[rn2ps]

I am going to be graduating from an ADN program in a week and as soon as I can after graduation I will take my boards. I was looking at being an ER nurse but was told by several people that getting ICU experience first would be a good idea. I am going to be taking the RN-BSN program starting next summer (2008). I was also looking for a RN-PS program in Iowa (if anyone knows of any good programs in Iowa, please let me know).

I have been running on a private ambulance service as an EMT-Basic for about 2.5 years and have worked as a CNA for almost 6 years doing orthopedics (4.5 years) and telemetry (about 1.5 years and I read the telemetry monitors as well). Just looking to see what people's views are for my plans and for any advice.

[rachelaleanRN2B]

If you want to be an ER nurse then do that. ICU experience is probaly not going to make a huge difference, if anything Med-Surg would but that is not necessary either, you will have training and orientation to the ER. I was an er nurse for 2.5 years at a level one trauma center straight out of nursing school. By the time I hit the floor I had ACLS, PALS, and TNCC. Believe me, er nurses and icu nurses think different hence the common feud between the two at most (not all) hospitals. Good luck!!

[Dakkon76]

We've got a guy in our class who has been an EMT for a few years and ED is doing all they can to recruit him. If you're comfortable starting in the ED, then I don't see why you shouldn't. Just make sure you start somewhere that offers a great education program. I was at the NSNA conference in Anaheim and went to the Emergency Nursing Association conference. The guest speaker stressed education and asking questions about the unit. She said if anywhere offers anything less than 16 weeks, run for the hills.

/dak

[Sherwood]

Originally Posted by rachelaleanRN2B

If you want to be an ER nurse then do that. ICU experience is probaly not going to make a huge difference, if anything Med-Surg would but that is not necessary either, you will have training and orientation to the ER. I was an er nurse for 2.5 years at a level one trauma center straight out of nursing school. By the time I hit the floor I had ACLS, PALS, and TNCC. Believe me, er nurses and icu nurses think different hence the common feud between the two at most (not all) hospitals. Good luck!!

If ER is where you really want to be then by all means go to ER. If you think ICU/CCU might also be in the cards then start in ICU.
I am an ICU/CCU Nurse and a Trauma Clinician so I get to spend time in both worlds. ER and Critical-Care in a busy large hospital hospital can be high pressure and high stress. I have a lot of respect for ER Nurses, my home is the Critical-Care unit. Most ER Nurses will admit that the ICU can be overwhelming as our patients can be hooked up to all the bells and whistles........IABP, ICP/Ventriculostomy drains, LICOX and a dozen ivp pumps with something dripping into each one. The ER tends to be fast paced with the stabilize and move 'em out idea but remember they get everything thats hits the door as is and they are good at dealing with it, buffering things before it hits the ICU/CCU.
One thing I noticed is that I see ICU Nurses can go help out in ER for just about anything except OB patients. ER Nurses tend to balk at "floating" to Critical-Care. Experienced Nurses from both units can run a code blindfolded. There is always a doctor in the ER to run something by, this might not be true in Critical-Care and you have to rely on your critical thinking skills or make that call at 03:30 to Dr. Grumpybutt.

[bronzegoddess]

As a beginning nurse, you should start wherever you are interested. There is no correct place to "start" as a nurse to get experience, with the nursing shortage these days--you just gotta jump in and go. Just remember that you are a new nurse, and you should act as such. New grads that act like they been a nurse for 20 years and no it all just aren't welcomed anywhere! Good luck!

[Sherwood]

Originally Posted by bronzegoddess

As a beginning nurse, you should start wherever you are interested. There is no correct place to "start" as a nurse to get experience, with the nursing shortage these days--you just gotta jump in and go. Just remember that you are a new nurse, and you should act as such. New grads that act like they been a nurse for 20 years and no it all just aren't welcomed anywhere! Good luck!

Good point! While being a nurses aid, LVN, Lab assistant or EMT does provide a great background, experience is what gives you the ablity to note that subtle change in your patients condition that can make all the difference in his or her outcome. Critical thinking skills gained through time and practice make all the difference. There are a lot of booksmart nurses and doctors out there who can talk the talk but cannot walk the walk.

[neneRN]

ICU patients are held for up to 24 hours in the ER at times (at the hospital where I'm at)..it would be very helpful to have ICU experience for those pts as we are doing invasive hemodynamic monitoring and following ICU protocols/standing orders for these pts in the ER. Many of the ER nurses aren't comfortable/don't have experience caring for these pts and have a hard time with it. But that said, I've been in ER since right out of school and I learned these things while in the ER...and I now teach the newer ER nurses to care for these pts- my ER doesn't have any formal orientation or training for these pts. So it would be a question to ask for the ER you're interested in- whether they frequently hold ICU pts and what kind of training you'll get for those pts. Otherwise, if you know you want ER and holding these pts isn't an issue where you're at, then go straight to ER.

[rn2ps]

Thanks for the advice/information!