Tips For New Grad ER Jobs

I would dtrongly suggest that you get a year of med/surg under your belt before taking any specialty position. You will be much more "marketable" for future jobs in ED or any other special area.

Either Med/Surg or Tele experience is what they will be looking for but sometimes if you precept in a certain ED and they like you enough you might get hired.

ACLS and PALS is a good idea for marketing yourself.

Here's my opinion from someone who started in the ED as a new grad...
There are many hospitals that offer a fellowship in ER nursing. At my hospital, we had several months of classroom review material (because no nursing school hits ER material) and critical care material. We then had a 4-5 month clinical practicum - work 40 hrs/week in the department with an assigned preceptor, with weekly objective reviews and meetings. It was very intense, but wonderful. I learned a lot, and because the hospital accepted new grads, the atmosphere in the department was very good (for the most part) for learning.

I don't feel new grads should jump straight into an ER that doesn't have any kind of program - the amount of things to learn is too great. BUT if I could do it again, I would probably do a year or two of ICU. I think ER is wonderful, but because it is usually a "cattle in, cattle out" philosophy, you don't always get a chance to fine tune your assessment skills.

If you are a smart person, sharp, willing to learn, and not afraid to ask questions, you'll probably do fine. You also need to be able to jump in and DO, instead of just standing outside of the door. During my fellowship, I went through TNCC, ACLS, ENPC, and the hospital paid for it Maybe get a book (Sheehy's Manual of Emergency Care is good) and start reading. I know the last thing you want to do while finishing up school is read a textbook that doesn't contribute to school, but it can help you feel more comfortable.

Good luck. Let us know what happens.

Don't want to be totally discouraging, but....if there is not an offical precepting program for ER then do Med-Surg and/or Tele for at least...at least a year. Even with that under your belt,( I am talking from experience ) and having twelve yrs of Echo, which gave me a extensive cardiac background, the ER on most days was daunting for me the first 6mo's. I was in a position that was precepted for 8 wks, and then they let me loose. Put it this way, I am O.K now.....don't know everything, who does?, but I now have a stomach ulcer from all the stress. Looking back I would have turned ER down and went to the ICU/CCU. This is mega stressful too but slower paced. Someone had mentioned that you can pretty much tweak your skills there and I would have to agree. Whatever you do, be prepared to self-educate when you are off work. Nursing school was just the tip of the iceburg. This is the way it is for ER, and I am sure it is for any CCU/ICU job. I wish you much success in what ever you choose. Take Care, Bindy

I will join the chorus and agree that under no circumstances should a new grad try to start in an ER unless the hospital has a good fellowship/preceptor program. In fact, it would be great to find a fellowship/preceptor program for whatever department you join. It is not that ER work is any more difficult than some others - a good Med-Surg nurse on a busy floor goes home just as tired as any ER nurse. Its just that ER work involves an enormous variety of patients and conditions, all at high speed, all changing by the minute. For those of us who love chaos, its great, but its definitely not a good place to learn basics. .... Now, if you have found a good preceptor program, don't worry too much about having ACLS, etc. Normally, those are all part of the program. They can't hurt, but aren't really necessary. What I'm told our supervisor looks for is someone with life experience who understands the reality of ER work and who can explain why they want to work there. If you have no prior EMS or ER experience, think about asking to do some observational shifts in one or, better yet, volunteer in one. You'll be stocking laundry and cleaning rooms, but you'll be learning how the ER works and you'll honestly be able to tell a recruiter that you've been there and know its your home. Best of luck

As a new grad starting in an ER, I feel I have learned more in the 3 months I have been with my preceptor than I would have ever learned in a general med/surg/tele unit. I think regardless of which department you want to start in or where your long term goals are you have to want to learn, be open to any chance to learn and show your coworkers you are willing to jump in and help out. The ER is something that you either love or hate. I was so tired of people telling me I needed experience in general dept, but I dont know of any other dept to gain assessment skills, procedure skills, critical thinking and thinking on your feel skills. If you want it and work hard you can succeed...approx 80% of the nurses in my ER started there as new grad and some have been there over 10 years....need I say more

Good luck and go for it!


one more thing: you need a good clinical partner/preceptor regardless of where you start

Im going to go with the find a hospital with an internship or ER nurse training program. As far as all the certifications while nice to have if you dont have the experence that goes with you they are just more information one has to process while learning the ER.

As far as med/surg first goes this topic has been discussed here in numerous threads. My take is having done ER for going on 19 years is personally it is easier to teach a rookie than it is to unteach someone coming from the floor with bad habits.

Rj

The ER that I will probably be doing my synthesis rotation at has 2 PT RN jobs available. I am taking this oppotunity to audition for a job.