new grad RN's in the ER - page 2

by jenny lynn

23,123 Views | 18 Comments

I know most Flight Nurses need to have at least 5 years of er or icu experience. Do you think that a new grad hired right into an er would be qualified in five years. I just graduated and my passion is ER, I'm meeting a lot of... Read More


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    I liked your reply trauma, I agree you MUST have a good orientation and precepter program to survive in an ER as a new grad. I had 3 years experience before I made the jump to ER. My opinion is this: If anything is going to burn you out, it will be working on a busy cardiac unit surrounded by negative people.

    When I went to the ER my whole life changed for the better. The crew I work with is like a second family and are very supportive. I had 12 weeks orientation and great preceptors. But to tell you the truth, I'd bet things here would have been alot harder for me without the med/surg/cardiac and ICU background I had. That has helped me gain confidence and vital assessment skills needed in the ER. You have to learn how to make good judgement calls, and that's something books don't teach you, only experience does. You would only benefit from spending a year on a floor.

    One more thing. If you were having an MI, would you want a new grad with a 2year degree pushing your Retavase?? Just a thought.
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    it's amazing to me that this discussion is still going on! I started this post back in 99, much has changed since. update: i did end up working in a float pool as a new grad at a county hospital (very scarey). it seems they don't really care what your experience is if they are desperate enough. 6 months later i was hired into the er at a different hospital. i feel very safe there, good staffing, resources, it's a team. so i guess it really depends on where you work. I would rather see a new grad in the er with a team backing him/her up than a new grad thrown out on a med/surg floor. it all comes down to safe patient care, what's safe and will you leave the shift with your license? i love me job, i get to be what i want, an er nurse.
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    Good for you Jenny Lynn Im glad you did what you wanted to do....that is what life is all about you cant worry about the negative ppl who feel just because you are a new grad you dont belong or cant fit...............EVERYONE have been a new grad once in their lifetime.......and to Nittlebug.........ID RATHER HAVE A COMPETENT NEW GRAD RN TO PUSH RETAVASE THAN AN EXPERIENCED REGISTERED NUT TO PUSH IT.....food for thought huh? I started in the NICU as a New Grad and I am doing just fine. So go after your hearts desires and dont let anyone deter you from it........
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    I agree with you EXOTIC NURSE. I also started as a new grad (back in May) in a CICU. And I am also doing just fine. Everyone is new at some point and what it takes is being confident...but with confidence comes the ability to admit when you need help, have questions, the willingness to learn and research. I have recieved many compliments from both staff and patients on my care. I have gotten along with patients and their families who experienced nurses haven't been able to deal with. I am not trying to toot my own horn, just trying to say that new grads can make it in speciality areas. When people ask me how long I have been a nurse, I tell them. Their response is that they are surprised and that I appear to have had much more experience as a nurse. And they still ask for me to be their nurse the next day....

    Newness does not mean incompetence. Infact, my unit hired three new grads. We all started at the same time and are all doing great. The unit also hired an experienced nurse who'd worked in the OR, Rehab, and M/S. Guess who was asked to leave before she was even done with orientation. THE EXPERIENCED NURSE!!!!!!!!!! She wasn't cutting it.

    My suggestion for those who really want an ICU or specialty area is to try and get a job while you are in school as a tech in that area. That way you can see if it really is what you want to do and also see first hand the environment as well as begin with some of those skills that you will need. Our techs can start IV's, draw blood, assist to an extent with codes (no meds obviously), put foleys in, put NG's down, etc. We have one girl who is a student currently and you bet she is in my room anytime I am gonna do a procedure, learning. Try and get your BLS and Telemetry down. If you do go for ACLS as well. But I would wait til pretty close to graduation so you have time as a nurse to actually use it. Read about Critical Care...join the AACN.... study and get yourself ready. If it is what you want.... by all means go for it.
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    I know what you mean, but the staff at the ER where I just started in February were great.
    One place actually accepted new grads in the ER because they feel they adjust better to the situations. The big reason is because of the pace of the situations, which some med/surg nurses have trouble converting over to.
    About becoming a flight nurse, you need to look at yourself and where you think you are in your comfort level. Always try to strive and learn more. Put yourself in situations where you will learn. Ask questions, even the doctors, most are willing to teach. But I will warn you some will have an attitude.
    GOOD LUCK in all your endeavors
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    This has been a very interesting discussion to read. I have been interested in the various attitudes about Emergency nurses, etc. I know that there have always been tension between Emergency and ICU nurses but it has been my opinion that this probably is due to the personality of the individuals involved vs. the practice itself. I suspect, these individuals would have a "chip" on their shoulder and present "attitude" no matter which area of nursing they are working in.

    To respond to the original post itself, I am an Emergency/Trauma RN who has worked in two different states as such. My experience in the ER began immediately as a new grad. In fact, I precepted in the ER and was hired from there. I now work to train/precept other new RN's orrienting to the ER and have helped develop programs to encorporate nurses into emergency medicine. My opinion, as one who has "been there, done that, still doing it" is that new grads are a great asset to ER's and have wonderful potential. I would suggest to you, that you pursue working pt. time in another area of medicine during the initial years in the ER, usually done as a shared employee of any hospital you find yourself working in. I did just what I am suggesting you do so I can speak from experience on this subject as well. My background as a new RN included pt. time in the ER with full time hrs. on post surgery and cardiotelemetry unit respectively. The experience you will get working on the floor will enable you to organize, prioritize and understand the concepts behind treatments offered in the ED. A strong ER nurse usually is found after a minimum of 5 years of good ED experience, in my opionion (my ER sees approx. 200 pt./day....very busy).

    I wish those of you who have such negative opinions of ER nurses the opportunity to work with some of these dynamic people in the ED/trauma environment and hope that your ideas with soften. Great nurses come in all types.

    Good luck!
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    I had a question about how you did the floor time while in the er. Did you only work part time in the er and the rest on the floor?

    Thank you very much for the advice. It will help immensely. My educator has also talked to me about getting time on the units, like the ICU, NICU, NCU, PICU etc. So that might help me .

    I am also finding that the more I work the better my organizational skills and prioritzation gets. I think that working in the non monitored part of our er helps when it comes to prioritization, because sometimes we have 4 patients up to five, and they can be sick people, but just no need to be on the monitor...if you know what i mean.

    Well if you have any questions or comments just reply...
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    I have to disagree with the post regarding new grads not working in the ER. While I will say that you do require a certain skillset and maturity for the ER, that does not mean that all new grads should be ruled out. For example, my friend just got hired in the ER, and she is a 38 year old mother with 2 kids, honours student, and a proven work history as a teacher. She can handle it.

    I am also a new grad at 37, with a proven work history, dedication, and the maturity to handle the demands of the job. I also take the initiative to continually learn, and I want to learn. There are younger new grads, who, I'm sure could handle it. I think the ER/ICU should be on a case by case basis. Also, most facilities that hire new grad ER expect you to be mentored in a 6-8 month on-the-job training program on site anyway.
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    Quote from clc19k30
    Hello, I seem to be late in replying to this topic, so please excuse my tardiness. I do not believe that new graduates should work in the ED or any intensive care unit. For one they new grad is not experienced enough in basic nursing care to effectively treat the critically ill patient. Second the pressures that are placed on the nurse in these units leads to burnout and stress induced physical ailments. This is evident by the high turnover rate that is associated with these positions. So how would a newly graduated nurse be prepared to handle this intense amount of pressure? I am not the typical graduate. I have been in the military my whole adult life and I am experienced with high pressure situations. I would not want to start my nursing career in a position where I could lose my intrest in such a wonderful career.
    I disagree, I think it depends on the person. For someone who gets bored easily, needs constant stimulation, and likes the pressure, ER is perfect, new grad or not. I think it is easier to mold/train habits as a fresh nurse vs. someone who went to a different floor/specialty then has to transition. Either way, they will have to learn to adapt to the unpredictable nature of the critical care units.


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