New grad in ER.. ADVICE PLEASE!!!

[nursemeow]

Any advice or words of wisdom from the wise would be appreciated sooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo much. I start my position as an RN ( ) in the emergency dept Feb 22nd, and I am starting to get nervous. I just grad. in Dec... Our ER is VVEEEERRRRYYY busy and in 07 it will actually be the largest on the east coast as it is being renovated and expanded everyday... My fear is that I will not have the quick assessment skills since I am a brandy new nurse.. I know it is critical to assess the c/c however I am also aware that the c/c is not always the chief problem... I am afraid that I might not pick up on KEY S&S.. I am confident in myself and I believe in myself.. but I hope that will be good enough to start.. Please share ideas or advice.. I can really use it from the vets!! Love to you all! Thanks

[teeituptom, BSN, RN]

Well you can pray a lot hahahahaha

[jaimealmostRN]

Great advice here! Does anyone know of any other peds emergency resources besides the ENA class? A book or PDA program or website maybe? Thanks.

[TinyNurse, RN]

I've been a nurse, and Er nurse for 1 1/2 years........ I once got some most wise advice......."go with your gut". those simple words have worked wonders for me.

you know your assessments ( years in school doing them, haha)

you just need to work on skills, anticipating, and "Triaging" level of acuity of your own patients.

Find a resource, it may or may not be your preceptor......... you'll find them i promise......... even now, i know my resources!( mostly an old icu nurse who has been there and done that)

Also, if you are "all caught up" on your own patients, etc.......... offer help to anyone around.......... if you offer help to people, people will help you when they are not busy.

but........going with your gut will take you A LONG way in the ER.

best of luck to you.....I know you'll do fine.

xo Jen

[teeituptom, BSN, RN]

I've been a nurse, and Er nurse for 1 1/2 years........ I once got some most wise advice......."go with your gut". those simple words have worked wonders for me.

you know your assessments ( years in school doing them, haha)

you just need to work on skills, anticipating, and "Triaging" level of acuity of your own patients.

Find a resource, it may or may not be your preceptor......... you'll find them i promise......... even now, i know my resources!( mostly an old icu nurse who has been there and done that)

Also, if you are "all caught up" on your own patients, etc.......... offer help to anyone around.......... if you offer help to people, people will help you when they are not busy.

but........going with your gut will take you A LONG way in the ER.

best of luck to you.....I know you'll do fine.

xo Jen

And when your gut tells you need either Zantac or Pizza, listen to it

[humiliated]

I started out brand new in the ER 6 months ago and felt similar to how you feel now. I have made is six months and feel very confident on some nights and then feel like an idiot on others. As time goes by I have way more confident ego boosting nights as opposed to bad nights. But, I must say if it weren't for those humbilng moments I wouldn't be learning and becoming a better nurse. There is some saying, I apoligize for butchering it, but you will get the gest of it, "To ask a stupid question makes you a fool for that one moment, but to never ask the question makes you a fool for life". Oh and my facility is a level 1 trauma center so we see a lot of difficult cases. I'm so happy I started here though, because I honestly can say I feel like I can handle anything. Maybe you should invest in a palm pilot. I have one and if something slips my brain, I have a backup right there. Another pointer, if your facility has protocols then get a list of all the sheets. It really helped me learn what I was suppose to be doing for each patient. I've gone from being somewhat hesistant in decision making to acting like an ER nurse and taking action. It's good you are at a tough hospital too, because getting some of the sickest patients. In our ER we are often acting like the ICU because we are short on beds in the ICU, so I have gained experience with the sickest patients to the regular patients that are merely seeking the ER as there primary care providers. And most importantly if you don't know something, don't be unsafe, look it up first or find a more experienced nurse that you trust their knowledge and skill level. As a new grad everyone expects you to ask questions. And don't let the stress get to you. I've learned to turn the stress into adrenaline and be excited and feel challenged about a difficult patient rather than think oh no what am I gonna do. You'll see in time you will look back and think I've come a long way although you'll still continue to learn new things everyday.

[nursemeow]

You guys are so helpful! I will keep ya posted on my journey as a new ER nurse! I just did the week of orientation for the hospital, now Monday is the real thing...in the ER!!! GULP! Thanks again!