Student Intern in ED-Can I be Productive??

EricJRN, MSN, RN · Jun 29, 2006

I don't currently work in the ER, but it's been my observation that students and interns who show willingness to perform basic tasks are more likely to be called upon to participate in the 'cool stuff' later. By basic tasks, I mean things that may include helping to clean up messes, lift patients, make trips to the lab, things like that. You shouldnt turn into a slave, but if you volunteer to help when this stuff comes up, the nurses are more likely to think of you as a helpful person and include you in things like IV's, CPR, etc.

I'm a fairly new grad and I've found a good way to approach things: If you see a nurse about to perform a task you know you're qualified to do, ask, 'Is there something else you could be doing while I take care of this?'

Dixielee, BSN, RN · Jun 30, 2006

I agree with Eric....if you want to fit in and be helpful and not a burden, then don't be afraid to get your hands dirty. I have had students refuse to give bedpans because "that is aid work and I am here to do nursing". Well.....the big news is, when no one else will take responsibility, it falls to the nurse. If the lab won't stick the patient, the nurse does it, if house keeping won't clean the room because it is too dirty, the nurse does it. If there are no transporters to take a patient to CT, the nurse does it. If there is no one to take a pillow to a patient...guess who??? If the patient is vomiting, pooping or having any other problem that no one is qualified or wants to do....the nurse is the one to do it. The doc is not going to clean up a patient, the clerks are not, your supervisor is not, if there is no tech or CNA, or it takes more than one....guess again?? Yep, the nurse.

So, if you get the picture, make yourself useful. Offer to sit with a confused patient, take meals to those who need it, draw labs, put in foleys, clean the room between patients, take patients to x-ray, bring them back from triage, assist the doc with suture placement....or just watch procedures, you will learn a lot.

Be available to work. Don't be sitting at a desk reading a magazine or even a text book. Be up, and moving. Don't make people look for you, be there when things are happening.

Things move quickly in the ER, no one has time to baby sit you, but if you are motivated, you will learn a lot, you will gain the respect of the staff and you will be a valuable member of the staff.

Have a good attitude. Make eye contact with the staff, don't sigh and roll your eyes if someone asks you to do an unpleasant task. It all comes with the territory. Then, when you feel more confident, have a little experience under your belt, you can come into the trauma room with me, and hook the patient up to the monitor, draw his blood, put in his foley, and run with me to CT with him. It is a team effort and no one is an island in the ER. You rely on each other or you die.

Good luck. You will learn more than you ever thought possible if you want to.

peds4now, RN · Jun 30, 2006

Thanks for your replies. I really would have liked to be in the ER. And I would have done all those things. The more advanced students told me that since I cannot start IVs or draw blood yet (which I can't because I haven't done them in school and therefore for liability reasons I cannot even let anyone teach me in my internship) that I would be totally useless in ER. I was thinking what about wounds or anxiety or respiratory illness/dyspnea and all other things. I thought I COULD maybe contribute especially in ER by just being willing to work! BUT, alas, their comments made me unsure enough of myself that I asked the woman assigning us to departments if she thought I was okay in ER without having done IVs yet. She said that she had only put me there because my instructor said I was good and should go there, but that actually I shouldn't be there since I haven't done advanced med-surg. So now I'm in telemetry (which also involved advanced med-surg skills...). Oh well. I'm kind of down about it. I mean, I agreed to the switch, but it was also kind of forced on me. I should have just kept my mouth shut (and my ears shut!). I'll visit the ER someday to try it out. TY

purplemania, BSN, RN · Jun 30, 2006

If you seem eager to learn and ask questions and are not always hiding then you will get to do more than you ever imagined!

NYCRN16 · Jul 1, 2006

I did an externship in the ED, and I am now working in an ED (started right after graduation 3 years ago). When I was an extern, I was not allowed to draw bloods or start IV's as per school and hospital policy, but I did give PO meds with the assistance of my preceptor, wrote assessment notes (that also depends on hospital policy) helped with ADL's and made patients comfortable. The most valuable thing you can get out of your externship no matter where you are is gaining assessment skills. Placing IV's and drawing bloods can be monkey's work, but assessing a patient is what makes you a nurse. Dont listen to your classmates who are bitter, if all they are worried about is tasks, then they are not going to be able to properly care for patients. Listen to lung and heart sounds, get a full history of the patient, review thier lab results and medications and make sense out of them. Keep a journal for yourself. Each day, write down your patients, what they are there for, what meds they are getting and thier labs. Take it upon yourself to prioritize which patients are a higher acuity than the others, which things need to be done first, and which people are at high risk for deteriorating. This is what makes a good nurse no matter where you work. As far as tasks go, be willing to do everything that you are asked to do. I am not saying that you should do bedpans for 12 hours straight and nothing else, but there are certainly things you can do. I never did even one IV before I started working in ER, I even mentioned it during my interview, but I still got the job as a new grad. You learn while you are working, its not really a big deal if you dont know how to do it when you start. If you are able to learn EKG's, foley's, NG tubes or other procedures while you are there, great. If not dont worry. Good luck!

Aneroo, LPN · Jul 4, 2006

Yikes! I'm 1 year into nursing school (ADN), and just got assigned to the ED for the internship I'm doing. It was my second choice, because there are some more advanced students in my program also, and they all wanted it really bad and kept telling me they were more qualified. So why did they stick me in ED and the others in telemetry? I'm happy, but now I wonder, what can I contribute exactly????
Is a student intern a burden, or a help to you? What tasks can I pick up right away so I can contribute while I figure out what's going on? I have some experience with wounds & dressings, injections, IVs, catheterization, and my interaction skills are good (that strikes me as a much-needed skill in the ED). And I'm no adrenaline-crazed youngster wanting to work in a sexy department. I'm a 37 year old mom of 6. I have experience holding my own kids down for needed procedures.
Basically, any advice for me so I can be more than just a body in the way???
TY

If they have more experience in an emergency type setting, that's why you were put there. You don't, and you need it. It's not going to harm them if they're not placed there since they've seen it before, right?

IMO, you're not here to "help". You're here to learn.

Jump in there. If you see something going on, ask what it is. Ask a LOT of questions, even if you think they sound dumb. Ask to see stuff. Say 'I don't have much experience with that. I would like to try that, but I'd like for you to stay with me to walk me through it". It's best to see it first then try it, but some things down there only happen every now and then.