About to start in ED

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I am a new nurse with 4 months experience on a cardiac step down floor. I have been looking to leave this floor for a few months due to the backstabbing nature of my co-workers. When I was in school I wanted to work ED to work with pediatric patients as well as adults as my goal is to become a FNP down the road. Well, I got in at a level one trauma hospital. Any suggestions on making this transition? Any readings I should brush up on?

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Specializes in Pediatrics, Emergency, Trauma.

I found an ENA book on eBay to get familiar with the ED; there is also Sheehy's manual that is good as well.

Get to know the ESI system, and arrange your nursing care based on their needs; understand that it's not always trauma, trauma, trauma, and you will find people that come in either because their doctor sent them in or there are no appointments-most of the people that have this issue at least at my hospital is there is an educational need; I spend a lot of time educating patients and families, something I enjoy.

Learning how to prioritize critical patients are key; know how to prepare and advocate early in order to minimize delays in care.

ED is a team sport; get to know your team, docs and techs; soft skills such as communicating effectively is key.

Best wishes!

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I started in ER straight out of school (although I had been working there in a different capacity for 5 years). I think the best thing to do is jump in, learn as much as you can from those with experience, and NEVER BE AFRAID TO ASK QUESTIONS!!!! I have been in the ER for 5 years now, and still ask questions DAILY. If I'm curious why we are giving a certain medication, or why we would choose one over another or why we wouldn't do a certain intervention, I ASK! The doctors are (usually) more than happy to educate if you don't come across as threatening or questioning their judgment. I also still will ask more experienced nurses for tips and tricks if I am having trouble with something. It will be an adjustment for you, not only in skills (because you seem to be on the right track with your experience so far) but with pace and environment. Don't give up if you don't feel comfortable after a few months. You learn to roll with the punches! Congrats, and good luck!

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Yes, I wanted ED mostly for the variety of cases and the pediatric component. I think trauma will be interesting though.

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Does Sheehy deal with ESI?

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Specializes in Family Nurse Practitioner.

Depending on your charting system, there may be a walk through to help you pick an ESI level when triaging patients. ESI is really a basic system once you get the hang of it. The key is recognizing who is sick and who isn't. The most common patients I see who were mistriaged are those who triaged an ESI 3 when they should have been a 2.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I'll bet there will be an extensive orientation process....at least I hope there is....even with some experience you will need it.

ESI

http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/esi/esihandbk.pdf

Chapter 3. ESI Level 2 | Agency for Healthcare Research & Quality

Go to this thread.....https://allnurses.com/emergency-nursing/adult-er-nurse-742288.html

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There most certainly is an extensive orientation process.

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Specializes in Family Nurse Practitioner.

Esme - thanks for that resource on ESI!

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Don't worry too much about ESI out of the gate. Get the free book and become familiar with it. To really be able to use it you kinda need to know what work ups will be done with what presenting chief complaint. It will make a lot more sense after a bit of time.

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I ordered Sheehy's and will order a few more books with next paycheck. I am hoping this move will make me a well rounded and more talented nurse.

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The ESI book is free btw

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