ER Orientation - what you should be doing....

ER orientation - how cool. The day finally arrived for the start of your orientation. However, what should you be learning in orientation? First, your ER should have a standardized length of orientation and it should definitely be more for the new grad RN. An orientation of 6-16 weeks is the norm, depending on your particular ER, number of visits and trauma level. Some things you want to accomplish while on orientation:


1. Notice the climate of the ER? Is this a fast-paced, 75,000 visits/year level one trauma center with 30 nurses on duty at all times or is it a community based ER with 23,000 visits/year and all traumas, AMIs, sick kids are turfed out or is it a rural Critical Access Hospital where there is just one RN on duty in the ER and your help comes in the form of the nursing supervisor?

2. Learn the basics first, then proceed to the more complex tasks. Basic tasks include learning how to operate the computer or learning the charting system, where are supplies kept, do you have the passwords needed to access supplies and meds if an automated system is used. Familiarize yourself with the lay of the land: where is the charge nurse, do you reach her by cell phone, pager or yelling across the room? What type of system is used for room assignments? Team or individual approach?

3. Next, every ER has protocols on which to base your care. These are pre-approved treatment modalities for different symptoms. For instance, you have a middle-aged male who presents with CP, you would automatically place the pt on a monitor, provide oxygen at 2L/NC, give ASA 324mg and of course obtain an EKG. There is often a time limit for these interventions. You won't need to memorize these protocols but as you go thru your orientation, you will start to learn them and they will become second nature.

4. As you get further into your orientation, start to scope out your fellow nurses: who do you admire, get along with exceptionally well or want to emulate? Approach them to help with mentoring. Your orientation will zoom by and soon you will be on your own and it is imporant to always have someone in your corner.

5. And...finally, relax and enjoy the ride!