Not properly trained for ER?????

I'm SO glad I am a tech. When I finish up grad school, I'll have a respect for techs I don't think you can get without being one.

I transitioned into an ED setting as an RN back in June. My background is from EMS but as a paramedic working in busy systems since 1992 (2 years before that as an EMT-I). Most EMT's that I have worked with over the years I do not think would make a successful transition from school to ED without a lot of stress on themselves and their patients. From medic to RN was not bad as I had a very strong foundation to build upon and I found the changes pretty easy. Do I think my nursing school provided an education that would prepare someone with less experience for a busy ED spot, no I honestly do not. But your mileage may vary.

I am a new grad 6 months into my first job in a level 1 trauma ER, 2 months off orientation. I've survived so far.. I do look at some of the more experienced nurses and wish I had their experience under my belt, but so far I like it and although it's fast paced I feel like I can handle it. The pace doesn't bother me - I was a waitress for 6 years and I am used to the juggling and prioritizing. I'm just looking for some feedback - what is the main reason everyone says that new grads should not work in the ER? Is it the pace? Or the lack of experience that hinders critical thinking skills? I know it is difficult to learn in a fast paced environment, but is doing homework at the end of the day good enough? Is it because the danger of making a mistake and killing someone and/or losing your license is higher in new grads? I'm just curious because I think about this a lot, and wonder if I am just lucky that I have not had a difficult time so far. I wonder if something bad will happen in the future, or if this really is the right place for me. (It feels like the right place..) Do you think that working in the ER as a new grad makes you a better nurse, or a worse nurse? Input?

I started my first job as an ER nurse in a Level 1 Trauma pediatric hospital. I LOVE IT. I am obviously not able to triage or be a trauma nurse, but I am able to do everything else. It was scary and hard when I first started out, and there are still some days when I look on the board to see who is coming and in and think " please don't give me that patient ", but I think a lot has to do with the team you are working with. A good team makes everything better! I am SOOOOOO glad I did NOT start out in Med Surg. I don't see how Med Surg can prepare you for the ER. Not even close. I think starting out in the ER has made me a better nurse. I have seen EVERYTHING there.

Just being honest here. When I first got out of RN school, I went straight to ICU, and was able to function. But now, 7 yrs later, now working in ER, i realize that I didn't know half enough of what I needed to. If something had went wrong, all it takes is a split second and a wrong decision to kill someone. It's too late to take it back and say, "I thought I was ready". I know that working as an EMT has probably given you exposure, but let me tell you, wait until you have walked a mile in a nurse's shoes. If you are so confident that ER would be no problem for you, then a year on Med/Surg should be no problem for you.

Hey there! You didn't mention if you were working still as an EMT? Did you think about applying as a tech in the ED during school? Our Level 1 usually hires new GNs if they have worked in the unit as a tech for at least 6 months. Personally, I think you have great insight into the world of emergency medicine being an EMT. I was (and still am) a medic for 5 years before nursing school and did the advanced track to graduate in a year. You are more qualified to work in the ED than a grad who has NO experience, but don't know if they will believe that is enough. BUT...if you really want to work in the ED then start thinking about getting a job there now to 'get known'.

For those asking about why not a new grad in an ER/ICU and why? It's simple.....you don't know what you don't know. Really it comes down to that. You just simply don't even realize it. I sometimes scare myself looking back on my lack of experience when I first started out. My gosh....lol But I can say that I got goood pretty darn fast. Not a single one of my patients died....partly because I worked with such an awesome team of nurses that would come running when I had a question or needed help. Things go bad and they go back fast.

But having said that I started out as a new grad in a level one trauma center PICU.

Most of the RNs I worked with, who have now been there for years and are EXCELLENT nurses, started off as new grads in the ICU/ER. The nurses that I worked with who were truly the best were the paramedic to RNs. When the resident is standing there shaking in his/her boots (believe me this happens) that RN can run the code easily.

I have seen MANY new grads do well, and MANY who did not.

Definitely get a job there as a tech while your in school.

A new grad is a new grad is a new grad. No program, be it diploma,ASN,ADN or even BSN, will prepare you for working in an ER directly out of school. I think it's pretty crummy that an instructor in your program would actually say this to her students. Your chosen route to become a nurse is just fine.

Hey Emergency dept. new grads,
I am not biased against new grads working in the ER, but I have a question about how you feel prepared. Of course an excellent orientation goes a long way, but there is soooo much to know. In a specialty, although you want to know how to treat the WHOLE PERSON, you still have a limited number of diagnosis to greatly familiarize yourself with. In the emergency department, you never know what you will get, so I would feel the need to familiarize myself with EVERYTHING about everything lol. Like someone above said, you don't know what you don't know...nothing personal, but how does a new grad know everything that I would think (as an outsider) would need in emergency nursing? So my question is just how do you feel prepared. Do you just remember everything from nursing school, or have you been through an amazing orientation? Kudos to all of you new grads who are getting through in the emergency dept. I would just like to know how you are doing, as I am somewhat considering an urgent care center (not quite, ED, but....) Thanks, I can't wait to hear from some of the ED grads!