[mattsmom81]

SuperCen, I had to laugh at your 'orientation' (or should I say lack of).

Sounds like 99.9% of mine too....'trial by fire' orientations!

"Yer on yer own, kid...we had 2 nurses call in...no time to orient"

Luckily I did OK...gotta thank my good ol' Diploma school for giving me the tools to succeed.

[rnetd]

I have been an exception to others account about new grads in the ER, I have been a Mobile Intensive Care Paramedic for 9 years, and still am, My training has extended me more of an insight to the specialty of Er nursing. During this crisis that nursing faces I dont think that we should be questioning new grads in an ER or any critical care enviorment,even Med surg faces the shortage. Have I taken care of 9-12 critical patients at once ? Yes I have, the reason is we have no new blood coming into the doors of these institutions, I have always said to myself that its a good day when none of my patients dies. That New Grad thing I believe must encompase the whole person and his/her ability to cope with the constantly changing enviornment of the Er. I always heard that you must get the med/surg done but I say that Med/Surg is a specialty unto itself as are other units. I have been trained in Critical Care and CCU courses by my institution as well as triage,Trauma, etc.

[Jean Roberson]

I agree that new grads should be considered for the eD on an individual basis, but as Manager of Nursing Education in my last job, I saw it work successfully. I believe the key was that individuals were hired as ED Techs while they were in school. This gave them 1-2 years to acclimate to the ED envoronment, and give staff a chance to know them. Personality is very important in this setting--must be self-directed, flexible, quick-thinking, adaptable. People who must think things out carefully, look up the policy (although I support this!) before doing anything will not work.
If they fit in as a Tech, by the time they graduate, they usually work out as an RN.

[Babs8171]

As a preceptor, I would rather have a new grad. and 3 months
to teach them, than to get a Nurse from a Med/Surg. floor with
one year nursing exp. and 4weeks to teach them.

[Nurse Ratched]

I would have been petrified to start in the ED fresh out of school, but that's me. I started on an Onc unit that got lots of Medsurg overflow. Now work med-psych and love it. Still have no desire to work ED, but I think those who have the love of the fast-paced right out of school should be considered case-by-case. Some preceptors would probably rather have a newbie that they could mold rather than a nurse who thinks she/he knows it all (whether or not they actually do!

[TaraER-RN]

A year ago i graduated from nursing school and was hired into an ED that I had been precepting at along with 6 other people. We got a total of about 3 months orientation along with a 9 week (once a week) ER course that teached us how to focus assessments. I did get tons of support...even from those that didn't want us "newbies" in their department. It definitely is on a case by case basis of who will make it in the ER, but you know what, I think it has NOTHING to do with being a new grad, it has to do with the person. I was actually admantly against working on med/surg first. I've taken patients up to the floor and realized I would never want to work there...I learned in my nursing school many of the same skills that I think I would have learned on a med/surg unit not all, but most. my skills and assessments in the ER have really helped me to focus on whats wrong with a patient at that time. I don;t have to worry (most of the time) about whether a patient has a had a BM or has peed for me that shift (unless they are a renal patient, etc) and I'm grateful for that. I respect Med/surg nurses, because its area I never wanted to be in...I am 100% grateful that I had the opportunity to start in a specialized area. And I do agree that CCU experience would really help me in the ER, and I eventually plan to move to that type of a unit, but yet if I had started in ICU then they would have said that I really should have had experience in another area first. Its a cycle. Some people around me don't think new grads should be there because they weren't allowed to go ito specialty areas when they graduated, and some have admitted they are jealous (and others won't admit to that)....its definitely the person that means whether they can cut it or not...and the support or training is what keeps them from killing a patient, not neccessarily the experience.

[flaerman]

I began my nursing career in Jan 1986 and started out on a tele unit before we became a med/surg unit. At that time new grads rarely got anything other than the floor and that was fine, I learned a lot. My career has spanned 3 states and 16 years, with almost the last 5 of which in the ER. I am a preceptor and night charge nurse on my unit and have precepted new staff in the ER. With the current nursing shortage and unable to recruit experienced staff we have decided "growing our own " is the logical way to help with the staffing shortage. New grads are fresh and knowledgable, eager to learn and succeed, and can become become productive staff members with proper mentoring and support. In a perfect world a little floor experience is good as well, but so is hands on. Not everyone is cut out to do well in the ER environment and they should be re-directed to other areas for the good of themsleves and our patients. The ones who are cut out for ER can and will do well. It takes a little time and work/support, but in the long run it can work out. No one is born a nurse and we all to learn ourselves. So remember what it was like when you started, mentor and support these new grads. They are the future of nursing.-----Paul

[MollyMo]

I don't think new grads should go straight to ER, but I don't think Med/Surg experience first is the answer either. Critical Care would be a better option for a while, then go to ER.

[alansmith52]

there is a shortage. new grads should be trained to work everywhere. sometimes a new grad is looking to work in a certain dept, and if your hosp won't hire them belive me another will. and I am not a new grad Iam an ICU nurse and we are taking new grads as well. times are diffrent. get a grip.
matt.