ER nursing as new grad

  1. I will be graduating in December and am considering applying as an RN in the ER. However, I'm a little nervous that I won't be able to think quick enough to handle certain situations. I don't even feel prepared to work on a regular floor, let alone a fast-paced environment. Are there any new ER nurses out there, and would you recommend it as a first job?
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  2. 15 Comments

  3. by   VivaLasViejas
    You really should get at least a couple of years' med/surg experience before you even think about working ER. Not only will you be a better all-around nurse, you'll have seen enough by then to be able to anticipate problems---a very much-needed skill in emergency nursing!

    I personally have never wanted to work ER---the occasional code 99 in med/surg or birthing center is all the adrenaline rush I can handle---but I've floated there a few times, and even as an experienced nurse, I'm definitely out of my league in that department. All of our ER nurses have been med/surg or critical care nurses before even being allowed to apply for an ER position, and I think that's good policy. Frankly, if I'm the patient being brought in for a r/o MI (and I have been that patient) I want someone taking care of me who's seen this before, knows how to recognize trouble, and can act fast if something starts hitting the fan!

    Good luck to you in your decision-making.
  4. by   nekhismom
    I agree that if I were the pt, I would want someone with experience. HOwever, I understand your wanting to enter a specialty area right out of school. I want to work in L&D, and that is really the only place i am considering right now. I think it all boils down to you....are you a fast learner? Do you feel ready to just jump right in amongst the action and take over? Are you confident enough with your assessment skills? You just have to examine yourself and do what is right for you. No real life experience to share here, just my own thoughts. I hope that everything works out to your liking, whatever that choice may be.
  5. by   fab4fan
    As an ED nurse, I would strongly suggest you get some experience first. Learn how to work with the basic disease proceses, get your skills down, learn how to prioritize.

    In the ED you are expected to be able to care for pts of all ages, all diseases. Do yourself, the patients, and your co-worker a favor and get some exp. first.
  6. by   Chrislynn2003
    Where I live,in Delaware, a hospital offers a graduate student the chance to participate in an internship; ER, OR, critical care, etc. This way you are taking classes and training on the job for about a year before you are on your own(and getting paid for taking class). Some people may start in the ER though if they have worked their previously as a CNA or something. Good luck

    Christine
  7. by   babycatcher68
    Working in the ER requires any nurse to be able to think quick and prioritize, even in the smallest ER setting. Sometimes you have to be able to anticipate the MD's orders to save a life. As a new graduate you will have your hands full balancing out all your new skills. Give yourself at least 6m-1yr in a med-surg setting and you can work anywhere and do anything. Don't be in a hurry to be unfair to yourself! Good luck with your choice...
  8. by   orca1
    Hi,
    I am a new grad nurse working as an RN in a very busy ER. I have had previous experience in the ER setting. I worked as an ER Tech for three years and an EMT on an ambulance for 1 year.

    As a new grad I feel that I have brought fresh ideas to the ER. I ask questions when I do not know the answer and my questions are answered; usually by one of the newer RN's or resident MD's. We all have to start at the bottom right?

    I knew from the get go that Med/Surg was not my thing. Yes, it is important to have those skills BUT if someone hates it so much then most likely another RN will be lost to burn out.

    Just my opinions...but I do know that the hospitals that DO hire new grads in the ER usually have a training course and a fairly long orientation.

    PUMPKIN: Please feel free to email me if you have any questions??

    Lisa
  9. by   petiteflower
    I went into a critical care setting right out of nursing school, and yes a new grad can learn it and do it. But what I found was, I didn't understand the basics, if someone wasn't on a vent or multiple drips, I didn't quite know what to do with them.

    I went to a smaller hospital where you do everything from recovery to ER. I learned alot, sharpened my basic skills, and now I am in charge of an ER.

    I think med surg experience, at least 6 months to a year is more helpful. I don't like med surg either, but you see everything, and you learn important skills and disease processes that you need to pull out of thin air at the drop of a hat in ER.

    I am not discouraging you from your dream, but med surg is the hearbeat of a hospital, and med surg nurses have to know a lot about everything, just like ER does. Don't sell yourself short.

    Good luck.
  10. by   tinyhands4Him
    I respectfully disagree with most of ya'll posts. I am a new RN (graduated in may) and was offered a position in a level 1 trauma pediatric ER in a large city. During my preceptorship before graduation I spent 3 days down there and both the nurses I was working with both begged me to apply for the opening they had. I was reluctant but they talked me into it. Working in any critical care area, even the ER is all the same and the majority of my nursing class went into some form of critical care area....all of us from a traditional BSN program. I turned down the ER position for a level III NICU position...my true love, but I think if you have the drive for it and love for it you can do it. You definately have to be willing to work and have a good orientation. Knowing the signs and symptoms of a patient going bad is critical on any floor and necessary....something all new grads have to learn, but any change to any department in the hospital makes it hard. When I did my time in the ER (I also shadowed an ER nurse for a day) and talked to them the majority of ER visits are things that should be handled in a clinic.....if you are working in a major trauma center then you will also have to deal with that but that isn't all of the time. There will always be people around to help you out and I'm sure your supervisor will assign you cases that he/she thinks you are ready for. In an actual trauma room there are lots of other nurses in there with you....you aren't alone. I also feel that nursing school doesn't really adequately prepare anyone for any nursing positon....there is tons to learn and experience in the real world and everyone starts out at the same place. If it is really something you want and you have done well in your nursing classes and clinicals....look for a hospital with a good nursing orientaion program and go for it.....as a new grad they won't hire you into the ER if they don't feel you have the ability or the personality! Good luck!
  11. by   orca1
    Tiny,
    You could not have said it better!! Thanks.

    How long have you been in the ER? I would love to chat and share stories.

    Lisa
  12. by   fourbirds4me
    I think it is definately "doable" and I encourage you to try it if that's what you want. Several graduates from our class have gone into specialty areas including ER and are doing fine.
  13. by   babynurse32
    I have to agree with Tinyhands4him. If that is what you want to do, then go for it. As a new grad you are not going to know everything anywhere you work. If you are determined and the department along with a good preceptor are behind you then you can do it. There will be alot to lear but that is what those older, seasoned nurses are there to do. As a student I wanted to work no where except L & D. Everyone told me you can't get in that area, you need experience, etc. I got the job of my dreams, and not, it isn't easy trying to learn a specialty like that. There is so much to learn, but if that is where you want to be, you will love learning it and be motivated to do it. I say go for it! Good Luck!
  14. by   newfloridaRN
    Hey all. I have to play there other side here. I'm a new RN in an ER- very busy, very TOURIST-y area. I participated in an ER-RN internship program, where i was paired with a preceptor for 16 weeks of clinical, along with classroom work. I am on my own now, and the ANM's say I'm doing great. They lead me into it slowly- first just doing assignments that are not trauma or code related. They weren't assigning me to code rooms at first so I could just stand back and watch- or start the IV's, or do chest compressions- just see how it works. I come from ZERO ER experience, other than 18 weeks in nursing school as my perceptorship. I think I'm doing fairly well now= handling Acute Mi's to codes, to Stroke Alerts and I'm doing just fine on my own. Granted, we have a great team in our ER and other nurses are always there to back me up. I say if you want to go right for ER, DO IT. I would never have been happy going to med/surg or another area. Just find a hospital with a great internship/orientation program. Any questions, send an email. Good luck from one new ER RN to a hopeful one!

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