NEW TO THE ER WORLD - page 2

by CaribeRN

4,479 Views | 22 Comments

Hi everyone, I am not a new RN. I worked in a Med/Surg unit for 2 years and I will be starting a new job in the Emergency Room as of May. I always wanted to work in a critical care/ emergency setting because I enjoy the... Read More


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    My orientation period will be 3 months. My supervisor told me if I am doing really good it might end sooner but I want to take advantage of the entire time. They will assess me on the rhythms to see where I stand maybe put me in a class for improvement. I am trying to read, listen to audio lectures and find as much materials I can find to help me be prepared and not pull out my hair especially with terms and procedures that I am not used to see or do.....
    Esme12 likes this.
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    I recently re-entered nursing after a long maternity leave and found that there are great resources on youtube and you can do unlimited CE's on many nursing websites. This was helpful when I realized when I renewed my ACLS that I couldn't identify a lot of rhythms on strips (except V-Tach and V-Fib, thank goodness). You seem to have a good head on your shoulders and know when to ask for help, as long as you do that you should be fine! Best of luck!
    Last edit by bebbercorn on Mar 11, '13 : Reason: spelling
    SuzieF likes this.
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    Quote from bebbercorn
    I recently re-entered nursing after a long maternity leave and found that there are great resources on youtube and you can do unlimited CE's on many nursing websites. This was helpful when I realized when I renewed my ACLS that I couldn't identify a lot of rhythms on strips (except V-Tach and V-Fib, thank goodness). You seem to have a good head on your shoulders and know when to ask for help, as long as you do that you should be fine! Best of luck!
    Thanks bebbercorn! I am actually renewing my ACLS. I feel so stupid... Recognizing V-Tach, Normal Sinus, asystole.... I know the drugs to push.... Hopefully, I will get the hang of it... Thank you for your support.
    bebbercorn likes this.
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    As a RN with 30 years experience in critical care and ER, I'd like to offer a few suggestions. Learn your rhythms backwards and forwards. Never rely on others to interpret for you. Getting others opinions is fine, but it's your license. Never give a drug you didn't mix or draw up. No matter how emergent the situation is. Never close yourself in a room with any type if psych eval patient. Never act like you know it all because your peers will gladly stand by and watch you sink Always offer to help others and never sit back and relax unless ALL of your peers are, too! Stay clear of triage for a lonnnnng time. Good Luck!
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    I love working in the ED (most of the time), especially at an academic facility... great relations with the docs and a team environment with the other nurses unlike anything else I've seen.

    One thing to keep in mind: You will be dealing with violent patients and psychotic patients. Watch your back (and face) around these folks. Keep up your guard and listen to the little voice in your head that says "careful..."
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    Quote from L_L_S_L_T_G_O
    As a RN with 30 years experience in critical care and ER, I'd like to offer a few suggestions. Learn your rhythms backwards and forwards. Never rely on others to interpret for you. Getting others opinions is fine, but it's your license. Never give a drug you didn't mix or draw up. No matter how emergent the situation is. Never close yourself in a room with any type if psych eval patient. Never act like you know it all because your peers will gladly stand by and watch you sink Always offer to help others and never sit back and relax unless ALL of your peers are, too! Stay clear of triage for a lonnnnng time. Good Luck!
    OMG..... I am trying my hardest to recognize the rhythms right now.... My philosophy is... I didn't take it out the Pyxis, scan it, put it in a syringe therefore I am not pushing it into a pt. As for triage, I will stay clear as long as I can.... Thanks for the feedback.... Greatly appreciated....
    Esme12 likes this.
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    Quote from ♪♫ in my ♥
    I love working in the ED (most of the time), especially at an academic facility... great relations with the docs and a team environment with the other nurses unlike anything else I've seen.

    One thing to keep in mind: You will be dealing with violent patients and psychotic patients. Watch your back (and face) around these folks. Keep up your guard and listen to the little voice in your head that says "careful..."
    My gut always tells me right, hope I follow it at all time.... Thank you for the advice...
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    Quote from L_L_S_L_T_G_O
    As a RN with 30 years experience in critical care and ER, I'd like to offer a few suggestions. Learn your rhythms backwards and forwards. Never rely on others to interpret for you. Getting others opinions is fine, but it's your license. Never give a drug you didn't mix or draw up. No matter how emergent the situation is. Never close yourself in a room with any type if psych eval patient. Never act like you know it all because your peers will gladly stand by and watch you sink Always offer to help others and never sit back and relax unless ALL of your peers are, too! Stay clear of triage for a lonnnnng time. Good Luck!
    Excellent advice...at least they have a Long orientation.

    OP take it all....there is a hige learning curve.!
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    Quote from L_L_S_L_T_G_O
    As a RN with 30 years experience in critical care and ER, I'd like to offer a few suggestions. Learn your rhythms backwards and forwards. Never rely on others to interpret for you. Getting others opinions is fine, but it's your license.
    I agree with this sentiment - and defer to someone with 10x more time-in-grade than me - but I prefer to spin it as "...fine, but it's your PATIENT." Practice the way that you would want your child's nurse to practice, not out of fear for your license... the end result is likely similar or identical but the motivation matters, too.
    Always offer to help others and never sit back and relax unless ALL of your peers are, too!
    This can't be emphasized highly enough... you are totally dependent on each other... be dependable and the one to always offer a hand - whether it's requested or not. A corollary is, they're all your patients... check on alarms immediately... 1000 false alarms are worth the one crashing patient you catch in time to effectively treat.

    Also want to add:

    1) Remember that medical/trauma patients may be psych patients, too... don't trust any of 'em too much.

    2) Even turkeys get sick... That patient who's presented 20 times for myriad complaints of chest pain or sob may, on #21 be having an MI or PE.
    mybrowneyedgirl and prnqday like this.
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    Be honest with yourself. If you find that you are not an ED nurse, then that is okay. Sometimes we have this idea of what a dream job is or what specialty we want to do and find out later that it is not what we thought it would be.
    If ED truly is your home, then my advice is to always ask questions. Never be afraid to stand up for what you believe in. Stay in your scope of practice. Even though the ED is fast paced and intense there are somethings RNS are NOT allowed to do. Do not let any doctor or anyone else bully you into doing something because " it is how we always do it". No, don't do it. You will get caught and they will not.
    Be a team player. Wishing you well.


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