[Neferet]

I think ICU is too boring…too much intense FOCUSed….it’s just not me……I don’t know…I enjoyed tele though….I love tele but the tele floor at the hospital that I was once at was a mistake waiting to happen….everyday I’d walk into to take reports and find that every morning I check meds…there’s always mistakes…somehow every nurse before me has not cross out dc’d meds from one-two days before….they were still being given…..it just throws me into a panic…because they’re heart patients….poor me….I felt so sorry for myself because it was difficult trying to learn new meds, and time management…and there I was….wasting time every morning fumbling through all the old physician’s orders to see when the meds were actually dc’d…..that was me every single morning….it just drove me crazy! I’d find dc’d orders that was crossed off as “dc’d”…but in the mar they’d still be there…and most times were still being given last shift….arrgggg! yep…I couldn’t deal with that. Too bad I really liked that place.

Other hospitals are too far…and I don’t know if I want to go that far.

Carachel2…..I know, nurses don’t really do that in ER…but I kind of like that kind of “skilled” environment…. I know that some emergency nurses out in the middle of nowhere do it sometimes. And they’ve had some kind of emergency training. I just kind of like the way the ER nurses know what to do when someone codes or something. They’ve faced it so much that it has actually become good skill.

Emtb2rn………yeah, I don’t think I’ll be flying on my own…but some RNs in the ER do expect you to know everything….even though you’re new.
What I meant by an emergency sending me into the books thing was that I get excited when learning how to deal with emergencies (people bleeding, coding, unable to breath, snake bites, anything that causes the nurse to act fast)…….so that I’d be prepared when it comes…….all the other things I do…but it doesn’t excite me….

MLOS….lol…I’m an liscensed RN new grad.
[Lack of confidence is pretty common for brand-new nurses. My preceptors routinely told me it would take a year to feel competent and another 1-2 to feel confident.]
Yeah…tell that to the preceptor that I’ve had.

[Not sure I understand this at all. You're saying you want to work in an ER environment but an *emergency* sends you ... to your books, and not to your patient?]
No, no…what I meant is that it actually makes me excited and want to be prepared for it….I want to be able to know what to do in case of an emergency…not going to my books in a middle of an emergency…that’ll be a disaster.

["Surgery" in the ER is limited to suturing (which you will not be doing as a nurse), chest tube insertion, and, in my experience in a Level I trauma center, very, very occasional thoracotomies and chrics. There are things you'll do to assist with these procedures, but you will not do them yourself.]
Yeah I know….but I can at least see some of the exciting stuff.

[I think confidence is gained from providing great care to the best of your (gradually increasing) ability day in and day out, more so than the occasional moments of "glory."]
This is so true. I feel that if I want to be an emergency nurse in some third world country or serving victims in a mass casualty or something, I at least should do some ER nursing to prepare for it.

[My suggestion: try to set up a shadowing experience with an ER nurse. Think through specifically why you think you are better suited to the ER than a med-surg unit.]
Uhmmm….I’ve been on med/surg for two semester of clinical, and FORCED myself to do a third clinical rotation there because I knew I hated it, but needed the skills. I don’t know what drives me crazy about it….I just HATED it. Not really hating the care of the patients, but just everything else that goes with the environment….most of the time I feel like a robot just filling out paper work instead of being with my patients. Medsurg is soo stressful….no, not really because of the care…something in the environment is just not healthy….one thing that gets me the most is co-workers who are unwilling to help eachother…..
I’d rather work in a real stressful, busy place and be supported by co-workers and know that my team has my back and know that they know what they’re doing…….than be in medsurg with 5+ patients and know that I am alone. I’ve been there three semesters…and I think it almost ruined my career.

Shadowing is a great idea.

GilaRN…..

[As far as lack of self esteem, I cannot help you on that one. You need to take a look inside and find out what keeps holding you back. Just like many others posted, you will need a couple of years of nursing experience before you start to put it all together.]
You’re right…med/surg has left scars….I was a young and I got eaten….

Jjjoy….thanks for your post, you know exactly what I’ve been through..

[Then. boom, you graduate, and are confronted with being responsible for everything: several patients with competing needs, rushed MDs, a ton of paperwork, etc. The newbie can see that the experienced nurses are barely getting everything done, though they're not even sure what 'everything' is. So the newbie is trying to figure out all that, AND also has to juggle competing patient needs and yet doesn't yet have the experience to really be able to recognize how to prioritize.]

Exactly!

TrudyRn…..[You have an understandable fear of rudeness from teachers/mentors but the ER pace requires more of a tougher skin, I think.]
Uhhh…that’s because my worst nightmare of the hospital had come true…working with nurses that don’t just eat their young…they swallow them whole…
I don’t blame myself, because they were rude and fearful. But you’re right when you say the ER requires more tougher skin….
[Maybe you're just not quite strong enough mentally/emotionally to deal with that right now and would be better off in a slower-paced setting, where people are more likely to take time to teach you slowly, courteously.]
Yeah, true……I just wish they’d do that in ER too, so that I can at least have a chance to see if I it’s really my nitch.


Jjjoy…..
[What setting is that? I must ask because the low-acuity settings tend to give more patients to the nurses (eg 30 patients in LTC) and thus the pace isn't really any slower and the nurses aren't any more likely to have the time, patience or inclination to teach slowly and courteously. When a newbie is having trouble adjusting, the advice is often to find something "slower." Perhaps when people say that they really mean "less acute" because passing med to 30 patients, each of whom have many meds, may have dementia, can't swallow well, etc, in two hours, charting on those patients, checking notes, and running yet another med pass is NOT slow.]

Yep, I agree….less acuity places sometimes mean death….even in medsurg they expected me to know everything. One thing I hate is when I ask a question and my preceptor is unable to tell me what the answer is. It’s not really their fault because maybe they weren’t train well either….But I need to know what I should know…

Most of the things that screwed with my time management were not even medical related….they were just things like: how do you work this stupid machine, where are all the VS carts?, how the heck should I know how to program the blood glucose machine without being taught or given the secret code needed?, how am I suppose to give 2O po meds to a patient without overloading him with water? Cuz he/she can only swallow a pill at a time with a cup of water…..and still I have to worry about my other 4 patients and possibly the LVN’s patients too…..and some patients are missing meds that are not up from pharmacy yet….and then I have to be away from my patients to chart on them 5+ patients….and there are still new orders coming in….and I have to check the charts again because we’re suppose to check or write something within a period of time…… blah blah blah I know that nurses on medsurg have to spend more time on these other things than direct patient contact…..….I hate that medsurg life....it may be a good place for others, but not for me…



I can’t believe I paid so much money in nursing school…..thanks for all your comments...they really helped....

[Altra]

Originally Posted by Neferet

Most of the things that screwed with my time management were not even medical related….they were just things like: how do you work this stupid machine, where are all the VS carts?, how the heck should I know how to program the blood glucose machine without being taught or given the secret code needed?, how am I suppose to give 2O po meds to a patient without overloading him with water? Cuz he/she can only swallow a pill at a time with a cup of water…..and still I have to worry about my other 4 patients and possibly the LVN’s patients too…..and some patients are missing meds that are not up from pharmacy yet….and then I have to be away from my patients to chart on them 5+ patients….and there are still new orders coming in….and I have to check the charts again because we’re suppose to check or write something within a period of time…… blah blah blah I know that nurses on medsurg have to spend more time on these other things than direct patient contact…..….I hate that medsurg life....it may be a good place for others, but not for me…

I can’t believe I paid so much money in nursing school…..thanks for all your comments...they really helped....

I hate to tell ya, but these same things will screw with your time management in the ER too.

And frankly, if you're going to make yourself scarce when it's time to take care of the endless stream of med-surg patients who come through the ER, and only show up for the good stuff, you will be labeled a "princess" in 5 minutes by your coworkers (regardless whether you are male or female). This does not make for good karma.

You have some thinking to do before you accept a position anywhere.

[MAISY, RN-ER]

After reading your post the first thing I thought is -are you always so scattered? I am not sure how old you are, but you have an awful lot of opinions that you have expressed during your short posting. My suggestion to you would be to pursue ER nursing only if you can listen openly, accept criticism and learn from it, keep your past knowledge how things should be done to yourself, and keep a stiff upper lip! ER nurses should and do back each other up. No one likes a know it all, no one wants to hear about your past likes or dislikes(especially during orientation), or how you would handle a situation(especially if it's only something you have heard about and not experienced). I was a new grad in the ER, and have seen many pass through. The successful ones observe and learn many different styles of nursing from the many people precepting. There is no one way to do anything, and every nurse has a reason why they perform the same task many different ways on their very different patients. It is up to you to glean the best of their skills and add them to your skill sets.
I would also suggest that your enthusiasm could work to your advantage, but I would carefully consider what I would say at a job interview. As someone who has hired many people-if your interview style was to say all you wrote-I would run the otherway as a manager. I would confine it to you wanting to convert your current skills to emergent care and why you would be a good fit. Good luck whatever you decide.

Also, to nursing students reading post-if ER is what you think you want. Become a ER medical technician during school time-see what it is all about-you cant possibly know until you are there or have provided emt services. Good luck to all.
Maisy

[Neferet]

Originally Posted by MLOS

I hate to tell ya, but these same things will screw with your time management in the ER too.

And frankly, if you're going to make yourself scarce when it's time to take care of the endless stream of med-surg patients who come through the ER, and only show up for the good stuff, you will be labeled a "princess" in 5 minutes by your coworkers (regardless whether you are male or female). This does not make for good karma.

You have some thinking to do before you accept a position anywhere.

Sorry, you got the wrong idea....I'm definitely not a
"princess." I find that I'm those nurses who slave over
their patients and I do it because I love them and care for them.
And it does make me feel good to do things for them.
Med/surg just isn't for me.

Originally Posted by MAISY, RN-ER

After reading your post the first thing I
thought is -are you always so scattered? I am not sure how old you are,
but you have an awful lot of opinions that you have expressed during
your short posting. My suggestion to you would be to pursue ER nursing only if you can listen openly, accept criticism and learn from it, keep your past knowledge how things should be done to yourself, and keep a stiff upper lip! ER nurses should and do back each other up. No one likes a know it all, no one wants to hear about your past likes or dislikes(especially during orientation), or how you would handle a situation(especially if it's only something you have heard about and not experienced). I was a new grad in the ER, and have seen many pass through. The successful ones observe and learn many different styles of nursing from the many people precepting. There is no one way to do anything, and every nurse has a reason why they perform the same task many different ways on their very different patients. It is up to you to glean the best of their skills and add them to your skill sets.
I would also suggest that your enthusiasm could work to your advantage, but I would carefully consider what I would say at a job interview. As someone who has hired many people-if your interview style was to say all you wrote-I would run the otherway as a manager. I would confine it to you wanting to convert your current skills to emergent care and why you would be a good fit. Good luck whatever you decide.

Also, to nursing students reading post-if ER is what you think you want. Become a ER medical technician during school time-see what it is all about-you cant possibly know until you are there or have provided emt services. Good luck to all.
Maisy

Your post seemed rude to me. Ummm....why would
I tell all this to my interviewers? I'm just
letting everything out so those who know about ER or have advice
can give it.

[are you always so scattered? I am not sure how old you are,
but you have an awful lot of opinions that you have expressed during
your short posting.]

Ummm..thanks for making me feel like bird-brain....that was exactly what I've come here for!
I'm not a child if that's what you think....
I said above I'm done with school and have taken the boards....

[keep your past knowledge how things should be done to yourself]
--wow, I guess ER nurses do not have their own outspoken opinions...

I don't know what more to say...I've already said it.

[Neferet]

Don't quote if you're just here to put me down, in order to exalt yourself.....

[Altra]

You asked for input, Neferet, and you've received some. You labeled your thread "Interested in ER but not quite ER material." Making a statement and waiting for someone to refute it does indeed demonstrate a lack of self-esteem, I agree with you there. It's also passive-aggressive.

Good luck to you in your job search.

[MAISY, RN-ER]

I re-read your posting, I stand by my post. To be a nurse anywhere you must have a backbone to deal with doctors, fellow nurses and difficult patients. You must also have the knowledge to back you and your fellow nurses up. I saw a post suggesting counseling, perhaps you liked that response better....reading your post brings several nurses I've worked with to mind. They did not make it in the ER after school and some were not even considered due to the type of interview they gave. Several have already been employed by a couple of different hospitals.
In addition, you did ask our opinions. Mine was given.
Maisy Good Luck to you.

[WDWpixieRN]

Originally Posted by MAISY, RN-ER

Also, to nursing students reading post-if ER is what you think you want. Become a ER medical technician during school time-see what it is all about-you cant possibly know until you are there or have provided emt services.

I am still a student, but I would definitely agree with this suggestion for those considering ER.

I was sure that ER would be my ultimate destination once I graduated, but I have taken a position in a hospital and after working there over the summer, have some doubts that it's "perfect" for me.

I do love the turnover, the interesting patients, the differentness of some days. I love seeing the (majority) staff work together well and without complaint.

BUT -- it's very sobering work sometimes (we're not even Level 1); the RNs are somewhat discouraging about new grads there, while the management is very ENcouraging (so, while Administration wants me there, am I going to get a good, thorough and enthusiastic training as a new grad? ). I find myself sometimes disenchanted by the negativity among the nurses who demean many of the patients for their complaints, sometimes to find out they're wrong. I'm not being ignorant; I know there's a lot of whiners and drug-seekers and people who should be seeing their PCP for a lot of complaints. But when a guy comes in complaining of chest and shoulder pain he's had for several days, and who appears to be in good shape and is fairly young, I hate to see them complaining about him like he's dumb schmuck for being there only to find out he's actually having a heart attack!!

Anyway, that's all a bit off-topic....but I definitely think seeing it from the inside would be advisable to someone considering ER work. It's not all like "Trauma, Life in the ER", lol. I haven't ruled it out entirely, but I'm not yet sure that it's the be-all and end-all for me just yet. But I've got a couple more semesters to figure that out!!

[MAISY, RN-ER]

Dear wdwpixie,

Good for you...try on as many hat as possible while still in school. I know it's hard when you are drilled that pain is 5th vital sign, and you see nurses talking about frequent flyers in the ER. I have struggled with that myself...but pain is what the patient says it is-if a patient is taking 2mg of dilaudid or 4mg of morphine without change in vitals-either they are an addict or with pain mgmt. Pain mgmt patients will usually have a doc who will write for pain control. An ER doc will never write enough pain control for these individuals. Addicts will be back, even asking when certain docs are working. Recently, we went to PO dilaudid and many of these people have gone away.
Orientation should be at least 16 weeks, mine was 20 weeks. If not, I am not sure I would take a job in ER as new grad. Either way, nothing is like a tv program, and while some days are exciting, other days you are begging the charge nurse not to give you a specific patient (frequent flyer pain in the neck). Good luck to you in your studies and in your career.
Maisy

[RNperdiem]

It sounds to me like you are looking for the nearest med-surg escape route. Do you really like ER, or do you really hate med-surg? If you really want to escape from med surg, then you have more options available.
Skills, confidence and nursing judgement are earned. They specifically are earned through hands on experience.
Keep in mind that the first year of nursing is tough emotionally.