best advice for new ER nurse

ERNurse752, RN · Jun 26, 2005

Congrats on making the change. :)

Check out http://www.ena.org and go to the marketplace and check out their books...lots of good ones. There is an EKG book by Dale Dubin that is excellent, I don't think it's on the ENA site though. It's around in book stores though...it's bright safety orange, so it's hard to miss.

This has been discussed before, so you can also do a search...lots more good tips floating around here.

Good luck!

austin heart, BSN, RN · Jun 26, 2005

Don't touch ANYTHING without gloves on! :chuckle

mommatrauma, RN · Jun 26, 2005

Dubin's definitely great for learning EKGs in a easy non-stressful, non-threatening way...that book has been around since probably before me and every time I hear about a book for EKGs its that one...

http://www.skillstat.com/ECG_Sim_demo.html

Also this link is for a book that is my BIBLE, its called fast facts by Kathy White..not quite pocket size but chock full of great info...there hasn't been one thing yet that I needed that wasn't in there...It comes complete with sections on CV, Hemodynamics, ACLS, Stat meds, Drip tables, EKG, Pacing, RESP, Neuro, renal/endo, lab/ivs/bld, and sepsis guidelines and a whole bunch of new stuff they just added, plus you can add any of the 4 optional topics of trauma care, IABP, CV Surgery, and peds...did I say I love this book??

http://www.kathywhite.com/ffpreview4.htm

amy · Jun 27, 2005

-"Rapid interpretation of EKG's" screaming bright oragnge cover... is great. I never lend it out becauseit's a "keeper" book.

-ACLS pocket guide by the American Heart Association... it's wonderful.

-a good IV med book (comprehensive). Most everything you give is IV, and this will tell you compatibilities, how to mix drips, rate of administration, desired and undesired side effects, etc. in 2 easy to read and easy to reference pages on every IV med. This book is invaluable!!!

-a good preceptor that loves his/her job. One who likes what they do helps you do the same. Some (many!) of the best ER nurses I know are men. Enough said.

-Also remember to change your gears. When I went to public health from ER, I went back to ER. I could not make the change from "instant gratification/adreneline junkie" to "baby steps" (NO slam intended!!! Just how my public health preceptor explained the difference to me that stuck with me). There is nothing like getting someone out the woods during an MI or an acute respiratory failure, just like there is nothing like getting someone from out of the hospital severely debilitated and having them hug you on your last visit because they thought they would never walk without their legs wrapped/a walker/a gaping abdominal wound/etc. again, saying you were their angel, or the angel to their recently departed loved one. I always loved it when I would go to a new patient's house and they would say "oh YOU'RE so-and-so that took care of Marge so well, etc." Funny, if you are having a heart attack, on 5 drips, in trendelenberg, I am your girl, but if you need a hospital bed at home, I STILL don't know what to tell you! LOL! Also, do not expect to manage this pt on 5 drips very soon. Lots to learn, and even those of us who have been doing it for years can't always do it alone. Keep the "baby step" mentality, because that is how I started in the ER, MY OWN baby steps, and you will do fine. Plus, you will be an ACE at discharge instructions!!! GOOD LUCK!!! yOU WILL BE AWESOME IF YOU DON'T PUT TOO MUCH PRESSURE ON YOURSELF! :balloons:

amy · Jun 27, 2005

Oh yeah, and if it's wet and it's not yours, don't touch it without gloves!!!

MrsWampthang, BSN, RN · Jun 27, 2005

My advice:

If a child is quiet.......be afraid! Be VERY afraid! :sofahider

This usually means a child is vewy, vewy siiiiiccccckkkkkk!!!! No kidding!

Pam

GeeBeeRN · Jun 27, 2005

Hi All!

This is a good one to post. Just like srknurse, I'm thinking of making the switch to ER nursing (my current background is in Ortho/Surgical nursing). I'm afraid of the change but I think it's time to challenge myself. Just wanted to say "good luck" to srknurse with her decision to switch and to everyone else to keep the advice coming! :)

barefootlady, ADN, RN · Jun 27, 2005

What a good source of information to each one of us. Thanks for the post.

One thing though, everywhere I have ever worked and I do mean everywhere, there is always a large poster hanging on the door of the med room. It names about every drug under the sun and tells how to mix, how to give, what to look for, and such. So, why do you need to carry another book in already stuffed pockets? I do not mean to sound stupid, just really want some input.

I agree about a silent child, too quiet, too sick. Also if a diabetic says something is very wrong, be very worried, they know how they feel in most situations, unless they are newly diagnosised, so listen to them.

No matter how rushed you are please, clean up all IV supplies and keep siderails up at all times. I know this should be a nobrainer, but last time hubby was in ER, older man rolled off carried because rails were not up properly. Also have seen many patients and staff stuck by needles left on carriers.

matt033174 · Jun 27, 2005

Welcome to the family. Start looking at your critical care classes. ACLS, PALS, TNCC, ENPC. They will clear up alot. And I agree quiet kids are dead kids. Find a good person in your ED to mentor you. And keep every text, flyer, hand put you ever get in classes. They will come in handy sometime. I like mosby "ECG's made easy" for rhythms. And ENA is a wonderful resource. Join the ENA and you get the emergency nurses journal from them which I think is a wonderful resource.

GeeBeeRN · Jun 27, 2005

I hope this doesn't sound stupid but I'm curious to know how staffing in the ER works. Does a nurse get assigned to a slot/room and gets whomever comes into those slots/rooms? All I know is Med/Surg nursing where we're assigned to patients based on acuity (or closeness of rooms). Thanks in advance.

matt033174 · Jun 27, 2005

I hope this doesn't sound stupid but I'm curious to know how staffing in the ER works. Does a nurse get assigned to a slot/room and gets whomever comes into those slots/rooms? All I know is Med/Surg nursing where we're assigned to patients based on acuity (or closeness of rooms). Thanks in advance.

I can't speak to a big ED, but in mine (rural oklahoma, 4 trauma beds, 6 exam/minor beds) we work as a team. You kinda rotate through who gets the next trauma or emergent patient, seeing non-emergent, and triage patients. We don't really assign who gets what though. At the most though we have three RNs and at the least we have one. Everybody really helps with everybody.