New Nurse Looking For ER Advice

Coulter630 · Jan 17, 2013

I really couldn't tell you a right answer on this. But, I will give you my opinion this last year being a nurse. I feel as if my calling is ER nursing as well. I work in a Rehabilitation hospital right now and have been there for 6 months. While I absolutely love the work I am doing (Med-surg), hopefully after a year in a half or so, I can move on to emergency nursing. I believe that my experience with the hospital I work at now is a must before moving on to emergency. I quickly realized that when I got this job. At an average, I'm assigned 8-10 patients and many I wouldn't consider "fit" for rehabilitation. i.e. IVs, PICCS, PEGs, type and cross, extensive wound care on some, O2, etc. The place where I work is a level below LTAC most days. My point is, we gain experience in A LOT of things and I'm so glad I decided to go this route instead of waiting for my dream job. I probably wouldn't have made it going right into emergency. It's very fast paced and as a new nurse, I don't think I would've made it hence the reason why many hospitals do not even consider new grads for the position.

I feel like after a year in a half would give me the experience I need to feel comfortable working in the ED.

p.s. I was dead set against doing med-surg but I've learned quickly it's awesome experience!

FERNtastic · Jan 17, 2013

I am a new grad and was fortunate to start my nursing career in the ED at a large, urban, county hospital. I have been there 5 months now and love it. It did, however, take about 4 months after I was licensed and looking for a job full-time to get in. 300 people applied, 30 were interviewed, and 4 were hired, so yes, I was very lucky. The market right now for new grads is not great, with stories of new grads taking over a year to find their first nursing job. Ideally, you'll land straight into the department of your choice (the ED), but I wouldn't hold out for that in this market or you may be waiting for an extended period of time. My advice would be to take what you can get but with a plan. I was preparing to enact my plan C to go into an LTC facilty halfway across the country before my boat came in. First off, if you can get into a facility with an ED where you'd want to work, take it, doesn't matter which department (med-surg, OB, peds, whatever) as long as it's acute care and you can do the job in a professional capacity. Likely, after some time and experience you can transfer into the ED through an interdepartmental transfer. Alternatively, if you can't get the transfer approved, you'll have gained the magical one-year of acute care experience opening up opportunities elsewhere. The experience working will likely build on your nursing foundation developed in school and make the transition into the ED easier. Best of luck to you!

DavidRamirez · Jan 17, 2013

Thanks for the input. I dont mind waiting, but I dont want to wait forever. I would love to go straight into ER but realize that it may be better to get experience on the floor first.

hiddencatRN, BSN, RN · Jan 17, 2013

What I did was focus on ED jobs initially and then widened my application net as time went on. I did end up starting in an ER position, and had several other classmates who started in specialty areas as well.

DavidRamirez · Jan 17, 2013

Was it a matter of putting your applications out there or were you meeting with directors?

gardengal1, ASN, RN · Jan 17, 2013

Most ER's don't hire new grads - they expect about 2 years of medical/surgical/ICU background before allowing a transfer into the ER. Get your foot in the hospital where you want to work on any floor that you have interest in. Pay your dues, watch for ER openings as it gets closer to your 2 year stint in the unit where you were working and then, start applying for a transfer. The transition will be much, much smoother for you with some experience under your belt. If, for some reason, you ARE hired into an ER, this is going to be extremely stressful for you as you learn to cope with the pace and knowledge base that you must have to function in that environment.

Sassy5d · Jan 18, 2013

My friend and I got hired out of school, different shifts. I honestly don't think I could have survived right out of school.. I have the LPN exp. but that's an entirely different story.

FERNtastic · Jan 18, 2013

I disagree about the mentality that you need to "pay your dues" before getting into the ER. This is the mindset of a lot of people, to go do some time in med-surg or another area before you're prepped to make it in the ER. I was hired and participated in about 5 months of orientation with a small group of new grads as well as a few experienced experienced nurses who had between 1-4 years of med-surg experience before making the transition. In my opinion, we all encountered similar challenges as we entered the ED and in many ways, the new grads excelled as we weren't as rigid in how we worked. The challenges faced by those coming from med-surg were different and often seemed to be focused on the autonomy and independence experienced by the ER nurse, whereas in med-surg you couldn't do anything without a doctors order, in the ER you have to think for yourself and have the ability to take action if your assessment warranted. As new grads, these limitations hadn't been ingrained yet, and so perhaps it was easier to follow the example of our preceptors. Granted, the time spent in med-surg likely helped develop familiarity with various medications, conditions, as well as hospital policy (they were interdepartment transfers), the difference between those with med-surg experience and new grads wasn't as clear as night and day as some would imagine.

All-in-all, the ER is certainly not suitable for every new grad, but if your heart is set on it and the opportunity presents itself, by all means go for it. Things to look for would be a culture supportive of new grads and a well developed and thorough orientation ideally 4-6 months in duration. Best of luck!

ernurse167 · Jan 18, 2013

If you are willing to relocate for your dream ER job, it can be done as a new grad. I have found that large teaching hospitals tend to be much more inclined to the hiring of new grads in the ED. I work in a 90 bed ED and we hire in batches of 15-20 new grads about every 6 months. I would suggest visiting the websites and searching job postings at larger hospitals in areas you would be willing to live. Good luck!

hiddencatRN, BSN, RN · Jan 18, 2013

Was it a matter of putting your applications out there or were you meeting with directors?

I joined the ENA and went to a chapter meeting where I met my future boss, but mostly I was applying to ER jobs. Many ERs in my area hire new grads: the positions are just very competitive to get.

sharon2012rn · Jan 18, 2013

Hi..Im starting ER new grad position next month..if its ok I will PM u some???

I am a new grad and was fortunate to start my nursing career in the ED at a large, urban, county hospital. I have been there 5 months now and love it. It did, however, take about 4 months after I was licensed and looking for a job full-time to get in. 300 people applied, 30 were interviewed, and 4 were hired, so yes, I was very lucky. The market right now for new grads is not great, with stories of new grads taking over a year to find their first nursing job. Ideally, you'll land straight into the department of your choice (the ED), but I wouldn't hold out for that in this market or you may be waiting for an extended period of time. My advice would be to take what you can get but with a plan. I was preparing to enact my plan C to go into an LTC facilty halfway across the country before my boat came in. First off, if you can get into a facility with an ED where you'd want to work, take it, doesn't matter which department (med-surg, OB, peds, whatever) as long as it's acute care and you can do the job in a professional capacity. Likely, after some time and experience you can transfer into the ED through an interdepartmental transfer. Alternatively, if you can't get the transfer approved, you'll have gained the magical one-year of acute care experience opening up opportunities elsewhere. The experience working will likely build on your nursing foundation developed in school and make the transition into the ED easier. Best of luck to you!