[RNcDreams]

Hello!

I just made a post on the First Year in Nursing board about some anxieties I'm having lately.

I have a question specifically for you seasoned Emergency folks.


In July, I will have hit the 1 year mark. I'm in a community ED, which has recently been SWAMPED, with pretty sick folks. I'm learning a lot....I'm still terrified of everything I don't know, but I'm diligent and ask for questions and supervision when I feel doubt.


At my one year evaluation, I will have the opportunity to voice my desire for a 36 hr position. If I am able to obtain this, I'd like to try and get a per diem job elsewhere....

My question is this:

Would I be better of trying to get a per diem job in Tele, so as to solidify my skills (like giving daily meds like coumadin, etc., getting better at reading tele, doing more thorough assessments, etc) or would I be better off trying to get a per diem job at a Level 3 trauma center, to get better with that?

I really don't know what to do next, but I want to make a move that will make me even better and safer at my job.

Thoughts?

Also, for those of you who are 20 years in and who STARTED in Emergency, looking back-- what would you have done differently? When did you feel solid in your skills? When did you stop feeling sick about everything you didn't know?

SHARE!

[Dixielee]

Why do you feel that you need a per diem job in another area? It seems to me that you could get all of what you are looking for in the ER. If you are still feeling uncomfortable there, then you probably need to stay there and work on your skills. You can get all the tele you want in an ER. Unless you think you want to work on a floor, you don't need "experience" giving meds. You give a wide variety of meds in the ER. Keep your drug book or PDA closeby and look up everything.

Davis Drug guide on my PDA gives me a lot of info that other programs don't, particularly nursing implications.

As far as a 36 hour position, I think they are the best anyway, it gives you more flexibility to have a life outside of nursing, so if that is an option, I would take it regardless of what else you decide.

If you have only been an RN and in the ER only a year, you should still feel uneasy! If you said you had it down pat and are looking for something more challenging, I would have some big questions about you. I started as a new grad in ICU, and moved to ER a few years later. I have blended the ER/ICU over the years, sometimes working per diem in one while week ends or PT in the other.

Generally, I would not recommend any new grad starting in a specialty area, but orientations and internships are better now than when I graduated, so it does work out well for some.

I have had most of my RN experience in ER/ICU, but have thrown in a bit of PACU, dialysis and home health. There are endless possibilities, so give yourself time to get good and comfortable where you are before you start taking on more.

If you talk to 100 ER nurses, I would expect you would get 100 responses that say we ALL feel uncomfortable from time to time. There are always new things to learn, new equipment, new meds, new procedures, classes to take, certifications to obtain and maintain. None of us know it all, you just build on what you already know and solidify it.

Good luck, give yourself time and don't worry about not knowing it all. If I could just remember all the stuff I have forgotten, I would consider myself a genious!

[northshore08]

Originally Posted by RNcDreams

At my one year evaluation, I will have the opportunity to voice my desire for a 36 hr position. If I am able to obtain this, I'd like to try and get a per diem job elsewhere....When did you stop feeling sick about everything you didn't know? SHARE!

Honey, I still feel sick when I miss something; it makes meget the book out or get online. Or I grill the docs again.

I vote for staying in your facility and getting hours there if you can; you would get a chance to meet others in your hospital (contacts are always nice) or if you are determined to seek other emloyment, I would go agency and try out different fields. You would begin to appreciate where your fulltime job is, or maybe to find the other one that you like better (not now, of course.)

[carebearRN08]

I'm not experienced or in the ER, lol, but just my is that you shouldn't go PD right now anywhere else because you don't want to burn yourself out too easy. You didn't mention if you work days or nights, but I can say that 12 hour nights will wear you out and you need some time off to yourself!!! I know you want to be good at your job, I do too, and overtime money is tempting, but don't lose your sanity in the process. Take care

[gonzo1]

I've been 4 years in the ER now. Still uncomfortable sometimes. I work with a lot of older, experienced RNs and they still tell me they get scared and worry sometimes.
It is the ones that say they know it all that I worry about.
You would be hard pressed to find an area where you will see more and do more than your ER.
I would just work there and focus on learning as much as you can.
It is also about the only area where you have complete and total access to your docs for any questions or concerns you have.
It is a great learning experience

[TraumaNurseRN]

"Would I be better of trying to get a per diem job in Tele, so as to solidify my skills (like giving daily meds like coumadin, etc., getting better at reading tele, doing more thorough assessments, etc) or would I be better off trying to get a per diem job at a Level 3 trauma center, to get better with that?"

Perhaps your advanced certifications would help you feel more confident in the ED. (acls,pals,TNCC, CEN)....Also, ask your supervisor about possibly working a different shift now and again or even extra within the unit. It can sometimes be a whole different tiger depending on what shift you work and how many nurses are staffed at any given time.