Tenure vs Newbie (feel sunk?)

This summer we are adding 5 new grads to our staffing.It is a managment decision, not supported by our working nurses. Will they be put in a sink or swimm situation?? Probably. But that is the nature of the beast. 5 yrs ago there was a policy that new grads would not have been hired in our ER. In the mean time our census went up 15% a yr, and our aquity continues to be high. We also are getting more and more people using the ER as primary access for their health, which has been adding to the national problem of ER overcrowding for the last 15 yrs. So we can work short, or hire the new grads. We have no choice as our current staffing issues are leading to burn out and increase in daily shift sign offs.

To the new grad going into an ER I say it will be a struggle, and I wouldn't recommend it to anyone. ER's need nurses who can hit the ground running. It's not a good learning enviroment as the physician's expect the nurses to know the standard treatment regimine's for whatever hit's the door. From adult medical issue's to peds trauma.

Could go on and on about why new grads shouldn't start in a ER, but the bottom line is it's the new reality, and a product of our f... up system of health care in the USA.

I have a question, as a student nurse graduating in dec 08--I wanted to be an er nurse, (I think I am an adreniline junkie, but thats a whole other post) should I get a year or two of med-surg under my belt or what would you recommend before coming to er

It is hard enough for an experienced RN to start in the ER. A new grad has a double whammy: you don't know how to nurse as far as time management goes and you don't have the nursing skills to be learn on the fly.

I would advise you to get some experience first before you hit the ER door. Get your organizational and basic skills down pat. Then...apply for the ER and you will still find many days that you are overwhelmed but you will have the skills to cope with it.

Good luck..

2 yrs med-surg could mean the difference between flourishing vs failing in the ER. I just haven't seen and good extended orientation in the ER that would prepare a new grad well enough to get comfortable for a long time. Where as ICU's and step-down units, med-surg, usually have a well establidhed orientation schedule that is more suited towards bring new grads into the work force.