[ParrotHeadRN]

So now I'm in my third week of ED orientation, back to nights FINALLY. The people I work with are wonderful and for the most part, so are the patients.

But here's my dilemma. I don't feel like I am really using my nursing skills. I feel like I am just an aide for the physician. Setting up suture trays, preparing equipment for pelvic exams, transporting pts to and from tests, etc. I don't know if it's because the physician is always there, and I'm used to being the one in charge. The critical care unit I came from encouraged nurses to be VERY autonomous. I don't feel like that now. Is it because I don't have enough experience yet?

Please, please, PLEASE don't misunderstand me. ER nurses ROCK and they work hard. Last night was BRUTAL. We were all on our feet for 10 hours straight. The night before, we had FOUR pt's all night! That was brutal too, in it's own way. I completely respect ED nurses and what they do. It's something I NEVER thought I would be doing, because I was afraid of it. I don't know if it's just SO different from what I am used to that it will take a little while or what, I just know I feel a little restless.

Will that change over time?

PH

[gonzo1]

It must be a huge change for you, and it will take some adjusting. It is very different from floor nursing but I think you just haven't been doing ER long enough to understand the nurses role or you wouldn't say we are aides. I use my invaluable assessment skills every minute I am there. And perhaps that is the most important thing a nurse can do. You must recognize immediately whether this pt is critical and needs 1:1 care and a visit from the doc immediately, or whether they can wait for a while. You need to decide right away if this is a stroke or a muscular problem, if its a heart attack or heart burn. and on and on. Give it some more time. I think you will begin to see that although the job is different you are still very much a hard working, hard thinking nurse with an important job.

[bill4745]

If there is one place that nurses must think on their own, it is the ER! Give it time and give yourself credit. It is the hardest place on a hospital to work but also potentially the most rewarding.

[rnmagnum05]

Welcome to the ranks, we're so glad to have those with your experience with us. As others have said, give it time. Use your skills and share your assessments with your physicians. I find my practice rewarding because I know my doctors trust my skills and expect me to use them to keep them up with the patients' needs. I work in a 24 bed facility, with 1 or 2 MD's on board. They rely on a nurse who can correctly assess and anticipate, who can take care of the small stuff while keeping them up with the big stuff. We have order sets that we devised with our doctors that allow us to drive our time more effectively, while helping stave off the patient frustration of "the long waits." We're always moving forward instead of stagnating.

Knowledge and trust make for a true collaborative relationship. Good luck and welcome.

[ParrotHeadRN]

Thank you all for the words of encouragement and support. I know it will take some time to transition. And I really didn't mean that all ED nurses are "physician's aides," I just meant I felt that way.

I go back Thursday after a good stretch off, so I plan to be rejuvenated.

Hope you all had a great Thanksgiving!

PH

[JBudd]

I know we do a lot of "aide" work, but my techs run around a lot too; if we didn't work as a team it would never all get done. Could be that on orientation you're still getting the routine stuff and concrete tasks, once you get into the routine you'll likely have a chance to start using all the rest of your knowledge and skills.

Welcome to our world!

[traumaRUs]

HI and welcome to the trenches. My best job was the 10 years I spent in the level one ER! Autonomous practice was the norm. I had come from an ICU where there were no MD's at night in the unit. So...I do know where you are coming from.

However, give yourself some time. Hopefully, you will love it!

[Epona]

This is a good thread.

Ok.. in what nursing positions will you find the most autonomy??