NEW TO THE ER WORLD

  1. 3 Hi everyone,

    I am not a new RN. I worked in a Med/Surg unit for 2 years and I will be starting a new job in the Emergency Room as of May. I always wanted to work in a critical care/ emergency setting because I enjoy the constant learning aspect and variety of disease process that this field brings in. Needless to say, I am excited and scared of this new environment. I was researching for extra materials that could help me ease my transition and found this blog. Thank you for sharing your stories and giving newbies like me advice for continuing our journeys.

    P.S. Any advice is welcome so I can be as prepared as I can for my first day.
  2. Enjoy this?

    Join thousands and get our weekly Nursing Insights newsletter with the hottest discussions, articles, and toons.


  3. Visit  CaribeRN profile page

    About CaribeRN

    Joined Mar '13; Posts: 13; Likes: 10.

    22 Comments so far...

  4. Visit  mybrowneyedgirl profile page
    4
    Congratulations! I hope you love it. It all comes with time and every ER has it's own procedures but :
    If they fainted- they will need an EKG and expect to fluid bolus them.
    Chest pain - Line, labs (including troponin) and EKG right away with bedside monitor.
    Abdominal pain - line and belly labs because they always give nausea meds/pain meds/fluid.
    Know your ACLS like the back of your hand.
    Study Sepsis.

    Let the docs know right away about critical labs: potassium off, lactic acid off, blood sugar off...
    Review your procedures. Youtube can be great for Artlines set ups etc.

    Don't expect too much of yourself right away but jump in right from the start.
    havemercy21, Esme12, SuzieF, and 1 other like this.
  5. Visit  CaribeRN profile page
    0
    Quote from mybrowneyedgirl
    Congratulations! I hope you love it. It all comes with time and every ER has it's own procedures but :
    If they fainted- they will need an EKG and expect to fluid bolus them.
    Chest pain - Line, labs (including troponin) and EKG right away with bedside monitor.
    Abdominal pain - line and belly labs because they always give nausea meds/pain meds/fluid.
    Know your ACLS like the back of your hand.
    Study Sepsis.

    Let the docs know right away about critical labs: potassium off, lactic acid off, blood sugar off...
    Review your procedures. Youtube can be great for Artlines set ups etc.

    Don't expect too much of yourself right away but jump in right from the start.
    Thank you so much for your feedback.... I will review as much as I can and follow your recommendation.... I hope I love it too!!!!
  6. Visit  Altra profile page
    4
    Be prepared to feel like a new grad again. Be prepared to "just go with the flow" for a while even if things are happening in such a way that would be frowned upon in the inpatient world. Realize that a greater range of vital signs and blood sugars are considered to be not a big deal in the ER. And oh yeah, forget that you ever knew such things as water pitchers, snacks and meal trays ever existed ... unless there's really a good reason to feed someone.

    Welcome to the dark side, CaribeRN -- I hope you love it!
  7. Visit  CaribeRN profile page
    1
    Quote from Altra
    Be prepared to feel like a new grad again. Be prepared to "just go with the flow" for a while even if things are happening in such a way that would be frowned upon in the inpatient world. Realize that a greater range of vital signs and blood sugars are considered to be not a big deal in the ER. And oh yeah, forget that you ever knew such things as water pitchers, snacks and meal trays ever existed ... unless there's really a good reason to feed someone.

    Welcome to the dark side, CaribeRN -- I hope you love it!
    Thank you for the words of wisdom.... You just confirmed my thoughts of feeling like a new grad once again... I hope I love it too. Everyone on my current unit is so excited for me... And telling me I will be just fine.... I am still scared but I guess some fear is normal especially when it's a new and different environment that I am used to.... I am researching materials and started my readings to be as prepared as possible.... Thanks again for the support....
    Esme12 likes this.
  8. Visit  Esme12 profile page
    2
    You will feel like a new grad again. Emergency nursing is VERY different. Fear is good.....it will help keep you safe. If you have access to hospital policies look up policies in the ED. Ask the manager for treatment policies/protocols for your new department. Do you have any monitoring experience? Learn your strips.

    Electrocardiogram (ECG, EKG) library
    Tools | SkillStat Learning - Fast, Fun and Effective!
    2013 ACLS Guidelines | ACLS Algorithms

    familiarize yourself with children and what is normal for them. Check out his thread......http://allnurses.com/emergency-nursi...se-742288.html good Luck!

    Welcome to bedlam!
    turnforthenurseRN and bebbercorn like this.
  9. Visit  CaribeRN profile page
    2
    Hi Esme 12.... I don't have any monitoring skills but had taken the Arrhythmia class on my last year of nursing school... It's been awhile that I've seen rhythms. I had taken ACLS,PALS about 2years ago just for my own knowledge but have not used it since it wasn't required for my unit and when we get a code or rapid response, the icu RN will come in to take the lead.... I will utilize the link given. Thank you for your support...
    Esme12 and bebbercorn like this.
  10. Visit  SuzieF profile page
    3
    I switched to the ER 3 years ago after many, many years in critical care and med surg.
    I can tell you that ER folks are a different breed. Their exteriors are tough due to the nature of the job/environment.
    Hang in there, because once you get to know them, you will find out that generally they are really loyal to patients and other team members.
    Be confident of the good skills/experience that you have already. Even though you should not be expected to "up to speed" right out of the gate, ER folks want to know you are tough enough for the work. Remember, they thought enough of you to pick you for the job in the first place.
    Best wishes!
    Suzie
    Williams75, prnqday, and bebbercorn like this.
  11. Visit  CaribeRN profile page
    1
    Thank you Suzie for your encouragement....
    SuzieF likes this.
  12. Visit  Esme12 profile page
    0
    Quote from CaribeRN
    Hi Esme 12.... I don't have any monitoring skills but had taken the Arrhythmia class on my last year of nursing school... It's been awhile that I've seen rhythms. I had taken ACLS,PALS about 2years ago just for my own knowledge but have not used it since it wasn't required for my unit and when we get a code or rapid response, the icu RN will come in to take the lead.... I will utilize the link given. Thank you for your support...
    SO you have a basic working knowledge of strips......at least you've seen one before.... SuzieF is right...ER nurses are a tough exterior group....it comes with the territory. Be patient with yourself...any questions you can post or PM me anytime.

    Don't go crazy..they chose you remember? They know you are going to need some time. How long is your orientation?
  13. Visit  CaribeRN profile page
    1
    My orientation period will be 3 months. My supervisor told me if I am doing really good it might end sooner but I want to take advantage of the entire time. They will assess me on the rhythms to see where I stand maybe put me in a class for improvement. I am trying to read, listen to audio lectures and find as much materials I can find to help me be prepared and not pull out my hair especially with terms and procedures that I am not used to see or do.....
    Esme12 likes this.
  14. Visit  bebbercorn profile page
    1
    I recently re-entered nursing after a long maternity leave and found that there are great resources on youtube and you can do unlimited CE's on many nursing websites. This was helpful when I realized when I renewed my ACLS that I couldn't identify a lot of rhythms on strips (except V-Tach and V-Fib, thank goodness). You seem to have a good head on your shoulders and know when to ask for help, as long as you do that you should be fine! Best of luck!
    Last edit by bebbercorn on Mar 11, '13 : Reason: spelling
    SuzieF likes this.
  15. Visit  CaribeRN profile page
    1
    Quote from bebbercorn
    I recently re-entered nursing after a long maternity leave and found that there are great resources on youtube and you can do unlimited CE's on many nursing websites. This was helpful when I realized when I renewed my ACLS that I couldn't identify a lot of rhythms on strips (except V-Tach and V-Fib, thank goodness). You seem to have a good head on your shoulders and know when to ask for help, as long as you do that you should be fine! Best of luck!
    Thanks bebbercorn! I am actually renewing my ACLS. I feel so stupid... Recognizing V-Tach, Normal Sinus, asystole.... I know the drugs to push.... Hopefully, I will get the hang of it... Thank you for your support.
    bebbercorn likes this.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

Top