When did you realize that "newbie" wouldn't cut it in the ER? - page 3

by lvnlrn 16,290 Views | 44 Comments

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


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    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.
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    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.
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    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.
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    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.
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    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'
  6. 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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    I agree with a previous poster about no sense of urgency being the kiss of death (sometimes quite literally for the pt) with a new grad or RN new to the ED. When you see the new person chatting with the pharmacist tech about the latest movie she saw while the rest of the team is coding HER pt its a very bad sign. What's awful is that now she's only on an extended orientation not moved back to her own no critical unit where she belongs. I'm just waiting for her to kill someone. Her preceptor is developing an ulcer from the whole affair. I love our union, really I do but fighting for someone like this to stay in critical care is insanity.
    canoehead likes this.
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    Quote from ADNRNTX
    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

    I hope you enjoy the ER as much as I do! My best advice is to always ask questions when you aren't sure of something and be eager to learn. In my ER a know it all or bad attitude gets outcasted real fast. The skills will come as you do them more and more. I would say brush up on your assessment skills: focused and head to toe. Depending on the situation you need both in the ER. Again, hope you enjoy it and find a home in the ER!
    Armygirl7 likes this.
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    There is one newbie I think won't make it where I work. At my hospital the first 6 months of your employment, you are on probation. She got put back on probation (i.e. at 6 months was not performing) after making multiple mistakes. Whenever I work with her, she is always drowning and if you ask her if she needs anything, she always says no. Once she took report from a nurse and later asked "Do you know who has that room?". This is a nurse who came to the ER with experience. Very bizarre!
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    The nurse that thinks she knows everything and/or is overconfident, won't ask for help, doesn't ever bother to help others but is often sitting on her arse, and even tries to tell others how it was done at her last hospital all the time won't make it.

    We have one new orientee right now and 2 weeks into it I'm betting she won't cut it. She's a brand new grad and never even had a "real" job before. Her coach is not on the trauma team so they never see the traumas to begin with. She was allowed to observe a Level 1 the other day and she was told to stand in the corner (away from the action) but yet she walks in and grabs some trauma lead and gown and MY orientee asked her what she was doing. This 4 week out of school grad thought she was just going to dress out and run that trauma. The fact that someone had to tell her she couldn't come to play was pretty scary.
    Lawgirl14 likes this.


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