[NewEDNurse]

I am a new nurse in the ED, Although I have been a RN for many years in many different departments ED nursing is brand new to me. The staff in the ED are excellant nurses: provide excellant care to the patient, able to do many things at one time and of course to prioritorize. The thing that really surprises me is the lack of support: emotional, psychological and physical that is provided to new nurses. Many of the nurses are the first ones to tell you what you did not do instead of assisting the new nurse to complete these tasks. I have never worked in a department that has so many people that are not willing to show some compassion and support for the new nurse. Instead they want to know why it did not get done. Is this common practice in ALL ED?? Or is this my own feeling of inadequacy making me feel this way?? I have always considered myself an excellant nurse till I started working in the ED. Now I am starting to question myself. Is this what they call eating your own??? Please give me some support and advise!!!

[NurseyK]

The ER is one of the few units in a hospital that attracts "strong" personalities (to put it politely). It is not uncommon for the nurses in my ER/Trauma Unit to hear from the floors: 'Brooms aren't just for sweeping anymore' -- unkind yes, but not so untrue. We are the first line of defense in the battle to save a life and, consequently, take our jobs very seriously. (Not to say we don't have senses of humor, sympathy and compassion for our patients.)
Yes, I remember being new...we all were. Fortunately, at that time, our unit was adequately staffed and I, for example, was given a 3 month *intense* orientation (yes, including written exams) with a phenominal 20yr+ experienced ER nurse. Now, in the days of the great "bottom line" where the almighty dollar rules with an iron fist and the threat of a lawsuit comes along with every chart your name is on, orientation time is less...and we expect more from you (yes, a Catch 22 and NOT your fault). The ER - a normally closed unit for experienced nurses only - has flung open its doors to the first warm body with a pulse out there. Of the 6 nurses we currently hired, only 1 is going to make it. Only 1 cares enough about the job to take the classes, stick her nose in people's work and say "what's that?" "what are you doing?" "Teach me", and have STRONG assessment skills and strong BASIC nursing skills (of which the other 5 sorely lack).
Part of all this is in the attitude. The 5 not going to make it are more interested in taking breaks than dealing with the rapid Afib-er and the symptomatic total heart block (that nurse went to "organize the tape drawer" feeling somehow that was more important).
Sorry to be so long-winded, I hope any of this helps. Keep in mind we are just as frustrated as you are -- the system stinks. Keep up a good attitude, read your ER policies inside and out, take your classes (Dysrhythmia, Basic Critical Care, ACLS, PALS, NALS, TNCC, ENPC), and study ER books at home just like you were taking a college class (excellent ones are Sheehy's Emergency Nursing Principles and Practice, and Emergency Nursing Core Curriculum -- you can order both from ENA). Also, see if you can find a nurse on your shift with experience who's willing to let you "pick their brain" when you need it.
I hope some of this helps, feel free to e-mail me -- good luck to you in the future.

Kat

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The grass isn't greener on the other side -- it's just different grass

Agree with NurseyK 100%. The environment itself turns you into a broomstick rider..You have to deal with residents (I hate July) with Trauma Surgeons,worse yet, Fellows, "Oh, excuse me for not giving up me seat to you" You have people who are ****** off because they've waited 4 hours to be seen for their hangnail, the woman brought in by rescue who doesn't even have a line and is blue (Oh, we were just down the street). The floor who won't take report for the 3rd time on an MI pt. who's been there overnight, and the triage nurse has informed you that the patient she just triaged, set himself on fire the last time he came to the ER...and by the way...what is that smell?? Put that man's shoes on...so hang in there, it's gets better if you tough it out and depending on where you are, can be the best learning experience around.