New RN in ED

jlkhorn · Jan 31, 2014

Congratulations on your first RN job. I went straight to ED also. The first thing I will tell you is that ED nursing is nothing like floor nursing. A lot of what you learned in clinicals will not apply in the ED. ED nursing is often a team effort. Communication with other RNs and techs is very important. Learn when to ask for help, and help others when you can. Don't abuse your techs. Again, DON'T ABUSE YOUR TECHS. Techs are not there to work for you or do the crap tasks that you don't want to do. They are part of the team, just like anyone else. A tech can make or break a zone. (In my ED each zone has 9 rooms with 3 RNs and 1 tech) If you treat them right, they will treat you right. Also, for a long time you will probably feel like you don't know a damn thing. And when you start to feel like you know what you're doing, you will have a case or a shift that challenges you, and again you will feel like you don't know a damn thing. That's ok. Ask questions...a lot of questions. Don't ask for just answers, but ask for the thought process that gets to the answers. Take notes. Sometimes you'll have to go home and look things up. Every patient is different. Every case is different. Every shift is different. Some days you will go home high on adrenaline and feeling great. Other days you will go home in tears. Make friends with your co-workers because they are often the only ones who understand, and don't be afraid to lean on them when you need it. Good luck and best wishes to you.

emtb2rn, BSN, RN, EMT-B · Jan 31, 2014

Open your mind to absorb tons of information. At first you'll be learning something every hour. Have fun. And it helps if you like surprises, 'cause they happen often.

MedicalPartisan · Jan 31, 2014

I am not a nurse but I can tell you that ED nursing is very different. The objective in the ED is to stabilize and discharge/admit. Wash, rinse, repeat. Floor nursing is more personal in that you spend a lot more time with the patient, family, et cetera. I am personally choosing a career in emergency medicine because it is crazy! It's very fast-paced and you get to see so much. I love it. Although I have no actual experience floor nursing (or nursing at all for that matter) (and please don't take offense, floor nurses, this is just my perceived opinion), floor nursing seems to be just a lot of routine assessments, charting, and pushing meds.

LaurenRay1983 · Jan 31, 2014

Congratulations on your first RN job. I went straight to ED also. The first thing I will tell you is that ED nursing is nothing like floor nursing. A lot of what you learned in clinicals will not apply in the ED. ED nursing is often a team effort. Communication with other RNs and techs is very important. Learn when to ask for help and help others when you can. Don't abuse your techs. Again, DON'T ABUSE YOUR TECHS. Techs are not there to work for you or do the crap tasks that you don't want to do. They are part of the team, just like anyone else. A tech can make or break a zone. (In my ED each zone has 9 rooms with 3 RNs and 1 tech) If you treat them right, they will treat you right. Also, for a long time you will probably feel like you don't know a damn thing. And when you start to feel like you know what you're doing, you will have a case or a shift that challenges you, and again you will feel like you don't know a damn thing. That's ok. Ask questions...a lot of questions. Don't ask for just answers, but ask for the thought process that gets to the answers. Take notes. Sometimes you'll have to go home and look things up. Every patient is different. Every case is different. Every shift is different. Some days you will go home high on adrenaline and feeling great. Other days you will go home in tears. Make friends with your co-workers because they are often the only ones who understand, and don't be afraid to lean on them when you need it. Good luck and best wishes to you.[/quote'] I just left work so I apologize for the delay. Thank you for the amazing advice. You are correct about techs. A team is a team. Thanks so much.

LaurenRay1983 · Jan 31, 2014

Open your mind to absorb tons of information. At first you'll be learning something every hour. Have fun. And it helps if you like surprises 'cause they happen often.[/quote'] thank you for this info. I appreciate it. I am scared and excited. Thank you again.

LaurenRay1983 · Jan 31, 2014

I am not a nurse but I can tell you that ED nursing is very different. The objective in the ED is to stabilize and discharge/admit. Wash rinse, repeat. Floor nursing is more personal in that you spend a lot more time with the patient, family, et cetera. I am personally choosing a career in emergency medicine because it is crazy! It's very fast-paced and you get to see so much. I love it. Although I have no actual experience floor nursing (or nursing at all for that matter) (and please don't take offense, floor nurses, this is just my perceived opinion), floor nursing seems to be just a lot of routine assessments, charting, and pushing meds.[/quote'] I appreciate your response. You will do well on your RN progress. I appreciate the difference in ED and Floor. Thanks again. Best of luck.

Superman_RN · Feb 15, 2014

Lauren,

I am also a new grad who started in ED. I've been working for about 5 months now. First thing you should know is YOU WILL FEEL LIKE GIVING UP SOMETIMES AND QUESTION IF THIS JOB IS FOR YOU. That's perfectly normal! Happened to me a few times the first 2 months and trust me, I have a strong personality lol. Secondly, it is a HUGE learning curve starting fresh from nursing school and completely unrelated. Know that you will know nothing when you first start. Accept it and be open to learning new things everyday. And like someone else said, take notes, and review notes. Don't be afraid to ask questions. Lots of them and get close to those who know their stuff. Great nurses can be very helpful and eye-opening.

That being said, stick with it because it will pay off once you get the hang of it. I love the rush in the ED and wouldn't trade it for anything else. I look forward to going to work and learn something new everyday. You will realize that although many things are different disease processes you essentially do the same things for them.

Master your IV skills because it will make the difference in saving that patient's life. The last thing you want is a crashing patient and not being able to administer meds because you don't have a line. Oh, and learn your meds too. Other than that, keep a positive attitude! :yes:

Mike.

1fastRN · Feb 15, 2014

Great advice in this thread! You will be overwhelmed and feel like your drowning. You even may want to cry. This is normal and it will get better. I promise.

Keep your head up, keep positive, treat your co workers with respect even if they don't treat you so nicely. Most of them will come around... ask lots of questions, even the stupid ones. There's always something to learn! Don't be afraid to ask for help. Even seasoned nurses need help at times. Don't take defense to constructive criticism... learn from it and use it to grow.

Keep a cheat sheet of medications so you have it handy. I keep a sheet with titratable drugs in my pocket (ie propofol, cardizem, etc) so you know what ranges to titrate at. If you don't know something, ask. If it can wait, write it down and research it later. It helps in the long run.

Feel free to PM me as I was in your shoes not long ago. I'd be happy to share my experiences and give you support.

You will do great as long as you keep an open mind and positive attitude! Welcome to the hectic and great world of the ER!

LaurenRay1983 · Feb 16, 2014

Lauren I am also a new grad who started in ED. I've been working for about 5 months now. First thing you should know is YOU WILL FEEL LIKE GIVING UP SOMETIMES AND QUESTION IF THIS JOB IS FOR YOU. That's perfectly normal! Happened to me a few times the first 2 months and trust me, I have a strong personality lol. Secondly, it is a HUGE learning curve starting fresh from nursing school and completely unrelated. Know that you will know nothing when you first start. Accept it and be open to learning new things everyday. And like someone else said, take notes, and review notes. Don't be afraid to ask questions. Lots of them and get close to those who know their stuff. Great nurses can be very helpful and eye-opening. That being said, stick with it because it will pay off once you get the hang of it. I love the rush in the ED and wouldn't trade it for anything else. I look forward to going to work and learn something new everyday. You will realize that although many things are different disease processes you essentially do the same things for them. Master your IV skills because it will make the difference in saving that patient's life. The last thing you want is a crashing patient and not being able to administer meds because you don't have a line. Oh, and learn your meds too. Other than that, keep a positive attitude! Mike.[/quote'] thank you so much for the great advice. I have been working for about two weeks in the ED and feel like I have never went to nursing school. Thx for your tips. I'm learning something new everyday.

LaurenRay1983 · Feb 16, 2014

Great advice in this thread! You will be overwhelmed and feel like your drowning. You even may want to cry. This is normal and it will get better. I promise. Keep your head up keep positive, treat your co workers with respect even if they don't treat you so nicely. Most of them will come around... ask lots of questions, even the stupid ones. There's always something to learn! Don't be afraid to ask for help. Even seasoned nurses need help at times. Don't take defense to constructive criticism... learn from it and use it to grow. Keep a cheat sheet of medications so you have it handy. I keep a sheet with titratable drugs in my pocket (ie propofol, cardizem, etc) so you know what ranges to titrate at. If you don't know something, ask. If it can wait, write it down and research it later. It helps in the long run. Feel free to PM me as I was in your shoes not long ago. I'd be happy to share my experiences and give you support. You will do great as long as you keep an open mind and positive attitude! Welcome to the hectic and great world of the ER![/quote'] thank you. I feel lost so far. I've been going strong for two weeks in the ER. My IV skills are getting better. I feel like I never attended nursing school. I'm working on ACLS now and I am getting frustrated with myself on everything. I am type A personality so if I make a mistake I feel betrayed by my own self. Thanks for the great advice.

1fastRN · Feb 16, 2014

thank you. I feel lost so far. I've been going strong for two weeks in the ER. My IV skills are getting better. I feel like I never attended nursing school. I'm working on ACLS now and I am getting frustrated with myself on everything. I am type A personality so if I make a mistake I feel betrayed by my own self. Thanks for the great advice.

Nursing school is NOTHING like working in the real world. You're not alone in feeling that way. you'll look back in a few months and be astonished at all the things you've learned so quickly. Ask away, most of your co workers will be happy to help. It's better to be "annoying" than unsafe/reckless.