When did you realize that "newbie" wouldn't cut it in the ER? - page 4

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. by   Pudnluv
    I really don't think the orientation period is the best time to judge whether a new nurse will make it or not. I've seen some nurse who do really well while on orientation, then fall on their faces when left alone. Also, I think you need to give newbies at least 6 months to a year to really acclimate to the ED. It's a whole different way of thinking in the ED. I know someone won't make it when I see that they never learn time management and they become too task oriented. Also, the ones that never seem to be able to look at whole picture and think critically. One thing I tell the new nurses that come from the floor is, this is not floor nursing. On the floor you hae a diagnoses and set plan of action. In the ED, everything new that comes in is a mystery to be solved. When you get that patient with abdominal pain, you need to think of everything it can be, start with the worse case scenario and work down from there. The nurses who can't grasp that are the ones that will never make it in the ED. Still, I believe in giving most nurses at least a year to learn this.
  2. by   SillyStudent
    I try to never judge new nurses in the orientation period. I have raised my eyebrows a few times, I will admit. Orientees tend to lean on their preceptor and ask them questions they already know the answer to. I think verifying their knowledge is a great thing. However, by 3 or 6 months out of orientation, they are either getting it, or completely flipped out and miserable.
  3. by   Sassy5d
    I made it past 6 months.. Just want to add a little something.
    I'm gravy at stuff that comes in frequently. I'm good at MI's, DKA,Seizures,strokes.. I know what's going on and what meds will be given ect.

    What I don't get to see a lot of, for instance, overdoses that just didn't respond to narcan.. All labs are critical, pt's critical, we're doing tons of drips and meds and ET tubes ect.. I don't do this very often.. So essentially, I'm really just a newish nurse in the room. I'm vague on meds and how fast to give them or if the dose the doc is rambling off is really what they want. So I take a deep breathe and feel like I'm back on day 1 of orientation.
    I'm not afraid to speak up, but I would hope people wouldn't be rolling their eyes at the 'newbie' making rookie mistakes
  4. by   exit96
    Probably when everyone gave up on the newbie...we really get hardened quickly don't we??...
    Addendum: there is no shortage of "non newbie RN's" that don't cut it, but have somehow survived.
  5. by   canoehead

    Yes, my reply was to your comment. Sorry so late in answering.
  6. by   SillyStudent
    Most of our newbies make it. I am referring to both new grads and nurses from other specialties.

    Actually, I prefer to train new grads. They don't have any expectations. Sometimes I run into experienced nurses from other specialties that grate on me a little. You can only hear "We did it THIS way on ortho/medicine/surgery/tele" so many times before your hair stands on end. I listen to the rationale every single time, and patiently explain why we do it this way in the ER. Usually because we don't have the same supplies/equipment or that it is not our focus here.

    I had weird expectations when I transferred from SICU, and I probably said the same things.