Are you required by law to have two years Med Surg experience prior to working in an ED?

[xxMichelleJxx]

Hi everyone, two questions. Would appreciate your insight.

1) Are you required by law to possess two years of Med-Surg experience prior to working in a ER? Is it okay for a New-Grad to work in a ER, for who the ER will be their first hospital job?

2) Is there a minimum amount of orientation time required for ER nurses?

Thank you.

- Michelle

Edit: What is your policy in your ER regarding ICU pts (Critical pts/trauma victims that become ICU pts and remain in the ER until theres a bed on the ICU?) Does your ER have a policy regarding how many other ER pts you can have when you have ICU pt(s)?

[offlabel]

1. No, yes

2. No

[JBudd, MSN]

ditto

2a: policy; take care of them

[applesxoranges, BSN, RN]

It may be an ER policy but not state law. I see a mix of both and it can negatively impact nurses view. ER nurses who start in the ER don't know the floor and stress that comes with it.

ICU holds are the worst. Very risky for patients. There are no official policies in my ER.

[EDnurseNY]

Nope, no med/surg needed! And I think this depends on what state you're in. In my state (NY), as far as I know, if you're a new grad in the ED you need to be in a residency program of at least six months. It used to be a year, but there are exceptions. The program I'm in is six months plus one of a "buddy system" with other residents.

It may be an ER policy but not state law. I see a mix of both and it can negatively impact nurses view. ER nurses who start in the ER don't know the floor and stress that comes with it.

I think this goes all ways, Med/Surg, ED, ICU. I feel like in a perfect world, everyone would routinely shadow at least one day in each setting. We get calls in the ED all the time from irate floor nurses with things like "why didn't you place that Foley before sending my patient up?!" And if we were honest, the answer would be some thing like "Because another of my patients crashed and I had to start compressions and call a code, not place a Foley." or "Right after calling report, a septic patient rolled into another of my rooms and his pressure was 70/30 so that was my priority, not a Foley." Literally just the other day, a nurse on med/psych called my CRN to try and report me for not getting a (not-immediately-critical) urine sample before sending the patient. I had a patient who couldn't breathe roll in right after giving report.

Each area has their stresses and it would be nice if we could all be a bit more empathetic with each other. I understand that floor nurses are very, very busy. When I have admitted patients boarding in the ED, things take much more time. We all need to cut each other some slack.

Sorry for the soap box!

[Buyer beware, BSN]

ED is an impromptu job.

You should have all the skills at your finger tips so you can quickly and efficiently move patients along. Therefore flexibility is the key but this is best achieved by working in an ICU setting. That's where you learn the ropes; meaning you don't get hung-up most often with "what's this or that."

After that you could do ED. (and p/u on the nuances ad-lib)

Sometimes people who know the ropes in the ICU don't especially like the ED because it very often doesn't have the A-Z order of individual patient care that some regimented nurses (personalities) seem to be comfortable with.

But no hospital job should be considered more skilled or better than any other.

All nurses in all areas can teach YOU a thing or two if you remain clear of the horses's ass mentality.

But to answer your question, 2 years in med-surg sounds like they have needs in that job category and are stealthily steering you in that direction.

[TheCommuter, BSN, RN]

Are you required by law to possess two years of Med-Surg experience prior to working in a ER?

Nope. State or federal laws do not govern a nurse's experiential level. Inexperienced new grads are hired into emergency departments at hospitals across the U.S.

Although individual hospital systems might have internal policies requiring two years of nursing experience prior to being allowed to work in the emergency department, no laws exist mandating that a nurse must have two years of experience.