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Any advice to help me prepare for larger ER?


Specializes in ER, LTC, IHS. Has 4 years experience.

I got my RN in late 07. I worked 1 year in a very small ER, just 5 beds had to transfer most everything out. Although we did not see alot of action what we did have was quite a variety. I have the basics down and what I believe to be a strong foundation to build on. I did order the Emergency Triage book and bought ER

facts and ECG made easy. The DON says although I don't have alot of experience, they usually don't hire anyone with less than 3 years ER experiece, he is willing to give me a chance since he has faith that I will work hard and succeed. I really know that this is the area I want for my career. There is a 5 week orientation period before I will have a patient of my own. I have my ACLS and TNCC certs and I plan to really hit the floor running, take notes and study hard. Is there any advice you can offer to help me succeed?


Specializes in Emergency Medicine. Has 17 years experience.

...I plan to really hit the floor running...

Hit the floor running you say...in a bigger ER?

Well then my suggestion:

A more comfortable pair of shoes. Soft, comfy...

Arch supports help. Perhaps some Spenco's or even some Rx- Orthotics. ;)

Really, a bigger ER just means you have to run around more. Patient care IS and always WILL be the same. Protocols will vary from place to place but you just have to get use to the way the new place does things.

I know of NO WAY to prepare for something that just comes from on-the-job training. You just can't. You will learn the most from just familiarizing yourself with how THEY do it.

They should break you in with a preceptorship program for a week or two but don't expect to find your "comfort zone" for a few months. It's not you. It's the nature of things.

Stroke Protocol-NIH, STEMI Protocol, Chest Pain Protocol, Hyperglycemia (DKA)Protocol, Fever Protocol... You just have to do it. No one will expect you to know it all. Just ask questions and you'll be fine. You only get into trouble when you think you know more than you do and do something wrong.

(Oh, and I'm really not kidding about the shoes :D)

Good Luck and welcome to the show.

rjflyn, ASN, RN

Specializes in Emergency. Has 23 years experience.

I agree about the shoes, just be sure to replace them often. YOu dont say how much bigger ER you are going to . ANd the best of intentions of not having your own patients for 5 weeks might last for 5 days. This is the real world be ready for it. I have been in the 5 bed ED, the 10 bed unit, the 20 bed unit, the 45+ ones. These numbers double when they start putting patients in every nook and cranny.

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

5 weeks orientation isn't enough IMHO. I worked level one trauma center (58 beds) and our current orientation is 6-8 weeks for experienced RNs (those that come from level I or II trauma centers) and 10-12 weeks for new grads.

I also work as an APN in a community ER (18 beds) and the orientation for RNs is still 6-8 weeks). Just don't sell yourself short when it comes to orientation.

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 12 years experience.

Ride that orientation train as long as possible! My orientation was about 14 weeks, until I was unceremoniously dumped from orientation when another RN called out sick. LOL.


Specializes in ER. Has 15 years experience.

observe, ask lots of questions, and you'll be fine.