New grad in rural ER?

[amzyRN]

I've been debating on whether to go out of state for an opportunity in a rural hospital. Part of my reluctance to go is based on concerns that I will not have enough support during orientation and that I will have too much responsibility too soon. Plus, I have been wanting to get a little floor experience before going into a specialty. However, floor experience is hard to come by. To cut it short, my question is how have new grads/inexperienced nurse done in a rural ED? This ED is a level V. What are your thoughts on the matter. Thank you.

[ED_Chris_RN]

I am a new grad and I work in a Level 2. I love my experience thus far! I think it is all about getting paired with the right preceptor for you, some people just do not mesh. I saw a bunch of my coworkers struggle because their preceptor/preceptee relationship was pretty bad.

[amzyRN]

I am a new grad and I work in a Level 2. I love my experience thus far! I think it is all about getting paired with the right preceptor for you, some people just do not mesh. I saw a bunch of my coworkers struggle because their preceptor/preceptee relationship was pretty bad.

Congratulations on your experience! I did a residency at a level 2, and though my preceptor was an excellent ER nurse (she was one of best nurses I've ever met), I found her to be a bit rough and for me it didn't work as much. Plus she was so far above my level of experience, I found it hard to learn from her. She did things without having to think about doing them, her actions were already hard wired, she was fast, confident, and had a very strong assertive personality. Having the right preceptor and support are key to success in any specialty. My concern about the rural setting is that there's not a lot of other staff on duty, so theoretically I could get swamped and overwhelmed with critical patients: traumas, MIs, brain bleeds, or sepsis patients, coming in all at once it would be all on me. This would be unlikely because sicker patients are brought to level 1s and level2s, but theoretically it could happened.

[ED_Chris_RN]

Thank you! I see what you are saying. I found that my first few times on the floor I was nervous but I really found my rhythm in a short amount of time. If you really feel like it is where you want to be shadow at the hospital you want to work at to get a good idea. I got to shadow at my hospital which helped me pick it over the hospital I was working at as a tech during school. Good luck!

[mediwizard]

I really like the ER. The variety is awesome, that's what I like about it. When I was in the ER (had an experience through school), I was a little bit overwhelmed. I felt like I needed more support. I also felt rushed, like I had to start an IV quickly, but I didn't have the technique down yet. I was able to start the IV, but it was stressing. I think the pace was what I was having trouble with and my time management needed work. I think I could probably handle a level V ER but want to be sure I can do it before moving.

How did you do it? I am thinking of doing the same and feeling both excitement and trepidation particularly with the limited support and more than likely the possibility of being the only RN

[mediwizard]

I just started at a rural ER with one year of experience, and it's so completely wonderful, IMO! 2 trauma beds and 5 non-urgent rooms. One RN, one mid level provider, and one CNA. The hardest part is just getting the rhythm of anything in nursing. It's all about timing whether it's ER or med/surg. Only time will allow you to get into your flow. It's just about when to go in the rooms, calling to give report to do admits, entering meds, past med hx, allergies, starting IV's, getting meds from the pharmacy. Vitals every 30 min. Then the other part of the ER stuff is kinda like OR nursing in that, you're charting when radiology gets the pt and brings them back, when the provider gets into the room, when you gave meds, follow-up on your meds, etc. The hardest part of any nursing job is learning their computer system and where to find what you want when you need it. It's gets chaotic when 4 people walk in together, but it's all about prioirtizing, and just going through the motions. Get'em in 'n'out is very nice. I love it, and my orientation is all dependent on how long it takes me to be independent. Then they say, you're off orientation, your first day on your shift is ........

Are you still working in that hospital? What do you think of a new grad doing what you were doing when you started working there? I know this is an old post but would appreciate feedback! Thank you

[GM2RN]

It sounds terrifying, but I don't think the DON would leave me stranded. She is 2 minutes away. All I can do is the best that I can and not make a mistake in prioritizing. I can do this on paper, but honestly, my skill set is not that good yet. My last preceptor said that I have the knowledge base down, but that I needed to be able to translate that knowledge physical reality and I did have difficulty with that. My time management is not efficient yet either. In a larger hospital, I know that unless I had a residency program that consisted of 6 month of orientation, I would not be able to do it, in the ED that is. My plan was to get into a med/surg unit and build from there. That opportunity does not exist for me at the present time. I have a job at a SNF now and another part time job. My thought was that this being a smaller hospital and lower acuity it would be easier for me to start in the ED, plus I would get a broader set of skills, and have more options in the future. The DON knows I'm a new grad and said that the hospital has oriented other new grads and that they love to teach there. She said that nursing students come and do clinicals there. Honestly, she is the nicest and most welcoming nurse I've ever spoken to. She is so appreciative of me coming on as a new employee. I've really never experienced that kind of gratitude before. It's hard for me to imagine that she would put me in a position that would risk the lives of others.

Comments removed due to old thread.