NEW TO THE ER WORLD

Specialties Emergency

Published

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.

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Specializes in Emergency Room.

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.

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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!!!!

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Specializes in Emergency & Trauma/Adult ICU.

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!

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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....

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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......https://allnurses.com/emergency-nursing/adult-er-nurse-742288.html good Luck!

Welcome to bedlam!

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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...

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Specializes in Most areas of adult hospital care.

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

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Thank you Suzie for your encouragement....

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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?

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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.....

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Specializes in Family practice, emergency.

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!

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