[SeriphumRN2b]

Wow, I am nervous to start in the ED. I had done my preceptor there and felt comfortable, but I think that I didnt have anything too difficult. Any advice on how to begin, how to adjuct from the orientation preceptor to being on one's own? It is an a great excitement, as well as a great nervousness. Any advice would be great! All of you RNs out there reply and help a new grad out! I thank you all for your many experiences that you will share. Thanks.

[TazziRN]

Don't be afraid to ask questions still, that's the biggest thing. Ask for help if you're not sure about something. And learn, learn, learn! Before you know it you will be a seasoned ER nurse and will identify with the Rules of the ER!

[traumaRUs]

Agree totally with Tazzi - ask questions, if there is something interesting going on - take a peak. Again, ask questions!

[EDValerieRN]

-Wipe a rear end the first day, on someone else's patient (with their help of course). You'll automatically get big points with all the staff because you don't run and hide when they need help.
It'll also make everyone much more inclined to help you, which will come in handy when a sickie comes along.
-Rely on your instincts. Just because you are new doesn't mean you shouldn't trust your own judgement.
-Think! Don't let the people around you fluster you... you don't want a med error.
-Have a good time! I sure am!

[mmutk]

Don't be afraid to ask for help when you need it.

Ohh and don't trust the psych patient's always keep
one eye in the back of your head...

[Larry77]

Don't be afraid to clean rooms and restock supplies, the techs will appreciate this and you want them on your side because they can make your life difficult.

Always have an open to learn type of mindset, nobody likes a newbie that thinks they "know it all".

If you have any down time look in every corner, cupboard, and room, so you become familier with where supplies are.

Get yourself an emergency nursing pocket guide, will be very handy when giving meds and doing procedures you are not really familier with.

Good luck and have fun!

[jojotoo]

The most important thing that you can learn is to PRIORITIZE. Sick people come to the ER, but not everybody that comes to the ER is sick. Each task does not not have equal weight. Sometimes equal tasks do not have equal weight. For example, getting a sandwich or a meal tray to a drunk that has been sleeping it off all night has a low priority. Getting that same sandwich / meal tray to a hypoglycemic diabetic that just had an amp of D50 by paramedics has a much higher priority.

Also, pay attention to your patient first, the monitors second. Be "hands on" with your patients - are they cool to touch, diaphoretic, trembling?

Work on your IV skills. Your patients and peers both will be appreciative. And I'm not talking about starting a 22g in the hand. Always be thinking - will I have to resuscitate this patient? Will I have to push code drugs? Will I have to give something potentially painful - KCL, Dilantin? Will Radiology have to use this IV for high flow contrast? So don't be afraid to start those 18g AC lines!

And finally, find yourself a good resource person. This may be your charge RN, but then again, it may not be. Don't be afraid to ask questions. I probably answer 99 "dumb" questions for evey really good one that I get. I only start to get annoyed when it's the same nurse repeatedly asking me the same "dumb" questions over and over again (and I don't mean twice).

Be Brave! Be Bold! Being an ER RN is not for the faint-hearted.

And remember, a big part of our job is to set limits for those who cannot set their own. (Usually patients, but sometimes staff also)

Good Luck!!