Any Advice for starting new job in the ER??

Specialties Emergency

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Specializes in RN.

I currently work on a heart and vascular intermediate care unit and have been a nurse for 1 year. We do take ICU pt's at times. My main concern is the change in atmosphere. What to expect? How to deal with pediatric population/and families of. And anything else you want to throw at me! Thanks!

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Specializes in ICU, Float RN , Quality & PI.

Fast pace... you will run around like a chicken with your head cut off!!! ER is fast, exciting, and scary all at the same time. You will witness things you never imagined and things you will wish you never see again. The pediatric population is tough. Kids bounce back quick but they also go down hill quick. Good luck with your new path of nursing and congrats!!!

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Specializes in CT-ICU, ER, Surgical.

ER is awesome... You may feel that you can't keep up at first, but stick it out... As long as they don't fire you, then consider yourself doing fine. You'll eventually get it, and likely enjoy it. I just left the ER for ICU, for different reasons, but I really miss the ER... overall it's a great place to work. Great relationships and learning opportunities working side by side with very skilled attending physicians. New experiences every day. Good luck!

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Specializes in Management, Emergency, Psych, Med Surg.

You better get yourself an Emergency nursing text and start reading. It is a lot to know. Pediatrics, OB and Psych also. You have to know something about everything. But you will LOVE IT. My years spend it the ED were some of the best years of my nursing career. I learned and saw things that I would never have seen anywhere else. Go to the largest hospital you can and try to work at a county hospital. You will have to learn on your feet and keep your mind sharp. No time to go over the details over and over. Keep a small notebook in your pocket to write down stuff you don't know and need to look up.

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Specializes in RN.

Thanks for the replies!!

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Specializes in ER, Trauma.

All of the above! And realize that ER nursing is backwards. On the floor you get an assignment, then immediatey look at the diagnosis. In the ER a patient gets a diagnosis when they're ready for discharge or admit. I think it's easier that way because you don't start in the middle of something. You do your assesment, NEVER FOGET THE A,B,C's, and go from there. In many busy ER's you'll learn new things, like ordering the obvious labs and x-rays so by the time the doc gets there, they have most of the answers already. You work at turning chaos to order continuously. And it's not for everybody. As long as it's exciting, great! When it's just stressful, do yourself a favor and find someplace else you'll enjoy. Good luck.

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One of the biggest differences I experienced was the speed in which we work. When I worked ICU, we gave our patients more personal time, families were given more time, to talk to, answer questions and the "fluff and puff" In the ER, it seems like we have to work so fast, as the next patient is waiting. Adminitration looks at turn around time.

The other thing I experienced was that because I was a ICU nurse, more was expected of me and if I did something that was not what a ER nurse would do, ie: placed an IV in the forearm verses AC, or used a ext. kit at the hub of the IV catheter verses using just a cap on the end of the catheter. I got tagged as being to slow. I love working in the ER, but I will have to say, yes ICU exp. is good, but the ER world is a different type of nursing. I really like the idea of keeping a notebook in your pocket. I hope I didn't sound to negative, like I said I love working in the ER, but it does take a bit to make the transition.

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Specializes in RN.

This is all great advice!! Keep em coming!! LOL Whether good or bad, I want to hear it all!! Only way I will know!!

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Specializes in ER, Trauma.

Learn to keep a straight face when a patient says "I have no idea how that got in there." Whether is it's a car antenae in a member, a baking potato in a lady parts, or when you help deliver a 1 foot long cucumber from a man's rectum. I could go on, but honest to Florence N. they're all true.

Sometimes being an ER nurse is like being a priest. We make a living off people's errors and sins.

Above all else, no matter what else you do, remember to FORGIVE THE PATIENTS!

Via con Dios mi amiga. Pablo

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everything from the above nurses is true. you might want to look at what level er it is. the highest level is level i, which is a trauma center. if you have one near you, and really want to learn, i would suggest going there.

also...rn in er stands for registered nut. lol

good luck!

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Specializes in Pediatric emergency medicine.

I have not seen any advice for working with our littlest patients so if I may I have a few things that might help you out when it comes to working with children in the ER. I am not an RN but have worked as a tech in our level one children's ER for six years and have learned so much from and about the nurses I have worked with over the years.

Our children's ER has people that want to be there because they enjoy the challenge that comes with caring for sick and injured children. On the other hand I know nurses that work in mixed units that would gladly pass on caring for a peds patient if given the chance,face it kids make some nurses very uncomfortable and that's okay,we all have are likes and dislikes. If you enjoy working with the little ones and are good at it you could become the go to peds person on your crew in a mixed ED. A great opportunity if your up to the challenge and have an intrest in childrens emergency medicine.

Remember the basic rule, children are not small adults they are complex and can compensate for a long period of time before abruptly crashing. Always expect the worst possible outcome and treat with that in mind. When I worked in the field I always kept this in mind along with all the other tricks I learned from the nurses in the peds ER and it made me much more comfortable on scenes where pediatric patients were involved.

The parents and or caregivers of your pediatric patient can be the best tool in your box and should be utilized whenever possible. From providing important and pertinent history and information for your assessment to helping with holds they are an invaluable resource. On the other hand they can be a real problem and can even become your next patient. Knowing when to have a parent leave the room could reduce the stress level for all involved. Most parents are very open to our suggestions and once a procedure is explained and they know what they may have to experience they usually will opt for a quick cup of coffee or a little walk. On my last shift we had a very sick 4D old that was proving to be a very tough stick, mom was already weak from her recent delivery and the stress that comes with caring for a sick newborn this along with some other medical problems had me really worried and I was sure we were going to be wheeling her across the hall. After a little apple juice and a short break she was good to go and even sat through the LP. Treat your parents and caregivers like patients and you will always be ahead in the game. Sick and injured kids can be stressful but use your tools and you should be fine. Good luck in your new position and remember to have fun and be nice to the techs.

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Specializes in RN.

Thank you for your advice!! I have 2 youg children of my own, and was a little worried with the Pediatric aspect of the Er. I know as a mother how I feel when my children are sick. And working with this population in the Er is what makes me somewhat nervous. But I hope to turn this into an aspect that makes me a good nurse in the ER when it comes to working with Peds. And absolutely, the techs will have my utmost repsect!! They sometimes know as much as RN's!!!

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