To all the newbie ER nurses out there... - page 2

I'd love to know what my fellow new grads have learned since becoming nurses. I'm a brand new RN and I've worked in a level 1 trauma center for 3 weeks now. Here are the most important things that... Read More

  1. by   shieldanvil81
    Quote from kyboyrn
    Congratulations! I too started out as a new nurse in the emergency room about 6 years ago. I worked in a rural area ER, but we were a VERY busy rural ER. Actually, one of the busier ERs in my state. One thing I advise is to read, read, read. Learn as much about the more commonly used medications in your emergency room as you can. Pay attention to how each of your providers do things. What I've noticed is that each doctor or other provider have their usual way of treating specific types of complaints (chest pain, abdominal pain, stroke symptoms, etc.) If you learn how your provider thinks, it allows you to better anticipate orders and effectively manage your time. Learn to prioritize. As an emergency nurse, you have to work quickly, and you have to know the patients that require your immediate attention, and those that can wait. Sometimes this is tough, as I can remember one particular time that I had a baby that was near coding, a patient having an MI, a patient with acute pancreatitis, and another with severe abdominal pain, all at one time and they all showed up within 30 minutes of one another. This leads me to my next point: do not be afraid to ask for help. Nurses within a unit are a team, and there are times you or your fellow coworkers are going to be overwhelmed. Learn to help your co-workers so that they will respect you and want to help you as well. I do not care how great of an ER nurse you are, how fast you work, how intelligent, etc. you are going to need help sometimes. I will miss working as an ER nurse, but I'm still going to be in the unit. I recently graduated NP school after 5 years as a staff/lead nurse in the ER (my only nursing job) and I got a job in the same ER as an NP. I actually just passed boards 2 weeks ago and got my license a few days ago! Anyway, just remember that ER nursing can try your patience. It can break you down, chew you up, and spit you out. Still, it can also be very rewarding, as there are times that patients will really appreciate what you are doing, and you have the unique opportunity to be an integral part in the saving of many lives. Good luck in your career. Read, learn, write things down. In the ER, knowledge truly is power. Learn as much as you can. There are required certifications (ACLS, PALS, etc. varies by facility) but also go for extra emergency oriented certificaitons and classes if you get the chance. TNCC is a very useful class, and I wouldn't be surprisd if it wasn't a requirement for nurses in a Level 1 Trauma center like yours. I wish you nothing but the best, and wish me the same as I transition into the provider role. No matter what, I'll always be a nurse, and I'll never forget my days as a staff nurse, and as a lead nurse (I wouldn't want to do those days over again for anything, lol)
    Thank you so much for that awesome reply, kyboyrn. It's great to get advice from an NP! Congratulations and good luck to you! My preceptor (I'm doing a 12 week internship) gave me much the same advice about the preferences of providers and prioritization. As for the certifications, we need to maintain BLS, PALS, ACLS, and TNCC . I think that's all. On a side note, this is the most amazing place I've ever worked. Teamwork is the name of the game here, and I'm constantly amazed by the atmosphere. It absolutely REEKS of caring, camaraderie, and patient safety. I feel like the luckiest nurse (holycrapIstillcan'tbelieveI'manurse) in the world.
  2. by   WonderRN
    Ok, I'll bite...... What is crumping !?!? I know what krumping (with a K) is.... and I'm pretty sure you don't mean beckoning providers to the bedside of pt's that are hip-hop dancing....

    Quote from VICEDRN
    how to start an iv while sweaty and on a screaming patient

    how to start an iv upside down...

    how to convince someone to look at my patient who is crumping

    what crumping means (and also what it looks like)

    the phone extension for security

    and when to call security...

    how to spot the fakers...

    how to fake out the fakers...

    how to develop a thick enough skin to be part of the most hated/complained about dept in the whole building...

    what nursing judgment means (and that's all i am gonna say)

    (been in the ER for 8 months and still love it!)
  3. by   TXTraumaRN
    An ER nurse's definition

    Crumping AKA "circling the drain" , "He doesn't look good" , "Come quick! I think my patient is dying!", getting really close to passing the point of no return
  4. by   ybq2008
    This is a great thread. Not quite in the ED yet, but hoping to be within the next year. Congrats OP!
  5. by   owhite9878
    chart as u go. eat something. go to the bathroom. wear ted stockings. how does the pt "look", do they look pale? is their skin very warm?
    keep tape, bandaids in your pocket. check id bands, ask the pt their name and allergies before giving meds. sometimes they forget allergies during triage.
    take the chart with u when u give meds
  6. by   katieRN911
    I was in your shoes 24 years ago and I can say that you have your priorities right.
    I would suggest taking a TNCC course if you haven't already. Otherwise learning level 1 Trauma nursing will take alot longer.
    Shadow a very experienced ER nurse where you work if you can, you learn so much from someone who's been working ER forever.
  7. by   NeoPediRN
    There's a whole lot of redundant documentation in the ER!
  8. by   Bundy4632
    I'm also a new grad in the ER and LOVE IT! What I have learned in my long 2 month career is:
    1) - Always ask questions
    2) - Learn from every nurse on your team
    3) - Be accurate first...speed will come with experience
    4) - God gave us 2 ears and 1 mouth, use them proportionately
    5) - 20 years experience trumps 4 years of class 99.9% of the time
    6) - When another nurse shares information with you, the only correct answer is "Thank you for the help," not "yeah I already know that." (I actually witnessed another newbie do this several times and now they are struggling)
    7) - you can do everything right and the still lose the pt

    Most's OK to say a little prayer while you are treating the patient.
  9. by   BLONDIE1630
    One of the most important things to remember (it will save your sanity)...You did not create their emergency, you are there to help them as much as you can..when you lose a patient, remember - you did not create their emergency.
  10. by   al7139
    Hi all, I am a new ER nurse who has experience in tele/ CSD now that I am an ER nurse, I am doing an orientation, which is humbling to me. I am used to working on my own, but have gotten used to having help in the ED. We are a great team and we don't screw around with ********., so I get the best of both worlds. Any help out there for a new ED nurse?
  11. by   CalDiveRN
    First thing I learned in the ED is Never stand when you can sit, never sit when you can lay back, and never volunteer for anything
  12. by   CrunchRN
    "I guess if I really cared about people knowing I was male, I'd have named myself RNhasapenis or ERmanlyb*lls"

  13. by   Annisme
    1. Trust your gut instinct. Even if it is wrong, you will learn something.
    2. If you don't know, say so and get help. Trying to bluff your way through might kill your patient.
    3. Don't take it personally.
    4. Appreciate the techs and those who help you, and tell them you do.
    5. Check meds the pharmacy sends you with the orders.
    6. Ask questions and listen to the answers.
    7. Working in the ED means you education is about to begin. Learn all you can from everyone you can.
    8. The hoofbeats are usually horses, but the zebras in the herd will get you if you don't watch for and recognize them.
    9. It's okay to cry with your patients and fellow nurses. We are caring human beings, no matter what the other floors think.
    10. Don't bring home to work, or work to home.
    11. Find someone safe to vent to.
    12. Be kind to yourself.