AN - be honest....do I suck as an ER nurse?

JKL33 · May 25, 2019

You have made appropriate inquiries about your performance but all of this hasn't gotten to the heart of the matter, so you need a more direct approach.

You need to state your desire for continued growth and ask them to start placing you in some of these other situations and/or providing the opportunity and training to handle harder cases.

Their actions in response to that will get you more of the answers you need. With any luck it's just a matter of them having overlooked your need for challenge because you are doing a good job in the assignments you have right now.

You probably do have an idea of your own practice and how it measures up - - If you know or suspect that there are reasonable concerns about your abilities then that should be addressed instead of asking for more challenges. Get together with your educator or manager and make a plan to advance to a point where you are ready to train for challenging cases.

If they seem fine with the status quo and aren't motivated to either start assigning you more or help you improve to that point, that's another matter.

Good luck!

Guest219794 · May 27, 2019

OK- I'll be honest.

Maybe you do suck as an ER nurse. Some people do. There is all kinds of nursing I would suck at, though my peers seem to think I am a competent ER nurse.

But, in your case this just seems unlikely. If you get consistently good evaluations, one of two things is possible.

A- the evaluations are accurate.

B- Those evaluating you are dishonest, incompetent, or poor judges of character.

Seems reasonable to go with A.

Make a real plan with your manager. By "real", I mean set quantifiable goals, a plan to meet those goals, and, and a time frame in which to re-evaluate.

Goal: work at least 3 ESI 1s, (or traumas, or whatever your goal is) in the next month.

Plan: Manager will speak with charge RNs on your shift so they are aware of this professional development plan.

Evaluate: in 5 weeks, you and manager meet to check in- if the goal is not met, create a new plan.

Sounds to me like you are on the right track. Advocate for yourself, and hold your manager accountable. He or she wants strong ER nurses, and should appreciate the fact that you have ambition.

Justdoingmybest, ADN · May 27, 2019

Thank you for your honest feedback.

I think my biggest problem is confidence. I ask for help or a 2nd opinion whenever I have had traumas in the past and maybe that has made my peers not trust me.

I will work with my manager regarding my concerns although its frustrating when they say "youre doing fine" and yet my room assignment never seems to be challenging.

This is why obtaining my CEN has been so important to me, bc you really cant argue with a nurse thats obtained their CEN.

This has been my plan...get certified. That will prove my skill set....right? Hopefully!

Ill keep you guys updated!

JKL33 · May 27, 2019

3 hours ago, Justdoingmybest said:
This is why obtaining my CEN has been so important to me, bc you really cant argue with a nurse thats obtained their CEN.
This has been my plan...get certified. That will prove my skill set....right? Hopefully!

While worthy in its own right, if many of your communications are compromised by lack of self-confidence, the CEN won't be the complete answer, except to the extent that it actually increases your confidence. Generally speaking, no, a course, a test, or a piece of paper does not prove one can succeed at a particular thing. You already know this ? - I'm just reinforcing the idea that additional efforts may be needed to get the action you want.

For now, try to be mindful to choose words carefully and use good non-verbals.

Stand up straight/good posture, make good eye contact, smile, don't fidget. Work quickly but purposefully (avoiding giving off that "frazzled" vibe). When asking others to double-check your work or your thought process, approach with confidence and state what you have done or what your assessments/interventions have been and ask, "Is there anything I've overlooked?" Keep it casual but use your pleases and thank-yous. Be upbeat.

That sort of thing.

Let us know how the convo with your manager/educator goes!

PMHNP Man, MSN, APRN, NP · May 29, 2019

I was actually bad at IVs. It wasn't so much an infiltration issue rather just not able to find them particularly in overweight (fat) people and most people are overweight these days so the problems went on in perpetuity. It was frustrating and time consuming so I quit about 90 days before I became a psych NP and just enjoyed being off. I only spent about 9 months in the ER and really only did that to get urgent care exposure as that was lacking in my psych-specific NP training, but I never got into the somatic, medical stuff. That bag is for someone else. I was a RN for three years (and never in psych). I get two General Medicine journals every month and read at most 2-3 articles in each, lol. The psych ones, however, are interesting!

Aggie RN, ADN · Jul 8, 2019

I am impressed with the high quality of feedback provided by all of you. Y'all are making me feel dumb.

Dacatster, ADN · Jul 22, 2019

Could be an issue of clicques too. I have seen where this has played an issue in a few ER's I worked. Basically during my eveal I would put as my goal as having more trauma experience, and my managers always helped me get that. I also worked on skills. It got word I was a good stick and a good person to be in trauma. It was never a problem after that. Just show your peers you are dependable.

**canoehead, BSN, RN** · Jul 25, 2019

If nurses with more seniority tend to get the assignments they want, you may need to wait a bit longer to get the challenging traumas.

eacue · Aug 7, 2019

I wouldn't worry about it, your probably doing such a good job in your assignment they don't want to move you. Remember charges and managers love it when they can stick the same person in an assignment knowing they will handle it and not bother them all shift. I've had the problem my entire career. I basically had to buy my time and shine when I finally got into a critical room. Since then I do nothing but traumas, codes, pediatric codes, strokes, etc. Let me tell you something... I AM OVER IT!!!!!!!! I pray everyday to be back in fast track and triage everyday lmao. Becareful what you wish for!!!

trauma_lama, BSN · Sep 10, 2019

On 7/22/2019 at 5:23 PM, Dacatster said:
Could be an issue of clicques too. I have seen where this has played an issue in a few ER's I worked. Basically during my eveal I would put as my goal as having more trauma experience, and my managers always helped me get that. I also worked on skills. It got word I was a good stick and a good person to be in trauma. It was never a problem after that. Just show your peers you are dependable.

This is the case in my department. It can be very disheartening to not be in the "in clique," and I'm 2+ years into the place. with over 5 years nsg exp.

guest464345 · Sep 14, 2019

Is it possibly a coincidence related to your shift or cohort? I was a midshifter in the ED, and my assignment was almost always opening up a section when the lobby filled up, covering lunches, floating, pulling people from the hallway, backing up triage, sometimes fast-track....that's just how it usually worked out for midshifters, it wasn't specific to me.

If you happen to be on the same schedule with a few long-timers who are trauma nurses and ask for that assignment, it might have nothing to do with you personally. I agree with eacue's post above - unless the charge nurses are dedicated to making sure everyone is well-trained in all areas, it's easier for them just to set up the assignments as simply as possible using tried-and-true arrangements.

Hopefully being explicit about your needs will help. Good luck!