Not properly trained for ER?????

Many graduated students from my school went right into ER. One is now a clinical instructor. I think it's doable. Of course, as a new grad, anything is going to be difficult no matter where you go. It's all about learning. If your heart is set on that, I'd say go for it. I had one professor say that new grads should do med/surg to get some experience (especially for taking care of multiple patients) before going into ER or ICU. The other one said that she believed you should go into ER or ICU right away if that's what you want to do. So, I think it really depends on the individuals. Do what makes you happy!!

We have a limited number of ER internships for new grads but the competition is fierce and there are many more applicants than positions. I do think going the tech route is the natural progression into the ER RN position. I would recommend all students to try and get on as a tech especially if your looking to go ER. Its a great way to figure out if the ER is really your cup of tea and the pay is better than most EMT-B jobs plus most tech schedules are very student friendly. We have had a few techs hired as RN's right out of school and they are all doing very well. Its not a given that if you tech that you will be offered a job but it does give you a leg up. If you have built a solid reputation and have the trust and respect of the ER staffI think your a great candidate for a new grad position even in a level one setting.

As techs we really do have our hands full taking care of our nurses but we are also always learning by watching you, you may not realize how much you teach us and even when you make that rare mistake its a learning opportunity for us. I have always thought that being a tech in the ER compliments my field experience as a FF/EMT and if and when I go to nursing school the years of working with the best in the field will benefit me greatly.

I think, as a general rule, that no, most new grads are not ready for a busy ER setting. There are exceptions, and some of those have been mentioned. I'd also like to mention that med/surg is no cakewalk, and while it may not be where you want to ultimately end up, don't discount the value of the experience just one year on the med/surg unit can provide.

OP: As a RN-BSN student I can safely state that BSN students who have NEVER EVER worked as RNs DO NOT have more skills and abilities then ADN New Grads. All New Grads are New Grads! I do not care how much time they precept on a specialty floor, they were not the RN in charge. They were students. However, similar to techs, the more exposure you have to a particular floor (not necessarily a specialty) will help you with that department in that hospital when you graduate.

Also, to answer your other question... My ADN instructors said the same about ADNs vs. BSNs. On the other hand, these same instructors had children who became nurses that were also ADN prepared that did not start out in Medical Surgical Nursing. In fact, most of my instructors (former ADNs) went straight into OB, ICU, Step-Down, and the ED! Why was Medical Surgical Nursing not necessary for them too??? Hmm..... I found out, from working as a tech, that my ADN program steered grads toward Medical Surgical Nursing because the local hospital had trouble filling positions at the time. PERIOD! Maybe it is the same for you too???

By the way, I am still a New Grad and feel that most of the nurses on here were eloquent in expressing their belief that a New Grad does not belong in a specialty setting. I cannot argue against their points based upon years of experience. However, I can share my experience with Medical Surgical Nursing and why I disagree.

I started out training and working on several Medical Surgical floors with an ultimate goal to become a Trauma Nurse. Along with the fact that most of the floors I worked were poorly managed (as is typical of Med Surg), my exposure to various trauma patients has been limited. Therefore, I do not think two years of further work experience would have prepared me for the ED!

In fact, two years on one floor will make you a competent nurse in that focus. That is all! Trauma nurses have to be competent in the emergency interventions regarding ALL forms of trauma not just one or two! Thus, I left my facility (I was unable to transfer into their ED and I was tired of hearing excuses) and recently landed an ED job post 9 months Medical Surgical Nursing experience.

Am I prepared to be an ER Nurse..? Nope, but I know that there is no true way to prepare for Emergency Nursing except to do the job while gaining additional training and education! In addition, as other New Grads have pointed out, having a supportive team to back you up and save your you-know-what (An aspect that is necessary in all aspects of nursing, not just the ED) is helpful too!

-New ER Nurse

IMHO, you will work better where your heart's desire is. I can tell you that most of the students in my class had NO desire to do critical care or ED. BUT, all the medics in my class did. As medics in our profession, we have already treated (albeit in the back of a truck for a max time of say 20-30 minutes), MIs, stroke, resp failure, done CPAP, major trauma, DKA, hypoglycemic coma, worked numerous codes (at best with 3 people), etc.

That being said, I completely understand that caring for a pt for 12 hours (our shifts at the level-1) is MUCH different than treating for 30 minutes. But, the clinical thinking that goes behind assessing a pt in their home with sometimes limited or NO information available, reacting QUICKLY, having CONFIDENCE, in what you are doing or are about to do, ADVOCATING for your pt are all similar actions performed in the ED. I completely agree with previous poster who stated that your team is the biggest contributing factor to the success of ANYONE in the ED...regardless if you have experience on med-surg or are a grad RN. If you are where you WANT TO BE...I don't believe anything can stop you from accomplishing your goal. I also agree with the poster that said as a grad RN, you are never truly prepared to work anywhere...how can you be?

Everyone is different. Some are more prepared for the ED than others. With my experience as an ED tech and as a paramedic, I was well suited to transitioning as an RN in my ED -- I have fabulous and supportive coworkers, had a great preceptor, and did an ED nursing fellowship at our hospital's Level 1 with a bunch of other new grads -- some so green they'd never even seen the ED before (yikes ... I wouldn't WANT that stress!!). I had a great orientation period, too. But even with all that support/help/knowledge/experience, it still took me time to transition into my new role as an ED RN. It was stressful. It still is!

But comparing being an EMT (even an EMT-P, in many regards) to being an ED RN? Apples and oranges, and I can say that from both sides of the fence. Yeah, they're both fruit, and that is the overlap, but they're very different roles.

Well...I TOTALLY disagree. If you are wanting to be an ER RN then do that. I would probably not go for the Level One Trauma Center, but honestly ER is its own world and being on the floor is not going to help. I went to ER 3 months after getting my RN license and cannot imagine being anywhere else. Now...it was and still is VERY hard, but it is all about your level of dedication. YOU CAN DO IT!!!
ALicia

Wow that is the most inaccurate and discouraging advice i have heard in a long time. ASN grads probably have twice as much clinical experience than a BSN grad. I am not taking anything away from the BSN grads but that is a fact just about anywhere here in the state of MD. Furthermore, I am a proud grad of an ASN program and was hired directly into the ER with NO previous hospital or healthcare experience. Don't believe the hype because that is truly BS!

Everyone coming to do emergency medicine for the 1st time isn't properly trained. There isn't a nursing program out there that can prepare you for what goes on in the ER. It's just experienced and learned.
So much of what we all do as nurses comes from O.J.T.

Now I wouldn't go looking for level 1 right out of the gate but no facility is going to throw you to the wolves. You will get an orientation period. You get to work quick care and lower acuity patients. You advance to patients of higher and higher acuity. You will know what it is to use critical thinking and assessment skills. Triage and priority! There will be a preceptor that will nurture you, help you grow and possibly shatter your desire to ever do nursing again.
Just kidding.

It's dynamic and rewarding. You will see people for diaper rash and splinters as well as Heart Attack, Stroke, Gunshot Wounds... There are people that fall off of roofs, hit by cars, hit other cars. (GOD I love it!)

There will be patients that hear for the 1st time diagnoses of Cancer, Diabetes, and other terminal illnesses. You will help people that are absolutely going through the worst and miserable times of their lives.

They're hurt, scared, and feel horrible both physically & mentally.
Nurses are there to help them. To be there to comfort them both sick & injured...
Somebody HAS to do it. Accidents and disease will continue to happen. You can BE that nurse!

You will love it or you will hate it. But don't turn your back because someone placed doubt in your mind.
Best of luck.

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