When did you realize that "newbie" wouldn't cut it in the ER? - page 2

Just curious to hear some of your stories regarding orienting nurses (either new grads or transfers) to the ER and when/how you know if someone is cut out for the ER or not.... Read More

  1. Visit  JBudd profile page
    2
    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    brillohead and canoehead like this.
  2. Visit  itsnowornever profile page
    0
    Quote from JBudd
    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    I can see where on the floor not having an order is an issue (just reading some of these posts where docs won't sign phone orders!) but in an ER with 5 million people who all hear the verbal order....well, you are covered, just give it!
  3. Visit  XmasShopperRN profile page
    6
    Quote from Heavenlee75
    A lot of nurses forget that at one time they too were new...I have a huge problem with nurses who think they're better or smarter than the next! I'm an experienced nurse who has oriented new nurses and student nurses and I enjoy teaching. The ER is a stressful place and although it might not be for everyone nobody should ever be made to feel like they're a burden to other nurses because they're new. That's why nursing is so stressful these days...bad attitudes to others!!!
    Heavenlee75, I'm right there with you on this! I've watched several new grads crash and burn after their orientation which consisted of their preceptor and the preceptor's buddies belittle every question or difficulty their preceptees had. I personally believe that the "old eating their young" really applied in this setting. It was really unfortunate considering a lot of these new grads had really solid assessment and critical thinking skills, but chose to move to other units because they were so miserable and intimidated. These "seasoned" nurses were notorious for making their own mistakes, including letting septic pts ivf's run dry, not giving abx's when ordered, and running pressors either at the incorrect rate or incorrect concentration because they were so busy sitting on their lazy **** and making fun of everyone else! But in the end, you reap what you sow; from what I hear, now the ED's so understaffed, and most are looking for new jobs.
    While I get that some people aren't cut out for the ED, "newbies" should be given every opportunity to prove that they can pull their own weight with the proper preceptorship and unit resources when they're cut loose. IMO.
    Last edit by Esme12 on Jan 29, '13
    AnGG, Armygirl7, Nursingluv101, and 3 others like this.
  4. Visit  whichone'spink profile page
    1
    Quote from JBudd
    If they can't get past the "I need an order in the computer first" before being willing to intervene in an urgent situation. Understandable at first, but not being able to learn to trust your team in the long run is a problem.
    I'm getting better at that. Now for a ACLS or trauma situation, there's no time to put orders in the computer. But it seems many doctors are too damn lazy to put in orders on non-urgent patients, so they give a verbal order. I'm learning which doctors I can trust, and which doctors I can't trust easily.
    MBARNBSN likes this.
  5. Visit  Heavenlee75 profile page
    0
    Quote from XmasShopperRN

    Heavenlee75, I'm right there with you on this! I've watched several new grads crash and burn after their orientation which consisted of their preceptor and the preceptor's buddies belittle every question or difficulty their preceptees had. I personally believe that the "old eating their young" really applied in this setting. It was really unfortunate considering a lot of these new grads had really solid assessment and critical thinking skills, but chose to move to other units because they were so miserable and intimidated. These "seasoned" nurses were notorious for making their own mistakes, including letting septic pts ivf's run dry, not giving abx's when ordered, and running pressors either at the incorrect rate or incorrect concentration because they were so busy sitting on their lazy **** and making fun of everyone else! But in the end, you reap what you sow; from what I hear, now the ED's so understaffed, and most are looking for new jobs.
    While I get that some people aren't cut out for the ED, "newbies" should be given every opportunity to prove that they can pull their own weight with the proper preceptorship and unit resources when they're cut loose. IMO.
    And I agree 100% with what you said...I watched one nurse who was super intimidating to new nurses but couldn't even spell good :-/
    Last edit by Esme12 on Jan 29, '13
  6. Visit  uRNmyway profile page
    8
    Lol, am I the only one who noticed the context of that previous post and giggled a bit? 'Couldn't even spell good'? :P
    Sorry, no offense meant, just a Monday morning brain fart.
  7. Visit  Christy1019 profile page
    0
    Quote from libran1984
    When the noob administered PO benadryl IVP and called the diphenhydramine an abx.

    ....

    I don't know much else.... just something i heard.
    Eeek!! Was it liquid or pill/capsule form and did the pt live???
    WOW!!!

    BeLLaRN
  8. Visit  Ciale profile page
    17
    Be careful about who you "write off" as not being a big bad er nurse like yourself. I've seen some of the most unlikely newbies quickly become our better nurses. Just sayin'. Be nice. You were totally clueless at one point too.
    AnGG, Irish_Mist, smurfynursey, and 14 others like this.
  9. Visit  R!XTER profile page
    2
    The #1 no-no for a newbie is no sense of urgency. I have seen a few of these and it's very hard to teach this. IMO if you don't have it you never will. In one case the person was completely clueless, moved really slow, and had no assessment skills. In the other, the person was smart and kind, but slightly arrogant, and no matter how many times he was redirected, he would just take his sweet old time, sometimes even just sitting around chilling while there was a LOT to be done. I can't figure out what it was about him, but I literally told him he needs to light a fire under his butt and it didn't make a dent of improvement. If you work in an ER, you need to know how to MOVE!!!
    Armygirl7 and JessiekRN like this.
  10. Visit  ADNRNTX profile page
    2
    I have worked on a very busy colon rectal urology post surgical unit for almost 5 years and I am going to do a "shadow shift" in the ED next week and hopefully transferring.. I love my unit and coworkers and am leaving a very secure position but have always wanted to do "emergency" I know some of my skills are going to need to be brushed up on (ie: iv's- we have an IV team) but I feel I'm taking some good skills too (ngt insertion, difficult foley insertions, ostomy mngmt, some wound care,etc) hearing what you have to say about newbies is both encouraging and discouraging.. But I believe I can do it in time! Any advice for things to look out for or absolute do's and don'ts would be greatly appreciated! Be honest I can handle the truth!! Sorry if I should have started a new "topic" but I'm new to the site and felt this had probably been covered but I didn't go back through all the old topics... Does that mean I'm not gonna cut it?? Jk
    Altra and KittyinNj like this.
  11. Visit  havemercy21 profile page
    2
    Quote from Sassy5d
    I was an LPN prior to RN. I've worked in various settings, many high pressure/stress in their own right, of course not ER. I don't work in a trauma center. Just a small community hospital, 23 beds or so with a fast track. I've been at this job just over 3 months. I'm sure I've said/done/reacted oddly to situations.

    Being the 'newbie' is very frustrating. We are well aware that it's a bother to be precepted and oriented. It's very uncomfortable most times.

    With that being said, and I know this isn't the point of this thread.. Try to cut some newbies a little slack.

    This was an issue at my job this week. With flu issue on top of the regular high volume of non-emergent visits.. It can be frustrating to even the most seasoned nurse.

    I found myself wearing down yesterday, no pee, no snacks, no break or food for 12 hours. Verbal abuse and demanding non-ill patients and family members, I was worn out. I made a snide remark at work and I was looked at like I just shot someone's kitten.. The response was like "you're new, what the hell do you know about anything and you're not gonna survive here if that's how you feel" like I'm too new to be frustrated.
    I have noticed that being the happy and bubbly one does not always work so well in the ER. I get looks all the time for being enthusiastic and optimistic--i wouldnt be this way if i didnt love my job. I am sorry for having a heart and actually feeling sorry for certain people. Every time i take even 1 extra minute to listen to a pt vent to me and confide, the nurses with 5 years experience will roll their eyes and comment to me saying "thats not gonna last too long". And god forbid i give people a piece of my mind instead of being the smiley, bubbly girl that i am, everyone's eyebrows raise and eyes pop out. Its okay for them to comment whatever way they choose, but if the newbie does, its the end of the world. i choose to want to work in the emergency dept but that doesnt mean that i am gonna change my positive personality and turn into a heartless b just to fit in with the rest of the crowd.
    jrsRN07 and krazievi3t6url like this.
  12. Visit  Sassy5d profile page
    0
    Quote from havemercy21

    I have noticed that being the happy and bubbly one does not always work so well in the ER. I get looks all the time for being enthusiastic and optimistic--i wouldnt be this way if i didnt love my job. I am sorry for having a heart and actually feeling sorry for certain people. Every time i take even 1 extra minute to listen to a pt vent to me and confide, the nurses with 5 years experience will roll their eyes and comment to me saying "thats not gonna last too long". And god forbid i give people a piece of my mind instead of being the smiley, bubbly girl that i am, everyone's eyebrows raise and eyes pop out. Its okay for them to comment whatever way they choose, but if the newbie does, its the end of the world. i choose to want to work in the emergency dept but that doesnt mean that i am gonna change my positive personality and turn into a heartless b just to fit in with the rest of the crowd.
    I'm just not allowed to get flustered or frustrated I guess. Cuz I'm 'new'
  13. Visit  leighTX profile page
    1
    15 weeks of orientation and a nurse is puzzled about accucheck?? I've only gone through one clinical rotation at an LTAC and that seems REALLY ridiculous.
    aachavez likes this.

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