New grad in the ER-How do you know if a new grad will make it?

[whichone'spink, BSN, RN]

I was reading in a thread by another new grad who just started in the ER, and how her preceptor told her she knows when a new person will make it in the ER or not. That got me thinking about how others will perceive me on day one in the ER, and making a damn good impression on my preceptor. For those of you who have worked in the ER for a while, maybe even as preceptors, how do you know if your preceptee is going to succeed in the ER or fail miserably?

[Altra, BSN, RN]

I precept frequently (by choice) and I don't agree with that statement. A great beginning with a joke and a smile at 0700 does not guarantee success. Motivated, capable individuals may start at the very (sometimes painful) beginning of the learning curve ... but they learn and adapt.

I also would never say that to an orientee, as if I were the Great and Powerful Oz. I'm not. In addition, it's my job to make it work ... to produce a reasonably well-adjusted, functional nurse at the end of the orientation period, with performance in line with their level of experience. Unless the hire/interview process has been completely dysfunctional, or the orientee decides it's not for them ... my job as preceptor/coach/cheerleader/taskmaster/etc. is to make sure the orientee knows his/her strengths and also is actively working to grow and to correct deficiencies. With rare exceptions ... I have been successful.

Good luck to you, OP. Welcome to the ED. :)

[harrird]

I definitely agree with Altra, BUT I would add a few things. I'm a new ER nurse, and I've had a couple of my peers that just didn't have the chops so to speak. One commonality between those of us that are doing well vs the wash outs is attitude. Pretty much everything can be taught and improved on over time, but approaching a new situation with the proper attitude can help you to standout or simply succeed. What's interesting is Attitude is about the only thing you CAN control in a busy ER. Sometimes as a new nurse, no matter how hard you try you're simply not going to be equipped for what comes through the door. You can't control the volume you're going to see on a given night nor the level of acuity. I think maybe what your preceptor meant is you have the right attitude and mindset. Some other traits that are inherent in successful people (regardless of department, or even profession) are perseverance, being open to instruction, and having a thick skin helps.

Best of luck, and welcome to the ER.

[JessiekRN]

Harrird this is off the OP's topic but I wanted to say thank you for pointing out that attitude is the only thing that can be controlled in the ED. After two shifts in a row dealing with some very interesting patients I woke up this morning feeling depressed about the general public, the sad state of healthcare, and the general abuse of the ED and nurses. I'm WAY too new in the ED (8 months) to be feeling quite so burned out. So I just wanted to say thank you cause you reminded me I can't control patients' behavior, ridiculous demand and expectations, or concepts of an "emergency". I can't control nursing management either. But I can control how I react to it. So, totally off topic, my apologies, but it was exactly what I needed to read, so thank you.

[NurseOnAMotorcycle, ASN, RN]

I agree with attitude.

Ar you the person who shies away from new experiences or jumps in feet first? Do you get depressed after doing something wrong or steel yourself and do it more often to get it right?

That's exactly the attitude that will make it or break it in the emergency room.

[LalaJJB]

Attitude, willingness to take criticism (from patient's and co-workers, whether it's warranted or not), thick skin, and ALWAYS BE WILLING TO LEARN and do research... Oh, and dont be afraid to ask for help EVER..even if it's something you should probably know. Especially with meds.

[phlebitis]

I think I wrote the post where I stated that my preceptor told me I would make it because she can usually tell as she has had students before. I just wanted to clarify that her statement wasn't made on day one. It was made after a couple of shifts and she also told me at the time that I am independent (not afraid to jump in and try something; even though I am on the inside :) and a quick learner. I think she was talking mainly about my willingness to learn and that I know I have so much to learn, I'm humble. I also ask 4million questions every shift. I don't think my preceptor thinks her opinion is the be all end all of my ability to make it in the ED. It was just something she told me while she was talking to me about working in the ED. I hope she is right and that I end up being a great ED nurse, because I really love it and I want to be good at it. So don't worry too much about hearing those words or not, they are just words. We have the ability in ourselves to make it.

[ecerrn]

common sense. willingness to learn. humility. knowing when you don't know and having the guts to ask.