Advice for nursing student

[guest901464]

Hello everyone,

I'm currently in nursing school and would like to work in the ED once I graduate. Either through a new nurse program or starting out at a smaller facility. I was wondering what advice ED nurses would give to someone in school? Obviously as a student I need to focus on learning everything I can but is there anything I can do while still in school that would help me be more prepared for a job in the ED? Not so much as far as networking and getting the job in the ED, but more of skills, knowledge etc. I have read the sticky on here but I didn't find much advice for someone still in school.

I have a second question and I might as well include it here instead of making a new post at a later date. As a new grad I read it's not a bad idea to start at a smaller ED so you can get more experience in various tasks due to less staff being available (lab staff, techs etc) but I was wondering what size facility would be good? There's a lot of EDs popping up around me but they seem almost small enough to be more of an urgent care. I'm currently working at a larger hospital as a tech and they have a critical care fellowship with one of the rotations being in the ED. I think that would be the best option. It is a Level II center. I do, however, like the idea of a smaller facility to gain experience and confidence in before moving to a larger, busier ED. It would be nice to have a closer relationship with the doctors to hopefully get more one on one learning. Any advice at would be appreciated.

Thank you!

[NurseOnAMotorcycle, ASN, RN]

Working in the E.D you need to be able to:

1. Always get medical history and meds the pts are taking.

2. Know signs/symptoms

3. Know risk factors.

4. Know the "impending code" danger signs (sweaty is ALWAYS bad).

5. Not be afraid to call for help or ask someone to "just check this one out to see if it's just me."

A nurse get paid to worry. Worry about everything that can go wrong and then not let it.

[NurseOnAMotorcycle, ASN, RN]

To add: I'm sorry that I only just noticed that you are an EMT-B.

You have got to be able to think critically. For example, why is a headache so very bad if someone is on insulin? Why should you never lay someone with a hemorrhagic stroke flat? What's the big deal with letting someone have a sip of water while on NPPV? Why is it an absolute emergency for someone to take their own prescribed epi-pen for tingly hands even though they have NKA? Why is blood pressure control so important for an ischemic stroke?

Anyone can do a procedure. You need to know why it needs to be done or why you should question the provider ordering it.

Why, why, why? That's what we need to know and then be able to act based on that information.

As far as getting into an ED, apply to all of them, take what you can get, and work your way over to what you want. The job market is tough and there's no time to be picky.

[BecomingNursey]

Also, do your best to stand out in clinicals. Snatch the stuff out of the person you are following hands. I had to. Lol I told him I wanted to do it and did it. (Okay, I didn't literally snatch it...but I insisted he give it to me so I could do it. Haha)

[lizrn1214]

Go big or go home. If you can get into a Level1 - why would you do a Level 2? Try to get EMS/ED type certifications - even if on your own. ACLS, TNCC, ENPC or NRP makes you more hire-able. A lot of nurses who start at a Level 2 and that's all they have ever done start thinking that's all there is - they don't realize that their low speed MVA would not be a trauma at a Level 2 - and they think their skills are more valueable then they might be.

Apply in the ER - let the manager know you are really interested and if your lack of experience doesnt land you an interview or an offer - ask, specifically, what you can do in the meantime so that once you are a more experienced nurse - you would be more eligible.

[Bobjohnny]

The flip side of working in a small ED without ancillary staff means that you have to do everything yourself. You may get more experience from doing so, but you have to do most stuff yourself. Ex: No housekeeping? Who's cleaning the beds? Only have 4 nurses in your ER? What happens when 2 cardiac arrests show up almost simultaneously? Trust me, not fun in the least. One of the small critical access hospitals that my facility owns has 2 RNs (including ER Charge, who also serves as house supervisor)1 EDT & 1 Doc at night. Less than ideal when more than 1 critical patient arrive in close succession.

In my opinion going to a ED at a big facility is better for a new grad, more people to help out. Maybe there isn't anything that small in your area, but that's what I think of when people say small ED.