Views on New Grads Entering the ER. - page 3

by StudentNurse825 | 16,321 Views | 36 Comments

hi all... i am in my final semester on nursing school!! my graduation is august 10th! woohoo ... sorry i am so excited! i am doing a school project on new grads entering the er. i would like your view points good and bad. do... Read More


  1. 0
    We have an ER nurse residency at out hospital. I think new grads are great!
    We assign the same nurses to a new grad for precepting. I think you can mold them into a good ER nurse this way.
  2. 0
    Hi,
    When I graduated from diploma school in 1967, I had been working in the er on the weekends during my senior yr. I loved it and that became my life for the next 20 yrs! However, at that time, as a new diploma grad you had been exposed to great more clinical experiences, than new grads w adn and bsn grads today. I recall when I had a new bsn grad and asked her to obtain a cath ua. 30 min later it had still had not been done and when I asked her about it, she hung her head and said that she had NEVER catheterized anyone before! I was shocked and immediately called the education dept and told them. Never did I want a new grad w no experience in my er again. Soon, thereafter, they in all their wisdom, developed an internship program for all new grads hired on in the hospital. Needless to say, I am against new grads in the er, if they are not diploma grads and they are, sadly, few and far between now. Too bad.....
  3. 0
    Quote from cab6e3
    Hi,
    When I graduated from diploma school in 1967, I had been working in the er on the weekends during my senior yr. I loved it and that became my life for the next 20 yrs! However, at that time, as a new diploma grad you had been exposed to great more clinical experiences, than new grads w adn and bsn grads today. I recall when I had a new bsn grad and asked her to obtain a cath ua. 30 min later it had still had not been done and when I asked her about it, she hung her head and said that she had NEVER catheterized anyone before! I was shocked and immediately called the education dept and told them. Never did I want a new grad w no experience in my er again. Soon, thereafter, they in all their wisdom, developed an internship program for all new grads hired on in the hospital. Needless to say, I am against new grads in the er, if they are not diploma grads and they are, sadly, few and far between now. Too bad.....
    I think it is pretty ridiculous to say "no new grads unless they're diploma grads." That would be like me saying "I only want to work with other BSNs because at least THEY have a 4 year degree" (which I would never say). It is unfortunate that one unprepared new grad has soured your view on new grads forever. I had a checklist of things I HAD to master before graduating - and if I didn't prove I could do them on at least 1 live person, I wouldn't graduate. This included caths, IVs, NGs, etc.

    The hospital where I work has a fellowship for every specialty....if you are a new grad, you don't just get an orientation to the unit and start working, you go through a 12-20 week fellowship (less time for med surg, the full 20 for ER) with classes and precepted caregiving in your unit. That means that for 20 weeks, I worked 40 hours in the ED with someone looking over my shoulder - she didn't take her own patients, she was just there to make sure I was doing okay and that my patients were okay as well.

    I don't think ANY new grad should be thrown into direct patient care. At least, not until nursing education changes to be more in line with "true" nursing as opposed to "pie in the sky" nursing. Maybe a combination of the philosophies of the BSN and diploma programs would be called for - the educational aspects and background of the BSN combined with the clinical hours of the diploma.

    And as an aside, I was visiting my grandmother on a med surg floor after abd surgery. The nurse, very nice, was giving my grandmother her meds - Gran had been dx with CHF recently, and didn't understand why she was taking the Lasix. The nurse could only tell her "it makes you pee more" she wasn't able to get into the patho of "weak heart, fluid backs up, the Lasix helps pull the fluid out of your kidneys etc etc etc". She said "it is the doctor's job" to explain the medical background. I asked her where she went to school, and she named a diploma school in the area.
    I'm sure glad I didn't make a generalization of all diploma nurses based on the actions of that one.
  4. 0
    Quote from cab6e3
    I recall when I had a new bsn grad and asked her to obtain a cath ua. 30 min later it had still had not been done and when I asked her about it, she hung her head and said that she had NEVER catheterized anyone before! I was shocked and immediately called the education dept and told them. .....
    Perhaps offering to show her once--which is probably all it would have taken and in less than 5 minutes---would've been less work for you than stomping down the hall to make your phone call of righteous indignation......

    What a nice object lesson about nursing in general for that new nurse:angryfire
    Last edit by Miss Mab on Aug 12, '06
  5. 0
    Quote from NurseErica
    I think it is pretty ridiculous to say "no new grads unless they're diploma grads." That would be like me saying "I only want to work with other BSNs because at least THEY have a 4 year degree" (which I would never say). It is unfortunate that one unprepared new grad has soured your view on new grads forever. I had a checklist of things I HAD to master before graduating - and if I didn't prove I could do them on at least 1 live person, I wouldn't graduate. This included caths, IVs, NGs, etc.

    The hospital where I work has a fellowship for every specialty....if you are a new grad, you don't just get an orientation to the unit and start working, you go through a 12-20 week fellowship (less time for med surg, the full 20 for ER) with classes and precepted caregiving in your unit. That means that for 20 weeks, I worked 40 hours in the ED with someone looking over my shoulder - she didn't take her own patients, she was just there to make sure I was doing okay and that my patients were okay as well.

    I don't think ANY new grad should be thrown into direct patient care. At least, not until nursing education changes to be more in line with "true" nursing as opposed to "pie in the sky" nursing. Maybe a combination of the philosophies of the BSN and diploma programs would be called for - the educational aspects and background of the BSN combined with the clinical hours of the diploma.

    And as an aside, I was visiting my grandmother on a med surg floor after abd surgery. The nurse, very nice, was giving my grandmother her meds - Gran had been dx with CHF recently, and didn't understand why she was taking the Lasix. The nurse could only tell her "it makes you pee more" she wasn't able to get into the patho of "weak heart, fluid backs up, the Lasix helps pull the fluid out of your kidneys etc etc etc". She said "it is the doctor's job" to explain the medical background. I asked her where she went to school, and she named a diploma school in the area.
    I'm sure glad I didn't make a generalization of all diploma nurses based on the actions of that one.

    on the general description of lasix - lol - i have many times had to say just that - when one tries to explain in depth to many older patients they either do not want to hear it or do not "get it" so its best to keep it simple is what i have found - however - i have no trouble explaining it to the family who can understand it. i know my grandma knows that her lasix makes her pee more and she knows it is to prevent her from going back to the hospital - she is 90 and that's all she cares to know - many of our elderly are still in the era of they trust their docs implicitly ( whether they should or not ) and do what they are told and dont ask dont wanna know. just what i have seen in my area.
  6. 0
    I think it is great to gear your education to the patient's levels of interest and understanding. But to not even know how a med works enough to be able to pass it on to family members....scary.
  7. 0
    Hi Erica
    thanks for asking this question, I am a new grad last may and am interviewing this week for jobs, 2 ER jobs one geri psych and one pedi office. Until I read your post, i was nervous about the ER job, but it is my first love. I have been an EMT for 5 yrs and just took an ACLS class, so I think I would be prepared, this hospital has a 6 month preceptor program and send you to take the other classes such as tnccp end encp classes, pals also. I know I can do it, and Im sure you can do. I also did a student nurse externship during school at a local ER for 3 months, loved it!!!!!
    thanks again!!!!
    love this web forum!!!
    Pam
  8. 0
    Quote from Melissa94RN
    Personally, I think that a new grad could be fine in the ER with the proper training, but in my experience most of the hospitals in my area are terrible with orientation. The nurses end up trying to fend for themselves and it can be a disaster. I was thankful for my experience prior to entering the ER but again, I had little or no orientation, kind of on the job training. In the hospital that I presently work, they require 1 yr of floor nursing prior to ER. Someone stated in a prior post that it takes a couple of years to feel truly comfortable and I truly feel that is true. After 9 yrs in the ER, there are days when I learn something new or see something that I have never seen before. I think though that is why the ER is definitely for me as I keep learning everytime I step through the door.
    Hi
    I am a new grad in a 30 bed ED, and this topic always gets me going. The ED is absolutely a place where an new grad can flourish, but ONLY if proper supervision/education is in place. I think that the mentality of "medsurg first" is antiquated for a few reasons. Mainly, the ED is a place where your mind works differently, and you have your hands on twice as many people so your assessment skills can really grow with the right guidance--working in medsurg means you can be great with assessments, but you have to adjust to just doing focused assessments and managing a very high turnover rate. You get the tele experience during the preceptorship, where you have opportunities to work inconjunction with a preceptor and actively learn what you are seeing, as opposed to repetition.

    My program is 6 months of precepting, 2 additional weeks precepting on off shifts, class time, med tests, ACLS, PALS, and discussions. It is a very well rounded and supportive program. I have had my moments where I feel out of control and almost unsafe, and others where I feel entirely in the right.

    My preceptor is always there to watch and ensure nothing is going off track, and in the meantime, it's my responsibility (and rightly so) to actively work at practicing assessments, reviewing appropriate documentation, and ALWAYS checking meds. I take one or two patients from her assignment, which she could manage alone, so there is room for discussion, review, and verification.

    ... I love it :spin:
  9. 0
    Anyone recommend any ER internships for new grads?
  10. 0
    Quote from radbird
    Anyone recommend any ER internships for new grads?
    I just completed a summer internship at a local hospital here in the midwest. They apparently also do winter internships during that break.

    You must be within a year of graduation and go through an application/interview process. I found this one through a local hospital/career fair they did on our campus. I would suggest checking local hospital websites under "Nursing" or "Student Nursing" if those headings are there. If not, you can try calling the Nurse Recruiter on staff (most of our local hospitals have these) and I bet you'd find they'd at least be more than willing to tell you what options they DO have for you. They're usually very helpful to students!


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