Air Tight Cliques-Level One Trauma ER Nurses/ Hospitals

Nurses General Nursing

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Most Valuable Dearest Nurses,

I have posted before about my excitement for my upcoming interview (in 11 days!!!) for a level one trauma ER in a large city in Southern California!!!:yeah::yeah:

A lot of research for this interview has been ongoing since. However my heart sunk after I have read various posts stating how it's almost impossible for a fairly new nurse (16 months acute rehab experience) to do well in a level one trauma facility :cry:. Most people say those are usually staffed with air tight cliques of veteran nurses :smokin: who not allow an inexperienced RN to work with or anywhere near them. Some suggest I should try a level 3 perhaps...get my feet wet because the ER is a totally different animal, especially those level ones with true traumas and other very real emergencies. I feel discouraged at this point...plus I have discovered it may be a night position, which I know will be hard to adjust to (I have been working days), but in this economy I will take anything.

I have posted this in the general discussion to get reposes from everyone, not just ER nurses...ex ER nurse who is in ob or med/surg/ICU...why did you leave....that sort of thing. Would love to hear from a level 1 trauma nurse who thinks a new nurse CAN make it in that enviroment

Thanks guys!!!!

Specializes in Med Surg, Ortho.

Jo has very good advice for you. I would definitely listen to her.

I think when she says don't show your weakness, she doesn't mean don't ask questions related to learning the profession, you need to ask ask ask. Always ask when you are unsure of something. Just never use the word "why" when you are asking another nurse something, this can be misconstrued and possibly insult the nurse that is training you.

Always ask, "what is your rationale for doing it this way, because I learned it this way in school." You will see that a lot.

I think a good example of showing a weakness would be crying, showing fear or acting like you can't handle the stress or getting frazzled easily.

I had a couple of nurses that tried to eat me alive when I first started, and I backed down a couple of time and I was actually a little scared of these two nurses. Every time they would jump on me about something, I would say, 'Oh, okay, I'm sorry." I was being little Miss Nice. Well, this was showing weakness to them and I learned that the hard way.

Well, I'm not that same little Miss Nice anymore. I show respect I much as I possibly can, but I stand my ground now, I do not let them run over me. I finally had to stand up for myself before they would back off. You'll see what I mean, it's going to evenually happen to you. Just stand your ground, but always ask questions, that is NOT showing weakness when you have to ask about something.

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Specializes in Cardiac Telemetry, ED.

I work in a Level 2, and yes, there are definitely a couple of "Power Cliques" as I call them. My assessment of the situation is that new people need to prove themselves before they will be accepted. That means you have to be willing to work your tail off, jump in and help where it's needed (without being asked), and be the kind of person that others know they can count on.

You will know you're on your way to earning their respect when a nurse turns to you at the end of the shift and thanks you, sincerely, for your help.

The learning curve is steep, and people aren't always nice to each other. But if you show up ready to work hard and let it roll off your back when people get gruff with you, then that's the first step.

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Specializes in rehab.

Ponits taken guys!

I think I will go for the job! If I get it, I will work hard and apply what you all have said. If I don't make it...oh well..will be misreable or jobless :)

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Just work hard, pay attention, pay attention to the science and patients, avoid the cliches and you will do fine.

I was a/the manager of what was then the largest ED in the US in late 90's, level 1 trauma and burn, center. and hired both new RN's and experienced RN's depending on our needs. We found that having a extensive orientation residency made the difference if a new RN wanted the job. Hopefully you will have a long orientation, we found that was the biggest indicator for sucess and found it was worth it to plow the resources into it to keep staff. It was to much to drop a new RN into though alot of it was also personality, if you want to do that for your professional track then you stick with it. I laugh that it takes a bit of a kink in ones' personality to tolerate that level of chaos and call it a living.

There are some tough cliches and some great friends to be found in ED's just as in jails, police depts and fire depts. That sort of work I think requires support of each other in some way, but different people have different ways in going about that. Don't stress (though I know all new RN's do and that is normal) just keep your ears open, learn, and mouth fairly shut.

I laugh about myself that the less I say usually the smarter I look.

Good Luck

Its good work

ap

PS I no longer work in that setting. YMMV,

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How do I make that first good impression...I will be clueless for a long time?!?

and I add

HA! I am still clueless

ap

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Specializes in ICU/Critical Care.

You are fooling yourself if you think there aren't cliques at a smaller hospital. There are cliques everywhere.

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It's funny about the whole impression thing and intimidation. I work in the ICU as mentioned earlier, and excuse my language, but other floors call us the Dick U, because nurses in ICU treat other nurses terribly. We get a patient from ER and we call them FERN, meaning F***ed up ER nurses; and we think that they bring their patient's to us in a mess. It just goes in cycles. Every department thinks they are the greatest. And each department has their own battle axes to go along with it. It just comes with the job. I, personally, don't try to intimidate anyone. I know that sometimes when I'm receiving patient's from the floor who have rapid responded or coded, the floor nurse is a little intimidated, but I try to make them feel as comfortable as possible, because I remember when I was a floor nurse and I received or gave report to an ICU nurse, I used to hate them with a passion because I thought they were all dicks. Again excuse my language.

The only problem I have is with getting report from PACU nurses haha, but I won't get into here. ;)

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
You are fooling yourself if you think there aren't cliques at a smaller hospital. There are cliques everywhere.

This I have to agree with.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
i don't like inexperienced people; they will only get in the way.

i am not going to sugar coat for you.

former l1 nurse.

um... so you were born with level 1 trauma experience??? you were never an inexperienced nurse???

btw, i like your post and i even like this one especially since you're being honest and are representing the sentiments of many others. however, i cannot help to point out the irony in the fact that there are nurses out there who think that just because they have more experience then another nurse, they are not a nurse who "gets in the way". in my experience, nurses with attitudes are nurses that get in the way, especially the "eat-your-young" types. they are bullies with a lot to hide. again, i am a fan of your posts so thanks for posting!

-new er nurse... soon to be trained in trauma... and hoping to land a level 1 postion within a year.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
would love to hear from a level 1 trauma nurse who thinks a new nurse can make it in that enviroment

thanks guys!!!!

i am not a level 1 trauma nurse yet but i will be soon!... nobody was born knowing level 1 trauma so do not forget that the nurses that try to eat you are also nurses who used to be really really inexperienced!!! if that does not work, just imagine all of them as stupid nursing students because they were all that once too!!!

btw, in general when someone tries to eat you, do your best to taste bad. when i first started out as a new grad i gave people indigestion (i was a med surg nurse). now i feel like a kick in the stomach (i'm now an er nurse)! gl! :twocents:

-new grad rn and new er nurse (finishing up my first year, baby!)

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Specializes in rehab.
um... so you were born with level 1 trauma experience??? you were never an inexperienced nurse???

btw, i like your post and i even like this one especially since you're being honest and are representing the sentiments of many others. however, i cannot help to point out the irony in the fact that there are nurses out there who think that just because they have more experience then another nurse, they are not a nurse who "gets in the way". in my experience, nurses with attitudes are nurses that get in the way, especially the "eat-your-young" types. they are bullies with a lot to hide. again, i am a fan of your posts so thanks for posting!

-new er nurse... soon to be trained in trauma... and hoping to land a level 1 postion within a year.

hey thanks for posting this. many nurses forget that they once were scared and inexperienced. someone said i will not be able to do acls and pals because i have never done it before, but how did anyone do it for the first time?!? no one was born with acls certification.:D

i can streess enough how greatful i am for the most valube information/ advice i have recieved her. i'm glad i know this now than walk into it and get the biggest shock of my life!!

thanks thanks to you all, especially you jo, no sugar coating:d:d

to pp, let me know how your new er experience is going :yeah:

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The ICU nurses I work with as a student definitely have pride. Been told that if I waste time by starting out in step down etc., my brain will rot. LOL. But I have already begged wisdom off Allnurses wise and powerful ICU mentors on that issue, and most likely will take their advice.:smokin:

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