my externship :)

KAS2689 · Dec 16, 2015

Hi ! Thank you for taking the time to reply. I'm heading out this week to stock up on some supplies and I will invest in another pair of trauma shears- it's such a good idea to carry two, great advice :) I checked out some of those apps and they look really helpful... Once again thanks :) it's greatly appreciated