New ER Tech

  1. After almost eight months and four interviews I have finally managed to get my foot in the door of the level one trauma center I have always wanted to work at. I will be coming in as part time ER technician and was hoping you all could give me some feedback about what makes a good or bad tech. Im looking for what a tech can do to make your shift easier and on the flip side what techs do that drive you crazy. I have done some ER work on clinical rotations so I have a good idea of what to expect and I am looking forward to learning as much as I can about the jobs in the ER. I have not made up my mind if I want to pursue my RN or my paramedic cert and Im hoping working in the busy level one environment will help me make a choice.

    I have been in the Fire/EMS side of the job for going on eight years but I realize I will be coming into the ER as a "snot nose rookie", I have no problem working within my scope of practice, being a team player and have a very good attitude about being the RN's second set of hands. Any comments are greatly appreciated.

    Doug
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  2. 8 Comments

  3. by   menolly_33
    congrats! Hope the job meets all your expectations. I love having ER tchs available, makes my job so much easier. Some advice, know what you are allowed to do, and what you are not. As an EMT you were able to do lots that you can't do in the ER as a tech - the RN's can't do some of the things you did as an EMT. I mention this because I have observed RN's and Docs that will ask tech's that they know have your background to do skills they can do in the field, but not in the hospital. It created lots of stress for the tech, who wanted to be helpful, but didn't want to lose a job, and sometimes, I hate to say, it pissed off the people asking for help when the tech said "no, I can't do that here".
    As an ER nurse I try to utilize the tech for task that they are qualified to do, while I do tasks that they cannot. Also, be willing to do the jobs asked of you without attitude, sometimes the nurse is asking you to do a job that she or he could do, but has lots of other tasks waiting that only another RN could do. I hate hearing, why don't you do that yourself, or what are you going to be doing? I don't always have time to explain everything, althogh if I do have time I like to say, "please do X, while I do Y." But if you do see nurses trying to have you do all there stuff cause they are lazy, call them on it, or go over their heads. Everyone that must work with them will appreciate it, and have probably already pointed it out to the manager.
    Last piece of advice, never go to work without your sense of humor. As an EMT you have seen JOHN Q at his best, so you understand what I mean.

    Again, Congrats, I know you will love it, I know i love working in the ER, everyday is different.
  4. by   county162
    Being an ex- ER Tech and now an Emergency Room new grad nurse I can tell you for a fact, you will realize that you are doing more of the leg work and hard labor than that of the RN but you are of course getting paid less. In my ER they had me doing alllll of there work that they could get away with except transfusions, medication administration and documentation. I have to be honest, I even triaged patients from time to time, and that is a big no-no.
    Being a tech was a great experience and it definitely made my transition into new grad rn so much easier. I would recommend that you learn as much as possible but don't do anything that makes you feel uncomfortable. The nurses and doctors really appreciated that I would do things for them without having to be asked.
    I was going through the process of being a firefighter but I married one, so I thought being an ER nurse was the next best thing, of course I do miss the fire. Good luck to you and think about being an ER nurse.
  5. by   KatieBell
    The best way to make yourself a good ED tech is to be PRESENT. If you go out of the dept to transport a patient, let someone know.

    All that is required to make me love a technician passionately is the tech doing the jobs that are daily without prompting (In my dept techs are supposed to take vital signs q 4 hrs and report the abnormal ones....). and to be willing to help me when you are available, doing only those things which you are licensed to do, and doing them well. Also letting me know if you are involved in something and can't complete a task I asked for. (Then, I can get someone else to do it, rather than getting upset when I find it isn't done.)

    A major complaint (correct me nurses if I am wrong), is that techs seem to have an ability to disappear into thin air.

    One other valuable skill is to know where equipment is kept (Bair hugger, hepa filters PPE, hare traction, extra colostomy supplies...many a time a tech has really helped me with that and I am very thrilled about that.
  6. by   Happy-ER-RN
    You don't seem like the kind of person who would do this, but, make sure that you don't act like you are overqualified for your job, even though you are. There is an ER tech I work with who is in paramedic school and is constantly trying to show off how much he knows and trying to show me he knows more than me and it is extremely annoying. The only other thing is when I am running my a*& off and I see techs standing around talking. I have to interrupt their conversation to beg for a little help.

    It will be difficult, but if someone starts telling you something you already know just nod and smile! Casually try to let people know you are in RN school and people will likely tell you or show you things, always act interested no matter what and you will probably learn some great things.

    The things I love about a tech is when they ask if you need anything when they are not busy, and when they are respectful to the pts--especially regarding privacy when doing EKGs. Really anyone who has good work ethic and some medical experience can become a great tech and you sound like you have both. I am sure you will be great!
  7. by   FirefighterDoug
    Thank you all for the feedback so far. I would love to answer each of you but time is precious so I hope this will work.

    On acting overqualified. How could I go into a new environment filled with people who have spent years on education and be anymore than the humble FF/EMT who just wants to see if he might make a fit on the team sometime down the road. My sister in law has been an RN for thirteen years and has done work in trauma as well as ICU and the burn unit which is where she has spent the last few years. We have had many talks about the very different jobs we do, her in the med center with all the "goodies" that make an RN's life good, a well lighted warm and dry work area, well trained and knowlegeable team of folks ready to preform all thier magic on the PTs arrival. Me 300 feet over the side multi-trauma in the rain at 0300, extended response time on the ALS rig and of course no Lifeflight because the clouds are on the deck. I have a BLS kit some O2 and a handfull of redneck First Responders pumped on adrenaline. Im kidding about the redkneck part,my crew always gets the job done. The point is I would never try to tell an RN or even another tech how to do what they do.

    On staying within my scope of practice. The thought among the ED managers I have interviewed with is no more paramedics, not that medics are not great ED techs but they cant help not trying to jump in and use those skills. Medics drop tubes and start lines and push meds in the field and believe me over the years I have seen a ton of medics work thru my departments ALS provider and medics preform well in the field. The ER is RN turf and I can respect that and I think management is right on that call. I do know however that the other level one facility in P-Town wants thier techs to have an OR medic cert, go figure.

    On the subject of the "disapperaing tech". This is not as much of a way to make a living as it is a way for me to have fun doing something I really enjoy. I dont really fit the entry level ER mold. I am older and wiser and know what the words responsibility,accountability and dedication mean and Im ready to apply those traits in this new job just as I do with everything else I do. On my last ER rotation my class mate left after the required eight hours I stayed twelve and would have stayed longer but had a shift to pull at my Teamster job.

    Thanks again for the pointers, keep um coming, your experience can help me and I appreciate you all taking your time to help the FNG.

    Doug
  8. by   happystudent
    hey doug!

    I too worked as a tech in a level one and now I am a nurse there. Based on experience, I would have to say that you should know your duties as a tech. For instance, When a chest pain rolls in the door, start an EKG and pull up an old one on that pt. (if available). Usually, if a trauma is 2 min out, make sure you are there in the trauma room anticipating the docs and nurses needs. Lastly, you must know where everything is!!
    I respect the techs I work with and they respect me because I was in their shoes at one point and I don't abuse thier help.

    Being a tech is cool, the pay sucks, but it is a nice job to have if you dont mind a little elbow grease, blood, sweat and tears....

    good luck to you!! Let us know how it goes....

    happy
  9. by   ImaERtraumaRN
    I think the fact that you are wanting to anticipate what is expected of you, and what to expect is a good sign that you will be an asset to your ED.

    I see techs and nurses who stand around and talk when we are in the middle of a post-CPR, a respiratory arrest and a hot MI two minutes out. I also pay attention to the ones who aren't standing around and who are working alongside of us and I try to make a point to appreciate them when it's all said and done. It can be a thankless job sometimes, but it can also be very rewarding.

    Make sure you dont let anyone else put you in an unsafe situation - get their butts in gear when things get tough and dont be afraid to ask for help. At the same time, when you have downtime (maybe not often), I always really appreciate it when our tech/EMTs come and ask if they can do anything for me. Even if the answer is no, it is good to know they are available. On the flip side I try to help get vitals, etc. when I have a little downtime as well. The size of the degree doesn't matter - we are first and foremost a team.

    Anticipate pt. needs - sometimes they just need to vent. I dont advocate or expect anyone to spend hours talking to a pt. - especially when we are slammed- but a couple of minutes to get an extra blanket or ice water is appreciated. Remember that you are helping them on what is probably the worst day of their life (at least in their eyes).

    As someone else said, watch what happens when certain pt. types come in. Learn to anticipate what your role will be and be in there to initiate the protocols that are within your scope (ECG, monitoring, removing clothing, setting up lines - if you are approved to do this). It will allow the RN to do the assessment and initiate protocols that are within his/her scope more efficiently.

    Hope this helps! Good luck with your new job!
  10. by   MrsWampthang
    Don't be afraid to get your hands dirty. If your willing to empty trash, linens and change a dirty bed when you see it needs done, without being told you will be the nurses best friend. They, in turn, will make sure you get to help when there is anything intense going on. Don't be sitting in the corner talking on the phone or playing on the computer when the nurses are running their butts off and there's still rooms that need turned over for the next patient. Sorry, but this is one of my pet peeves when I worked in the ER. If there's work to be done, DO IT!!! Don't think yourself above doing things. Help as much as you can and the nurses will love you!!! And, if you smoke, don't ask for smoke breaks during busy times. Also, if you are pretty good friends with the staff, a back rub now and then never hurts! Good luck!!!

    Pam

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