A Question for all you ER Nurses out there...

allnurses Guide · Apr 10, 2008

Well, I've been precepting a new nurse who was EMT before. One challenge is learning to balance all aspects of care, not just zoom in on the immediate emergency. Also, having more than one person to concentrate on, in the rig there is usually only one victim at a time (note the word usually:lol2:). In the ER, on a good night we have at least 4.

Nursing looks at the entire picture, all the systems not just the chief complaint, complete history not just focused.

Glad you chose nursing! :up: Welcome!

MikeInCO · Apr 10, 2008

Well, I've been precepting a new nurse who was EMT before. One challenge is learning to balance all aspects of care, not just zoom in on the immediate emergency. Also, having more than one person to concentrate on, in the rig there is usually only one victim at a time (note the word usually:lol2:). In the ER, on a good night we have at least 4.
Nursing looks at the entire picture, all the systems not just the chief complaint, complete history not just focused.
Glad you chose nursing! Welcome!

Thanks for your input. My pre-nursing advisor had said something similar. She advised me that while having the background of EMT knowledge will help some I have to remember that it is different when you look at things as a nurse... ie the whole chief compalint versus all of the sytsems. :up:

Hagabel · Apr 10, 2008

First of all get into and graduate nursing school!

EMS experience will always help you get a job in the ER but not ICU. Maybe you can do some volunteer ems work or get a parttime job in the ER as a tech. Not sure quite how you would fit this in with nursing school though.

CEN is something you take post graduating RN school and after having some ER experience. CCRN is something I did not feel ready to take after 14 yrs of ICU!!! (Hate exams!)

One step at a time and keep up the enthusiasm. I work ER and ICU and enjoy both.

Good luck!

:wink2:

KatieBell · Apr 10, 2008

I will be starting Nursing school in a little over a year and I feel that my calling is the ER and eventually Flight. I am a former EMT-B and thats when I got interested in emergency medicine. I decided to go to nursing school instead of paramedic school. My question is what can I do during nursing school to prepare myself for a future career in the ER or ICU w/ dreams of one day being a flight nurse? I do plan on getting the CEN, CCRN certs. Do any of you have thoughts on those?
-Mike :)

If you are really interested in Flight, i really recommend getting a strong ICU background, as those patients are going to be sick, possibly on multiple drips etc...while i take care of patients on drips in the ER, it is no where near the frequency that I did in the unit. You really want to be familiar with what happens with each of these drips in a variety of situations...etc....

One thing you can do if you have the time, is to take a Monitor technician class, that certifies you to read the tele monitors on a telemetry unit. I took this class in nursing school and it probably helped me land a job in the iCU right out of school (Back when they only took like 1 new grad per unit...) Plus you will be waaay more confident with that under your belt. I'd also take ACLS and PALS as you are an EMT-B, you might be allowed to take the classes. (I was allowed to take ACLS without a nursing license, so i am not sure what the req's are).

best Wishes!

MikeInCO · Apr 10, 2008

If you are really interested in Flight, i really recommend getting a strong ICU background, as those patients are going to be sick, possibly on multiple drips etc...while i take care of patients on drips in the ER, it is no where near the frequency that I did in the unit. You really want to be familiar with what happens with each of these drips in a variety of situations...etc....
One thing you can do if you have the time, is to take a Monitor technician class, that certifies you to read the tele monitors on a telemetry unit. I took this class in nursing school and it probably helped me land a job in the iCU right out of school (Back when they only took like 1 new grad per unit...) Plus you will be waaay more confident with that under your belt. I'd also take ACLS and PALS as you are an EMT-B, you might be allowed to take the classes. (I was allowed to take ACLS without a nursing license, so i am not sure what the req's are).
best Wishes!

Katie,

Thanks for the advice. It's funny that you mentioned that I get a strong ICU background as the flight nurse that I met many years ago doing my EMT clinicals said the same thing. She said that she did at least 10 years in the ICU before switching to the ER for several years and THEN going to flight. And I'll look into the req's for ACLS and PALS as I don't remember them off hand.

Mike :up: :wink2:

CraigB-RN, MSN, RN · Apr 10, 2008

Hey Mike, Congrats on nursing school.

Ok here it is from an EMT/ICU/ER/Flight Nurses. :)

First of all, for hte next year, don't worry about it. Make sure that you've got all the hard sciences and things done and under your belt, Start planning now for future grad school. Do some EMT work if you can, to keep those skills up. If your EMT has expired, maybe take thisyear to get it back. DOn't worry about things like PALS and ACLS right now. WOrry about htat when you graduate and get a job. A) the hospital will prob pay for it, B) you'll loose a lot of it between now and graduating.

Once you've graduated, get a job. Ideally in a high accuity area , either ER or ICU. My personal preference and this is just a personal one, is a high acucity ICU, then get some ER experience. Now once you've graduated and have the letters after your name, start networking. Keep an eye out for Critical Care and Emergency Conitnuing education, loko for classes being held by the flight services and take them.

Then study your but off. Teke the CEN and CCRN exam. They are hard but very doable. Neither of them is rocket science, they are basic nursing, with specialized knowledge. As your studying now and after becoming a nurse, get in the habit of looking up each disea process you've never seen before, and studying it, make sure that while in school you actually learn normal and abnormal lab values.

check out http://www.flightweb.com.

Also keep an open mind. A paramedic partner of mine went to nursing school, he was so sure that he was going to be a flight nurse, found out he he loved pediatris and is now working as a pediatric nurse practiioner. Never flew once.

MAke sure you check out the flight services i the area you plan on living, find out their needs and wants and make sure you work toward having all those needs.

again, enjoy school and just focuse on becoming the best Nurse you can be for the next few years.

Feel free to drop me aline if you have any more or any specific questions.

(used to work in COlorado SPrings many many many years ago. )

MikeInCO · Apr 11, 2008

I was wondering something... I've seen several nurses and/or people get their RN license then go and challenge the Paramedic exam and/or compelte a short program to sit for their Medic license and this begs me to question... Why?? If you spent all of that time going through nursing school and passed the boards, why on earth would you want to go through a little more work just to get a medic cert? Can someone please shed some light on this for me? Thanks! :yeah:

CraigB-RN, MSN, RN · Apr 11, 2008

There is a thought out there that the RN's aren't prepared for the scene calls and that going to PM school fixes that. I know there is at least one state that requires the EMT-P. You have to jump though the hoops for wherever your working or plan on working. The paramedic is a different skill set, and for some people/locations going through a full program is needed. In other locations, once you've got the ICU/E experience, it's as easy as challenging the exam or taking bridge program.

Personally, I kept my EMT-P for almost 20 years, as well as my RN license. Then one day I discovered that I wasn't using it, and it was a pain to keep taking the recert every two years and then keep up the nursing stuff also, so I let mine go. There are times I regret it, but for the most part, It hasn't made a difference.

Check out the job openings on flightweb.com and see how many of them require EMT or EMT-P and make your own decisions on what you need to do. You've got time, and like I think I posed earlier, fo rnow, just keep your EMT current,and focus on nursing school. Then becoming the next nurse you can be, and go from there. One other thing you might want to look into though is to see what companies to Critical Care Transports and see if you can get to work with them. It's income while in school and good experience.

ANd to keep things in perspective. I challenged the EMT-P certification in CO back in the 70's when you could do it off of military training. No one ever knew that had never taken a formal EMT-P course. It wasn't until I needed the NREMT-P that I went to a paramedic program.

Craig