New grad in rural ER? - page 3

by 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... Read More


  1. 1
    I think you are panicking before it is time. I really do. The DON wouldn't hire a new grad and ditch them like that, liability is on her too. I think that other people are mixing up posts (it wasn't the OP that said she was left alone or would be left alone, she stated there are 3 on shift) and getting you worried. I think you will do great. You know your limits, the time it would take to feel comfortable (and with the descriptions you are giving, I think you are freaking out and way under crediting yourself). I think you will be fine! If you wanna be there, say yes. You can do this. Do not discredit yourself or let others freak you out. It isn't as if you will be cracking chests, massaging hearts and dealing with blocked airways alone. This isn't major trauma, you will be FINE!
    amzyRN likes this.
  2. 2
    What I understand is that there are three on shift, but those three cover the ER, and 25 other patients in the hospital. If that's true the RN going down to the ER can easily be alone, and someone being able to come from the floor is a great plan on paper, but the ratio doesn't make it very dependable.
    Multicollinearity and JustaGypsy like this.
  3. 0
    Quote from canoehead
    Are you doing nights or days, or rotating? Daytime you'll have managers, a secretary and respiratory to fall back on if it's busy. Nights, you may be in that ER all by yourself, especially if the floor is full. It's not just a skill issue, but a security issue.

    Are you ready to stabilize a sick chest pain with multiple drips, and juggle the paperwork and other patients as they come in? If you are in the middle of that chest pain and a second one walks in, can you handle it? No matter what they tell you, that is the level of juggling you are looking at. If a third one walked in... who are your resources that can come immediately? (not call around and find someone at home) I am concerned about this job, though it sounds like a good opportunity, it will require mad prioritizing and efficiency on your part.

    Four weeks orientation isn't enugh for a new grad in med surg, and you will be orienting to med surg and ER. (AND charge??!) I worked in a critical access hospital the same size, and some shifts were dead, some shifts were like the gates were opened and poured criticals. It was just me and the maintenance man. How far away from the ER area are your med/surg nurses? If you hollered would they hear? Realistically, with 25 other patients you cannot pull from them. If your boss is your backup ask her how often she's put on scrubs and worked as staff. If she says once a year, that's no good, but once a month is really good.
    This is the voice of wisdom. I've been in a similar spot, and let me tell you...waiting for the helicopter to show up while one is circling the drain and you've got other high acuity patients...it is terrifying.
  4. 0
    Quote from Multicollinearity
    This is the voice of wisdom. I've been in a similar spot, and let me tell you...waiting for the helicopter to show up while one is circling the drain and you've got other high acuity patients...it is terrifying.
    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.
  5. 0
    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.
  6. 0
    Quote from 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.
    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.
  7. 1
    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!
    amzyRN likes this.


Top