Questions from a Struggling ER New Grad - page 3

Hello ER Nurses! I started in my ER in August and have extended my orientation twice (it was only supposed to be 8 weeks and I am going on my 11th). This hospital is relatively new at starting new... Read More

  1. by   kingramon15
    I want to become an ER nurse!
  2. by   star77
    30 bed ED.
    STEMI, Stroke, Rape Treatment Center, EDAP.

    26 weeks have been scheduled for orientation. I'm just finishing my 20th. I feel like I'm beginning to realize what I don't know, which is extremely helpful, but I have a long way to go before I feel comfortable.
    I'm not as terrified, and I feel like less of an impostor, but I'm far away from feeling confident.

    I can't imagine having to do this on my own after 8 weeks or 12 weeks.
  3. by   allstar6sb
    I completely know what your going through. I am 6 months fresh out of nursing school working in a ED at a small hospital. Ive had nurses tell me confidence comes with time. Nursing school was just a stepping stone to where we are now. Now the real learning and tests (notice i said testS) are taking place. Find someone like I did to confide in, ask questions, and who you know will be completely honest with you. Dont be afraid to ask questions. There was a time when the person your asking didnt know the answer either. Good luck to ya and I hope everything works out for the best!!
  4. by   jennash
    I am also a new grad in the ED. We have about 40 beds and we are in a very busy district. Everyday seems overwhelming, stressful, and busy but at the same time I do love it. I am on my 11th week out of 18. I agree that I don't think I will ever be ready! At first I found it hard to adjust to the "flow" of the ED just because it is so different. There are so many "if this, than that's" but nothing is generalized - you need experience and the ability to critically think to judge what each patient needs. I still find this very difficult. Anyway here are a few things that have helped me:

    1. Stepping past your comfort zone (while you have a preceptor u can ask)
    2. Looking up meds, diseases, and questions you may have had during the day when you get home. I also jot these down quickly during my day or else I would forget.
    3. Pampering on days off Yoga has really helped me to de-stress and focus my mind.
    4. Finding out how to use your resources - who is great at foley's, iv's, who will not judge you for asking a silly question, ect. I haven't exactly mastered this one but many fellow nurses have told me how important it is so I am working on it.

    One thing I struggle with is that currently I take 3 out of the 4 beds assigned to my preceptor and I, but because the ED is so fast paced and busy they always end up helping me with tasks during the day. I know that they mean well and that they are trying to help, but I really need to work on my time management and feel that it will never come if I have this help. After all, when my precepting time is over - I WILL have to do it all on my own. I have told them to please let me be but somehow it always happens. Any suggestions?
  5. by   Footballnut
    Jennash,

    Good ideas! It sounds like you are working your way through.

    In answer to your question, be clear with your preceptor about what your goals are. I would write them down and take 5 minutes before the shift starts to go over them. Perhaps you can ask your preceptor to shadow you as much as possible and give you time management hints based on what you are doing. Be sure and ask for what is working as well as what you need to look at. I often do this for my orientees when they are working on time management. I keep notes on each patient as we go along so I can give specific feedback and the orientee can relate to the situation. The orientees tell me they generally learn a lot from this. Depending on what works for you, go over the time management hints as you go along or go over them when you have time to review. Doing this also gives your preceptor something to do if they need to keep busy. I'm sure they mean well but no ED nurse can stand to let something sit for long.

    Many time management issues are related to predicting what your patient needs and starting it or setting up to do it. I'm way ahead of the game if I have all my ducks quickly in a row before I have to move on and predicting has a lot to do with it. Other time management issues are often related to bundling tasks. Predicting and bundling both involve doing the nursing process over and over all day. Also, sometimes the order you do things in makes a huge difference.

    And keep in mind that your preceptor may be under a certain amount of pressure to keep things moving. The department needs may be looming large. It's always a tight line between giving the orientee enough slack and keeping the department gods happy when it comes to time management.

    All the best, I am sure you will do just fine!
    Last edit by Footballnut on Jun 5, '10
  6. by   jennash
    Thank you, Footballnut! Last week was way too crazy to NOT ask for help.. but I am working this weekend and plan on trying out the time management idea for my preceptor. I really appreciate your advice.

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